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2025 Supreme(Online)(SCDRC) 1213

STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Mrs. Justice Daya Chaudhary, CJ, Ms. Simarjot Kaur, J, Mr. Vishav Kant Garg, J
The Oriental Insurance Company Ltd. – Appellant
Versus
Sh.Ravinder Kumar – Respondent


Advocates:
For the Appellants/Petitioners:Sh.Ram Avtar, Advocate
For the Respondents:Sh.Vinay Puri, Advocate

Table of Content
1. details of the insurance claim and its rejection. (Para 3 , 4 , 5)
2. response and objections from the insurance company. (Para 6 , 8)
3. arguments by the appellant regarding policy terms. (Para 9 , 10)
4. arguments by the respondent regarding claim justification. (Para 11 , 12)
5. court's review of the case and issues at hand. (Para 16 , 18)
6. clarification on the definition of pre-existing diseases. (Para 21 , 22 , 23)
7. court's ruling on the unjustified claim repudiation. (Para 24 , 25)
8. final decision and order of the court. (Para 27 , 28 , 29 , 30)

SIMARJOT KAUR, MEMBER

This Appeal has been filed by the Appellant/Opposite Party under Section 41 of the Consumer Protection Act, 2019 (in short ‘The Act’) being aggrieved by the impugned Order dated 08.12.2022 passed by the District Consumer Disputes Redressal Commission Jalandhar (in short ‘the District Commission’) whereby the partly allowed the Complaint of the Complainant.

2. It would be apposite to mention that hereinafter the parties will be referred, as had been arrayed before the District Commission.

3. Briefly, the facts of the case as made out by the Complainant before the District Commission are that the Comp

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