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2020 Supreme(Del) 743

NAVIN CHAWLA
Pavan Sachdeva – Appellant
Versus
Office of Insurance Ombudsman – Respondent


Advocates Appeared:
Petitioner In Person, Advocate, Sushant Thakur, Advocate

JUDGMENT

Navin Chawla, J. - This petition has been filed by the petitioner inter alia challenging the order dated 21.02.2019 passed by the respondent no. 1 whereby the complaint of the petitioner against the rejection of his claim under the "Cigna TTK Health Insurance Family Policy" (hereinafter referred to as the "Policy") taken by him was rejected and the decision of the respondent no. 2 was upheld.

2. It is the case of the petitioner that the petitioner had obtained the abovementioned Policy from the respondent no. 2 on 14.08.2017. On 16.09.2017, while undertaking his morning walk, the petitioner felt mild pain and visited Fortis Escort Hospital. On 23.09.2017, after an Angiography, the petitioner was advised to undergo a bypass surgery, which was duly carried out on the petitioner. The petitioner lodged a claim against the abovementioned Policy with the respondent no. 2, however, the respondent no. 2 denied the same with the following remarks:-

    "Note: The policy since 14/8/2017. The liability cannot be ascertained at this juncture, as the patient has history of Sarcoidosis since 1997; which is preexisting to the policy inception with CignaTTK which is non-disclosure of material





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