Pradip Baburao Hivare v. National Insurance Co.Ltd.

12/7/17 21/3/18 (- . . . , )

1. , 1986 12 . ...1 .. . 270807/48/16/8500001624 .18/01/2017 17/01/2018 .1,00,000/- . .. . clauses . . Rt.Middle Conevorum Fracture Hypovoluic Hypotension due to excessive blood , .19/2/17 23/2/7 . . .. .22,461/- . .83 . 24 . . 31443--1 .25/11/1992 16/10/07 () . . .8/10/1998 . .. , . .. . , .22,461/- .19/02/17 .... 18 , .10,000/- .10,000/- .. .

2. , .. , .. , , , , , . 23 . , . , , .

3. ...1 .07/09/17 . ...1 , . . . .. .. . , .. . .. . .. . . 3.14 .. , . .... .. . , .. .20,000/- , .. .

4. ...1 . .

5. .. . . -. .

1 .. ? .. . 270807/48/16/8500001624 .18/01/2017 17/01/2018 .1,00,000/- . . . 6. Rt.Middle Conevorum Fracture Hypovoluic Hypotension due to excessive blood , .19/2/17 23/2/7 . .22,461/- .. . 18/3/17 . .. . , .. ? . .5/6/17 , On scrutiny, it was found that the allopathy treatment in this case is taken by an Ayurvedic doctor which is cross pathy and not payable. Therefore, your claim stands repudiated as per clause 3.19 of policy terms and conditions.

7. .. . .... . .... . 3.14 . .. . .3.14 Medical Practitioner means a person who holds a valid registration from the Medical Council of any State or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Government of India or a State Government and is thereby entitled to practice medicine within its jurisdiction and is acting within the scope and jurisdiction of licence.

8. . 23/2/17 . Rt. Middle canirovuro Hypovosumic Hypotension due to excessive blood loss Reg.No. 31443, A-1 . .23/2/17 , .... (.) . , , . .

9. . 3.19 - Medical Practitioner means a person who holds a valid registration from the Medical Council of any State or Medical Council of India or Council for Indian Medicine or for Homeopathy set up by the Govt. of India or a State Govt. and is, thereby entitled to practice medicine within its jurisdiction; and is acting within the scope and jurisdiction of license. - Medical council of any state Medical Council of India Council for Indian Medicine .

10. . Maharashra Council of Indian Medicine Constituted under M.M.P. Act 1961, Govt. of Maharashtra, Reg.No. 1-31443-A-1 Reg. Date 20/08/1997 . Council of Indian Medicines .

11. -- Ayurvedic practitioners enrolled on the State Register of Practitioners of Indian Medicine holding qualification specified in Parts A. B and A-1 of the schedule appended to the said act shall be eligible to practice the modern system of medicine which is known as allopathic system of medicines, to the extent of the training they received in that system (Circular dated 25/11/1992) (Annexure-B). .16/10/2007 , . .. .26/6/2014 , Sec. 25 Maharashtra Medical Practitioner Act, 1961 (iv) (v) amended allowing the BAMS/BUMS medical graduates to practice allopathy medicines.

12. SLP/CC/9134/2015 IMA Pune unit had approached the Mumbai High Court against Maharashtra Governments Resolution and its writ petition was set aside by the Division bench of Mumbai High Court. IMA Pune had then approached the Supreme Court filing SLP. Honble Justice A.K. Sikri disposing of the SLP/CC/9134/2015 July upheld the G.R. issued by Maharashtra Government and allowed BAMS graduates to practice the allopathy medicines. Honble Justice A.K. Sikri B.A.M.S. .

13. .. . , , .83 , . Medical Practitioner . Rt.Middle Conevorum Fracture Hypovoluic Hypotension due to excessive blood . , .... (.) . . , .. Direct nexus .

14. , Council Indian Medicine , .. , . , .1 . .2 3

15. .1 .. . .. .22,461/- . . .. . .. . 22,461/- . .12/7/17 ....9 .3,000/- .2,000/- . . .4 -

1) : .

2) .. . 270807/48/16/8500001624 . 22,461/- . .12/07/2017 .... 9 .

3) .. . 3,000/- ( ) .

4) .. .2,000/- ( ) .

5) .. 45 .

6) , 1986 25 27 .. .

7) . [HON'BLE MRS. Savita P. Bhosale] PRESIDENT [HON'BLE MRS. Rupali D. Ghatage] MEMBER