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SUBHASH CHANDRA, J. RAJENDRA
Kashmir Singh Gill – Appellant
Versus
Bajaj Allianz General Insurance Company Limited – Respondent
ORDER
This Revision Petition No.277 of 2017 filed under Section 21(b) of the Consumer Protection Act, 1986 (for short, “the Act”), challenges the order dated 01.09.2016, of the Haryana State Consumer Dispute Redressal Commission, Panchkula (in short, “the State Commission”) in First Appeal No.274 of 2016 wherein the State Commission, allowed the appeal filed by the Respondents and set aside the order 03.03.2016 passed by the District Forum, Panchkula in Complaint Case No.196/2015.
2. We have heard the Learned counsels for both the parties and perused the records.
3. The relevant facts of the case, in brief, are that the Petitioner had been regularly taking travel insurance policies for his trips to the USA. In 2014, he obtained a “Travel Super Age Elite” policy on 21.06.2014 valid from 24.06.2014 to 21.09.2014 for a sum assured of USD 50,000 after paying a premium of Rs.13,693. Prior to the issue of the policy, the Petitioner underwent a medical examination by the Respondent’s recommended doctors on 06.06.2014, which did not reveal any ailment, although the Petitioner himself disclosed that he had an hypertension and asthma. During his stay in the USA, the Petitioner requested an e
Travel Medical Policy – Repudiation of claim – When the insured was thoroughly examined by doctor of insurance company before approval of the insurance policy, repudiation on ground of non-disclosure....
(1) Insurance – A contract of insurance is one of utmost good faith. (2) Proposer – Proposer who seeks to obtain a policy of life insurance is duty bound to disclose all material facts bearing upon t....
There should be nexus with pre-existing disease & disease for which claim has been made.
(1) Proof of delivery - In the absence of proof of delivery, therefore, Commission cannot rely solely on the Respondent’s statement before the District Commission that it had duly supplied the terms ....
(1) Exemption Clause - It is a fundamental principle in the insurance contracts that the party claiming the exemption clause needs to establish the same.(2) Subsequent stage - Mere isolated event of ....
Contract of Insurance – A contract of insurance is one of utmost good faith. A proposer who seeks to obtain a policy of life insurance is duty bound to disclose all material facts bearing upon the is....
Since medical insurance policy was issued after examination of insured, policy claim cannot be repudiated on ground of pre-existing disease.
Insurance Policy must be read holistically so as to give effect to reasonable expectations of all parties including insured & beneficiaries.
Point of Law : No fault can be found with the repudiation and the order of Ombudsman affirming the said repudiation and disallowing the claim. [Para 13]
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