ORIENTAL INSURANCE CO. LTD Vs. VIKRANT TEWARI

JUDGEMENT

(1.) These Revision Petitions bearing Nos. 2151 of 2017 and 2152 of 2017 have been filed by the Petitioner/ Oriental Insurance Co. Ltd. against the Respondents/Complainants challenging the separate impugned Orders dtd. 27/2/2017 passed by the State Consumer Disputes Redressal Commission, Lucknow, Uttar Pradesh, in Appeals bearing Nos. 2882 of 2016 and 2883 of 2016. Vide such Orders, the State Commission had dismissed both the Appeals while upholding the common Order dtd. 22/8/2016 passed in CC/291/2008 and CC/386/2012 and common Order dtd. 22/8/2016 passed in CC/292/2008 and CC/385/2012 respectively by the District Consumer Disputes Redressal Forum, Kanpur.

(2.) The said Petitions are being decided by this common Order as both the Petitions have been preferred by the same the Opposite Party/Oriental Insurance Co. Ltd.; and involve the same questions of law with only minor variations on facts like policy nos., amounts, etc. Therefore, for the sake of brevity, RP/2151/2017 is being treated as the lead case, and the facts have been taken therefrom.

(3.) The brief facts of the case are that the Complainant No.1 had filed a Consumer Complaint bearing No. 291/2008 stating that he had taken an Insurance Policy from the Opposite Party which was regularly renewed and his wife was also insured under the said Policy who had raised a claim for Knee replacement vide policy No. 1168. Since, the claim was found genuine, the amount spent was reimbursed by theOpposite Parties. However, the said disease was excluded in the new Policy and 100% loading was done on the Complainant's Policy which was liable to be refunded. The amount paid in excess as loading charges was Rs.42,027.00. Further, the Opposite Party No.1 returned the cheque which was tendered by the Complainant for payment of premium for renewal of the Policy. Thus, it was contended that the Opposite Party No.1 failed to renew the Policy and deprived the Complainant of the benefit of the Mediclaim policy due the Complainant's claim of Knee replacement and, on the pretext that the claim ratio had gone high. Refusal to renew was illegal. Therefore, the Complaint was filed before the Ld. District Forum seeking renewal of the Policy for a further period of one year.