Uttar Pradesh

Aligarh

CC/52/2020

BIJENDRASINGH - Complainant(s)

Versus

DIVISIONAL MANAGER UNITED INDIA INSURANCE CO LTD - Opp.Party(s)

15 Apr 2023

ORDER

न्यायालय जिला उपभोक्ता विवाद प्रतितोष आयोग अलीगढ

Complaint Case No. CC/52/2020 ( Date of Filing : 15 Sep 2020 )   1. BIJENDRASINGH R/O RAM PYARI HOSPITAL SOOTMIL CHAURAHA GT ROAD ALIGARH ...........Complainant(s) Versus 1. DIVISIONAL MANAGER UNITED INDIA INSURENCE CO LTD 60/4 FCI BUILDING SANJAY PALACE AGRA 2. UNITED INDIA INSURENCE COMPANY LTD DM OFFICE083000 KUBER ABODE HIG 96 B SWRAN JAYANTINAGAR RAMGHAT ROAD ALIGARH 202001 ............Opp.Party(s)

BEFORE:     HON'BLE MR. HASNAIN QURESHI PRESIDENT   HON'BLE MR. ALOK UPADHYAYA MEMBER

PRESENT:

Dated : 15 Apr 2023

Final Order / Judgement The present complaint has been filed by the complainant before this commission for  the following reliefs- The Op be directed to pay reimburse medical expenses Rs. 24654/ with interest. The Complainant was the account holder of saving bank account in Syndicate Bank AMU Branch, Aligarh. The scheme of Syndicate Bank through United India Insurance Company for customer of the Bank for getting themselves insured of mediclaim the complainant applied for mediclaim policy and subscription was paid through account of the complainant. Medi-claim policy no. 0830002816 P 110956142 was issued by the insurance company which was valid from 20.11.2016 to 19.11.2017. Complainant became the patient of Cataract which required operation. Complainant was admitted in Gandhi Eye Hospital, Aligarh on 31.10.2017 where he was operated upon for Cataract and was discharged on 1.11.2017.Complainant had incurred Rs.24645/ in operation and other expenses and claim the about of Rs. 24645/ for reimbursement.  Op insurance company stated in the WS that the complainant had not provided all the documents necessary for settlement of claim. However op no.2 had permitted the amount Rs. 24664/ subject to the terms and conditions of the policy which could not be released on account of pendency of case.  Complainant has filed his affidavit and papers in support of his pleadings. Ops have also filed affidavit in support of their pleadings. We have perused the material available on record and heard the parties counsel. The first question of consideration before us is whether the complainant is entitled for reimbursement? Admittedly, the Op no.2 an authority of the insurance company has permitted the grant of Rs.24664/ subject to the terms and condition of the policy. Insurance Company has stated the delay in releasing the money. The delay is pendency of the case and now case stands decided and the amount be released. The question formulated above is decided accordingly in favour of the complainat. We hereby direct to Op insurance company  to reimburse  the complainant  for Rs. 24664/ with pendente- lite and future interest at the rate 9% per annum. Op shall comply with the direction within a month failing which OPs shall be prosecuted for non-compliance in accordance with section 72 of the Act for awarding punishment against him. A copy of this judgment be provided to all the parties as per rule as mandated by Consumer Protection Act, 2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties. File be consigned to record room along with a copy of this judgment.

[HON'BLE MR. HASNAIN QURESHI] PRESIDENT     [HON'BLE MR. ALOK UPADHYAYA] MEMBER