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Ritesh Sharma (Advocate)     07 August 2011

Shifted medi claim policy

i had a medi claim policy from United India insurance for the year 2005-2006,2006-2007 and then for next 2 year 2007-2008 and 2008-2009 from New India insurance... there was no lapse of  policy in these 4 years. i got operated  in 2009 for some ailment(diabetes related) to which my current insurer i.e New India insurance co. is saying that this ailment is not covered in the second year of medi claim policy so they will not reimburse the treatment for same. my submission is that although it is my second year with the current insurer i.e NIA but it is my continuous 4th year of mediclaim policy...first 2 yrs from United India n next 2 yrs from NIA(current insurer).

both of these insurance co. are GIC Companies ( public sector ). the case is pending in consumer forum and i am in dire need of some relevant citations of apex courts to prove my point..that when a consumer is insured in past from some co. and then he shifted from is past insurer to a new insurer and the policies were never lapsed and the continuity is never broken then the second insurer should give the weightage to the policies of the earlier insurer and the current insurer cannot deny the claim mere on this fact that the consumer is a new consumer to the current insurance co. therefore he will be treated as a fresh consumer.



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