- (1.) THESE appeals under Section 15 of the Consumer Protection Act, 1986, arise out of the order dated 24.7.2002, passed in Complaint No. 106/2002 by the District Consumer Disputes Redressal Forum, Raipur (hereinafter referred to as the 'Distt. Forum' for short) whereby the complaint was allowed and the opposite parties were held jointly and severally liable for deficiency in service. As both the appeals arise out of the same order they are being disposed of by this common order.
(2.) THE facts not presently in dispute are that the complainant/respondent No. 1 in both the appeals had obtained Mediclaim Policy bearing No. 1170/2000 from the opposite party Nos. 1 and 2 for the period from 29.12.2000 to 28.12.2001. During the coverage period on 13.12.2000 the complainant suffered chest pain at Nagpur and the complainant had informed the insurer by phonogram.
(3.) AS per the averments made in the complaint the complainant was examined by Dr. S.G. Vashisth on 14.12.2001 and was admitted to the Spandan Hospital on the following day and after detailed investigations was diagnosed to be suferring from "tripple vessel disease". The expenditure for various tests on 15.12.2001 came to be Rs. 15,145 and the complainant had filed the claim for the aforesaid sum on 7.2.2002. The doctors were of the opinion that the complainant will have to undergo surgery for his heart problem. As the validity period of the Mediclaim Policy was to lapse in December, 2001, the complainant got the same renewed for a period of one year from the opposite party No. 3 (a new agent) as the earlier agent had expired. It is further averred that the complainant had informed the agent that he is sufering from heart problem and the doctors have advised surgery within a month or so. It is further averred that the agent advised the complainant to get the amount of policy doubled so that all the expenditure incurred in treatment could be covered. Thereupon the complainant paid the requisite amount of premium for Rs. 2,00,000 on 25.12.2001 thereupon renewed policy was issued bearing Mediclaim Policy No. 1295/2002. As per the averments the complainant had informed the opposite party No. 2 on 19.2.2000 i.e., before surgery and on 22.2.2002 i.e., on the date of surgery, by telegram and on 27.1.2002 the brother of the complainant had personally informed the opposite party No. 2, in writing, regarding treatment of the complainant. Vide letter dated 29.1.2002 the opposite party No. 1 had intimated cancellation of the renewed Mediclaim Policy dated 26.12.2001 and returned the amount of premium by means of cheque for a sum of Rs. 4,196. The aforesaid cancellation was without the stipulated notice. Hence the complainant had filed complaint before the District Forum so that the amount of Rs. 1,53,661 spent by the complainant in his treatment may be awarded.;