H. P. Chowdhury – Appellant
Versus
N. I. Company – Respondent
Pror. S.K. Kar,Member - Itis the case of the Appellant who was the petitioner in C.D.F. Case No. 1223192 that he purchased one Hospitalization and Domiciliary Hospitalization Benefit Policy bearing No. 100900/48/3701899191 from the Respondent, National Insurance Company Limited upon payment of premium of Rs.950/- on 8.2.1991. The said policy was valid from 11.2.1991 to 10.2.1992. In terms of the said policy any person covered under the said policy contacts any disease and takes advice of Medical Practitioner and incur Medical/Surgical expenses at any Clinic, Nursing Home, Hospital or Domiciliary treatment the respondent will pay the insured person full amount of such expenses. It is also the case that the Appellant suffered from Hamia and Prostrate Gland and was admitted in a Nursing Home for one week from 18.12.1991 and incurred expenses of Rs.20,313/- and accordingly submitted its claim with the respondent on 19.2.1992 for reimbursement thereof. The Respondent Opposite parties vide its letter No. 100900/583/TD192 dated 25.6.1992 repudiated the claim of the Appellant/Petitioner observing that the disease being pre-existing in nature the claim of the Appellant is not admissibl
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