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1 - 3 of 3 (0.24 seconds)National Insurance Co. Ltd. vs Rameshwar Lal & Anr. on 18 September, 2019
Madhu Bansal vs Life Insurance Corporation Of India & ... on 5 August, 2020
11. Mr. Piyush Sharma Advocate, learned counsel for the
appellants at the very outset has submitted that the controversy
involves in the present case is squarely covered by the judgment of
this Commission passed in case tiled as "Madhu Bansal Vs. Life
Insurance Corporation of India & another", F.A. No.42 of 2019,
decided on 26.11.2021, wherein the appeal filed by the insured was
dismissed and the order passed by the District Commission in favour
of the Insurance Company was upheld. Learned counsel has
vehemently argued that the District Commission had partly allowed
the complaint without taking into consideration a material fact that it
was not a case of any surgery and the impugned order has been
passed contrary to the terms and conditions of the policy. Learned
counsel has further submitted that the treatment of paralysis was not
falling under the category of Surgery and the insured was not entitled
for the amount which has been awarded. Learned counsel has further
submitted that the District Commission has ignored the material facts
that the complainant had not submitted all the documents at the time
of submission of his claim. The benefits were granted only on the
basis of the fact that the patient had remained admitted in the hospital
for a period of more than 48 hours. It was not a mediclaim policy but
still the District Commission had awarded reimbursement of all the
bills incurred on the treatment of the insured. The claim had been
allowed only on the ground that the complainant had remained
8
First Appeal No.202 of 2021
admitted in ICU whereas it was not a case of any surgery. Learned
counsel has also relied upon following judgments in support of his
averments :
1