No. 5/18.03.2009.

HON’BLE JUSTICE SRI A. CHAKRABARTI, PRESIDENT.

Appellant through Mr. Debjit Sinha, the Ld. Advocate and Respondent through Mr. P. Banerjee, the Ld. Advocate are present.  Heard the Ld. Advocates for both sides.  This is an application for condonation of delay of 18 days in preferring the appeal.  On perusal of the application we find that the delay has occurred in view of decision taken by various authorities located at various places.  On scrutiny we do not find that the delay had occurred for a long period at particular stage.  The delay having occurred under circumstances beyond the control of the Appellant, the same is hereby condoned.  The application is allowed.  Delay being condoned we take up the matter for admissibility of the appeal.  Heard the Ld. Advocate for the Appellant.  Perused the impugned judgement, memo of appeal and other relevant documents.  Considered.  Let the appeal be admitted and registered.  As parties agreed to disposal of the appeal at this stage and notices having been completed, the hearing of the appeal is taken up.

This appeal was filed challenging the order dated 03.10.2008 by C.D.R.F., Nadia in CF Case No. NAD/52/O/07 where the complaint was allowed and payment of compensation as also the claim amount were directed.  The Ld. Advocate for the Appellant contends that claim of the Complainant was rightly repudiated as the Claimant was having the disease preexisting.  In support of such contention the Ld. Advocate for the Appellant produces the ‘case summary’ dated 03.11.2008 issued by Sankara Nethralaya and the ‘Discharge Summary – Surgery’ issued by Sankara Nethralaya.  It appears that the Claimant took the Policy covering the period between 29.03.2006 and 28.03.2007 and the Complainant had the eye surgery on 12.09.2006 in respect of which the claim was made, the Ld. Advocate for the Appellant strongly relied on the case summary for showing that the disease was preexisting for a period of six years.  The first paragraph of the case summary has been strongly relied on which runs as follows :

“Mr. Indra Nath Mitra (our MAD No. 1276491) a 49-year-old gentleman from West Bengal was first seen by us on 07.09.2006 with complaint of diminution of vision in both the eyes since the last two months.  The patient reports a history of diabetes mellitus since the last six years and systemic hypertension since the last two years and is under treatment for the same”.

On perusal of the same we find that the patient was found having diabetes mellitus for last six years and was having hypertension for last two years.  But case summary does not indicate that the problem of the eye was preexisting for a period of more than two months.  This case summary being dated 03.11.2008, the said period of two months can take us to early July, 2006.  This apparently is not a preexisting disease in respect of a Policy valid from 29.03.2006.

Moreover, the Discharge Summary – Surgery shows that the Complainant was admitted on 12.09.2006, date of surgery was 14.09.2006 and his discharge date was 14.09.2006.  The diagnosis recorded therein shows disease in respect of eyes only.  Nothing has been mentioned either relating to diabetes mellitus or of hypertension.

No other record having been shown.  We are unable to agree to the contention that the disease in respect of which surgery took place, was preexisting in respect of the said Policy which was initiated on 29.03.2006.  Therefore, we find findings of the Forum below in the impugned judgement cannot be disturbed and the same is hereby affirmed and the appeal is dismissed.  There is no order as to cost.