C.S.PURI vs National Insurance Company Limited

THE present appeal, filed by the appellant, under Section 15 of the Consumer Protection Act, 1986 (hereinafter referred to as ''the Act''), is directed against order dated 27th January, 2003, passed by District Forum-II, Udyog Sadan, Institutional Area, Mehrauli, New Delhi, in Complaint Case No. 2284/2000 - entitled Shri C.S. Puri v. THE National Insurance Company Limited.

THE facts, relevant for the disposal of the present appeal, briefly stated, are that the appellant Shri C.S. Puri had filed a complaint under Section 12 of the Act before the District Forum, averring therein that the appellant was earlier working with Good Year India Limited as Chief Personnel Manager, stationed at New Delhi and was insured under the Group Medical Insurance Scheme since 1970. It was stated that the appellant retired from the service of Good Year India Limited in the Year 1987 but the medical insurance policy continued to cover the appellant till 30th September, 1999 when he attained the age of 70 years. It was stated that in the year 1992 the appellant got Mediclaim Policy from Jhandewalan Office of the respondent in addition to the above mentioned Group Medical Insurance. It was stated that w.e.f 31st March, 1997 the appellant took the Mediclaim Policy in question from Yusaf Sarai Branch of the respondent as the appellant was living at Aurobindo Marg, New Delhi. That policy, as per the case of the appellant, was valid till 30th March, 1998. It was stated that on 18th January, 1998 the appellant was hit by a speeding scooter at Hauz Khas, as a result of which the neck of femur of his left leg got fractured and he was taken to Ashlok Hospital by his wife. It was stated that at Ashlok Hospital after X-ray of the injured area, operation was suggested to set right the fracture but as C-Arm Operation Facilities were not available at Ashlok Hospital, the appellant was operated upon at Othonowa Hospital, Madangir, New Delhi on 19th January, 1998 and after operation was again shifted back to Ashlok Hospital on the same day for post operative care wherefrom he was discharged on 23rd January, 1998. It was stated that the appellant in all had paid a sum of Rs. 1,05,706/- to Ashlok Hospital for treatment vide receipts dated 19th January, 1998 and 23rd January, 1998. It was stated that the appellant preferred his claim with respondent on 2nd February, 1998 and the Surveyor appointed by the the respondent visited the appellant at his residence on 5th February, 1998 and thereafter on 7th February, 1998. THE appellant handed over all the reports and papers to that Surveyor of the respondent when the Surveyor visited the appellant of his residence. It was stated that the appellant thereafter raised a further claim of Rs. 22,022/- on 6th May, 1998 on account of expenses incurred on post-hospitalisation recovery. It was further stated that the claim of the appellant was repudiated by the respondent vide letter dated 18th November, 1998. THE grievance of the appellant, in the complaint filed by him before the District Forum, in nutshell, was that the repudiation of his claim by the respondent was unjustified which amounted to deficiency in service. It was prayed by him that a direction be issued to the respondent to pay a sum of Rs. 1,31,166/- towards his claim and another sum of Rs. 2,50,000/- towards damages plus interest @ 18% per annum. The claim of the appellant in the District Forum was resisted by the respondent and in the reply/written version, filed on behalf of the respondent, it was stated that the respondent on the basis of the report of the Surveyor suspected the factum of accident on the ground that No FIR was lodged by the complainant and also on the basis of discrepancies in the bills issued by the hospitals. It was stated that as per the report of Dr. L.C. Gupta the fracture was at least six months old and could not have been happend on 18th January, 1998, as claimed by the appellant.

The learned District Forum vide impugned order has held the respondent guilty of deficiency in service and on the basis of the above finding has directed the respondent to pay a sum of Rs. 1,31,166/- with interest @ 10% per annum from 1st May 1998 till payment. The learned District Forum has also awarded cost of litigation amounting to Rs. 5,000/- to be paid to the appellant by the respondent.

NOT feeling satisfied with the relief granted by the District Forum, the appellant has preferred the present appeal under Section 15 of the Act. We have heard the learned Counsel for the appellant at length on the question of admission of the present appeal and have also carefully gone through the documents/material on record. During the course of arguments, one of the contentions which has been advanced by the learned Counsel for the appellant before us is that though the appellant had claimed compensation/damages of Rs. 2,50,000/- but the learned District Forum vide impugned order has not awarded any compensation/damages. The second contention advanced is that the cost of litigation awarded by the District Forum is also inadequate. Insofar as the first contention, advanced by the learned Counsel for the appellant regarding the grant of compensation is concerned, the position is that the same is devoid of substance because the learned District Forum, as already stated, has awarded interest on the amount due and payable to the appellant. Double benefit of interest and compensation cannot be awarded to a consumer by a Redressal agency, established under the Act. In our above views, we stand fortified by a decision of the Hon''ble National Commission, in case Laxmi Vilas Bank Ltd. & Anr. v. P.R. Krishnan & Anr., reported as I (1995) CPJ 43 (NC)=1986-96 Consumer 3234 (NS). In the above said decision the Hon''ble National Commission has held : "In our opinion all that the complainants were entitled to was to be compensated for the loss sustained by them by reason of the failure on the part of the bank to pay the amount due under the fixed deposit on the date when it matured for payment. This could be done either by awarding them interest in lieu of damages or by awarding a lumpsum compensation based on the evidence, if any, adduced by the complainants regarding the actual loss sustained by them. The conferment of a double benefit by awarding both interest as well as lumpsum compensation in our opinion is not justified in law." (Emphasis supplied)

THE above decision of the Hon''ble National Commission clinches the issue finally and placing reliance on the above decision of the Apex Commission, we have no hesitation in holding that the above contention, being advanced by the learned Counsel for the appellant, is devoid of merit and is therefore rejected summarily. As regards the second contention advanced by the learned Counsel for the appellant that the cost of litigation awarded by the District Forum is inadequate, the same is also devoid of merit because the learned Counsel for the appellant failed to satisfy us as to how the amount of Rs. 5,000/- awarded as cost of litigation can be treated or termed as inadequate in the given facts. No other point has been urged or pressed before us. In view of the above discussion, the above mentioned appeal, filed by the appellant, is devoid of substance. THE same merits dismissal, Accordingly, the same is dismissed in limine, with no order as to costs. Appeal dismissed.