State Consumer Disputes Redressal Commission
Bhartiya Jeevan Bima Nigam & Ors. vs Smt. Aarti Pagare on 5 October, 2017
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miHkksDrk fookn Áfrrks"k.k vk;ksx] iaMjh] jk;iqj vihy Øekad%FA/2017/494 lafLFkr fnukad: 04.07.2017 1- Hkkjrh; thou chek fuxe] }kjk izca/kd@lapkyd] dk;kZy;&jktHkou ds ikl] flfoy ykbZu] jk;iqj¼N-x-½ ----vihykFkhZ dz-1@ vukosnd dz-1 2- Hkkjrh; thou chek fuxe] }kjk e.My izca/kd@lapkyd e.My dk;kZy;&thou chek ekxZ] iks-vk- c-la- 10] i.Mjh] jk;iqj] ftyk jk;iqj¼N-x-½ ----vihykFkhZ dz-2@ vukosnd dz-2 3- chek yksdiky] Hkkjrh; thou chek fuxe] dk;kZy;&chek yksdiky] tud fogkj dkEIysDl] f}rh; ry&6 ekyoh; uxj] Hkksiky¼e-iz-½ ----vihykFkhZ dz-3@ vukosnd dz-3 lHkh dh vksj ls vf/kd`r }kjk&izca/kd ¼fof/k ,oa laifRr iks"k.k½ eaMy dk;kZy;] thou izdk'k] thou chek ekxZ] iaMjh] jk;iqj¼N-x-½ ----vihykFkhZ dz-4@ vukosnd dz-4 fo:) Jherh vkjrh ixkjs] ifr Lo- y{ehukjk;.k ixkjs] fuoklh&dekZ pkSd] jkeuxj] iks-vk-xqf<+;kjh&jk;iqj¼N-x-½ ----mRrjokfnuh@ ifjokfnuh le{k% ekuuh; U;k;ewfrZ vkj-,l-'kekZ] v/;{k ekuuh; Jh Mh-ds-iksn~nkj] lnL;
ekuuh; Jh ujsUnz xqIrk] lnL;
i{kdkjksa ds vf/koDrk vihykFkhZx.k dh vksj ls Jh ,u-ds-JhokLro] vf/koDrkA mRrjoknh dh vksj ls Jh vkj-ds-Hkkoukuh] vf/koDrkA // 2 // vkns'k fnukad% 05@10@2017 }kjk%&ekuuh; Jh ujsUnz] xqIrk] lnL;
vihykFkhZx.k us ;g vihy /kkjk&15 miHkksDrk laj{k.k vf/kfu;e] 1986] ds varxZr ftyk miHkksDrk fookn izfrrks"k.k Qksje] jk;iqj¼N0x0½ ¼ftls vkxs laf{kIr esa ^^ftyk Qksje** lacksf/kr fd;k tk,xk½ ds ifjokn izdj.k dzekad&725@2015 **Jherh vkjrh ixkjs fo:) Hkkjrh; thou chek fuxe o vU;** esa ikfjr vkns'k fnukad&06-04-2017 ftlds }kjk ifjokfnuh ds ifjokn dks vkaf'kd :i ls Lohdkj dj vknsf'kr fd;k x;k gS fd ¼v½ vukosnd dz-1 o 2] ifjokfnuh dks chek/ku dh jkf'k 6]00]000@&¼N% yk[k :i;s½ ifjokn fnukad 10-11-2015 ls vnk;xh fnukad rd 6 izfr'kr lk/kkj.k okf"kZd C;kt lfgr vnk djsaxsA ¼c½ vukosnd dz-1 o 2] ifjokfnuh dks mijksDr d`R; ds dkj.k gqbZ ekufld d"V ds fy, 50]000@&¼ipkl gtkj :i;s½ vnk djsaxsA ¼l½ vukosnd dz-1 o 2 ifjokfnuh dks vf/koDrk 'kqYd rFkk okn O;; ds :i esa 2]000@&¼nks gtkj :i;s½ Hkh vnk djsaxsA ls nqf[kr gksdj izLrqr fd;k gSA 2- ifjokfnuh dk ifjokn ftyk Qksje ds le{k laf{kIr esa bl izdkj jgk gS fd ifjokfnuh ds ifr Lo- y{ehukjk;.k ixkjs }kjk vius thou dky esa vukosnd dz-1 ds flfoy ykbZu fLFkr dk;kZy; ls vius Lo;a dk thou chek chek/ku 6]00]000@&¼N% yk[k :i;s½ dk fnukad 27-12-2011 dks djok;k Fkk ftldh ikWfylh la[;k 387039114 gS ftldk ekfld izhfe;e jkf'k 3]094@&¼rhu gtkj pkSjkUcs :i;s½ fu/kkZfjr FkkA ifjokfnuh ds ifr }kjk vius thou dky esa ebZ 2012 rd dk ekfld izhfe;e tek fd;k x;k gSA fnukad 27-05-2012 dks ifjokfnuh ds ifr ds // 3 // lhus esa vpkud nnZ gksus ls mls rRdky Jh ckykth gkfLiVy] jk;iqj esa bZykt gsrq HkrhZ djk;k x;k] tgka fny dk nkSjk iM+us ls ifjokfnuh ds ifr y{ehukjk;.k ixkjs dh vkdfLed e`R;q fnukad 27-05-2012 dks gks xbZ ftldh lwpuk rRdky vukosnd dz-1 dks nh xbZA mDr chek ikWfylh dh ukfeuh o chek/kkjd dh iRuh gksus ls ifjokfnuh us chek nkok jkf'k izkIr djus ds fy;s fu/kkZfjr QkeZ esa nkok vkosnu vukosnd dz-1 dk;kZy; esa tek fd;kA ftls vukosnd dz-1 }kjk vLohdkj djrs gq, bldh lwpuk vukosnd dz-1 o 2 }kjk fnukad 11-11-2013 dks i= ds ek/;e ls nh xbZA ifjokfnuh ds ifr dks vius thou dky esa fdlh izdkj dh dksbZ chekjh ugha Fkh RkFkk chek ikfylh fy;s tkrs le; og iw.kZ :i ls LoLFk Fks rFkk mudk LokLF; ijh{k.k Hkh chek fuxe }kjk fu;qDr MkDVj ds }kjk fd;k x;k Fkk ftlds mijkar gh mlds ifr dks chek ikWfylh tkjh dh xbZ FkhA blds ckotwn vukosnd dz-1 }kjk chek nkok jkf'k dk Hkqxrku ifjokfnuh dks ugha fd;k x;k tks vukosndx.k dh lsok esa fuEurk dks n'kkZrk gSA ifjokfnuh }kjk vukosndx.k ds lykg ij {ks=h; nkok lfefr] Hkksiky esa vihy dh xbZ ftls vLohd`r dj fn;k x;k rRi'pkr~ dsUnzh; dk;kZy;] eqEcbZ nkok leh{kk lfefr esa Hkh vihy dh xbZ ftls fujLr dj fn;k x;kA ifjokfnuh us vius vf/koDrk ds ek/;e ls vukosndx.k dks oS/kkfud uksfVl fnukad 15-10-2015 izsf"kr dj nkok jkf'k iznku djus dh ekax dh fdarq vukosndx.k }kjk chek nkok jkf'k iznku ugha dh xbZA bl izdkj vukosndx.k }kjk lsok eas fuEurk dh xbZ gSA ifjokfnuh }kjk vukosndx.k dh bl lsok esa deh ds fy;s vius ifjokn i= dh dafMdk ^^izkFkZuk** esa of.kZr vuqlkj vuqrks"k fnyk;s tkus dk fuosnu fd;k gSA 3- ifjokfnuh }kjk ifjokn i= esa fd;s x;s vfHkdFku ds leFkZu esa Lo;a dk 'kiFk i= fnukafdr 09-11-2015 rFkk lwph vuqlkj nLrkostks dh QksVksizfr izLrqr fd;k gSA // 4 // 4- vukosndx.k }kjk ftyk Qksje ds le{k tokcnkok izLrqr dj vfHkopu fd;k x;k fd e`rd chek/kkjd dh e`R;q ikWfylh ysus ds ek= 4 ekg 14 fnu ckn gks xbZA nkok izi= fnukad 20-06-2012 esa e`R;q dk okLrfod dkj.k Mh ,e VkbZi&2 n'kkZ;k x;k gSA ,e-Mh-esfMlhu ckykth lqij Lis'kfyVh gkfLiVy] jk;iqj esa of.kZr fd;k gS fd &Q.No.(6) Diagnosis arrived at Hospital- DM/Chronic Pancratitis, Pseudocyst, Pancreatic. Q.No.(7) Was there any other disease, illness which preceded or co existed with the ailments-DM/Chronic Pancratitis Pseudocyst, PancreaticA vkfnR; gkfLiVy dh fjiksVZ fnukad 18-09-2010 ds vuqlkj e`rd chek/kkjd vLirky esa fnukad 17-09-2010 dks HkrhZ gqvk ,oa fnukad 18-09-2010 dks fMLpktZ gqvkA mDr vof/k esa chek/kkjd dks Mk;Xuksfll fd;k x;k mlds vuqlkj og Acute Pancreatitis Alcoholic /Hepatitis/DM ls ihfM+r FkkA ckykth lqij Lis'kfyVh gkfLiVy] jk;iqj us viuh fjiksVZ fnukad 19-09-2010 esa ;g mYys[k fd;k gS fd e`rd chek/kkjd Acute intestinal pancreatitis, mild fatty liver, Mild ascitis bilateral pleural effusion ls ihfM+r FkkA bl izdkj mDr of.kZr chekfj;ksa dk mipkj izLrko frfFk ds iwoZ e`rd chek/kkjd }kjk fy;k x;k FkkA vr% Li"V :i ls e`rd chek/kkjd }kjk rkfRod rF;ksa dks izLrko i= esa fNikdj ikWfylh izkIr dh FkhA bl izdkj izLrko i= ds iz'u dzekad &11 O;fDrxr bfro`Rr ds varxZr midafMdk (a) (b) (d) (e) (h) (i) (j) dk mRrj ugha esa fn;k x;k gSA chek ,d lafonk gS] tks ije ln~Hkkouk ds fl)kar ij vk/kkfjr gksrh gSA e`rd chek/kkjd }kjk vius LokLF; laca/kh rF;ksa dh lgh tkudkjh chek daiuh dks iznku ugha dh ,oa rkfRod rF;kas dks fNikdj "kM+;a=iwoZd ikWfylh izkIr djus dk dnkpkj fd;k x;k gSA chek/kkjd }kjk fy;s x;s mipkj] ikWfylh izkIr djus dh frfFk ds iwoZ ds gSa ftUgsa izLrko i= esa mYysf[kr fd;k tkuk Fkk fdarq bu rF;ksa dks ugha n'kkZ;k x;kA mDr vk/kkj ij vukosndx.k }kjk ifjokfnuh dk ifjokn fujLr fd;s tkus dk fuosnu fd;k x;k gSA // 5 // 5- vukosndx.k dh vksj ls vius tokcnkok ds leFkZu esa Jh egsUnz dqekj xqIrk] ¼izca/kd fof/k½] Hkkjrh; thou chek fuxe i.Mjh] jk;iqj dk 'kiFk i= fnukafdr 22-02-2016 dk izLrqr fd;k x;k gSA 6- ftyk Qksje }kjk mHk;i{kksa dh vksj ls izLrqr nLrkosth lk{;ksa ,oa 'kiFki=ksa ds ifj'khyu ds i'pkr~ mRrjokfnuh@ifjokfnuh dk ifjokn] ;g fu"d"kZ fudkyrs gq, fd vukosnd dz-1 o 2 la;qDr vFkok i`Fkd&i`Fkd :i mRrjokfnuh@ifjokfnuh ds laca/k esa lsok esa fuEurk ,oa O;olkf;d dnkpj.k ds nks"kh gS] Lohdkj fd;k x;k] ftlds fo:) ;g vihy gSA 7- [email protected] dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh ,u-ds-JhokLro }kjk rdZ izLrqr dj ;g vk/kkj fy;k x;k fd ftyk Qksje }kjk ikfjr vkns'k esa fof/k ,oa rF;ksa dh Hkwy dh xbZ gSA ftyk Qksje }kjk ;g le>us esa Hkwy dh gS fd chek dh lafonk ije ln~Hkkouk ds fl)kar ij vk/kkfjr gksrh gS vkSj chek /kkjd dks chek ikWfylh dk izLrko i= Hkjrs le; vius O;fDrxr tkudkjh ds leLr rF;ksa dk mRrj lgh&lgh nsuk vR;ar vko';d FkkA e`rd chek /kkjd Lo- y{ehukjk;.k ixkjs us tkucw>dj vius LokLF; ls lacaf/kr egRoiw.kZ rF;ksa dks vkSj isufdz;kl ,oa yhoj ls lacaf/kr chekjh ,oa lkFk gh lkFk e/kqesg dh chekjh dks tks mUgsa chek izLrko i= Hkjus ds iwoZ ls Fkh vkSj ftldk mUgksaus yxkrkj bykt djok;k FkkA ml rF; dks Nqikdj vihykFkhZ fuxe ls /kks[kk dj fofHkUu chek ikWfyfl;ksa dks dz; fd;k Fkk] vkSj ,slk djkj chek vf/kfu;e dh /kkjk 45 ds rgr vkjaHk ls gh 'kwU; FkkA ;fn chek/kkjd }kjk mDr LokLF; ds rF;ksa dks izdV fd;k x;k gksrk rks [email protected] fuxe mDr ifjfLFkfr ds vuqlkj chek /kkjd dh chek ikWfylh dks iznku djus ds QSlys dks mDr tksf[ke ds izdk'k esa ysus esa leFkZ gks ikrkA ftyk Qksje }kjk ;g ekudj Hkwy // 6 // dh gS fd e`rd chek/kkjd dks chek ikWfylh dk izLrko i= uoEcj 2012 esa Hkjrs le; bl rF; dh tkudkjh ugha Fkh fd mls dksbZ xaHkhj chekjh gSA tcfd [email protected] }kjk ftyk Qksje ds le{k izLrqr fd;s x;s nLrkost nkok izi= fnukad 20-06-2012 ds vuqlkj e`rd chek/kkjd ds e`R;q dk okLrfod dkj.k Mh,e VkbZi&2 n'kkZ;k x;k gSA blds vfrfjDr e`rd chek/kkjd ds gh ckykth lqij Lis'kfyVh gkWfLiVy jk;iqj ds MkWDVjksa }kjk tgkW e`rd chek/kkjd ds e`R;q ds le; bZykt fd;k x;k mUgksaus gkWfLiVy VªhVesaV lfVZfQdsV iz'u dz-06 Diagnosis arrived at Hospital ds tokc esa DM/Chgronic Pancreatitis, Pseudocyst, Pancreatic ,oa iz'u dz-7 Was there any other disease, illness, which preceded or co existed with the ailments ds tokc esa DM/Chronic Pancratitis Pseudocyst, Pancreatis dk mYys[k dj ;g Li"V :i ls izekf.kr fd;k gS fd e`rd chek/kkjd chek ysus ls iwoZ mijksDr chekfj;ksa ls ihfM+r FkkA blds vfrfjDr vkfnR; gkWfLiVy dh fjiksVZ fnukad 18-09- 2010 ds vuqlkj e`rd chek/kkjd gkfLiVy esa fnukad 17-09-2010 dks HkrhZ gqvk fnukad 18-09-2010 dks fMLpktZ gqvk FkkA mDr vof/k esa chek /kkjd dks Acute pancreatitis/Alcoholic/Hepatitis/DM ls ihfM+r gksus dh Mk;Xuksfll dh x;h Fkh] ftl rF; dks utjvankt dj ftyk Qksje us fof/k ,oa rF; dh Hkwy dh gSA ftyk Qksje }kjk bl rF; dks Hkh utjvankt dj xaHkhj Hkwy dh gS fd mDr e`rd chek /kkjd uoEcj 2011 esa Hkjs x;s chek izLrko i= ds yxHkx 1 o"kZ iwoZ ckykth lqij Lis'kfyVh gkWfLiVy jk;iqj dh fjiksVZ fnukad 19-09-2010 ds vuqlkj e`rd chek/kkjd Acute intestinal pancreatitis, mld fatty liver. Mild ascitis bilateral pleural effusion ls ihfM+r FkkA ftyk Qksje }kjk ;g le>us esa Hkwy dh xbZ gS fd mDr lHkh fpfdRldh; nLrkost mRrjokfnuh@ifjokfnuh }kjk Lo;a e`R;q nkos ds fujkdj.k ds fy, [email protected] fuxe ds le{k izLrqr fd, x, FksA ,sls nLrkostksa ij fo'okl u dj ftyk Qksje }kjk Hkwy dh xbZ gSA vr% // 7 // vf/koDrk us mijksDr vk/kkj ij [email protected] dh vihy Lohdkj fd;s tkus ,oa ftyk Qksje }kjk ikfjr vkns'k dks fujLr fd;s tkus dk fuosnu fd;k x;k gSA 8- mRrjokfnuh@ifjokfnuh dh vksj ls milatkr gksus okys fo}ku vf/koDrk Jh vkj-ds-Hkkoukuh }kjk ftyk Qksje }kjk ikfjr vkns'k dk leFkZu djrs gq, [email protected] dh vihy fujLr fd;s tkus dk fuosnu fd;k x;k gSA 9- geus mHk;i{k ds fo}ku vf/koDrkvksa dk rdZ Jo.k fd;k rFkk ftyk Qksje ds vfHkys[k ,oa vkyksP; vkns'k dk Hkh ifj'khyu fd;kA 10- izdj.k ds U;k;ksfpr fujkdj.k gsrq gesa bl rF; ij fopkj.k djuk gS fd D;k [email protected] }kjk mRrjokfnuh@ ifjokfnuh ds ifr ds e`R;q nkos dks fujLr dj lsok esa fuEurk dh gS\ 11- mRrjokfnuh@ifjokfnuh }kjk vius ifjokn i= esa ;g vfHkopu fd;k gS fd mRrjokfnuh@ifjokfnuh ds ifr Lo- y{ehukjk;.k ixkjs }kjk vukosnd dz-1 ls ,d chek ikfylh ekfld izhfe;e jkf'k 3]094@&:-
vnk dj dz; fd;k FkkA ikfylh dz- 387039114 FkkA ikfylh dk chek/ku 6]00]000@&:- rFkk ikfylh dh izkjaHk frfFk 13-01-2012 FkhA mRrjokfnuh@ifjokfnuh ds ifr dks ikfylh ysus ds dbZ efgus ckn vpkud lhus esa nnZ gksus ls Jh ckykth gkfLiVy jk;iqj esa fnukad 27- 05-2012 dks bZykt gsrq HkrhZ djk;k x;k tgk fny dk nkSjk iM+us ls Lo- y{ehukjk;.k ixkjs dh vkdfLed e`R;q Jh ckykth gkfLiVy jk;iqj esa fnukad 27-05-2012 dks gks xbZA mRrjokfnuh@ifjokfnuh }kjk vius ifr ds e`R;q nkos dks izkIr djus gsrq leLr nLrkost [email protected] ds dk;kZy; esa tek djk;s x;s] ijarq [email protected] }kjk ;g dFku djrs gq, fd chek/kkjd // 8 // y{ehukjk;.k ixkjs }kjk chek ysrs le; iwoZorhZ chekfj;ksa dks tks mUgsa chek ysus ds ,d o"kZ iwoZ Fkh Nqik;k gS] mRrjokfnuh@ifjokfnuh }kjk izLrqr e`R;q nkos dks fujLr dj fn;k tks lsok esa fuEurk rFkk O;olkf;d dnkpj.k gSA okLrfod rF; ;g gS fd mRrjokfnuh@ifjokfnuh ds ifr chek ysus ds igys iw.kZ :i ls LoLFk FksA chek daiuh ds fpfdRld }kjk Lo- y{ehukjk;.k ixkjs dh fpfdRlh; tkap dh xbZ Fkh vkSj mUgas LoLFk ik;k x;k Fkk blh vk/kkj ij chek nkok Lohdkj fd;k x;k FkkA 12- izdj.k esa mRrjokfnuh@ifjokfnuh }kjk vihykFkhZx.k@ vukosndx.k }kjk izsf"kr Dyse fjiqfM;s'ku i= dks layXu fd;k gS tks bl izdkj gS%& Hkkjrh; thou chek fuxe e.My dk;kZy; thou izdk'k thou chek ekxZ iks-ck-l 10 i.Mjh jk;iqj&492004¼N-x-½ [email protected] dk;kZy; fnukad 11@11@13 Jherh vkjrh ixkjs] W/O Lo- y{eh ukjk;.k ixkjs] dyek pkSd] jkeuxj jk;iqj] ftyk&jk;iqj¼N-x-½ egksn;] @@iathd`r Mkd ls vfHkLohd`fr ckcr~@@ fo"k;% e`R;q nkok ikfylh la[;k 387039114 Lo0 y{eh ukjk;.k ixkjs] ds thou ijA e`rd Lo- y{eh ukjk;.k ixkjs ds thou ij tkjh mijksDr ikfylh ds vUrxZr vkids nkosa ds lanHkZ esa gesa vkidks lwfpr djuk gS fd e`rd gekjs ;gkW chek djkrs le; vius LokLF; ds laca/k esa lgh tkudkjh fNikus ds dkj.k geus mijksDr ikfylh ds vUrxZr leLr nkf;Roksa dks vLohdkj djus dk fu.kZ; fd;k gSA bl laca/k esa gesa vkidks lwfpr djuk gSa fd chek ds fy, izLrko i= fnukad 27@12@2011] dks e`rd chesnkj }kjk gLrk{kj fd;s x;s O;fDrxr izdFku esa mlus uhps fy[ks iz'uksa ds mRrj fuEufyf[kr fn;s gSa iz'u mRrj // 9 // 11]d] D;k vkius fiNys ikWp o"kksZ ds Hkhrj fdlh ,slh chekjh ds fy;s ftlesa ,d lIrkg ls vf/kd le; rd mipkj dh vko';drk jgh gks fdlh fpfdRld ugha ls ijke'kZ fd;k gS\ 11][k] D;k vkidks dHkh tkWp] ns[kHkky] mipkj ;k fdlh izdkj dh 'kY; fpfdRlk ds fy, fdlh ugha vLirky ;k lsokx`g esa nkf[ky fd;k x;k gS\ 11]x] D;k vki fiNys ikWp o"kksZ ds nkSjku LokLF; ugha ds vk/kkj ij vius dk;Z ls vuqifLFkr jgsa gSa\ 11]?k] D;k vki ftxj] isV] g`n;] QsQMs+s] xqnkZ] efLr"d ,oa Luk;qeaMy lacaf/kr fdlh jksxksa ls dHkh ugha ihfM+r jgs gSa ;k bl le; ihfM+r gSaA 11]M-] D;k vki e/kqesg] {k;] mPp ;k fuEu jDrpki] uklwj fejxh] vkWar mrjuk Qksrh dk c<+uk] dks<+ ,oa ugha fdlh vU; jksx ls ihfM+r jgsa gSa ;k bl le; ihfM+r gSaA 11]p] D;k vkidh 'kkjhfjd cukoV esa dksbZ =qfV ;k nks"k gS\ ugha 11]N] D;k vki dHkh nq?kZVukxzLr gq, gSa ;k vkidks pksV yxh gSa\ ugha 11]t] D;k vki fuEu es ls fdlh Hkh ,d ;k lHkh eknd nzo dk mi;ksx dHkh fd;k gSa] djrs gSa\ 1- eknd is; % ugha 2- vU; vkSf"kf/k % ugha 3- laosnu eknd % ugha 4- rackdw fdlh izdkj ds%ugha 11]>- lkekU;r% vkids LokLF; dh fLFkfr dSlh jgh gSA vPNh 11]=] D;k vkius dHkh gsikVkbZfVl ch ;k ,M~l ls lacaf/kr chekfj;ksa dk dksbZ bykt djok;k &gSa ;k djok jgs gSa\ ;k bl laca/k esa dksbZ fpfdRldh; lykg yh gSa\ ugha rFkkfi ge ;g dguk pkgrs gSa fd mijksDr lHkh rF; vlR; Fks] D;ksafd gekjs ikl ;g fl) djus ds fy;s fufoZokn lk{; gSa fd mijksDr ikfylh ds fy, izLrko djus ds iwoZ fnukad 18-09-2010 dks e`rd chek/kkjd Acute Alcoholic Pancreatitis + Hepatitis+ Urinarty infaction ds dkj.k vLirky esa HkrhZ gqvk Fkk ftlds fy, mlus fpfdRld ls ijke'kZ fd;k Fkk vkSj mlls bykt djk;k Fkk og ,d vLirky esa fnukad 18-09-10 ls 19-09-10 rd nkf[ky FkkA ysfdu e`rd us bu rF;ksa dks // 10 // vius chek izLrko i=@O;fDrxr izdFku esa izdV ugha fd;k mlds LFkku ij vlR; mRrj fn;k tSlk fd mij crk;k x;k gSA vr% ;g fl) gksrk gS fd mlus chek djkrs le; vius LokLF; ds laca/k esa tkucq>dj v'kq) dFku fd;k vkSj lgh tkudkjh gels fNik;k vkSj blfy, ikWfylh ds fuca/ku vkSj chek ds fy, izLrko i= ds ?kks"k.kk ds vuqlkj ge ,rn }kjk ewy chek/ku ds nkos dks vLohdkj djrs gSa vkSj rnuqlkj mijksDr ikWfylh ds varxZr fdlh izdkj ds Hkqxrku ds fy, nf;Ro ds v/khu ugha gS vkSj QyLo:i og lkjh /ku jkf'k tks mlds }kjk pqdk;h xbZ gSa] og vkidks ns; ugha gSA ;fn vki gekjs mijksDr fu.kZ; ls lger u gksa rks gekjs {ks=h; nkok leh{kk lfefr ds le{k i= ij vafdr fnukad ls rhu ekg ds vUnj vihy dj ldrs gSa] ftldk irk fuEu gSa%& {ks=h; izca/kd¼{ks=h; nkok leh{kk lfefr½ Hkkjrh; thou chek fuxe] thou f'k[kk 60&ch- gks'kaxkckn jksM] Hkksiky¼e-iz-½ Hkonh;
ofj"B eaMy izca/kd 13- i= ds ifj'khyu ls Li"V gksrk gS fd [email protected] }kjk bl vk/kkj ij fd Lo- y{ehukjk;.k ixkjs chek ysus ds iwoZ fnuakd 18-09-2010 dks Acute Alcoholic Pancreatitis +Hepatitis + Urinary infaction ds dkj.k vLirky esa HkrhZ gqvk Fkk rFkk bZykt Hkh djok;k Fkk ysfdu e`rd us bu rF;kas dks vius chek izLrko i= esa izxV ugha fd;kA blfy;s ikfylh ds fuca/ku vkSj chek ds fy;s izLrko i= ds ?kks"k.kk ds vuqlkj [email protected] }kjk mRrjokfnuh@ ifjokfnuh ds ifr ds e`R;q nkos dks vLohdkj fd;kA 14- ge [email protected] ds bl rdZ ls lger ugha gSA vukosndx.k }kjk izdj.k esa ,slk dksbZ nLrkost izLrqr ugha fd;k gS ftlls ;g izekf.kr gksrk fd chek ysus ds iwoZ e`rd chek/kkjd // 11 // y{ehukjk;.k ixkjs dks mijksDr chekjh Fkh ftlds fy;s og vLirky esa HkrhZ gqvk FkkA [email protected] }kjk e`rd chek /kkjd Lo- y{eh ukjk;.k ixkjs ikfylh ysus ds iwoZ bl chekjh dk fdl fpfdRld ls bZykt djokrk Fkk rFkk og dkSu lh nokbZ ysrk Fkk blds izek.k esa Hkh dksbZ Hkh nLrkost izLrqr ugha fd;k gSA ek= ;g dFku djus ls fd chek/kkjd 2010 esa mijksDr chekfj;ksa ls xzflr Fkk ml ij fo'okl ugha fd;k tk ldrkA vr% ge ;gka [email protected] ds bl rdZ dks Lohdkj ;ksX; ugha ikrs gSa fd chek/kkjd Lo- y{ehukjk;.k ixkjs }kjk chek ysus ds iwoZ iwoZorhZ chekfj;ksa dks fNikdj chek djk;k FkkA 15- 2017(3)CLT(NC), National Insurance co. Ltd. Vs. Shiv Charan Gupta & anr. Decided on 18.05.2017 esa Hkh ekuuh; jk"Vªh; vk;ksx }kjk ;g vfHkfu/kkZfjr fd;k x;k gS%& "Consumer Protection Act, 1986, Section2(1)(g)-Insurance claim- Preexisting disease-Held- It is the onus upon the insurance company to prove that the complainant was suffering from the pre-existing disease."
16. 2016(I) CPR 566(NC), LIC of India & and. Vs. Kolla santhi & anr. Decided on 22-01-2016 esa Hkh ekuuh; jk"Vªh; vk;ksx }kjk ;g vfHkfu/kkZfjr fd;k x;k gS%& "petitioner insurance company has not produced any evidence showing treatment of insured before date of proposal in any hospital Blood pressure and diabetes are such diseases that are not some times known to patient as they to not manifest any serious symptom's in patient Actual cause of death has been cardio respiratory arrest which can also not be said to be pre-existing disease and canoccur suddenly Revision petition dismissed."
17- mijksDr U;k;n`"Vkarks esa Hkh ekuuh; jk"Vªh; vk;ksx }kjk chek daiuh }kjk iwoZorhZ chekjh dk dksbZ nLrkost izLrqr ugha djus ds dkj.k chek daiuh }kjk iwoZorhZ chekjh dks Nqikus ds rdZ dks vekU; fd;k gSA // 12 // 18- mijksDr foospuk ls ge bl fu"d"kZ ij igqaprs gSa fd [email protected]@chek daiuh ;g izekf.kr djus esa foQy jgh gS fd mRrjokfnuh@ifjokfnuh ds ifr chek /kkjd Lo- y{ehukjk;.k ixkjs chek ysus ds iwoZ Acute Alcoholic Pancreatitis +Hepatitis + Urinary infaction ls xzflr FksA ftyk Qksje }kjk tks vkns'k ikfjr fd;k x;k gS og iwjh rjg ls mfpr o fof/k lEer gSA 19- vr% ftyk Qksje }kjk ikfjr vkyksP; vkns'k fnukad 06-04-2017 dh iqf"V djrs gq, [email protected]@chek daiuh dh vihy fujLr dh tkrh gSA vihy O;; ds laca/k esa dksbZ vkns'k ugha fd;k tk jgk gSA ¼U;k;ewfrZvkj-,l-'kekZ½ ¼Mh-ds-iksn~nkj½ ¼ujsUnz xqIrk½ lnL; lnL; lnL;
05@10@2017 05@10@2017 05@10@2017