Delhi

New Delhi

CC/287/2012

Sumit Bhasin - Complainant(s)

Versus

M/S. E-Meditek & Anr. - Opp.Party(s)

26 Mar 2015

ORDER

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI), ‘M’ BLOCK, 1^STFLOOR,

VIKAS BHAWAN, I.P.ESTATE,

NEW DELHI-110002.

 

Case No.CC/287/12                                                                                                                                                                               Dated:

In the matter of:

Sh. Sumit Bhasin,

S/o Late Sh. Chander Parkash,

R/o B-10/20 A Rajouri Garden, New Delhi

 

……..COMPLAINANT

       

VERSUS

 

1. E-Meditek,

        45 Nathupur road, DLF Phase-II,

        Gurgaon-122002

 

2. New India Assurance Co. Ltd.,

        L-Level-5 Tower-II,

        Jeevan Bharti Bldg.,

        124, Connaught Circus, New Delhi-110001

 

                                         ……. OPPOSITE PARTY

 

ORDER (Oral)

Date of Arguments: 26.03.2015

President: C.K Chaturvedi

Present:    Both the parties.

                Arguments heard at length.

 

The short facts of complaint alleged deficiency that complainant purchase a medi claim policy bearing no.311301/34/09/11/00000741 from 17.09.09 to 16.09.10 for a sum insured for Rs.5,00,000/-. Complainant was hospitalized from 21.03.10 to 26.03.10 and incurred hospital expenses amounting to Rs.2,72,500/-. OP repudiated the claim under exclusion clause 4.4.6 of policy.

Scrutinizing of records and considered the arguments advanced by both counsels’ reveals that Clause 4.4.6 stipulate the exclusion of “Obesity treatment and its complication”. Complainant’s discharge summary establishes that hospitalization was for Bariatric Surgery and complainant has admitted in complaint that the said surgery was for morbid obesity. The medical proceeds falls squarely under the exclusion clause 4.4.6 of policy terms and conditions. We therefore, find no deficiency on part of OP in repudiating the claim and the captioned complaint, hence stands dismissed.

File be consigned to record room.

Copy of the order be sent to the parties free of cost.

 

 

        Pronounced in open Court on 26.03.2015.

 

 

(C.K.CHATURVEDI)

PRESIDENT

 

 

(S.R. CHAUDHARY)                 (Ritu Garodia)

MEMBER                                  MEMBER