Overseas Travel Insurance Policy – Exclusion of expenses incurred on treatment in India
On 15.12.2022, the Insured had taken Overseas Travel Insurance Policy of the petitioner through Online Platform based on his declaration. It was for the period from 17.1.2023 to 16.5.2023 for travel to Europe by the Insured with his wife. During the overseas travel, the insured experienced the symptoms of vertigo and sought medical consultation on 8.5.2023. However, he aborted the journey due to persistent symptoms and returned to India on 10.5.2023. He was admitted in the Reliance Hospital from 15th to 22nd May 2023, for some other disease.
On 10.6.2023 the insured filed the claim for expenses on treatment in Reliance Hospital. It was denied by the email dated 20.6.2023.
On 4.3.2024, the Insurance Ombudsman allowed the complaint and passed the award for the entire claim.
HELD that unless there is evidence on record to show that the treatment in India was in continuation of treatment of the diseases diagnosed overseas, no such finding by the Ombudsman could have been recorded. Moreover, in the absence of any term of policy or acceptance of liability in advance by the Insurer, no such liability can be fastened on the Insurer.
Shrivastava Legal LLP appeared for the petitioner
Judgment dated 14.8.2024 of the Bombay High Court in W.P.No.6625 of 2024 of Tata AIG General Insurance Co. Ltd Vs. Insurance Ombudsman for Mumbai and another
