Date of filling:- 20/02/2022                                                                                                                                                                                                             Date of Order/Judgement:-19/12/2022.

DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION,

B A R G A R H.

Consumer Complaint No. 25 of 2020.

 Indrajit Singh, S/o. Dhan Singh, aged about    years, At. Saraswati Enclave, N.H.6, Bargarh, Po/Ps/Tahasil/Dist. Bargarh.                                               …….     .....       Complainant.

V e r s u s

1. The General Manager, STAR HEALTH AND ALLIED INSURANCE COMPANY LTD, Regd. And Corporate Office,1.New Tank Street, Valluvar Kottam High Road  Nungam Bakkam, Chennai 600034.
2. The Branch Manager, STAR HEALTH AND ALLIED INSURANCE COMPANY LTD, Area Office, Bhubaneswar, 2nd Floor Plot No. 23(F), Ashok Nagar, Bhubaneswar 751009.                                                                                                       …..  Opposite Parties.                         

Counsel for the Parties:-

For the Complainant :-                                  :- Sri M.K. Satpathy and  Associate.

For the Opposite Party No.1 and 2 :-            :- Sri Ashok Kumar Dash.

                                                -: P  R  E  S  E  N  T :-

Smt. Jigeesha Mishra            .....       .....       .....       .....       .....       P r e s i d e n t.

Smt. Anju Agarwal             .....         .....       .....       .....       .....       M e m b e r (W).

Dt.19/12/2022.                                 -: J   U  D   G  E  M  E  N  T:-

Presented by Smt. Jigeesha Mishra, President :-

1. The Case of the Complainant is that the Complainant is a bonafide Consumer of insurance policy done for health vide policy No. P/191200/02/2017/000370. For the policy the Complainant had also paid the requisite premium. The Complainant and his wife namely Harjit Kaur are the insured in the policy. The wife of the Complainant was a healthy hale and hearty person during the drawing of the policy so also thereafter. Unfortunately she was effected with cancer and met with an untimely death. The Complainant is entitled for the insurance claim as his wife was insured in the insurance policy. Accordingly the Complainant placed the insurance claim before the Opposite Parties. The Complainant has also furnished relevant documents as desired by them time to time on their direction. Instead of setting the claim of the Complainant, the Opposite parties have deferred the matter on different plea. On dated 20/12/2019 the Complainant sent a pleader notice on the Opposite Parties. Calling upon them to pay the insurance claim amount to him. The Opposite Parties have received the notice but remained silent. Being harassed the Complainant filed this case before this Commission.
2. The Case of the Opposite Parties is that the Opposite Parties filed their Version and submitted that the Complainant had taken the said policy only for the period from 22/10/2016 till 21/10/2017, which was never renewed thereafter for the subsequent years. Further the Opposite Party submitted that the death of Mrs Harjit Kour (insured) due to cancer as stated by the Complainant in his Complaint occurred in the year 2019. The Complainant intentionally did not mention the exact date of death of the insured in the Complaint. The Claim of the Complainant would not be admissible as the policy was never renewed beyond October 2017, under which he intends the claim to be paid. The policy only covers claims arising out of accidents of the insured persons covered in the policy. As per medical expenses incurred by such insured person, additional premium to be paid. In the present case the policy did not provide coverage towards any medical expenses. The death of the insured due to health related problem like cancer does not come under the ambit of this policy and hence this opposite parties are not liable for any compensation on that score.
3. Perused the records and it reveals that the policy was insured for the period from 22/10/2016 to 21/10/2017. The Complainant did not mention about the date of death of the insured in his Complaint petition. He has not produced any document relating to death of the insured. Hence it is presumed that the Complainant has suppressed the material fact regarding death of the insured. The Opposite party objected that the policy did not cover medical expenses. Perused the policy bond and it reveals that the insurance company did not take any premium for medical expenses. The policy was covered for accidental claim and not for medical claim. The policy was not renewed after 21/10/2017. Which is reveals from documents. The Complainant has not come to the Commission with clean hand and suppressed the material fact.

Accordingly it is ordered.

O R D E R

The Complaint is dismissed on contest. The Complainant is not entitled to get any relief which he has claimed.

Order pronounced in open court on this 19^th day of  December 2022.

            Supply free copies to the parties.  

      Typed to my dictation

                                                                                              and corrected by me.                                                                                           

                   I  agree/-                                                                       

       ( Smt. Anju Agrawal )                                                                  ( Jigeesha Mishra )

              Dt.19/12/2022                                                                            Dt.19/12/2022

              M e m b e r  (w)                                                                        P r e s i d e n t.

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