Haryana

Yamunanagar

CC/438/2023

Sarika Sharma S/o Rajiv Sharma - Complainant(s)

Versus

Aditya Birla Health Insurance Company Ltd. - Opp.Party(s)

Rupinder Singh

06 Mar 2024

ORDER

CC No. 438 of 2023

Sarika Sharma Vs. Aditya Birla

 

Present:      Sh. Rupinder Singh, Adv. and Sh. Vinay Gupta, Adv. for the complainant.

                   Opponent No.1 ex-parte.

                   (Notice of complaint was not ordered against opponents No.2 & 3).

 

1.                Heard.

2.          Complainant filed her claim No.1112185002584 with the opponent, under the insurance policy Ex.C3 bearing No.21-21-0034405-00, which was valid for the period 18.6.2021 to 17.6.2022. On receipt of claim from the complainant, opponent issued a letter dated 10.11.2022, telling the complainat, she had not disclosed, the patient of Diabetes, since nine years and as per the record of this complaint, the complainant never reply to letter dated 10.11.2022, received from the opponent, rather, straight forwardedly, came before the Commission and the letter dated 10.11.2022 shows, claim of the complainant has neither been rejected nor settled by the opponent. The complaint is on face of it, is pre mature and at this stage, is liable to be dismissed. However, in order to, maintain the balance and to avoid any sort of prejudice to the complainant, if, appropriate directions are given to the parties, to perform, their part of obligations, then, it will suffice the purpose and ends of justice will meet.

3.             Hence, due to reasons stated hereinbefore,  complaint is dismissed, it being pre-mature. Complainant will gave reply to the letter dated 10.11.2022 to the opponent, through its nearest branch office, within 15 days, from the date of order and on receipt of written reply, from the complainant, the opponent shall decide, her claim, under the relevant policy, already referred, within the period of one month, by passing speaking order. Thereafter, if, the claim of the complainant, is not settled, in either way, or the complainant is not satisfied, with the settlement, then, she shall be at liberty to file a fresh complaint, before the Commission, if, advised so, and in the fresh complaint, complainant will disclose the particulars of this complaint, it fate and will attach the copy of this order. Certified copy of order be supplied to the complainant, free of cost and the complainant will communicate the certified copy of this order, to the opponent No.1, at her own responsibility, by sending the same, to the opponent No.1 through registered post or E-mail, as the case may be. Apart from it, she will also make efforts, to deliver the certified copy of this order, to the opponent No.1, through nearest local branch, of the opponent No.1.

4.                File be consigned to the records.

                                                                                                            President,

  L. Member.                            Member.                                             DCDRC, YNR,

                                                                                                            06.03.2024.

 

 

Typed by: Aarti.