NEW INDIA ASSURANCE COMPANY LIMITED Vs. RAJANI SURI

JUDGEMENT

(1.) ADMITTED facts giving rise to this case are that Mr. Arun Kumar predecessor -in -interest of the respondents had obtained a medi -claim insurance policy from the appellant. He was admitted at Indraprastha Apollo Hospital, New Delhi for some heart problem. Record of the Forum below shows that he has admitted in the said hospital on 5.2.2000 at 11.38 and was discharged on the next day on 6.2.2000 at 9.00 this period is less than 24 hours. He had obtained the Medi -claim insurance policy subject to terms and condition as contained in it. Clause 2.3 of this policy reads as under :

(2.) COMPLAINT was originally filed by Mr. Arun Kumar who died during the pendency of the said complaint, therefore, respondents were substituted in his place. Forum below after hearing parties allowed the complaint and directed the appellant to pay the sum of Rs. 13,590 i.e., the amount of bills sent by the deceased for reimbursement of the appellant along with 6% interst from the date of filing of the complaint (i.e. 28.8.2000), besides Rs. 1,000 as costs.

(3.) AT the time of hearing Mr. Ratish Sharma, learned Counsel for the appellant submitted that the medi -claim policy issued in this case is governed by the terms subject to which risk was covered by his client and according to him this Commission would not either "alter" and/or "read down" anything into the terms and conditions of the policy. Those have to be strictly adhered to. Further according to him in case the deceased wanted to be reimbursed for the money spent on his treatment, unless he was hospitalized for a period of 24 hours, he would not be entitled to any amount. Thus he prayed for allowing this appeal. On the other hand learned Counsel for the respondent submitted that his client had remained admitted for slightly less than 24 hours, therefore, submission made on behalf of the appellant is highly technical. Looking to the beneficial provisions of the Consumer Protection Act, 1986 and deceased having admittedly undergone treatment for which he had furnished the bills, this appeal deserves to be dismissed, otherwise the very purpose of obtaining medi -claim policy would be frustrated Act of 1986 , needs to be liberally construed to achieve the object with which it was enacted. We may notice here that it is not the case of the appellant that the deceased had not undergone the treatment.