NEW INDIA ASSURANCE COMPANY LTD. REGIONAL OFFICE Vs. REKHA MALHOTRA & ORS. WD/O PAPPU MALHOTRA, R/O 153 GOLDEN AVENUE, REHON ROAD, LUDHIANA PUNJAB

JUDGEMENT

(1.) Challenge in this Revision Petition by New India Assurance Co. Ltd. (for short "the Insurance Company ") is to the order dated 28.11.2014, passed by the State Consumer Disputes Redressal Commission, Punjab at Chandigarh (for short "the State Commission ") in First Appeal No.1636/2012. By the impugned order, while over-turning the order dated 23.10.2012, passed by the District Consumer Disputes Redressal Forum, Ludhiana (for short "the District Forum ") in CC No.113 of 13.2.2012, whereby the Complaint was dismissed, the State Commission has allowed the Complaint with a direction to the Insurance Company to pay to the Complainants a sum of Rs. 4,19,325.00 along with compensation of Rs. 10,000.00 and litigation expenses quantified at Rs. 5,000.00, with a default stipulation that in case the order is not complied with within 45 days, the Complainant shall be entitled to interest at the rate of 9% p.a. from the date of its order till actual payment.

(2.) Briefly stated, the facts necessary for appreciating the controversy involved are : that the husband of Complainant No.1 and father of Complainants No.2 and 3, obtained a hospitalization and domiciliary hospitalization benefit policy called "Family floater Mediclaim Policy, from the Insurance Company for himself and his wife. The premium amounting to Rs. 27,716/- was paid. The policy issued on 10.6.2010 was valid for the period from 10.6.2010 to 9.6.2011.

(3.) During the tenure of the policy, the insured was admitted in the hospital from 7.7.2010 to 12.7.2010 with the Complaint of fever, cough associated with chills. He was diagnosed to be a patient of Pneumonia (lungs infection) as well as fibrocavtay disease - ABPA, systemic HT, DM-2, Acute and chronic renal failure and certain other serious complications. On 30.7.2010, the insured was shifted to another hospital, where he breathed his last on 31.7.2010.