BY AD vs GEORGE A.CHERIAN

Note: Even after twenty four months of Continuous Coverage, the above illnesses will not be covered if they arise from a Pre- existing condition, until 48 months of Continuous Coverage have elapsed since inception of the first policy with the company.”

4. It is submitted that the respondent is suffering from Upper Airway Obstruction, and this disease is WP(C) NO. 27088 OF 2022 4 exempted from reimbursement if it is detected and treatment is taken within 24 months of taking the policy. It is submitted that the respondent was diagnosed with the disease of Upper Airway Obstruction within 8 months of taking the policy, and therefore, he is not entitled for reimbursement of the amount of medical expenses incurred by him.

5. The Permanent Lok Adalat has held that the exclusion clause relied on by the petitioner company would not be applicable inasmuch as the respondent was never made aware of such a clause and the said terms and conditions were not supplied to him.

6. As the respondent was not made aware of the terms and conditions of the exclusion, the repudiation of the claim placing reliance on such an exclusion clause has been found to be illegal. The Permanent Lok Adalat further come to the conclusion that the respondent has preferred the claim within the period of three years from WP(C) NO. 27088 OF 2022 5 the date of the cause of action ie., from the date of repudiation and therefore, the claim was well within the time. Thus, the Permanent Lok Adalat has allowed the claim petition and directed the petitioner company to pay a sum of Rs.1,06,841/- along with interest as mentioned above.

7. The learned counsel for the petitioner has placed reliance on the judgment of the Hon’ble Supreme Court in the Case of Export Credit Guarantee Corporation of India Limited v. GARG Sons International [(2014) 1 SC 686] which has no relevance. I have considered the submissions and gone through the impugned award passed by the Permanent Lok Adalat. This Court under Article 226 of the Constitution of India would not be required to re- appreciate evidence laid by the parties before the Permanent Lok Adalat. This Court is required to consider that whether there is any gross illegality committed or WP(C) NO. 27088 OF 2022 6 the award is without jurisdiction. This Court does not find that the award passed by the Permanent Lok Adalat are such, which can be said to be perverse. The award is a well-reasoned award. Every aspect and contentions have been considered by the Permanent Lok Adalat in a detailed manner, and I do not find that the findings recorded by the Permanent Lok Adalat are such which can be said to be perverse. Thus, there is no scope to interfere with the well-reasoned award. The present writ petition is hereby dismissed, without cost. Sd/- D. K. SINGH JUDGE AP WP(C) NO. 27088 OF 2022 7 APPENDIX OF WP(C) 27088/2022 PETITIONER EXHIBITS Exhibit P1 Exhibit P2 Exhibit P3 Exhibit P4 TRUE COPY OF O.P.NO.10558/2020 OF PERMANENT LOK ADALATH, ERNAKULAM. TRUE COPY OF THE WRITTEN STATEMENT DATED 5/8/2011 BEFORE THE PERMANENT LOK ADALATH, ERNAKULAM. TRUE COPY OF THE LETTER DATED 1/1/18 ISSUED BY THE PETITIONER COMPANY TO RESPONDENT. TRUE COPY OF THE POLICY WITH TERMS AND CONDITIONS. Exhibit P5 TRUE COPY OF THE AWARD DATED 21/7/22. RESPONDENT EXHIBITS Exhibit R1(a) Exhibit R1(b) Exhibit R1(c) The true copy of the deposition of the 1st Respondent dt. 10.01.2022 in O.P. No. 10558/2020 on the files of the 2nd Respondent The true copy of the proceedings dt. 18.02.2022 in O.P. No. 10558/2020 on the files of the 2nd Respondent A TRUE COPY OF PROOF AFFIDAVIT FILED IN LIEU OF THE CHIEF EXAMINATION AND AN ENGLISH TRANSLATION OF THE SAID EXT.R1 (A) DEPOSITION