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HIMACHAL PRADESH STATE CONSUMER DISPUTES REDRESSAL COMMISSION, SHIMLA
* Inder Singh Mehta (President), Sunita Sharma, R. K. Verma (Members)
Kundan Palmoo Negi v. PNB Met Life Insurance Company Ltd.
| Table of Content |
|---|
| 1. claim for health-related insurance denial. (Para 1 , 2 , 3) |
| 2. opponents' response to the complaint. (Para 4 , 5 , 6) |
| 3. contentions of the complainant and opponents. (Para 8 , 9 , 10) |
| 4. expenses and evaluation of the insurer. (Para 11 , 12 , 13) |
| 5. justification of the claim denial. (Para 14 , 15 , 16 , 17) |
| 6. evaluation of evidence regarding diabetes. (Para 18 , 19 , 20) |
| 7. significance of medical tests and compliance. (Para 21 , 22 , 23) |
| 8. final determination on insurance claim. (Para 24 , 25) |
| 9. court's directive for payment. (Para 26) |
1. The complainant has filed the instant complaint seeking directions to the opposite parties to pay the balance personal claim amount of Rs.50.00 lacs due under the policy along with interest @12% per annum from the date of death of late Sru Thakur Singh, till its realization, to pay Rs.1.00 lac as damages on account of mental agony & harassment, besides litigation charges to the tune of Rs.30,000.
2. Brief facts of Case:
Briefly, the case of the complainant is that her brother late Sh. Thakur Singh was employee of opposite parties No. 2 and late Sh. Thakur Singh was insured under Group Insurance Policy No. 0003390 purchased by opposit
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