KRANTI P JAIN Vs. NATIONAL INSURANCE COMPANY LTD

JUDGEMENT

(1.) This Revision Petition No.590 of 2013 challenges the impugned order of the State Commission Disputes Redressal Commission, Haryana, Panchkula in F.A. No.106 of 2009. Vide this order, the State Commission had set aside the order of the District Forum in C.C. No.283 of 2004.

(2.) Briefly, the facts of the case per available record are that the petitioner/complainant (complainant hereafter) had taken a Videsh Yatra Mitra Policy (Overseas Medical Policy) bearing No.48602 from the opposite party No.1 for the period 03.02.2000 to 02.02.2001. While abroad, he felt chest pain and was admitted in Cleveland clinic Foundation, U.S.A. w.e.f. 07.02.2000 to 15.2.2000 where he was operated for coronary artery bypass. According to the complainant, he spent, in all, at USA and London, the equivalent of Rs.21,28,009.50. He submitted his claim with the respondent-opposite party No.1 through opposite party No.2. However, this claim was not settled. So, he filed a consumer complaint before the District Consumer Forum seeking direction to the OPs to pay Rs.20 lakh towards the expenses incurred on his treatment besides damages and compensation on account mental agony and harassment as well as legal expenses. Respondent/OP 1-National Insurance Co. Ltd. (OP1 hereafter) contested the complaint before the District Forum.

(3.) The District Forum, after hearing arguments, allowed the complaint vide order dated 24.6.2008, directing OP-1 as under: