However, the Commission headed by Justice J D Kapoor and Member Ruminita Mittal, though upheld the Forum's verdict, did away the interest part of the award and asked the company to pay Rs 2.19 lakh as full and final compensation including the litigation cost.
As per Khosla's complaint, he, on November one, 1991, bought a mediclaim insurance policy for a year from the NIACL. Later, he kept on renewing the policy.
In June 1994, Khosala was admitted to Escorts Heart Institute following some cardiac complications and underwent bypass surgery.
The company refused to reimburse his medical expenses stating the disease was pre-existing, which was not divulged at the time of renewal, and the policy was not continuous. The Commission, taking cognizance of the plight of the insured, said "the policy in question was continuation of the earlier policy and not a fresh contract and for the NIACL' act of ommission and commission, interest of insured can not be put in jeopardy." The commission also held such diseases can not be said to be pre-existing hence, the repudiation was not just.
(Source: PTI)