IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT : THE HONOURABLE MR. JUSTICE ANTONY DOMINIC FRIDAY, THE 29TH FEBRUARY 2008 / 10TH PHALGUNA 1929 WP(C).No. 36235 of 2005(L) -------------------------- PETITIONER: ------------ K.GOPAKUMAR, T.C.44/1622, ARYASALA, THIRUVANANTHAPURAM. BY ADV. SRI.R.MANOJ SMT.SINDHU MANOJ RESPONDENT: ------------- THE ORIENTAL INSURANCE COMPANY, DIVISIONAL OFFICE-I, THIRUVANANTHAPURAM, REPRESENTED BY ITS ASSISTANT DIVISIONAL MANAGER, THIRUVANANTHAPURAM. BY ADV. SRI.GEORGE CHERIAN (THIRUVALLA) THIS WRIT PETITION (CIVIL) HAVING COME UP FOR ADMISSION ON 29/02/2008, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: W.P.(C) NO.36235/2005/L APPENDIX PETITIONER'S EXHIBITS: EXT. P1: COPY OF THE POLICY AND ITS SCHEDULE. EXT. P2: COPY OF THE DISCHARGE CARD OF CHELSA HOSPITAL, THIRUVANANTHAPURAM. EXT. P3: COPY OF THE ORDER REJECTING THE CLAIM OF THE PETITIONER ISSUED ON BEHALF OF THE RESPONDENT COMPANY. EXT. P4: COPY OF THE AWARD PASSED BY THE INSURANCE OMBUDSMAN DATED 11.1.2005. /TRUE COPY/ P.A. TO JUDGE JP ANTONY DOMINIC, J. ======================= W.P.(C) No.36235 of 2005 (L) ======================= Dated this the 29th day of February, 2008 JUDGMENT The prayers sought for in this writ petition are to quash Ext.P4 order of the Insurance Ombudsman, Kochi and to direct the respondents to settle the claim of the petitioner, which is rejected in Ext.P3. There is a further prayer to declare clause 4.3 of Ext.P1 policy to be illegal. 2. In this case, petitioner had subscribed a medical insurance policy the relevant period of which was from 13.5.2003 to 12.5.2004. During the currency of the policy petitioner suffered Hydrocele and was hospitalised from 8.4.2004. He claimed the benefit of Ext.P1 policy and that was declined. 3. Thereupon the petitioner approached the Insurance Ombudsman, Kochi but by Ext.P4 order the stand taken by the Insurance Company was upheld. It is in this background writ W.P.(C) No.36235/2005 -2- petition has been filed. Since the relationship between the parties is governed by the conditions of Ext.P1 policy, the relevant clause of which is 4.3, and the same is extracted hereunder for reference. "During the first year of the operation of insurance cover, the expenses on treatment of diseases such as cataract, Benign, Prostatic Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital internal Diseases, Fistula in anus, Piles, Sinusitis and related disorders are not payable. If these diseases are pre- existing at the time of proposal, they will not be covered even during subsequent period of renewal too:" Clause 4.3 shows that petitioner is not entitled to a claim for hospitalisation if it was made during the initial first year period since what he suffered was hydrocele. It being a contract entered into between the parties, I do not find anything illegal in clause 4.3. Petitioner refers to the judgment of the supreme court in United Insurance Co. Ltd v. Harchand Rai (2004 (3) 560 KLT). That was a case where a claim for covering burglary policy was dealt with by the apex court and it was held that the claim has to be dealt with as per the policy conditions. 4. For these reasons, I cannot find any thing W.P.(C) No.36235/2005 -3- objectionable either in the policy or in the stand of the Insurance Ombudsman and the writ petition is only to be dismissed. I dismiss the writ petition. ANTONY DOMINIC, JUDGE jp