PRAMODNATH DAS, ARATI MOHANTY, D.M.PATNAIK
GITA MOHAPATRA – Appellant
Versus
GENERAL INSURANCE CORPORATION OF INDIA – Respondent
Mr. Justice D.M. Patnaik, President—This is an appeal against the order dated 11.5.1999 of the District Forum, Cuttack dismissing the complaint petition of the complainant.
2. Complainant’s case is she and her husband purchased 1900 units of GIC Mutual Fund and the scheme allowed personal medical insurance benefits. While the said mutual fund certificates were valid, the complainant was treated for some heart ailment on 5.7.1994 and on examination she was found to have heart-block and was advised as a matter of treatment by the doctor to go for an implantation of a pace-maker. Since the facility for such implantation was not available in Orissa, she was referred to Anandalok Hospital at Calcutta where she was admitted on 9.7.1994. She sent a claim form on 1.8.1994 with cash memo receipts etc. to the Insurance Company and subsequently on the request of the Insurance Company she also sent the original pass-book and copies of the unit certificates duly signed and copies of the test report duly attested by the doctor of the Nursing Home for the purpose of processing the claim. But the Insurance Company repudiated the claim on the ground that their panel of doctors who examined the
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