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STATE CONSUMER DISPUTES REDRESSAL COMMISSION
HON’BLE JUSTICE SANGITA DHINGRA SEHGAL, CJ, HON’BLE MS. PINKI, J
MR. AMIT SINGHAL – Appellant
Versus
CARE HEALTH INSURANCE LIMITED – Respondent
| Table of Content |
|---|
| 1. factual background of the case and claims. (Para 1 , 2) |
| 2. arguments from the respondent about claim denial and evidence presented. (Para 3 , 4 , 5 , 6 , 11) |
| 3. court's analysis of credibility of medical opinions and evidence. (Para 10 , 12 , 13) |
| 4. legal principles on insurance policy and duty of disclosure. (Para 18 , 19) |
| 5. final judgment and directives to the respondent. (Para 21 , 22 , 24) |
JUDGMENT
1. The facts of the case as per the District Commission record are:
“1. The case of the Complainant as revealed from the record is that the Complainant has earlier filed a complaint vide CC No. 940 of 2017 in the Hon'ble State Commission and the same was disposed of by the Hon’ble Commission in which the Hon'ble Commission gave direction to the Opposite Party to decide the claim of the Complainant within 3 months vide order dated 24.07.2019, and also gave permission to Complainant to file a fresh complaint against the Opposite Party in case Opposite Party repudiate the claim. It is his case that Opposite Party had not complied with the above mentioned order and after the expiry of 3 months period i.e. 23.10.2019, a legal notice dated 23.10.2019 was sent to the Opposite
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