ORIENTAL INSURANCE CO LTD & ANR Vs. RAJENDRA KUMAR BANERJEE & ANR

JUDGEMENT

(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.