Chandigarh

StateCommission

A/337/2016

Max Bupa Health Insurance Company Limited - Complainant(s)

Versus

Achla Goswamy - Opp.Party(s)

Gaurav Bhardwaj,Adv.

20 Feb 2017

ORDER

It is vehemently argued by Sh. Gaurav Bhardwaj, Advocate, Counsel for the appellants that the Forum has granted an amount of Rs.5,54,498/- whereas as per claim raised by the respondent/complainant, he had claimed only an amount of Rs.3,83,569/-. It is further stated by the Counsel for the appellants that after making some deductions, at the maximum, the complainants is entitled to get an amount of Rs.3,71,867/-.

                        At this stage, very graciously, it was accepted by Sh. Rajiv Sharma, Advocate, Counsel for the respondent/complainant that there was some mis-calculation and in fact, the respondent/complainant will be satisfied, if the amount of Rs.3,71,867/- is granted to the respondent/complainant alongwith compensation awarded and litigation expenses.

                        Sh. Gaurav Bhardwaj, Advocate, Counsel for the appellants has raised objection regarding grant of compensation and litigation.

                        We are not satisfied with the plea raised. Whatever amount was due to the respondent/complainant, the Company should have reimbursed that amount forthwith. By not doing so and forcing the respondent/complainant to adopt way of litigation to redress his grievance, the Company has failed to perform his duty.

                        In view of above, plea raised by the Counsel for the appellants is rejected. The appellants are directed to pay an amount of Rs.3,71,867/- plus Rs.50,000/- awarded towards compensation and Rs.10,000/- towards litigation expenses, to the respondent/complainant, within 30 days from today. We make it very clear that in case, the amount is not so paid, then for forcing the respondent/complainant to come before this Commission in appeal, a compensation of Rs.50,000/- shall be deemed to have been imposed and further the respondent/complainant will be entitled to get interest @12% per annum on the entire amount, so awarded, after lapse of period of one month.

                        The appeal stands disposed of in the aforesaid terms.

                        Certified copies of the order be sent to the parties free of charge.