Delhi

StateCommission

FA/13/355

SURINDER KR. SAPRA - Complainant(s)

Versus

NATIONAL INSURANCE CO. LTD. - Opp.Party(s)

18 Mar 2016

ORDER

IN THE STATE COMMISSION : DELHI

(Constituted under Section 9 of the Consumer Protection Act, 1986)

 

Date of Decision: 18.03.2016

 

Appeal No.355/2013

(Arising out of the order dated 07.12.2012 passed in Complaint Case No.406/2009 by the District Consumer Redressal Forum(North), Delhi

 

In the matter of:

 

Shri Surinder Kumar Sapra,

F-18-8, Opp. MCD Dispensary School Lane,

Rajouri Garden, New Delhi                                                                                     ....Appellant

 

Versus

 

1. M/s. National Insurance Company Limited,

D.O. IV, 21, Darya Ganj, Delhi.

 

2. M/s. National Insurance Company Limited,

3, Middleton street,

Post Box No.9229,

Kolkatta -7000071.                                                                      ….….....Respondents

                                                                

CORAM

Justice Veena Birbal, President.

Ms. Salma Noor, Member.

 

 

1.     Whether reporters of local newspaper be allowed to see the judgment?

2.      To be referred to the reporter or not?

 

 

Justice Veena Birbal, President

 

1. The grievance of the appellant /complainant against the order dated 07.12.2012 passed by the Consumer District Redressal Forum is that no interest has been awarded to the appellant by the Ld. District Forum while disposing of the complaint i.e. CC No.406/2009.
2. We have perused the impugned order.
3. A claim based on medi-claim policy was lodged with the respondent/OP by the appellant/complainant for a sum of Rs.1,24,336/- as being spent on the treatment of his wife. The same was repudiated by the respondent/OP on the ground that there was no proper hospitalization in this case and treatment was done on OPD basis.
4. Aggrieved with the repudiation, a complaint was filed before the District Forum, wherein appellant/complainant had made prayer for reimbursement of Rs.1,24,336/- having spent on the treatment of his wife alongwith compensation and litigation costs.
5. After considering the material on record and evidence of both the parties, the Ld. District Forum found that the repudiation was unjustified and directed the respondent/OP as under:

“However, at this stage we cannot calculate what amount the complainant is entitled for reimbursement as per terms of the policy, therefore the only direction which we can give to the OP is to process the claim of the complainant in terms of the conditions of the policy afresh and reimburse the amount which complainant is entitled to in terms of the policy.  No other relief can be given. However, since the repudiation has been found to be unjustified in terms of the conditions of the policy itself, OP shall pay a sum of Rs.2,000/- to the complainant by way of cost. The order shall be complied with within 30 days of receipt of this order .Present complaint is accordingly disposed of.

 

6. Ld. Counsel for the appellant/complainant has submitted that when the District Forum has held that the repudiation was unjustified in that event the District Forum ought to have ordered to pay interest also on the calculations which were to be made by the respondent/OP.
7. During the course of arguments, Ld. counsel for the respondent/OP has stated that in compliance of the order of the District Forum calculation has been made and a sum of Rs.1,26,336/- in all has been paid to the appellant/complainant in February 2013. Ld. Counsel for the appellant/complainant has confirmed the said position.
8. As regards contention for awarding the interest, after some arguments, counsel for the respondent/OP states that respondent/OP is willing to pay the interest @9% per annum on the aforesaid amount from the date of filing of the complaint by the appellant/complainant before District Forum till its realization.
9. Ld. Counsel for the appellant/complainant states that CC No.406/2009 was filed on 20.05.2009 and has also agreed for the grant of interest from the aforesaid date @9% per annum.
10. We have also considered the facts and circumstances of the case, considering the totality of the facts and circumstances, the rate of interest and the period which has been offered by the respondent/OP appears to be fair and proper. Accordingly, we direct the respondent/OP to pay interest @9% per annum to the appellant/complainant on the amount of Rs.1,24,336/- from 20.05.2009 i.e. the date of filing of the complaint till its payment i.e. February 2013.
11. Compliance be done within four weeks.
12. Appeal stands disposed of accordingly.

              File be consigned to Record Room.

 

(Justice Veena Birbal)

President

 

(Salma Noor)

Member