BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

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Santokh Nursing Homes through its sole proprietor Dr.Kuldeep Singh, H.No.846, Sector 38-A, Chandigarh

….…Complainant

                                V E R S U S

1]     New India Assurance Company Ltd. through its Division through its Divisional Manager, Branch Office at SCO No.58, Sector 26, Chandigarh.

2]     New India Assurance Company Ltd. through its Manager, Regd. Head Office New India Assurance Building, 87, Mahatma Gandhi Road, Fort, Mumbai 400001

                                        ..…Opposite Parties

CORAM:    SH.RAJINDER SINGH GILL     PRESIDING MEMBER

                MRS. MADHU MUTNEJA                MEMBER

Argued by:            Sh.Vivek Dawar, Adv. for the complainant.

Sh. Sukaam Gupta, Adv. for OPs.

PER MRS.MADHU MUTNEJA, MEMBER

               The instant complaint relates to a dispute between Santokh Nursing Home and New India Assurance Company Ltd. for payment of interest on the decreed amount in an earlier complaint.

2.             Reference needs to be made here to complaint case No.8 of 2004 filed by Jaswinder Singh & Ors. Against Santokh Nursing Home and Ors. Which was allowed in favour of the complainants by the Hon’ble State Commission vide their order dated 7.11.2005.  The operative part of the order reads as under:-

“For the foregoing reasons, complaint is accepted with costs.  Complainants No.1 & 2 are allowed compensation of Rs.12,34,314.50p against respondent NO.1 to 4 who are liable jointly and severally to make payment of this amount alongwith interest @6% p.a. from the date of filing complaint till the payment of the amount.  Costs are quantified at Rs.10,000/-.  However, the liability of respondent No.4 is limited to the extent of Rupees five lacs only.  Complaint of complainant No.3 Smt.Charandeep Kaur is dismissed.”

        The array of parties in the case were as under:-

“1.Sh. Jaswinder Singh,

  2.Sh.Parminder Singh,

  3.Smt.Charandeep Kaur.

All residents of H.No.3639, Sector 23-D, Chandigarh.

                                                ……Complainants.

Versus

"1.     Santokh Nursing Home, Kothi No.846, Sector 38-A, Chandigarh through its Proprietor Dr.Kuldip Singh Santokh.

2.      Dr.Kuldip Singh Santokh, Proprietor, Santokh Nursing Home, Kothi No.846, Sector 38-A, Chandigarh.

3.      Rashmi Jain, Surgeon C/o Santokh Nursing Home, Kothi No.846, Sector 38-A, Chandigarh

4.      The New India Assurance Company SCO No.58, Sector 26, Chandigarh through its Divisional Manager.

5.      Dr.K.S.Kalsi, Senior Surgeon C/o Santokh Nursing Home, Kothi No.846, Sector 38-A, Chandigarh.

6.      FORTIS HEART & Multi Specialty Hospital, Mohali, through its Primary Consultant Dr.K.P.Singh.

7.      Dr.K.P.Singh, Physician C/o FORTIS HEART & Multi Specialty Hospital, Mohali

8.      Dr.N.C.Raina, Surgeon, C/o FORTIS HEART & Multi Specialty Hospital, Mohali

9.      Post Graduate Institute of Medical Education & Research (PGIMER) through its Primary Consultant Dr.L.Kamaan.

10.    Dr.L.Kamaan, Surgeon, C/o Post Graduate Institute of Medical Education & Research (PGIMER)

11.    Dr.S.R.Sudeep, Surgeon, C/o Post Graduate Institute of Medical Education & Research (PGIMER).”

                                                        ….Respondents

All the affected parties went in appeal before the Hon’ble National Commission.  The complainants for enhancement of decreed amount, and OP’s for reduction of decreed amount.  The Hon’ble National Commission while deciding the case reduced the amount of compensation awarded to the complainant to Rs.8.00 lacs in Para No.12 of their order.      It was held as under:-

“12. We are informed that during the pendency of the present appeal, the appellant Nursing Home has paid a sum of Rs.2 lakh to the respondents/complainants and has further deposited a sum of Rs.5 lakh with this Commission.  Besides, the appellant, Dr.Rashmi Jain has also deposited a sum of Rs.3 lakh with this Commission.  We, therefore, order that besides the amount of Rs.2 lakh already received by the respondents, the respondents shall be entitled to receive the entire sum of Rs.3 lakh deposited by Dr.Rashmi Jain alongwith interest accrued thereon as also a further sum of Rs.3 lakh alongwith proportionate interest accrued thereon out of the amount of Rs.5 lakh deposited by the appellant Nursing Home and the balance amount of Rs.2 lakh alongwith proportionate interest may be refunded to the Santokh Nursing Home.  It would be open to the Nursing Home to claim the amount paid by it from the insurance company in terms of the insurance policy obtained by it.”

                After the refund was received by Santokh Nursing Home from the deposited amount as per orders of the Hon’ble National Commission, the factum of interest on the decreed amount arose between Santokh Nursing Home and the Insurance Company.

                The issue in the instant case is between Santokh Nursing Home and New India Assurance Company Ltd. on this factum of interest alone. 

                As per the agreement of insurance, the present complainant was insured with the OPs for Rs.2 Crores with liability for one particular case being to a maximum of Rs.5.00 lacs.  The Hon’ble State Commission as well as the Hon’ble National Commission while holding the Nursing Home as well as the doctor liable had granted compensation to the complainants alongwith interest.  But it was specifically held that the liability of the insurance company was limited to the extent of Rs. 5 lacs only.

                The complainant in the present complaint have stated that since the insurance company had not deposited Rs.5  lacs with the Hon’ble State Commission when the case was filed before the Hon’ble National Commission, hence Santokh Nursing Home had to raise money from their own sources.    Rs.5 lakh of the decreed amount was infact payable by the Insurance Company and should have been deposited by them with the Hon’ble State Commission.  But when the appeal was filed they had not tendered this amount.  Hence, the interest paid on this amount was the liability of the insurance company also.  They have thus prayed that the OPs be directed to pay this interest to them as per the orders of the Hon’ble National Commission.

3]             The OPs in their written reply have submitted that their liability as per the insurance policy was restricted to Rs.5 lacs only for a particular case.  When the case was filed before the Hon’ble National Commission, the orders of the Hon’ble State Commission had been stayed, hence they had not made payment.  The demand of the complainant for interest on Rs.5 lacs is, therefore, baseless.  It has been submitted that the Hon’ble National Commission in their order has stated that the Nursing Home could claim the awarded amount from the insurance company in terms of the insurance policy only.  The insurance policy allows for a maximum of Rs.5 lacs only per case.  The OPs have thus prayed for dismissal of the complaint.

4]             Parties led evidence in support of their contentions.

5]             We have heard the ld.Counsel for the parties and have also perused the record.

6]                      The grievance of the complainant is that after the Hon’ble State Commission, Chandigarh passed its judgment in the above mentioned case, all the parties had gone in appeal before the Hon’ble National Commission, New Delhi.  However, as per direction of the Hon’ble National Commission, New Delhi, the appeal was admitted with a direction to the complainant to deposit a total sum of Rs.7.00 lacs with the Hon’ble State Commission, Chandigarh.  When the complainant informed the insurance company (OP-1 in this case) to make payment towards their liability of insured amount, which was Rs.5.00 lacs, the insurance company did not make the payment. 

                The insurance company has submitted that the orders of the Hon’ble State Commission had been stayed by the Hon’ble National Commission, hence they could not release the payment until the final outcome of the case before the Hon’ble National Commission, New Delhi.  The amount was thus paid by the complainant. After the final decision, they had released Rs.4,95,000/- after deducting Rs.5000/- as excess charge to the Santokh Nursing Home. 

                The complainant has demanded interest on Rs.5.00 lacs deposited with the Hon’ble State Commission, Chandigarh as per the orders of the Hon’ble National Commission, New Delhi, which was actually the liability of the insurance company.

7]             In this regard, a perusal needs to be made of the order of Hon’ble National Commission, New Delhi and the Insurance Policy.  The Hon’ble National Commission, New Delhi while deciding the case has held that “…It would be open to the Nursing Home to claim the amount paid by it from the insurance company in terms of the insurance policy obtained by it.” 

                The liability of the insurance company in terms of the policy was limited to Rs.5.00 lacs only.  The claim of the complainant for interest on the said amount does not seem sustainable as per the policy.  It was not part of the policy.  There is no direction by the Hon’ble National Commission, New Delhi for payment of interest to the complainant by the OPs.  The liability was limited to the direction of the insurance policy only. 

8]             The OPs as per the condition of the policy have already refunded Rs.4,95,000/- after deducting Rs.5,000/- as excess clause.  In our opinion, no further amount needs to be paid by them to the complainant.  This complaint needs dismissal in view of the orders passed by the Hon’ble National Commission, New Delhi. 

                We therefore, dismiss this complaint with no orders as to costs.

                Certified copies of this order be sent to the parties free of cost. The file be consigned.