UNITED INDIA INSURANCE CO.LTD Vs. HAMSA

JUDGEMENT

(1.) Appellant is the opposite party and respondent is the complainant in CC.131/09 on the file of CDRF, Palakkad. The complaint therein was filed alleging deficiency in service on the part of the opposite party United India Insurance Company Ltd; in repudiating the insurance claim for Rs.17373/ - under the Universal Health Insurance Policy. The opposite party entered appearance and filed written version denying the alleged deficiency in service. The Insurance Company justified their action in repudiating the insurance claim. It was contended that the disease for which the insurance claim is preferred was a pre -existing disease and that the same is not covered by the insurance policy. Thus, the opposite party/Insurance Company prayed for dismissal of the complaint.

(2.) Before the Forum below, the complainant filed proof affidavit. Exts.A1 to A6 were marked on his side. Though the opposite party filed proof affidavit and the 2 documents, he was not ready for submitting himself for cross -examination. The complainant filed an interlocutory application seeking permission to cross examine the opposite party. The Forum below allowed the said petition for cross examination of the opposite party. But, the opposite party failed to appear before the Forum below for cross -examination. Hence, the documents and the affidavit filed by the opposite party were not accepted by the Forum below. On an appreciation of the evidence on record, the Forum below passed the impugned order dated 17.7.10 allowing the complaint and directing the opposite party/Insurance company to pay the insurance claim for Rs.17,373/ - with interest at the rate of 12% per annum from the date of repudiation till the date of the impugned order and cost of Rs.2,000/ -. The opposite party is directed to pay the decreed amount within one month from the date of receipt of the impugned order, failing which the opposite party is directed to pay interest on the whole amount at the rate of 9% per annum from the date of the order till realization. Hence the present appeal.

(3.) We heard both sides.