SC/5/A/263/2019 The New India Assurance Company Limited 06.10.2025 Sh. Rajendra Kumar STATE CONSUMER DISPUTES REDRESSAL COMMISSION UTTARAKHAND DEHRADUN Date of Admission: 04.07.2019 Date of Final Hearing: 26.09.2025 Date of Pronouncement: 06.10.2025 SC/5/A/256/2019 Sh. Rajendra Kumar aged about 64 years’ S/o Sh. Vinod Prakash Singh R/o Ashirwad Green View Enclave, Near Jwalapur Inter College Jwalapur, Tehsil and District Haridwar (Through: Sh. Vikrant Gambhir, Advocate)

…… Appellant Versus The New India Assurance Company Limited through Branch Manager, Branch at Ranipur More Haridwar (Through: Smt. Anjali Gusain, Advocate)

…… Respondent AND Date of Admission: 29.07.2019 Date of Final Hearing: 26.09.2025 Date of Pronouncement: 06.10.2025 SC/5/A/263/2019 The New India Assurance Company Limited Niranjanpur, Saharanpur Road, Dehradun through its Regional Manager (Through: Smt. Anjali Gusain, Advocate)

…… Appellant Versus Sh. Rajendra Kumar S/o Sh. Vinod Prakash Singh R/o Ashirwad Green View Enclave, Near Jwalapur Inter College Jwalapur, Tehsil and District Haridwar (Through: Sh. Vikrant Gambhir, Advocate)

…… Respondent SC/5/A/263/2019 The New India Assurance Company Limited 06.10.2025 Sh. Rajendra Kumar Coram:

Ms. Kumkum Rani, President Mr. B.S. Manral, Member

ORDER

(Per: Ms. Kumkum Rani, President):

Both these appeals under Section 15 of the Consumer Protection Act, 1986 have been directed against the impugned judgment and order dated 30.05.2019 passed by learned District Consumer Disputes Redressal Forum, Haridwar (hereinafter to be referred as “The District Commission”) in consumer complaint No. 291 of 2017, styled as Sh. Rajendra Kumar Vs. The New India Assurance Company Limited, wherein and whereby the consumer complaint was allowed and the opposite party – insurance company was directed to pay an amount of Rs. 3,02,472/- to the complainant towards the amount spent in his treatment together with interest @6% p.a. from the date of filing of the consumer complaint till payment and Rs. 10,000/- towards litigation expenses. Since both the above-mentioned appeals have arisen out of the same judgment and order, hence both are decided together by this common judgment.

2. The brief facts of the case are as such that the complainant – Sh. Rajendra Kumar had obtained a mediclaim policy bearing No. 34090034132500000128 from the opposite party – The New India Assurance Company Limited for insured sum of Rs. 3,00,000/-, carrying validity for the period from 15.01.2014 to 14.01.2015, upon payment of annual premium of Rs. 14,944/-. The area of coverage under the said policy was all India excluding Greater Mumbai. Before expiry of coverage period of the aforesaid policy, the complainant got SC/5/A/263/2019 The New India Assurance Company Limited 06.10.2025 Sh. Rajendra Kumar the policy renewed for the period from 12.01.2015 to 11.01.2016 under New India Floater Mediclaim Policy and the same (New India Floater Mediclaim Policy) was further renewed for the period from 12.01.2016 to 11.01.2017 and from 18.01.2017 to 17.01.2018. In April, 1998, the complainant faced heart problem, in regard to which, he got himself treated at Fortis Escorts Heart Institute, New Delhi, where stent was implanted in heart vessels, whereafter the complainant got well and obtained the mediclaim policy in the year 2014. On 26.12.2016, the complainant felt chest tightness and suffocation and got himself checked at Ramakrishna Mission Sevashrama, Kankhal, Haridwar, where the doctors referred the complainant to higher centre. The insurance company was informed by the complainant on 27.12.2016 that he will have to go to New Delhi for treatment, whereupon the officials of the insurance company told him to get himself admitted in Fortis Escorts Heart Institute, New Delhi, as the said medical institute is on the panel of the insurance company and the complainant does not have to incur any expenditure. The complainant got himself admitted in Fortis Escorts Heart Institute, New Delhi