defendant company refused to reimburse the said amount stating that the
congenital diseases are not covered under the scope of the policy. Hence,
the suit ... deceased of the son of the
plaintiff being preexisting and congenital disease is not covered in the
first four years of the policy
from Bilatral severe Pes Planus and mental retardation since
her birth (congenital disease). It is averred that she was given some
treatment by doctors till ... years with no success
in betterment of her congenital disease. She has more than 80%
intellectual disability and not in a mental state to take
from double vision (in primary case) and it is not a congenital disease in
normal course of leaving. The aforesaid problem will occur special
circumstances
CSMA Rules and
secondly the patient had already been suffering from congenital Heart
Disease i.e the disease which the patient was suffering since birth ... CSMA Rules
and the patient had already been suffering from congenital Heart Disease i.e the
disease which the patient was suffering since birth
Menorrhagia or Fibromyoma, Hernia, Hydrocele,
Congenital internal disease, Fistula in anus, piles,
Sinusitis and related disorders, Gail Bladder Stone
removal, Gout & Rheumatism, Calculus Diseases ... diseases mentioned in Exclusion no.4.3 and 4.4
(other than congenital internal disease) are pre-existing
at the time of proposal they will
Cataract, Benign Prostatic Hypertrophy Hyserectomy for
memorhagia, fibromyoma, hernia, Hydrocole, Internal
Congenital Defects/Diseases or Anomalies, Fistula in Anus,
Piles, Chronic Fissure in Anus, Pilonidal ... congenital
Defects/Diseases or Anomalies. Fistula in Anus, Piles, Chronic,
Fissure in Anus, Pilonidal Sinus, Sinusitis, Stone disease of any
size, Benign Lumps/growths
detecting genetic
abnormalities or metabolic disorders or chromosomal abnormalities or
certain congenital malformations or sex-linked disorders and for the
prevention of their misuse ... namely:--
(i) chromosomal abnormalities;
(ii) genetic metabolic diseases;
(iii) haemoglobinopathies;
(iv) sex-linked genetic diseases;
(v) congenital anomalies;
(vi) any other abnormalities or diseases
suffering
from and she was diagnosed of operative case of congenital heart
disease with mixed connective tissue disorder (diffuse cutaneous
scleroderma with interstitial lung disease
cheerful child and loves to play and smile but suffering
from congenital heart disease.
24. Going by the above circumstances, I am satisfied that
tests, they diagnosed the
plaintiff to be suffering from 'Acumatic Congenital heart
disease and severe MR, Large LAA aneurysm'.
Accordingly, his treatment started
