Manpreet Singh filed a consumer case on 25 Nov 2022 against Apollo Munich Health Ins.Co.Ltd. in the Rupnagar Consumer Court. The case no is RBT/CC/18/328 and the judgment uploaded on 08 Dec 2022.
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, CAMP COURT AT LUDHIANA
RBT/Consumer Complaint No. 328 of 14.5.2018
Date of Decision: 25.11.2022
Manpreet Singh Walia, 8750, Street No.6, New Subhash Nagar, Basti Jodhewal, Ludhiana
……Complainant
Versus
….Opposite Parties
Complaint under Consumer Protection Act
QUORUM:-
SH. RANJIT SINGH, PRESIDENT
SMT. RANVIR KAUR, MEMBER
ARGUED BY:-
Sh. CS Chopra, Adv. For complainant
Sh. Ajay Chawla, Adv. For Ops
ORDER:-
SH. RANJIT SINGH, PRESIDENT
The present order of ours will dispose of the above complaint received by way of transfer from District Consumer Commission, Ludhiana, filed under Consumer Protection Act, by the complainant against the opposite parties on the ground that the OP No.1 issued to the complainant easy health floater standard insurance policy for coverage of Rs.3,00,000/- for the period from 14.9.2017 to 13.09.2018 in continuation to its initial policies which started with the Ops from 13.9.2013 regularly without any break, and thus the policy of the complainant is running in the 5th year from its inception. Further the policy was initially issued under the portability scheme. Insured No.2 in the policy Mrs. Parminder Kaur Walia wife of the complainant was admitted in Fortis Hospital on 15.3.2018 and was discharged on 16.3.2018. After the admission the cashless approval was applied by the complainant and the same was repudiated by the Ops and this gave immense mental torture harassment pain and agony to the complainant, as at the time of giving the policy the complainant was assured that he will not have to pay any amount if ever he gets admitted in the hospital for the treatment. Thereafter when the complainant contacted the Ops the Ops asked him to submit all the original documents to the office and the claim will be paid to him. Thereafter, the complainant submitted all the original documents along with bills to the Ops for a total claim amount of Rs.25,597/- but the complainant was shocked to receive the letter dated 16.3.20178 in which the Ops not only repudiated the claim but terminated the policy. Further in this matter, the complainant personally visited the Ops office and met the officials of the company and has also corresponded the matter through email and other sources, thereby clarifying the entire matter and even presented the report of the doctor to the Ops but the Ops stuck to their arrogant stand and did not paid the claim amount to the complainant and thus the deficiency in service on the part of Ops towards the complainant and further it amounted to unfair trade practices as the Ops had not abided with the terms and condition of the policy. Thus, alleging unfair trade practice and deficiency in service on the part of the OPs, the complainant sought the following reliefs against the OPs:-
Announced:
24.11.2022
(RANJIT SINGH)
PRESIDENT
(RANVIR KAUR)
MEMBER
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