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SUPREME COURT OF INDIA

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CASE NO.:

Appeal (civil) 2296 of 2000

PETITIONER:

BIMAN KRISHNA BOSE

Vs.

RESPONDENT:

UNITED INDIA INSURANCE CO.LTD. & ANR.

DATE OF JUDGMENT: 02/08/2001

BENCH:

V.N. Khare & Shivaraj V. Patil

JUDGMENT:

V.N. KHARE, J.:

The appellant herein and his wife Smt. Alka Bose, took out a

mediclaim insurance policy from the respondent United India Insurance

Company (hereinafter referred to as insurance company) on December 14,

1990. In July 1991, Smt. Alka Bose fell ill and as per advice of the doctor

she was admitted to a hospital on August 14, 1991. She paid Rs.8,243/-

towards the charges for her treatment to the hospital. On August 30, 1991

the appellant lodged a claim for Rs.8,243/- with the insurance company

along with necessary papers. Despite repeated requests the claim was not

honored, with the result the appellant approached the District Consumer

Grievance Redressal Forum (District Forum Calcutta) but the said complaint

was rejected. On appeal before the State Commission, the order of the

District Forum was set aside and direction was issued to the respondent

insurance company to pay to the appellant a sum of Rs.8,243/-. The

insurance company thereafter went in revision before the National Consumer

Redressal Commission which allowed the revision and set aside the order of

the State Commission. Aggrieved, the appellant filed an appeal before this

Court. On May 10, 1995 this Court allowed the appeal with costs which was

quantified at Rs.20,000/-. Despite the order of this Court, the payment was

not made with the result the appellant had to take further proceedings.

While the said litigation was going on, appellants policy fell due for

renewal. Under such circumstances, the appellant on 24.1.1996, sent a letter

along with a cheque of Rs.1,796/- to the respondent insurance company

requesting for renewal of his existing mediclaim policy. On 7.3.1996, the

insurance company declined to renew the mediclaim policy as per the advice

of the competent authority of the company. Under the aforesaid

circumstances, the appellant filed a writ petition under Article 226 of the

Constitution before the Calcutta High Court challenging the order passed by

the respondent insurance company refusing to renew the mediclaim policy.

The said writ petition was allowed and the order refusing to renew the policy

was set aside and a direction was issued to the insurance company to renew

the mediclaim policy earlier taken out by the appellant. Aggrieved, the

respondent insurance company filed an appeal against the judgment of

learned Single Judge. The Division Bench of the Calcutta High Court while

agreeing with the view taken by the learned Single Judge substantially

dismissed the appeal. Yet, the High Court directed the appellant to take

fresh mediclaim policy, as the renewal of mediclaim policy cannot be

granted with retrospective effect, as the period for which renewal was

required has already expired. It is against the said part of the order the

appellant has preferred this appeal.

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The appellant, Biman Krishna Bose, has appeared in person. He

argued that the High Court even after setting aside the order refusing to

renew the policy, was not justified in directing the appellant to take fresh

mediclaim policy. According to the appellant, by the said order of the High

Court he has been placed at a great disadvantageous position. The appellant

referred to the exclusion clause of the policy taken out by him. Relevant

clauses 2.1 and 2.1.14 of the mediclaim policy run as under:

2.1 The Company shall not be liable to make

any payment under this policy in respect of any

expenses whatsoever incurred by any Insured

Person in connect with or in respect of: -

2.1.14 All diseases/injuries which are pre-

existing when the cover incepts for the first time.

On the strength of the exclusion clause, the appellant urge