First Appeal No. 105 of 2014. Case: Star Health & Allied Insurance Co. Ltd. Vs Asha and Ors.. Haryana State Consumer Disputes Redressal Commission
| Case Number | First Appeal No. 105 of 2014 |
| Counsel | For Appellant: Rajneesh Malhotra, Advocate and For Respondents: D.P. Chhachhia, Advocate |
| Judges | R.K. Bishnoi, Member (J) and Urvashi Agnihotri, Member |
| Issue | Consumer Law |
| Citation | II (2015) CPJ 78 (Har.) |
| Judgement Date | Tuesday January 27, 2015 |
| Court | Haryana State Consumer Disputes Redressal Commission |
Order:
R.K. Bishnoi, Member (J)
As per complainant her husband obtained medical insurance policy from appellant-opposite parties for the period 19.4.2010 to 18.4.2011 she was not suffering from any ailment before availing the policy. On 22.3.2011 she developed acute pain in the uterus and was admitted at Ahuja Hospital, Panipat where she remained admitted from 22.3.2011 to 28.3.2011 and Rs. 70,000 were spent on her treatment. It was assured by opposite party No. 2 that all the expenses of treatment would be reimbursed. As per that assurance medical policy was got renewed. Vide letter dated 23.5.2011 her claim was repudiated. Legal notice was also sent, but, to no result. Opposite parties controverted her averments and alleged that Mr. Deepak Kumar Thareja obtained the insurance policy for himself as well as his family members. He was explained about the terms and conditions of the insurance policy including exclusion clause at that time. Complainant was suffering from Fibroid Uterus since more than one year and was aware about the disease, but, was not disclosed at the time of obtaining insurance policy just to get false reimbursement. She was never assured that the reimbursement would be made if policy would be got renewed. Treatment obtained for Fibroid Uterus is not covered for the first two years as per exclusion clause No. 3 of the terms and conditions of the insurance policy. There was no deficiency in service on...
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