STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
UNION TERRITORY, CHANDIGARH
|
First Appeal No.
|
214 of 2013
|
|
Date of Institution
|
27.05.2013
|
|
Date of Decision
|
16.07.2013
|
National Insurance Company Limited (Through its Divisional Manager), SCO 813, Chandigarh Kalka Road, Manimajra (U.T.). 160 101 now through Mrs.Anju Dhanda, Deputy Manager, National Insurance Company Limited, SCO 337-340, Sector 35-B, Chandigarh.
….…Appellant/Opposite Party No.1.
VERSUS
1. Darshana Behl w/o Sh.M.L.Behl, C/o M/s. Rana Polycot Limited, SCO 49-50, Sector 8-C, Madhya Marg, Chandigarh.
---Respondent/Complainant.
2. M/s Rana Polycot Limited (Through its Managing Director), SCO 49-50, Sector 8-C, Madhya Marg, Chandigarh.
.…..Respondent/Opposite Party No.2.
BEFORE: JUSTICE SHAM SUNDER (RETD.), PRESIDENT
SH.DEV RAJ, MEMBER
Argued by:Sh.Raghujeet Singh Madan, Advocate for the appellant.
Sh.Vaibhav Sharma, Advocate for the respondents.
DEV RAJ, MEMBER
This appeal is directed against the order dated 17.04.2013, rendered by the District Consumer Disputes Redressal Forum-I, UT, Chandigarh (hereinafter to be called as the District Forum only) vide which it allowed the complaint filed by the complainant and directed Opposite Party No.1(now appellant) as under:-
“16] In view of the foregoings, we are of the opinion that the complaint must succeed. The same is accordingly allowed against OP No.1. The OP No.1 is directed to pay the insurance claim of Rs.1,93,511/- to the complainant (Ann.C-5) along with interest @9% p.a. from the date of repudiation i.e. 26.11.2010 (Ann.C-4) till its actual payment. The OP No.1 is also directed to pay litigation cost of Rs.15,000/-.
This order be complied with by OP NO.1 within a period of 30 days from the date of receipt of copy of its copy, failing which it shall be liable to pay the above awarded amount of Rs.1,93,511/- to the complainant along with interest @12% p.a. from the date of repudiation of claim i.e. 26.11.2010 till its actual payment, apart from paying litigation cost of Rs.15,000/-.”
2. In brief, the facts of the case are that Opposite Party No.2 - M/s Rana Polycot Limited took a Group Mediclaim Policy bearing No.420200/46/09/8500000192, in the year 2009 (in fact 2010) (Ann.C-1) from Opposite Party No.1 whereby among others, the complainant and her husband Mr. M. L. Behl were also covered. It was stated that the complainant, in the meanwhile, was also holding an independent policy with Opposite Party No.1, since the year 2006 (Annexure C-2 Colly.). It was further stated that at the time of issuance of policies (Annexures C-1 & C-2), the complainant was not suffering from any pre-existing disease, as defined, in the terms thereof. However, in October, 2010, on account of her advanced age of more than 60 years, there was a sudden onset of arthritis in her knees, which required knee replacement surgery. It was further stated that as the complainant had been holding an independent cashless insuranc
Back
