(- . . . , ) :
1) , 1986, 12 . , . , . . .. . .. New India Floater Mediclaim Insurance Policy No. 151100/34/15/28/00000264 . 15-09-2015 14-09-2016 . 2,00,000/-(Sum insured) . .. .. . . . 8 (Acute Tonsilitis) . 19-04-2016 , , . . . 20-04-2016 . . 15,916/- .. . 30-04-2016 . .. 24 . 7-05-2016 . (Acute) / . .. . . . , . .
2) , .. . 15,916/- . .. . 30-04-2016 , . 5,000/- . 5,000/- .. .
3) , . 5 .. , , , , . .
4) . . , . . .. . .. . .. .
(i) .
(ii) . .. . . 4.3.1 .
(iii) 24 admissible payable (Continous coverage in excess of 24 monhs is necessary to claim become payable or admissible as per Cl. 4.3.1. Provided illness mentioned in the said clause is not pre-existing and it is suddenly arose).
(iv) .. / .
(v) .. . .. .. . , .. .
5) .. . . -. .
2 .. ?
3 .. ? . 1 3
5) . 1 3 . .. New India Floater Mediclaim Insurance Policy No. 151100/34/15/28/00000264 . 15-09-2015 14-09-2013 . 2,00,000/-( ) . .. . , ..
8 (Acute Tonsilitis) . 18-04-2016 , , . 20-04-2016 . .. . 15,916/- . 30-04-2016 . .. 24 . 7-05-2016 . Acute Tonsilitis Exclusion Clause . .. . . .. (Exclusion Clause) . .. . (2015) CJ 299 (N.C.) Indraprastha Gas Ltd Vs. New India Assurance Co. Ltd., :- Head Note Where particular damage is not exclused under the terms and conditions of policy. The insurance company cannot avoid its liability. , Exclusion Clause .. .. . .. . 15,916/- ( ) . 30-042016 .... 18 % . 3,000/- . 3,000/- . , . , .
1) : .
2) .. . 15,916/- ( ) . .. . 30-04-2016 .... 9 % .
3) . 3,000/- ( ) . 3,000/- ( ) .. .
4) .. .1 45 .
6) , 1986 25 27 .. .
7) . [HON'BLE MRS. Savita P. Bhosale] PRESIDENT [HON'BLE MRS. Rupali D. Ghatage] MEMBER [HON'BLE MRS. Manisha S.Kulkarni] MEMBER