NEW INDIA ASSURANCE CO LTD Vs. BALAJI HOSPITAL

JUDGEMENT

(1.) The complainant/respondent obtained an Electronic Equipment Insurance Policy from the appellant for the period from 7.7.2012 to 6.7.2013. During the subsistence of the aforesaid policy, the Cardiac Cathlab Machine which was covered under the said policy stopped functioning. On inspection by the service engineer, it was revealed that the X-ray tube of the said Cardiac Cathlab Machine had failed and required replacement. On intimation being given to the appellant, a surveyor was appointed to inspect the machine. The surveyor vide his report dated 6.10.2012, interalia reported that since the damaged tube was more than 60 months old and more than 40,000 exposures, the claim could not be indemnified in accordance with the terms and conditions of TAC Circular dated 13.6.2001. Upon receipt of the report of the surveyor, the claim was repudiated by the appellant vide its letter dated 7.12.2012 which to the extent, it is relevant reads as under:-

(2.) Being aggrieved from the repudiation of the claim, the respondent approached the concerned State Commission by way of a consumer complaint. The complaint was resisted by the appellant primarily on the ground on which the claim had been repudiated.

(3.) The State Commission, vide impugned order dated 5.12.2017, allowed the complaint and directed the appellant to pay a sum of Rs.4145499/- to the respondent along with interest @ 9% p.a. and compensation quantified at Rs.5 lakhs besides the cost of litigation quantified at Rs.10000/-. Being aggrieved from the order passed by the State Commission, the appellant is before this Commission by way of this appeal.