Question
Appellant and his wife Smt. Sonia Jain took a mediclaim insurance policy from respondent on 14-12-1990. Thereafter appellant's wife fell ill and was admitted to
Appellant and his wife Smt. Sonia Jain took a mediclaim insurance policy from respondent on 14-12-1990. Thereafter appellant's wife fell ill and was admitted to hospital on 14-8-1991. He paid Rs. 8243 towards the charges of her treatment and appellant lodged a claim for the same with respondent.
Despite repeated request for payment they were not honored and she decided to file an application with District Forum, but the complaint was rejected, on further appeal State Commission stuck down the said order and directed the Company to pay the appellant. Further National Consumer Redressal Commission stuck down the demand for payment of money from insurance Co. while the litigation was still going on. In the meanwhile appellant's policy fell due of renewal therefore he sent a letter along with cheques of Rs. 1796 for renewal of his existing mediclaim policy, on 24-1-1996 and was refused of the same by the insurance company on the bases of his previous conduct. Because of non- acceptance of renewal premium the policy lapsed.
In view of the above facts, explain the following
a. Is the Insurance company right in not accepting the renewal premium?
b. Is the insurance company right in not paying the medical charges without giving any reason to the insured?
c. In case of lapsed policy can the claim still be paid for the previous year when the policy was in force
d. Can pre-existing disease, if any can be covered during the time when policy was not in force
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