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Judgment
Dr. Inder Jit Singh, Presiding Member
The present Revision Petition (RP) has been filed by the Petitioner against Respondent as detailed above, under section 21 (b) of Consumer Protection Act 2019, against the order dated 26.08.2020 of the State Consumer Disputes Redressal Commission Odisha (hereinafter referred to as the ‘State Commission’), in First Appeal (FA) No. 27 of 2016 in which order dated 21.12.2015 of Khurda District Consumer Disputes Redressal Forum (hereinafter referred to as District Forum) in Consumer Complaint (CC) no. 04 of 2014 was challenged, inter alia praying for enhancement of compensation payable by the respondent by awarding suitable interest on the amount of Rs.7,65,606/- and also award compensation for harassment and litigation expenses.
While the Revision Petitioner (hereinafter also referred to as Complainant) was Appellant and the Respondent(s) (hereinafter also referred to as OPs were Respondent(s) in the said FA No. 27 of 2016 before the State Commission, the Revision Petitioner was Complainant and Respondent(s) was OP(s) before the District Forum in the CC no. 04 of 2014.
Notice was issued to the Respondent(s) on 23.04.2021. Parties filed Written Arguments/Synopsis on 03.02.2023 ( Petitioner) and 17.10.2023( Respondent) respectively.
Brief facts of the case, as emerged from the RP, Order of the State Commission, Order of the District Forum and other case records are that Complainant purchased a policy under the name and style ‘Star Travel Protect Insurance Policy” from OP(s) on payment of premium of premium of Rs.4961/- to secure himself against the risk of sudden and unexpected sickness/illness or accident on his foreign trip to USA from 28.08.2013 to 09.10.2013 along with his wife. The Complainant made trip to Houston (USA) where he fell ill suddenly on 22.09.2013 and was treated at St. Michael’s Emergency Room, 16062, Southwest Freeway, Sugar Land, TX 7747. The Complainant had to shell out huge sum of money amounting to USD12,307.82 ( equivalent to Rs.7,65,606/-). The Complainant submitted the claim for reimbursement of the said amount but OP(s) repudiated the claim on the ground that complainant has got past history of diabetes mellitus and hypertension but did not disclose the same in the proposal form. Being aggrieved, the Complainant filed CC before the District Forum and District Forum vide order dated 21.12.2015 dismissed the complaint. Being aggrieved, the Complainant preferred an Appeal before the State Commission and State Commission vide order dated 26.08.2020 allowed the Appeal of the Complainant. The Complainant is before this Commission now in the present RP.
Petitioner has challenged the said Order dated 26.08.2020 of the State Commission mainly on following grounds:
i. The impugned order failed to appreciate that as per the Insurance Regulatory and Development Authority of India ( Protection of Policy Holders Interest) Regulation 2017, so far it applies to health insurance policy, the petitioner is entitled interest on the claimed amount of Rs.7,65,607/- from the submission of claim till actual date of payment of that claim.
ii. The State Commission has wrongly assessed the mental agony and harassment amount at Rs.50,000/- without considering the fact that policy provides for cashless treatment in the network hospital as the respondent did not make the payment and the petitioner has to arrange money while in USA for clearing the hospital bill and suffered huge mental agony and harassment. Even the cost of litigation awarded at Rs.5000/- is very less in comparison to the actual expenses made by the complainant for seven years.
iii. Counsel relied on the following judgment of the Hon’ble Supreme Court / National Commission on the issue of award of compensation and awarding interest in case of delayed settlement :
a. Secretary, Irrigation Department, Govt. of Orissa Vs. G.C.Roy ( 1992) 1 SCC 508
b. Kaushnuma Begum Vs. New India Assurance Co. Ltd. ( 2001) 2 SCC 9.
c. Sri Venkateswar Syndicate Vs. Oriental Insurance Co. Ltd. & Anr. ( 2009) 8 SCC 507
d. Mala Sahni Seth Vs. New India Assurance Co. Ltd. CC No. 971 of 2018.
e. Madan Lal Gupta Vs. Divisional Manager, National Insurance Company – FA No. 260 of 2011
f. Sri Ram Krishna Khandelwal Vs. Divisional Manager, National Insurance Co- FA No. 261 of 2011.
Heard counsels of both sides. Contentions/pleas of the parties, on various issues raised in the RP, Written Arguments, and Oral Arguments advanced during the hearing, are summed up below.
6.1 Counsel for the Petitioner repeated the points which are stated in para 5, grounds for challenging the order of the State Commission, hence the same are not being repeated here.
6.2. Counsel for the Respondent(s) argued that Petitioner’s claim as considered and awarded by the State Commission has already been paid by the respondent. State Commission has not found it a fit case to order interest on the awarded amount for the period the dispute was under consideration by the Forum below except that high sum of Rs.50,000/- was awarded as compensation for mental agony and harassment. Counsel further argued that as per several decisions of this Commission, the amount of compensation awarded takes care of interest part. It is further argued that there is no provision of grant of interest in Consumer Protection Act, 1986 and interest is granted in the form of compensation. It can be inferred that when a Court does not go into the question of awarding any interest pendent-lite, it would ipso facto means that no interest was awardable in the circumstances of the given case. Counsel further argued that if at all, any interest is found payable, it would have to be at very reasonable rate i.e. 6% p.a. being provided by the Reserve Bank of India.
We have carefully gone through the orders of State Commission, other relevant records and rival contentions of the parties. Keeping in view the entirety of facts and circumstances of the case, considering that claim of Complainant has been admitted by the State Commission and findings of State Commission have not been challenged by the Respondent herein, we are of the considered view that Complainant is entitled to a reasonable amount of interest on the claim amount. Accordingly, we award interest @ 9% on Rs.7,65,607/- w.e.f. one month from the date of submission of claim, till the date of payment of this amount, in addition to the compensation amount of Rs.50,000/- and litigation cost of Rs.5000/ as awarded by the State Commission. All amounts payable as per this order, read with order of the State Commission, minus the amount(s) already paid, if any, shall be paid by the Respondent herein to Petitioner herein within 30 days, failing which, it shall carry interest @ 12% p.a. Revision Petition is disposed off accordingly.
The pending IAs in the case, if any, also stand disposed off.