KERALA STATE CONSUMER DISPUTES REDRESSAL

COMMISSION VAZHUTHACAUD, THIRUVANANTHAPURAM.

APPEAL No. 628/2010

JUDGMENT DATED: 21-12-2010

PRESENT:

JUSTICE SHRI. K.R. UDAYABHANU              :PRESIDENT

SHRI.S. CHANDRAMOHAN NAIR                             : MEMBER

The Divisional Manager,

M/s National Insurance Company Ltd.,

PB No.434. St. Joseph Press Bldgs;               : APPELLANT

Vazhuthacadu, TVPM.

(By Adv. Sri.Prasannakumaran Nair)

          Vs.

1.      M. Divakaran Nair,

Sumeru, T.C.29/890(2) CPRA-19,

Palkulangara, Pettah.P.O, TVPM.

                                                                   : RESPONDENTS

2.      M/s TTK Health Care Services (Pvt) Ltd.,

Mareena Buildings, M.G.Road,

Ravipuram, Ernakulam, Kochi.

JUDGMENT

JUSTICE SHRI. K.R. UDAYABHANU:PRESIDENT

The appellants are the opposite parties in CC.357/05 in the file of CDRF, Thiruvananthapuram.

2. The matter relates to the repudiation of a medi claim.  The opposite parties did not adduce any evidence.  The complaint was allowed directing the opposite parties to pay a sum of Rs.95,764.13 with interest at 12% from 17/5/2004 till realization and cost of Rs.2000/-.

3. The contention of the opposite parties is that pre-existing disease was suppressed.  It is also contended that the policy coverage is confined to Rs.60,000/- whereas the Forum is allowed a higher amount.  We find that in the absence of evidence adduced by the opposite parties/appellants, the contention that there was suppression of material facts cannot be entertained.  All the same we find that the sum assured is Rs.60,000/-.  Hence the complainant at any rate cannot get a decree for a sum over Rs.60,000/-.

4. In the circumstances the order of the Forum is modified as follows:-

The opposite parties would be liable to pay a sum of Rs.60,000/- to the complainant with interest at 9% from 17/5/2004 and cost of Rs.2000/-.  The amounts are to be paid within 3 months from the date of receipt of this order.  If the amount is not paid within the above period the complainant will be entitled for interest at 12% from 21/12/2010 the date of this order.

The office will forward a copy of this order to the Forum urgently.

JUSTICE K.R. UDAYABHANU:PRESIDENT

S. CHANDRAMOHAN NAIR : MEMBER

VL.