By Smt. C.S. Sulekha Beevi, President,<br /> <br /> 1. According to complainant he had taken Jana Seva Insurance Policy with opposite party. The period of validity of policy was from 17-10-01 to 16-10-2004. While so on 24-10-01 complainant sustained injuries in an accident and was treated as inpatient in Chaliyar Hospital, Nilambur from 24-10-01 to 31-10-01. He is aggrieved that opposite party failed to pay the benefits under the policy.<br /> <br /> <br /> <br /> 2. Version was filed by opposite party admitting issuance of policy. It is submitted that even<br /> though claim was preferred by complainant contending that accident occurred on 24-10-01, the documents produced showed that injuries were sustained prior to 17-10-01. the claim was repudiated<br /> for this reason and hence there is no deficiency of service.<br /> <br /> 3. Evidence consists of affidavits filed by both sides. Exts.A1 to A4 marked on behalf of complainant. Exts.B1 to B5 marked on behalf of opposite party.<br /> <br /> 4. The admitted facts of this case are that complainant had availed the services of opposite party with respect of insurance policy and the validity period of the policy is 17-10-01 to 16-10-04. According to complainant the accident occurred on 24-10-01. Ext.A3 is the discharge card issued from Chaliyar Hospital, Nilambur which shows that complainant was treated as inpatient from 24-10-01 to 31-10-01 for fracture of 2nd metacarpel. In Ext.A3 it is stated that patient was admitted with history of fall from height. Opposite party resists the claim contending that the documents produced on the side of complainant along with the claim clearly shows that the accident occurred prior to 17-10-01. Opposite party relies on Ext.B1 to B3 which are documents submitted by complainant to opposite party along with claim application. Ext.B1 series are the original prescriptions issued to complainant from Chaliyar Hospital which are eight in number. Ext.B1(a) prescription is dated, 16-10-01. In Ext.B1(a) it is stated that POP is applied. Ext.B1(b) is dated, 24-10-01. Ext.B3 is the X-ray along with it's envelope. The date of taking the X-ray as noted on the envelope is 17-10-01. Ext.B1 and B2 bears the hospital registration number of the patient as noted in Ext.A3 discharge card. Counsel for opposite party has submitted that on scrutiny of medical bills it showed alterations were<br /> <br /> <br /> made in the dates. Ext.B3 series are the medical bills. The date on Ext.B3(a) and B3 (b) appear to be over written. It appears to be altered from 16-10-01 to 26-10-01. Opposite party has put forward a consistent case that the accident occurred prior to the commencement of the policy. Ext.B1 to B3 amply proves the contention of opposite party. Complainant has not come with clean hands. We find opposite party was right in repudiating the claim. Therefore there is no deficiency of service on the part of opposite party.<br /> <br /> 5. In the result, complaint dismissed. No order as to costs.<br /> <br /> Dated this 5th day of April, 2008.<br /> <br /> <br /> <br /> C.S. SULEKHA BEEVI, PRESIDENT<br /> <br /> <br /> <br /> <br /> E. AYISHAKUTTY, MEMBER<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> APPENDIX<br /> <br /> <br /> Witness examined on the side of the complainant : Nil <br /> Documents marked on the side of the complainant : Ext.A1 to A4<br /> Ext.A1 : Insurance Certificate dated, 17-10-01 in favour of complainant.<br /> Ext.A2 : Policy conditions by National Insurance Company Ltd. <br /> Ext.A3 : Patient reference card from Chaliyar Hospital, Nilambur <br /> Ext.A4 : Photo copy of the repudiation letter dated, 22-2-2002 from <br /> opposite party to complainant.<br /> Witness examined on the side of the opposite parties : Nil<br /> Documents marked on the side of the opposite parties : Ext.B1 to B5<br /> Ext.B1 series : Prescriptions (8 nos.) for medicines by Chaliyar Hospital<br /> to complainant. <br /> Ext.B2 : X-ray film submitted by complainant to opposite party.<br /> Ext.B3 : Bills (10 nos.) submitted by complainant to opposite party. <br /> Ext.B4 : Hospitalization and Domiciliary Hospitalisation benefit policy claim form<br /> submitted by complainant to opposite party.<br /> Ext.B5 : Medical Report by Dr. Prakash Sebastian in favour of complainant.<br /> <br /> <br /> <br /> <br /> C.S. SULEKHA BEEVI, PRESIDENT<br /> <br /> <br /> <br /> <br /> <br /> E. AYISHAKUTTY, MEMBER<br />