Delhi

New Delhi

CC/323/2011

Inder Mohan Taneja - Complainant(s)

Versus

M/S. Royal Sundaram Alliance Insurance Company Ltd. - Opp.Party(s)

24 Feb 2015

ORDER

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI), ‘M’ BLOCK, 1^STFLOOR,

VIKAS BHAWAN, I.P.ESTATE,

NEW DELHI-110002.

 

Case No.CC/323/11                        Dated:

In the matter of:

Sh. Inder Mohan Taneja,

S/o Late Mr. Sham Lal Taneja,

R/o 120/3, Silver Oak Appartments,

DLF Phase-1, Gurgaon-122002

……..COMPLAINANT

       

VERSUS

1. Royal Sundaram Alliance Insurance Co. Ltd.,

        1505-1506, Ambadeep Building, 15^th FL,

        14, K.G Marg, C.P, New Delhi-110001

Also at:

2. Royal Sundaram Alliance Insurance Co. Ltd.,

        Ride House, GF, plot no.156, Sector-44,

        Gurgaon-122002

 

3. To Customer Care Head,

        Claim Section,

        Royal Sundaram Alliance Insurance Co. Ltd.,

        Sundaram towers, 45-46, Whites Road,

        Chennai-600014

                                         ……. OPPOSITE PARTIES

ORDER

President:  C.K Chaturvedi

The complainant with his wife is consumer of OP under a Hospitalization Policy which was taken in 2007 and had been regularly renewed year to year till 2011. It is alleged that in 2010 the complainant, who is an advocate and 71 years of age, had to go a minor surgery in PSRI, Saket, for removal of a stricture in urinary passage blocking emptying of bladder through penis. A short procedure removed the trouble and he spent Rs.3,000/-only. He presented a claim stating all facts, but the OP rejected the claim on the ground that it was a pre-existing disease and therefore excluded. It stated that in 2006 he had undergone similar procedure. The complainant who was maintaining this policy had so far paid Rs.34,000/-so far was shocked by this approach and even decided to opt out of this policy. He issued a legal notice explaining that the policy was not taken since 2007 only to get somehow this small sum of Rs.3,000/- as appears to be suggested by OP and told that in 2006 before the policy was taken the bladder was not emptying and the stricture in the penis was removed, and this is not a disease but  a medical condition which can appear anytime with anyone. Thereafter also nothing happened and he filed this complaint.

The OP in its reply has reiterated the same stand. The complainant claims that for all this behavior the OP should return the premium paid so far with interest.

We have considered the rival case and perused the material on record, the hospital document etc. We are ex facie satisfied that OP has acted arbitrarily and without application in mind with by treating a surgical intervention in 2006 as a disease and fully share the disappointment of the complainant with the approach of OP, which has treated a small claim of a Senior citizen in a callous and insensitive manner, forcing him to vindicate his position by this litigation.

In this view of the matter, we direct OP to pay Rs.3,000/- with an interest of 9% from the date of claim till payment. We find that it is case of punitive compensation for the insensitive attitude of the insurance company. We award punitive compensation of Rs.25,000/- inclusive of litigation expenses.

The order shall be complied within 30 days of the receipt of the copy of the order; otherwise action can be taken under Section 25 / 27 of the Consumer Protection Act.

File be consigned to record room.

Copy of the order be sent to the parties free of cost.

 

        Pronounced in open Court on 24.02.2015.

 

 

(C.K.CHATURVEDI)

PRESIDENT

 

 

(S.R. CHAUDHARY)                 (RITU GARODIA)

MEMBER                          MEMBER