IN THE NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI NC/REVISION PETITION NO. 114 OF 2023 (A g a in st th e o rd e r d a te d 1 9 .1 0 .2 0 2 2 in F A N o. 148 o f 2 0 1 5 o f th e S ta te C o n su m e r D isp u te s R e d re ssa l C o m m issio n , T a m il N a d u )

W ith N C /IA /6 8 8 /2 0 2 3 (S tay)

N C /IA /1 0 2 1 8 /2 0 2 3 (L e g a l H e irs)

N C /IA /1 2 5 7 4 /2 0 2 4 (S u b stitu te d S e rvice )

R o ya l S u n d a ra m G e n e ra l In su ra n ce C o m p a n y Ltd.

F o rm e rly kn o w n a s R o ya l S u n d a ra m A llia n ce In su ra n ce C o m p a n y Ltd.

h a vin g its R e g io n a l O ffice a t-

P lo t N o. 136, R id e r H o u se , S e cto r 4 4 , G u ru g ra m -1 2 2 0 0 2 , H a rya n a T h ro u g h its A u th o rise d S ig n a to ry A lso a t- S u n d ra ra m T o w e rs, 4 5 & 4 6 W h ite s R o a d , C h e n n a i-6 0 0 0 1 4 , T a m il N a d u. P e titio n e r V e rs u s

1. S . K a rth ike ya n (S in ce d e ce a se d th ro u g h L R )

S . M e e n a ksh i, W /o L a te S . K a rth ike ya n , 3 3 A , B h a ra th i U la R o a d , S ri Je ya sh ri A p a rtm e n ts, P h a se I, 2 nd F lo o r, A -2 R a ce C o u rse C o lo n y, M a d u ra i-6 2 5 0 0 2 , T a m il N a d u .

2 .D r. R a vich a n d ra n , T h e S e n io r C o n su lta n t, D e p a rtm e n t o f U ro lo g y, M e e n a kch i M issio n H o sp ital, a n d R e se a rch C e n tre , M e lu r R o a d , M a d u ra i-6 2 5 1 0 7 , T a m il N a d u

3. M e e n a ksh i M issio n H o sp ita l a n d R e se a rch C e n tre , M e lu rR o a d , M a d u ra i-6 2 5 1 0 7 , T a m il N a d u R e sp o n d e n ts BEFORE HON'BLE DR. SADHNA SHANKER, PRESIDING MEMBER HON’BLE MRS. JUSTICE SAROJ YADAV, MEMBER F o r th e P e titio n e r : M r. R a vilo ch a n D a lip a rth i, A d vo ca te F o r th e R e sp o n d e n t N o. 1 : E x p a rte vid e o rd e r d a te d 1 3 .0 1 .2 0 2 5 F o r th e R e sp o n d e n ts N o. 2 & 3 : E x p a rte vid e o rd e r d a te d 0 4 .0 4 .2 0 2 5 Pronounced on :3I July, 2025

ORDER

DR. SADHNA SHANKER, MEMBER

1. T h is re visio n p e titio n h a s b e e n file d u n d e r se ctio n 2 1 (b ) o f th e C o n su m e r P ro te ctio n A ct, 1 9 8 6 (in sh o rt, th e ‘A c t’) ch a lle n g in g th e o rd e r d a ted 1 9 .1 0 .2 0 2 2 p a sse d in first a p p e a l N o. 1 4 8 o f 2 0 1 5 o f th e C ircu it B e n ch o f T a m il N a d u S ta te C o n su m e r D isp u te s R e d re ssa l C o m m issio n , M a d u ra i (in sh o rt, th e ‘S ta te C o m m issio n ’) vid e w h ich th e a p p e a l o f th e a p p e lla n t / co m p la in a n t w a s a llo w e d a n d th e O rd e r d a te d 2 2 .0 4 .2 0 1 5 o f th e D istrict C o n su m e r D isp u te s R e d re ssa l F o ru m , M a d u ra i (in sh o rt, th e ‘D istrict F o ru m ’)

in C o n su m e r C o m p la in t no. 1 1 3 o f 2 0 1 0 w a s se t a sid e .

2. W e h a ve h e a rd th e le a rn e d co u n se l fo r th e p e titio n e r (h e re in a fte r re fe rre d to a s th e ‘in su ra n ce co m p a n y’) a n d p e ru se d th e re co rd .

T h e re sp o n d e n t no.1 (h e re in a fte r re fe rre d to a s th e ‘co m p la in a n t’) w a s p ro ce e d e d e x-p a rte vid e o rd e r d a te d 1 3 .0 1 .2 0 2 5 a n d th e re sp o n d e n ts no. 2 (h e re in a fte r re fe rre d to a s th e ‘d o cto r’) a n d th e re sp o n d e n t no. 3 (h e re in a fte r re fe rre d to a s th e ‘h o sp ita l’) w e re p ro ce e d e d e x-p a rte vid e o rd e r d a te d

0 4 .0 4 .2 0 2 5 .

3. B rie f fa cts o f th e ca se a re th a t co m p la in a n t o b ta in e d a “H e a lth S h ie ld P la n ” In su ra n ce P o licy b e a rin g N o. H S 0 0 1 1 0 5 6 4 4 0 0 0 1 0 0 on 1 7 .1 0 .2 0 0 6 , w h ich p o licy w a s su b je ct to a n n u a l re n e w a l. T h e sa id p o licy w a s d u ly re n e w e d fo r th e p e rio d fro m 1 3 .1 0 .2 0 0 8 to 1 2 .1 0 .2 0 0 9 . U n d e r th e te rm s o f th e p o licy, b o th th e co m p la in a n t a n d h is sp o u se w e re in su red fo r a su m o f ? 1 ,0 0 ,0 0 0 /-. It is a lle g e d th a t a t th e tim