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PREM NARAIN
Nirmal Jain – Appellant
Versus
United India Insurance Company Limited – Respondent


Advocates:
Counsel for the Parties:
For the Petitioner:Mr. Ritesh Khare , Advocate
For the Respondent:Mr. Rajesh K. Gupta, Advocate

ORDER

This revision petition has been filed by the petitioner Nirmal Jain against the order dated 11.6.2013 of the State Consumer Disputes Redressal Commission, Madhya Pradesh, (in short ‘the State Commission’) passed in Appeal No.1035 of 2010.

2. Brief facts of the case are that the petitioner/complainant has taken a medi-claim policy from respondent/opposite party and the same was valid from 29.5.2007 to 28.5.2008. The petitioner/complainant got himself treated for by-pass surgery of heart and was admitted in S.A.L. hospital on 23.6.2007. He was operated on 26.6.2007 and was discharged on 6.7.2007. The claim under the medi-claim insurance was submitted by the complainant after the Insurance Company repudiated on 18.03.2008 and then again on 07.5.2008 the claim was repudiated on two ground that under Clause 4.2 of the exclusion clause, the claim was not admissible as the treatment started within 30 days of the commencement of the policy. The other ground of repudiation was that the claim is not admissible for any pre-existing disease as per the Exclusion Clause No.4.1. The petitioner filed a consumer complaint bearing No.14/2009 before the District Consumer Disputes Redressal Foru

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