Punjab

Sangrur

CC/1214/2021

Nishu Rani - Complainant(s)

Versus

Reliance General Insurance Company Ltd. - Opp.Party(s)

Sh. Nem Kumar

30 Nov 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

 

                                                                        Complaint No. 1214

 Instituted on:   12.10.2021

                                                                         Decided on:     30.11.2023

 

Nishu Rani aged 37 years wife of Shri Pardeep Jindal R/O H.No.249, Ward No.10A, AP Enclave, Near Jindal Public School, Dhuri, Tehsil Dhuri, District Sangrur (Aadhaar No.3304 5132 4235, Mob. No.98554-44033).

                                                         …. Complainant 

                                                 Versus

1.     Reliance General Insurance Company Limited through its MD, Reliance Centre, South Wing, 4^th Floor, Santa Cruise, East, Western Express Highway, Mumbai 400055.

2.     Reliance General Insurance Company Limited through its Branch Manager, Plot No.36-37, 1^st Floor, New Leela Bhawan, Patiala 147001.

                                                        ..Opposite parties

 

For the complainant    :       Shri Nem Kumar, Adv.

For the OPs               :       Shri Amit Goyal, Adv.

 

Quorum                                           

Jot Naranjan Singh Gill, President

Sarita Garg, Member

                        Kanwaljeet Singh, Member

 

ORDER

SARITA GARG, MEMBER:

 

1.             Complainant has preferred the present complaint against the opposite parties on the ground that she availed services of the OP by getting medical insurance policy for herself by paying the requisite premium of Rs.6844/- from her bank account with the YES Bank Branch Dhuri which was valid for the period from 24.10.2020 to 23.10.2021 and the policy was for the insured sum of Rs.3,00,000/- on floater basis.  Further case of complainant is that she suffered from ailment/fever and remained admitted from 29.6.2021 to 4.7.2021 in Subhash Nursing Home, Dhuri, where she spent an amount of Rs.53,040/- and thereafter the complainant submitted the bills to the OPs for reimbursement, but the same was not paid despite her best efforts. The complainant then got served a legal notice on 13.9.2021 upon the OPs, but of no avail. Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the OPs be directed to pay to the complainant the claim amount of Rs.53,040/- along with interest and further claimed compensation and litigation expenses.

2.             In reply filed by OPs, legal objections are taken up on the grounds that the complaint is not maintainable in the present form, that the complainant has not come to this Commission with clean hands and that the complainant has dragged the OPs into unwanted litigation and that the complainant has become infructous as the claim amount to the tune of Rs.53040/- has already been paid by the OPs on 28.3.2022 through NEFT in the account of the complainant.  On merits, it is stated that after taking the lenient view, the OPs paid the amount of Rs.53040/- to the complainant and now nothing remains outstanding against the OPs and lastly prayed for dismissal of complaint.

3.             The learned counsel for the complainant has produced Ex.C-1 to Ex.C-11 copies of documents and affidavit and closed evidence. On the other hand, the learned counsel for OPs has produced Ex.OPs/1 to Ex.OPs/3 copies of documents and affidavit and closed evidence.

4.             We have gone through the pleadings put in by  the parties along with their supporting documents with their valuable assistance. 

5.             At the outset, it is not in dispute between the parties that the complainant took a medical insurance policy from the OPs, that the complainant remained admitted in Subhash Nursing Home, Dhuri for the period from 29.6.2021 to 4.7.2021 and spent an amount of Rs.53040/- for the treatment.  Thereafter the complainant submitted all the bills to the OPs for payment and when the payment was not made to the complainant, then she filed the present complaint.

6.             A bare perusal of the written reply shows that during the present proceedings, the OPs  paid the full claim amount of Rs.53,040/- to the complainant on 28.3.2022, which fact is also supported by the affidavit of the complainant Nishu Rani, Ex.C-11, wherein she has clearly mentioned that the amount of Rs.53,040/- has been paid on 28.3.2022. We may mention that though the complainant filed the present complaint on 12.10.2021 and thereafter the OPs paid the amount of Rs.53,040/- to the complainant on 28.3.2022 after filing of the present complaint.  There is no explanation from the side of the OPs that why they did not pay the claim amount earlier and paid the amount only after filing of the present complaint, which we feel is a case of deficiency in service on the part of the OPs and the OPs are found liable to pay interest on the said amount.     

7.             In view of our above discussion, we allow the complaint and direct OPs to pay to the complainant interest @ 7% per annum on the claim amount of Rs.53,040/- from 6.7.2021 to 28.03.2022 and further an amount of Rs.5000/- in lieu of consolidated amount of compensation as well as litigation expenses. This order shall be complied with by OPs within a period of thirty days of receipt of copy of this order.

8.             The complaint could not be decided within the statutory time period due to heavy pendency of cases.

9.             Copy of this order be supplied to the parties free of cost. File be consigned to the records after its due compliance. 

                        Pronounced.

 

                        November 30, 2023.