Supreme Court Overturns Insurance Claim Denial: A Landmark Victory for Policyholder Rights

 

In the bustling streets of India, a tale of justice and insurance unfolds. 🏛️ Manmohan Nanda, our protagonist, sought to insure his journey to the USA for a joyous occasion—the wedding of his sister-in-law’s daughter. ✈️🇺🇸 He approached United India Assurance Co. Ltd., the guardians of his travel safety, for an overseas mediclaim policy.

Manmohan was no stranger to life’s sweet and sour moments, living with diabetes mellitus type II, a condition he managed with care. 🩺 The insurance company, acting with due diligence, had Manmohan medically examined. The doctor’s verdict was clear: aside from diabetes, Manmohan was fit as a fiddle. 🎻

With the doctor’s assurance, the insurance company granted Manmohan the policy, a beacon of security for his travels. 🌟 The policy was a promise, a contract of trust between Manmohan and the insurer.

As Manmohan set foot on American soil, an unexpected twist struck. He felt a sudden weakness, a sweat breaking out on his brow. His wife, ever so vigilant, rushed him to medical aid at the airport, and then to Mills Peninsula Medical Centre. There, amidst the beeps and hums of machines, doctors worked tirelessly to insert three stents and clear the blockages in his heart. 💔➡️❤️

The bills piled up, a mountain of expenses that Manmohan believed would be covered by his policy. But fate had another plan. The insurance company, upon reviewing his case, saw a shadow of doubt—Manmohan had been on statins, a medication that hinted at a pre-existing heart condition, something not disclosed when the policy was crafted. 📜

Manmohan, feeling betrayed by the twist of events, stood his ground. He argued that his medication was a precaution, not an indication of heart disease. The dispute escalated to the halls of justice, where the National Consumer Disputes Redressal Commission weighed in, siding with the insurer. 🏛️⚖️

Refusing to accept this outcome, Manmohan turned to the highest echelons of justice—the Supreme Court of India. The court, a beacon of hope, delved into the intricacies of the case. They pondered over the duty of disclosure, the principles of insurance, and the fine line between what is known and what is assumed. 🤔

In the end, the Supreme Court rendered its judgment, a decision that would resonate with the principles of fairness and the sanctity of contracts. The story of Manmohan Nanda and United India Assurance Co. Ltd. serves as a reminder of the complexities of law and the importance of transparency. 📖🔍

And so, the tale concludes, leaving behind lessons on the delicate dance between duty and disclosure, and the ever-watchful eyes of justice. ⚖️👁️‍🗨️

(Note: This story is a creative interpretation of a legal judgment and is not a substitute for the actual judgment or legal advice.) The case number is Civil Appeal No.8386/2015 Manmohan Nanda vs. United India Assurance Co. Ltd. & Anr.