National Insurance Co. Ltd vs Shaik Khadar Dada

The present Revision Petition has been filed against the order 09.02.2017 passed by the Telangana State Consumer Disputes Redressal Commission, Hyderabad (hereinafter referred to as "the State Commission"). Whereby the Appeal No. 104 of 2015 preferred by the Petitioner herein has been dismissed and the Appeal No. 89 of 2016 preferred by the Complainant/ Respondent is allowed in part. The order of the District Consumer Disputes Redressal Forum-III, Hyderabad (in short "the District Forum") has been modified and the State Commission has directed the Petitioner herein to pay to the Complainant a sum of 33,102/- towards medical claim along with interest @ 12% p.a. from the date of claim till the date of realization and further to pay a compensation of 1,00,000/-with cost of 5,000/-.

We have heard Mr. V. Sambasiva Rao, learned Counsel appearing for the Petitioner and Mr. Shaik Khader Auulia, the Complainant who has appeared in person. We have perused the impugned order passed by the State Commission. The learned Counsel for the Petitioner submitted that the State Commission was not justified in directing the Petitioner to pay a sum of 33,102/- towards medical claim with interest @ 12 % p.a. as also the compensation of 1,00,000/-and costs of 5,000/-, for the simple reason that the full documents were not submitted by the Complainant while making the claim or reimbursement of medical expenses to the tune of 33,102/-.

A perusal of the order of the District Forum, we find that the Complainant had submitted the bills for claiming the amount of medical expenses incurred, however, certain supporting documents were not filed. It may mention here that the Complainant/ Respondent was an employee of the Petitioner Company and after retirement he had taken Medical Insurance Policy and submitted bills for reimbursement. The bills submitted by the Complainant was sufficient proof of the treatment having been undertaken and the expenses incurred and therefore the Petitioner herein ought to have reimbursed the amount of 33,102/- as claimed by the Complainant/ Respondent. Therefore, we are of the considered opinion that the State Commission has rightly directed the Petitioner to pay a sum of 33,102/- along with interest @ 12% p.a. from the date of claim till the date of realization. However, as the interest has been awarded by the State Commission, there is no question of awarding any further compensation. The order for payment of compensation of 1,00,000/- is therefore deleted.

From a perusal of the order dated 30.06.2017, we find that interim order was granted to the Petitioner on deposit of 1,00,000/- before the District Forum. This amount of 1,00,000/- deposited by the Petitioner before the District Forum along with accrued interest , if any, shall be paid over to the Complainant/ Respondent herein in full and final satisfaction of the entire claim and no further amounts to be paid by the Petitioner.

In the result, this Revision Petition is disposed of with the aforenoted directions.