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| Consumer Court fines LIC | | Judges Lone, Kirmani, Farooqi deliver significant judgement | |
Jammu, Feb 27
In a significant judgement passed by Divisional Consumers Protection Forum, Kashmir comprising of Rashid Ahmed Lone (District & Sessions Judge), M.I. Kirmani and Amina Farooqi (Members) in complaint filed by one Ghulam Mohi-ud-Din Khanday R/O Baghat Barzulla Srinagar against Life Insurance Corporation of India. The Life Insurance Corporation has been directed to pay Rs.2,50,000/- to the complainant towards the reimbursement of his medical expenses incurred by him. The policies of the complainant which were cancelled by the Life Insurance Corporation has been ordered to be restored immediately without any surcharge to be levied on past payments. Rupees 20,000/- compensation has also been awarded in favour of the complainant which shall be paid by the four members of the standing committee namely Sanjay Verma, B.P.Singh, R.C. Bhat and O.P. Batra in equal shares to the complainant within a month. An amount of Rs.4,000/- has also been awarded as court of Litigation which also shall be borne by the above referred four members of the standing committee of Life Insurance Corporation of India, Srinagar.
The brief history of the case is that the complainant namely Ghulam Mohi-ud-Din Khanday had taken two health policies under “Asha Deep Ji and Jeevan Asha” for an amount of Rs.3,00,000/- each which were commencing from February 1999 and February 2000 respectively. Under these policies the complainant was entitled for reimbursement to the tune of 50% of the sum insured under both the policies as for such benefit, he was entitled under benefit-B Clause (1) as under benefit-B, he was suffering from such ailment which is mentioned in 11(a) & 11 (c) of the terms and conditions as enshrined in the policies. It is claimed that during the currency of both these policies in the month of December 2003, the complainant approached the Life Insurance Corporation for the reimbursement of the expenses incurred by him for his treatment in Batra Hospital, New Delhi and the request of the complainant was turned down and the reimbursement of expenses incurred by him were refused by the Life Insurance Corporation. The complainant filed the above referred complaint in the Divisional Consumers Protection Forum, Srinagar. Parties were heard and the judgement as referred to above was announced. The Manager Claims of Life Insurance Corporation has considered the claim of the complainant and found the same to be genuine and even obtained opinion from the Panel Doctor and even after his recommendation, the four member standing committee constituted in the Divisional office of the Life Insurance Corporation have turned down the recommendations of Branch Manager and the Panel Doctor. The Forum has taken serious note of the recommendation of the members of the standing committee namely Sanjay Verma, B.P. Singh, R.C. Bhat and O.P. Batra. In view of the malafide action and wrong decision of this committee, the Forum has imposed penalty of Rs.24,000/- to be paid to the complainant by way of compensation and litigation charges in equal shares by the four members of the standing committee, as the complainant suffered and the LIC got involved in litigation by this wrong decision of the above four members of the committee.
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