PREM NARAIN
Ashish Sharma – Appellant
Versus
United India Insurance Co. Ltd. – Respondent
Prem Narain, Presiding Member—This revision petition has been filed by the complainant, Dr. Ashish Sharma, against the order dated 23.02.2012 of the Punjab State Consumer Disputes Redressal Commission, (in short ‘the State Commission’).
2. Brief facts of the case are that That Dr. M.L.Sharma father of the petitioner herein had taken medi-claim policy issued by the respondents and had been renewing the same without any break and had been paying the premium regularly. The father of the petitioner (insured) was admitted to hospital from 9.10.2005 to 15.10.2005 and expenses to the tune of Rs.1,45,829/- were incurred. On 22.10.2005 the petitioner made the claim for the expenses incurred to the respondents. The father of the petitioner (insured) expired on 29.10.2005.
3. The respondent No.1 vide its letter dated 10.01.2006 rejected the claim of the petitioner on the ground that patient is known as a case of HTN since 10 years and COPD since 15 years and his present ailment is complication of COPD. The respondents further alleged that the date of inception to medi-claim policy is 06.04.2005 so the ailment comes as pre-existing and as per terms & conditions of the policy, pre-existing a
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