FIROZE S BHARUCHA Vs. ORIENTAL INSURANCE COMPANY LTD
MAHARASHTRA STATE CONSUMER DISPUTES REDRESSAL COMMISSION
Firoze S Bharucha
ORIENTAL INSURANCE COMPANY LTD
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(1.)HEARD Adv. Sureshchandra N. Chataule, proxy advocate for Adv. Harshad H. Trivedi on behalf of the Appellant. At the time of hearing of the appeal Respondent as well as learned advocate for the Respondent preferred to remain absent. We have also perused the record. This appeal takes an exception to an order dated 18/11/2003 passed by the South Mumbai District Consumer Disputes Redressal Forum (hereinafter referred to as 'the Forum' for the sake of brevity) in Consumer Complaint No. 370 of 2000, Mr. Bharucha Firoze S. v. The Oriental Insurance Company Ltd. It was a consumer complaint pertaining to non -settlement of the mediclaim arbitrarily by the insurance company. In fact, insurance company repudiated the mediclaim referring the exclusion clauses. Upholding the case of the Appellant/Complainant (hereinafter referred to as 'the Complainant' for the sake of brevity) regarding deficiency in service on part of the Respondent/Opponent - The Oriental Insurance Company Ltd. (hereinafter referred to as 'the Insurance Company' for the sake of brevity), the Forum partly allowed the consumer complaint and awarded compensation of Rs. 1,70,000/ - to the Complainant together with interest thereon @ 9% p.a. with effect from 25/9/2000 besides costs of Rs. 2,000/ -. However, not satisfied by the compensation awarded by the Forum as per impugned order, the Complainant preferred this appeal for enhancement of compensation.
(2.)WHILE awarding compensation of Rs. 1,70,000/ - to the Complainant instead of Rs. 3,40,000/ - as claimed by the Complainant, the Forum observed as below: - -
"The Complainant has preferred a claim of Rs. 3,40,000/ - including bonus and cost and compensation of the proceeding. The amount of claim is disputed by the Opposite Party for want of bills or receipts of the expenses. Till today Complainant has not produced the authentic bills or receipts of his expenses. Exhibit -1 produced with the complaint is the mere Discharge Summary of the Complainant. The exact expenses are not mentioned there. Except the words of the Complainant there is no material on record to come to definite figure of expenses. Having regard to the facts and circumstances of the case and probable cost of such treatment, we peg the amount 50% of his claim which comes to Rs. 1,70,000/ -. It would be just and proper to reimburse the claim of the Complainant. Besides, he is entitled to interest on the said amount from date of complaint and cost of Rs. 2,000/ -..."
We asked Learned Advocate for the Appellant/Complainant as to what evidence is led to substantiate the claim of the Complainant for enhancement of compensation. He referred to Exhibit -D which is merely list of medical bills. That cannot be termed as 'evidence' in view of provisions of Section -13(4) of the Consumer Protection Act, 1986. The Forum on invoking a novel theory upon taking into consideration probable cost of such treatment assessed the compensation @ 50% of the amount claimed by the Complainant. Since there is no appeal preferred by the Insurance Company challenging the impugned order, we would not go beyond it. But, certainly, this is not a fit case for enhancement of amount of compensation. Thus, finding the appeal devoid of substance, we pass following order: - -
"Appeal stands dismissed.
In the given circumstances, no order as to costs."
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