Judgment:
Per Shri P.N. Kashalkar, Honble Presiding Judicial Member
1. This revision petition is filed by M/s.United India Insurance Co. Ltd. against the interim order passed by District Consumer Forum, Mumbai Suburban, whereby in the pending complaint no.386/2008, interim application was allowed on 30/1/2009 and Insurance company was directed to retain terms and conditions mentioned in the Mediclaim policy for the subsequent renewal of policies to be issued to the complainant. Forum below also directed O.P.no.1/Insurance Company to maintain the same methods awarding benefits adopted in the mediclaim policy issued during the year 2006 in the renewed policies issued subsequently. Aggrieved by this order, Insurance Company filed this revision seeking quashing of the said order.
2. According to Mr.A.S.Vidyarthi-Advocate, complainant had purchased Mediclaim insurance policy (under Hospitalization and Domiciliary Hospitalization Benefit policy) since January 2006. Initially, it was a policy issued for the period 31/1/2006 to 30/1/2007. O.P. renewed the said policy for further period of 31/1/2007 to 30/1/2008 under the same terms and conditions, on which for the first time this type of policy was issued to the complainant by accepting premium of Rs.4,377/- and sum assured was Rs.2 lakhs with cum bonus amount of Rs.10,000/-. Complainant further renewed this policy for a period of one year from 31/1/2008 to 30/1/2009. However, when claim was preferred for hospitalization expenses under this policy, it was rejected by the Insurance Co. on the ground that claim was not admissible as per clause no.4.13 of the terms and conditions of the policy. It is the grievance of the complainant that his mediclaim was illegally repudiated by the Insurance Co. and therefore, Insurance Co. should be directed to pay him Rs.84,491/- and further, O.P.no.1-Insurance Co. should be directed to issue and renew the policy for the year 2008-2009 and subsequent renewal periods on the same terms and conditions that prevailed on the date of first inception of the policy.
3. During the pendency of this complaint, he moved an interim application on 25/7/2008 and by allowing the said interim relief application offending order was passed to the effect that while issuing the subsequent renewed policy, Insurance Company was directed to retain terms and conditions in the Mediclaim policy first issued to the complainant and it was further directed to maintain the same methods awarding benefits adopted in the mediclaim policy issued during the year 2006 and the renewed policies issued subsequently. It is these two directions given in the interim relief application, which are taken exception of by the Insurance Company by filing this revision.
4. We heard Mr.A.S.Vidyarthi-Advocate for the revisionist and Mr.M.G.Barve-Advocate for the respondent.
5. We are finding that the order of the Forum below passed in interim relief application should have been confined to only one year in which complaint was filed and complaint is required to be decided within 90 days. So any interim relief application should have granted strictly for a limited period, which was applicable to the only one renewed policy and not to the subsequent renewed policies as mentioned in the order passed by the Forum below in an order passed on interim relief application. It is very strange that by allowing interim relief application, final prayer made in the complaint itself has been granted at the stage of interim relief application by the Forum below by the said impugned order, which is not permissible in law. Final direction or final prayer in the complaint can be passed by the Forum below only when it considers affidavits and documents adduced by the parties, but in interim relief application, interim relief should be given confined to a very limited period and it should not be such as to cover subsequent renewal policies of subsequent years. We reiterate that any interim relief order should have been confined to only one year in which complaint was filed and it should not be made applicable to the subsequent renewal of policies to be made by the complainant by purchasing subsequent yearly policies. To this extent Forum below committed an error in passing blanket order as reproduced above. We are inclined to interfere with this order by making modification in the same and to this extent we are inclined to allow the revision partly. As such, we pass following order:-
Order:
1. Revision petition is partly allowed.
2. In place of direction dated 30/1/2009 given on interim relief application, we direct respondent no.1-Insurance Company to retain terms and conditions mentioned in Mediclaim policy, which it had renewed for the years 2008-2009 and 2009-2010 (i.e.upto 28/1/2010 or till complaint is pending.
3. We also direct Insurance Company to maintain same methods awarding benefits admitted in the Mediclaim policy issued in the year 2006, in the subsequently issued policy covering the period 29/1/2008 to 28/1/2009 and not for subsequent renewals and further period of 29/1/2009 to 28/1/2010 or till complaint is pending and not the subsequent policies that may be purchased by the complainant.
4. O.P.no.1 is also directed to maintain the same methods awarding benefits in the mediclaim policy till the expiry of mediclaim policy purchased by the complainant upto 28/1/2010.
5. Forum below is directed to dispose of the complaint at the earliest and in any case, within two months from receipt of this order and not to drag on this complaint any longer.
6. Copies of the order be furnished to the parties.