NEW INDIA ASSURANCE COMPANY LIMITED Vs. SAROJ SIAN

JUDGEMENT

(1.) This appeal has been directed by opposite party-New India Assurance Company Ltd. against order dated 26.2.2007 passed by Consumer Disputes Redressal Forum-II, U. T. Chandigarh (hereinafter to be referred as District Consumer Forum), vide which the complaint of respondent No.1 Smt. Saroj Sian (complainant) was accepted and the New India Assurance Company Ltd. was directed to pay Rs.67,846 along with interest @ 9% p. a. from the date of repudiation of claim i. e.25.10.2005 till payment and further to pay Rs.10,000 as compensation on account of damages for harassment besides Rs.2,500 as litigation expenses. The order was directed to be complied with by the insurance company within two months from the date of receipt of its copy.

(2.) Briefly stated the facts are that Smt. Saroj Sian, complainant (respondent No.1) along with Balwinder Singh took joint medi-claim policy from New India Assurance Company Ltd. bearing No.350102/48/02/00382 dated 31.3.2003, Annexure C-1 for the period 31.3.2003 to 30.3.2004 for a sum of Rs. one lac each and premium of Rs.3,274 was paid. At the time of taking insurance policy, she was not suffering from any kind of disease. Earlier also in the years 2000-01 and 2001-02, she had taken medical insurance policies Annexure C-2 from the New India Assurance Company Limited on payment of premium.

(3.) It was next averred that on or about 3.2.2004, she went to Fortis Heart and Multi Specialty Hospital ( OP No.5 in the complaint) as she was having some pain in the lower abdomen and there she was examined by Dr. Rashmi Garg, Gynaecologist, who after medical checkup advised her to undergo surgery for the removal of uterus. Accordingly she was admitted in the hospital on 6.2.2004 where some medical tests were conducted and she was discharged on 8.2.2004 and at the time of discharge from the hospital, she had paid a sum of Rs.14,177 to the hospital for medical investigation and tests which are Annexure C-3.