N.K.JAIN, B.L.KHARE, PRAMILA S.KUMAR
NEW INDIA ASSURANCE CO. LTD. – Appellant
Versus
VIMAL CHAND JAIN – Respondent
Mr. Justice N.K. Jain, President —This appeal is by opposite party, the New India Assurance Company Ltd. against the order dated 23.10.2002 passed by the District Consumer Disputes Redressal Forum, Damoh in Case No. 31/2001 allowing the complaint of the respondent and directing the appellant-Insurance Company to reimburse the treatment expenses incurred by the respondent, under a mediclaim policy taken out by the latter from the former on 26.11.2001.
2.Respondent-complainant had under-gone heart surgery at Apollo Hospital, Hyderabad on 6.2.2002. The claim of the respondent was repudiated by the appellant-Insurance Company mainly on the ground of suppression of pre-existing heart ailment. However, no evidence as to this pre-existing heart ailment could be adduced by the appellant-Insurance Company. As per discharge summary prepared at the time of discharge of the respondent-patient at the said hospital, it is clearly recorded that the respondent aged 61 years was found having exertional angina grade II with dyspnoea on exertion grade I from one month. Known hypertensive from one month. It cannot be thus said that the ailment existed on or before the date of taking out of the po
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