| Complaint Case No. CC/42/2017 | | ( Date of Filing : 19 Apr 2017 ) |
| | | | 1. Sudeep Kumar Sabat | | S/o- Late Sudhir Kumar Sabat, Jaya Prakash Nagar, 1st Lane, Extension, Near Sri Ram Hospital, Berhampur, Ganjam. | | 2. Sonam Sabat | | W/o- Suraj Kumar Panigrahi, Gandhinagar, 2nd Lane, Berhampur. | | 3. Rashmita Sabat | | W/o- Late Sudhir Kumar Sabat, Jaya Prakash Nagar, 1st Lane, Extension, Near Sri Ram Hospital, Berhampur, Ganjam. |
| ...........Complainant(s) | |
| Versus | | 1. Claim Settlement Officer, Apollo Munich Health Insurance Co. Ltd. | | Ground Floor, Sri Nilaya Cyber Spazio, Road No. 2, Banzarahills, Hyderabad, Andhra Pradesh. | | 2. Claim Settlement Officer, Apollo Munich Health Insurance Co. Ltd. | | Central processing Centre, i-Labs, 2nd & 3rd Floor, Plot No. 404-405, Udyog Vihar, Phase-III, Gurgaon, Haryana. | | 3. Territory Manager, Bancassurance , Appolo Munich Health Insurance Co. Ltd. | | 2nd Floor, 501/1741/1845, Kharvel Nagar, Unit-3, Janpath, Bhubaneswar. | | 4. Claim Settlement Officer, Apollo Munich Health Insurance Co. Ltd. | | Bhubaneswar Branch, Unit III, 2nd Floor, Kharvel Nagar, Unit-3, Janpath, Bhubaneswar, Khurda. | | 5. Deputy Manager, Circle Office Canara Bank, | | 1st Floor, Red Cross Bhawan, Sachivalaya Marg, Unit-4, Bhubaneswar, Khurda. | | 6. Branch Manager, Canara Bank | | Sana Bazar, Berhampur. |
| ............Opp.Party(s) |
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| Final Order / Judgement | Learned counsel for the complainant filed the affidavit of complainant no.3. Copy of the same is served on the counsel for the opposite parties. 2. Heard learned counsel for both the sides. 3. The case of the complainant is that the husband of Rashmita Sabat had purchased a Medi-claim Policy from opposite party-Insurance Company during his life time for the period which is valid till 8.7.2015. During that time, he suffered cardiac arrest and remained in Apollo Hospital from 19.9.2014 to 26.9.2014 and thereafter submitted bills to the opposite party for reimbursement. The bill was not cleared and for that he suffered a lot and finally he expired. 4. The opposite party nos.1 to 4 being the insurer submitted that they have settled the claim amount at Rs. 4,84,015/- and accordingly they have deposited the money in the account of the deceased husband of Rashmita Sabat. 5. Both the parties filed evidence on affidavit which also discloses the above facts. 6. It is admitted fact that the claim has already been settled and deposited in the name of the deceased policy holder. The only claim of the complainant is that for mental agony deceased suffered and died, he should be paid some compensation. Since the medi-claim policy is only to give the reimbursement towards medical expenses incurred, the settled amount has been deposited in the name of deceased-husband of Rashmita Sabat, and same should be available to the legal heirs. 7. In view of the above discussion, opposite party nos. 5 and 6 are directed to pay Rs. 4,84,015/- with interest as accrued as on the date of payment to the legal heirs of deceased who are there on record after proper identification. So, the opposite party nos. 5 and 6 are directed to pay above amount to legal heirs within a period of 45 days failing which interest at the rate of 18% from the date of deposit in the bank till the date of payment would be paid. The complaint case is accordingly disposed of. | |
