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2010 (9) TMI 214 - HC - Companies LawReimburse the expenses incurred by the Petitioner towards the treatment of cancer (intravenous chemotherapy) in terms of the mediclaim policy taken by the Petitioner - Power of Ombudsman Held that:- The Award dated 18-3-2004 has in fact been acted upon by Respondent No.1, but for some reason, only in part. The reasons for not renewing the policy continuously from 30-7-2003 as mandated by the Award dated 18-3-2004 are both unconvincing and unacceptable. The Award is unambiguous that the renewal had to be on the basis that the policy is ‘continued’ with effect from 30-7-2003. As held in subsequent Award dated 26-4-2005, Respondent No.1 ought to have collected the premium pro rata for the period 30-7-2003 to 14-4-2004 and renewed the mediclaim policy of the deceased Petitioner for this period as well. The communication dated 18-3-2004 from the office of the governing body of the General Insurance Council at Mumbai advising the Insurance Ombudsman not to entertain complaints in respect of non-renewal of mediclaim policies, was issued on the same date as the Award of the Insurance Ombudsman i.e. 18-3-2004. Without examining the question of validity of such advice, this Court is of the view that the said advice could not govern the Award dated 18-3-2004 which had already been passed on that day in respect of the complaint of the Petitioner which was made prior thereto. Writ petition is allowed with a direction to Respondent No.1 to communicate to the Petitioner’s LRs the pro rata premium amount payable for the renewal of the mediclaim policy of the Petitioner for the period 30-7-2003 to 14-4-2004 within a period of two weeks from today. The LRs of the deceased Petitioner will make the payment of the said premium amount within a further period of two weeks thereafter. Within a further period of four weeks thereafter, Respondent No.1 will process all the claims made by the Petitioner during the period i.e. 30-7-2003 to 14-4-2004 and reimburse to the LRs of the Petitioners the said claims to the extent they are found admissible.
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