High Court of Punjab and Haryana
ALOK SINGH, J.
Reliance General Insurance Company Limited
Versus
Vijay Kumar & Another
C.W.P. No. 20825 of 2010
Decided On : 04-01-2012
Alok Singh, J.
Petitioner Insurance company has invoked jurisdiction of this Court under Articles 226/227 of the Constitution of India assailing the award dated 27.07.2010, passed by Permanent Lok Adalat (Public Utility Services) (hereinafter referred to as 'PLA PUS'), Gurgaon.
Brief facts, inter alia, are that respondent No.1-Vijay Kumar has submitted an application at pre litigation stage under Section 22C of the Legal Services Authorities Act, 1987 (hereinafter to be referred as 'the Act') to recover from the Insurance company Rs.23,726/- along with interest at the rate of 12 % per annum on account of medi-claim; inter alia, contending therein that the claimant (respondent No.1 herein) was having medi-claim No.282510413811 for the period 05.05.2009 to midnight 04.05.2010 for a sum of Rs.1 lac; claimant suffered from several difficulty in breathing with high grade fever and vomiting with productive cough and was diagnosed on investigation as a case of acute bronchitis; he rushed and admitted in Park Hostipal 1, Dundahera, Gurgaon and remained admitted upto 30.11.2009 and has incurred a sum of Rs.24,509/- on his treatment, however, Insurance company is not reimbursing the amount incurred by the claimant towards the treatment in hospital.
Insurance company has filed written statement before the Lok Adalat denying the contentions made in the claim petition and has taken specific stand that matter was thoroughly got investigated by the Insurance company and claim of the claimant was found to be bogus and not genuine. It was also stated by the Insurance company that hospital in question was indulging in issuing incorrect, false and bogus medical certificates to the claimants facilitating them to raise false claim against the Insurance Companies. In paragraph No.10 of the reply the specific plea of Insurance company is that complaint cannot be decided by PLA PUS as lot of evidence and cross examination would be required to justify and prove the claim of the claimant.
Learned Lok Adalat in the impugned judgment in paragraph Nos.4 and 5 has observed as under :-
“4. We have heard Ld. Counsel for the parties and have gone through the pleadings and the documents. It is not disputed that applicant had medi-claim policy from the respondent. Admission of the applicant in the hospital is also not disputed. The policy is not made out cashless. The applicant remained under treatment from 26.11.2009 to 30.11.2009. He has spent Rs.24,509/- on his treatment as is clear from the copy of the bill produced. So we direct the respondent to pay a sum of Rs.24,509/- (Twenty four thousand five hundred and nine only) to the applicant alongwith interest at the rate of 9% pa from the date of institution of the application till payment. The petition is disposed of accordingly. File be consigned to the record room.”
I have heard learned counsel for the parties and have perused the record. Learned counsel for the petitioner contends that Lok Adalat has passed the award on merit; award can be passed as per the compromise or settlement between the parties and not on merit.
Learned counsel for the respondent-claimant contends that combined reading of Section 22C(8), Sections 22D and 22E would suggest that even if parties fail to reach to settlement Lok Adalat shall decide the case on merit. As per learned counsel sub-section (8) of Section 22C reads “where parties fail to reach at an agreement, Permanent Lok Adalat shall decide the dispute”; Section 22D further reads “while conducting, conciliation proceedings or deciding the dispute on merit” goes to prove that PLA PUS can decide the dispute on merit; further contends that even language of Section 22E “Award of the Permanent Lok Adalat either on merit or in terms of a settlement agreement shall be final” would show that Permanent Lok Adalat can decide the dispute on merit if parties fail to reach a settlement.
Before proceeding further, this Court would like to point out that this Court is shocked to not
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