JACOB PUNNEN Vs. UNITED INDIA INSURANCE CO. LTD

JUDGEMENT

(1.) The appellants challenge the order of the National Consumer Disputes Redressal Commission ("the NCDRC") (Order dated 11.07.2012 in Revision Petition No.2743 of 2011) which upheld the concurrent rejection of their application seeking relief.

(2.) The undisputed facts are that the appellants contracted with the respondent (hereinafter referred to as "the insurer"), and secured a medical insurance policy (hereinafter referred to as "Mediclaim"), for the first time in 1982. The policy was annual and was renewed successively, each year by the appellants by paying the appropriate premium - the last renewal policy forming the subject matter of the present appeal. The policy renewed by the appellants on 28.03.2007 was in force for a year i.e., till 27.03.2008. Before the date of expiry of the Mediclaim (on 27.03.2008), the insurer sent a reminder to the appellants to renew their policy, if they so wished, annually. The reminder also intimated the appellants that the premium was 17,705/- and had to be paid by 27.03.2008. The appellants paid the requisite amount by cheque (issued on 26.03.2008) and in this regard the receipt was received from the insurer on 30.03.2008. This receipt indicated that the insurance policy period would be operative from 28.03.2008 to 27.03.2009. The monetary coverage of the policy was Rs. 8,00,000/- (Rs. 4,25,000/- for the first appellant and Rs. 3,75,000/- for the second appellant). The second appellant had to undergo angioplasty in June (09.06.2008 to 12.06.2008) at Chennai. The appellants submitted a claim for Rs. 3,82,705.27/- to the insurer, as amounts due under the contract of insurance policy, towards the expenses incurred by them. The insurer, however, accepted the claim and paid the partial amount by releasing Rs. 2,00,000/- to them.

(3.) Feeling aggrieved, the appellants represented to the insurer, repeatedly and unavailingly to the insurer to make good the balance amount. Exhausted, the appellants filed a complaint before the District Consumer Disputes Redressal Forum (hereafter "the District Forum"), Kottayam for a direction that the insurer ought to pay them Rs. 2,07,705/- along with costs and interests on the compensation.