BEFORE THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION (under Consumer Protection Act, 1986) OF TELANGANA AT HYDERABAD
FA NO.70 OF 2016 AGAINST CC NO.662 OF 2014
ON THE FILE OF DISTRICT FORUM-I, HYDERABAD
Between:
Ranga Rao Katikaneni
S/o Gopal Kishan Rao Katikaneni,
Aged 55 years, Occ: Private Service,
R/o 1-31-53/5, Street No.8,
2nd Floor, Plot No.182, Satyasai Enclave,
Bowenpally, Hyderabad.
…Appellant/Complainant
And
1) M/s Bajaj Allianz Life Insurance Company Limited,
a Company incorporated under the Companies Act, 1956,
having its registered office at Plot No.1078,
2nd Floor, United Chambers, Sathy Road,
Ganapathi, Combatore, Tamilnadu,
Rep. by its Managing Director.
2) M/s Bajaj Allianz Life Insurance Company Limited,
201-A, B, II Floor, City Centre Complex,
Opp: Hyundai Showroom, Himayath Nagar,
Hyderabad, Andhra Pradesh – 500 029,
Rep. by its Branch Manager.
…Respondents/Opposite parties
Counsel for the Appellant : Sri P.Raja Sripathi Rao
Counsel for the Respondents : Sri Srinivas Karra
CORAM :
Hon’ble Sri Justice MSK Jaiswal … President
Thursday, the Twenty Fifth day of
October, Two thousand Eighteen
Oral Order :
***
Complainant in CC No.662 of 2014 on the file of District Consumer Forum-I, Hyderabad filed this appeal feeling aggrieved by the orders of dismissal of complaint for non-prosecution, dated 16.11.2015.
2) For the sake of convenience, the parties are referred to as arrayed in the complaint.
3) The case of the Complainant, in brief, is that he obtained “Bajaj Allianz Health Care” policy bearing No.0302842712 from the Opposite parties by paying necessary premium, which he received on 02.08.2013. As per terms and conditions of the policy, in case of hospitalization, the policy holder is entitled for reimbursement of the expenses incurred thereon. That, on 14.07.2014, he was hospitalized and undergone Angioplast at KIMS, for which, a procedure was conducted on 15.07.2014 and discharged on 16.07.2014 billing an amount of Rs.1,84,180/-. On making the application for claim duly submitting all the relevant documents, the same is repudiated by letter dated 22.09.2014 by allowing the claim for a sum of Rs.45,000/- only.
4) It is contended that the act of the Opposite parties in granting the claim of Rs.45,000/- only is arbitrary and illegal which is nothing but amounts to unfair trade practice. Having no other go, knocked the doors of the forum below praying to allow the complaint and direct the Opposite parties to pay the total sum insured together with interest @ 24% per annum from the date of claim till date of payment; to pay compensation of Rs.1,00,000/- towards mental agony, to award costs of Rs.50,000/- and any other reliefs.
5) Opposite parties resisted the claim by filing their written version contending that the complaint is not maintainable either on facts or in law and liable to be dismissed in limine. The complaint is filed contrary to the contract. The Complainant lodged three claims with them which were processed in accordance with the terms and conditions of the policy. As against the claim of Rs.11,943.94, an amount of Rs.10,000/- is approved towards claim No.AZBJ/00184194. Likewise, as against the claim of Rs.1,84,180/-, an amount of Rs.45,000/- is approved towards claim No.AZBJ/00185292 and as against the claim of Rs.1,73,517/-, an amount of Rs.38,500/- is approved towards claim No.AZBJ/00196107. Conveniently, the Complainant specified the total amount of claims ignoring the details specifications of heads of expenses under which the same were incurred.
6) It is contended that the complaint is filed with false statements only with an intention to malign the reputation of the Opposite parties. There is no deficiency of service on their part. They repudiated the claim which is not covered by the terms and conditions of the policy agreement. As such, Complainant is not entitled for any reliefs and accordingly prayed to dismiss the complaint with exemplary costs.
7) As the Complainant failed to evince any interest in filing his evidence affidavit in spite of sufficient opportunity, by orders dated 16.11.2015, the forum below was pleased to dismiss the complaint for non-prosecution. Feeling aggrieved by the same, the present appeal is preferred.
8) The Appellant would contend that the forum below ought to have considered the fact that the Consumer Protection Act being a beneficial legislation, it ought not to have dismissed the complaint for non-prosecution in view of the fact that as there was no quorum for considerable time and as there was stop gap arrangement of Hon’ble President of the other forum, there was delay in filing evidence affidavit and as such an opportunity should have been given to the Appellant. As a result of impugned orders, irreparable loss and damage is caused to the Appellant which cannot be compensated. Hence, prayed to allow the appeal by setting aside the orders of the forum below.
9) The point that arises for consideration is whether there is any irregularity or infirmity in the orders passed by the forum below in dismissal of the complaint for non-prosecution? To what relief?
10) Heard both sides. Perused the material on record and also the claim of the Complainant and the contentions of the Respondent. It is not in dispute that the Appellant had obtained health insurance policy from the Respondents insurance company and further it is not in dispute that the Appellant submitted claims to the respondents. The only dispute is that the claims were not honoured in full and that the forum below had dismissed the complaint for non-prosecution without giving opportunity to the Appellant to let-in his evidence.
11) It is an admitted fact that the complaint filed by the Appellant was dismissed for non-prosecution on 16.11.2015. In the grounds of appeal, it is categorically submitted that the Forum was non-functional for want of quorum for considerable time and as stop-gap arrangement, the President of other Forum were conducting the proceedings. That the evidence affidavit also could not be filed and therefore, the interest of justice demands that an opportunity shall be given to the Appellant/Complainant for filing evidence affidavit instead of making him to suffer of the order of default.
12) Since the orders of the forum below which is under challenge in this appeal is not passed on merits, it is a fit case where the interest of justice would demand that an opportunity should be given to adduce evidence rather than in allowing the Appellant to suffer the order of default. This can be done if the order impugned is set aside. In the circumstances, the orders in CC No.662/2014 dated 16.11.2015 is set aside and the consumer complaint is restored to its original number subject to condition that the Appellant shall pay Rs.1000/- as costs which are paid. Accordingly, the matter is remitted to the forum below.
13) In the result, the appeal is allowed setting aside the orders dated 16.11.2015 passed in CC No.662/2014 by the District Consumer Forum-I, Hyderabad remitting the matter back to its file for fresh disposal by giving opportunity to both sides to adduce evidence and for disposal of the matter on merits. The parties shall bear their own costs.
PRESIDENT
Dated 25.10.2018
