(1.) THIS appeal has been directed by opposite parties 1 and 2 i. e. United India Insurance Company against order dated 27. 11. 2007 passed by Consumer Disputes Redressal Forum-II, U. T. Chandigarh (hereinafter to be referred as District Consumer Forum), vide which complaint of respondent No. 1 Mr. Rajesh Bassi was accepted with cots of Rs. 3,000 and appellant as well as M/s. Paramount Health Services Pvt. Ltd. respondent No. 2 were directed to pay Rs. 3,47,498 along with interest @ 9% p. a. from the date of repudiation of the claim i. e. 20. 3. 2005 till the date of payment and further to pay Rs. 1,500 as compensation for harassment and mental agony.
(2.) BRIEFLY stated the facts are that Shri Rajesh Bassirespondent No. 1 (complainant) had taken medical policies Annexures C-1 to C-5 starting from 7. 3. 2000 till 5. 3. 2005 on yearly basis. The last policy Annexure C-5 was for the period 6. 3. 2004 to 5. 3. 2005 for a sum of Rs. 4 lakh with bonus of Rs. 50,000. It was further renewed for the period 6. 3. 2005 to 5. 3. 2006 for a sum of Rs. 5 lacs with a bonus of Rs. 1. 25 lacs.
(3.) IT was next averred that respondent (complainant) felt uneasiness in Feb. 2005 and he consulted his regular medical consultant who after preliminary investigation found him to be suffering from diabetes mellitus and hypertension and further suspected him to be a case of some heart problem and advised him to consult the cardiologist. Accordingly he consulted cardiologist in Fortis Hospital, Mohali where he remained admitted from 14. 2. 2005 to 17. 2. 2005 and underwent coronary angiography and angioplasty. As per advice of hospital doctors, he again remained admitted in Fortis Hospital on 9. 3. 2005 and for further follow-up and treatment he again remained admitted in Escorts Heart Institute and Research Centre from 18. 3. 2005 to 20. 3. 2005. During this period further coronary angiography and angioplasty were done and then he was again admitted in Escorts Hospital on 22. 4. 2005.