Delhi

New Delhi

CC/1256/2009

Anita Bhardwaj - Complainant(s)

Versus

M/S. The New India Assurance Company Ltd. - Opp.Party(s)

02 Jul 2015

ORDER

 

CONSUMER DISPUTES REDRESSAL FORUM-VI

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

VIKAS BHAWAN, I.P.ESTATE,

NEW DELHI-110001.

 

Case No.CC/1256/09                                                                                                                                                                              Dated:

In the matter of:

MS. ANITA BHARDWAJ

W/O SHRI AJIT KUMAR BHARDWAJ

R/O 107, NEELGIRI APARTMENT,

SECTOR-09 ROHINI,

NEW DELHI-110085

……..COMPLAINANT

       

VERSUS

 

1.     (THROUGH)THE DIVISIONAL MANAGER

        M/S. NEW INDIA ASSURANCE CO. LTD.& ANR

        BOMBAY LIFE BUILDING

        CONNAUGHT CIRCUS,N-34

        NEW DELHI110001

       

2.     (THROUGH) MANAGER

        M/S. NEW INDIA ASSURANCE CO. LTD.& ANR

NEW INDIA ASSURANCE BUILDING,

87, M G ROAD FORT,

MUMBAI-400001

       

………. OPPOSITE PARTIES

 

 

ORDER 

MEMBER: RTU GARODIA

 

The complaint pertains to repudiation of medi claim by OP.

The brief facts are that complainant has purchased a medi claim policy bearing no.310300/34/07/11/00001558 covering a period from 8.10.2007 to 7.10.2008.  The complainant was hospitalized on 8.8.2008 and incurred an expenses of Rs.32,070/-   OP repudiated to claim and complainant was filed.

OP in its version has drawn attention to Item 16 (exclusion 4.3) Sl. No. 12 of terms and condition of policy.  OP has placed discharge card of complainant on record.

We have perused the file documents annexed throughout.  Discharge Card shows that procedure performed was Myomectomy done under general anesthesia. Clause 16 subsection (12) of policy clearly excludes  myomectony in first two years of policy.  The present claim is filed in the first year of policy and OP is well within its right to repudiate the claim on terms and condition of policy.  Thus, there is no deficiency and compliant is dismissed.

The order shall be complied with within 30 days of the receipt of the copy of the order; otherwise action can be taken under Section 25 / 27 of the Consumer Protection Act.

File be consigned to record room.

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

        Pronounced in open Court on 02.07.2015.

 

 

(C.K.CHATURVEDI)

PRESIDENT

 

 

 (RITU GARODIA)

MEMBER