C.W.P. No. 20825 of 2010

1

IN THE HIGH COURT OF PUNJAB AND HARYANA

AT CHANDIGARH

C.W.P. No. 20825 of 2010

Date of Decision : 04.01.2012

Reliance General Insurance Company Limited

........Petitioner

Versus

Vijay Kumar & another

........Respondents

******

CORAM: HON'BLE MR. JUSTICE ALOK SINGH

-.-

1. Whether Reporters of local newspapers may be allowed to see judgment?

2. To be referred to the Reporters or not ?

3. Whether the judgment should be reported in the Digest?

Present: Mr. P.M. Goyal, Advocate,

for the petitioner.

Mr. S.K. Bawa, Advocate,

for respondent No.1

***

Alok Singh, J. (Oral)

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

C.W.P. No. 20825 of 2010

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from the Insurance company `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 `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 `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

C.W.P. No. 20825 of 2010

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26.11.2009 to 30.11.2009. He has spent `24,509/- on his treatment

as is clear from the copy of the bill produced.

5.

So we direct the respondent to pay a sum of `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 re