Delhi

StateCommission

A/196/2015

SH. KRISHANAND PATHAK - Complainant(s)

Versus

BAJAJ ALLIANZ LIFE INSURANCE CO. LTD. - Opp.Party(s)

11 Sep 2017

ORDER

IN THE STATE COMMISSION: DELHI

(Constituted under section 9 of the Consumer Protection Act, 1986)

 

Date of Decision: 11.09.2017

 

 

 

First Appeal No. 196/2015

(Arising out of order dated 17.02.2015 passed by the Consumer Disputes Redressal Forum, Nand Nagri, Delhi in Complaint Case No. 481/12)

 

 

        In the Matter of:

 

                Sh. Krishanand Pathak,

          S/o Sh. Maneeji

          R/o 138, Village Khajuri Khas

          Nathu Ram Bhawan,

          Delhi- 110094

 

……Appellant     Versus     Bajaj Allianz Life Insurance Co. Ltd. GE Plaza, Ground Floor, Airport Road, Yerawada, Pune- 411006   Also At: Bajaj Allianz Life Insurance Co. Ltd. First Floor, Rajdarshan Shopping Complex, Delhi, Saharanpur Road, Baghpat- 250609, U.P.   Also At Bajaj Allianz Life Insurance Co. Ltd. Plot No. 23, Community Centre-S P-11, Karkardooma, Delhi-110092                                                                            …….Respondent

CORAM

 

Justice Veena Birbal, President

Ms. Salma Noor, Member

 

1.   Whether reporters of local newspaper be allowed to see the   judgment? 

2.   To be referred to the reporter or not?

 

 

Justice Veena Birbal, President

1.             This is an appeal wherein challenge is made to order dated 17.02.2015 passed by the Consumer Disputes Rederessal Forum, North East, Nand Nagri, Delhi in Complaint Case No. 481/12 whereby the aforesaid complaint has been dismissed on the ground that appellant/complainant did not file evidence by way of affidavit despite  opportunities given.

2.             A complaint u/s 12 of the Consumer Protection Act (in short ‘the Act’) was filed before the Ld. District Forum by the appellant/complainant for reimbursement of medical expenses of Rs. 53,712/-. It was alleged that the appellant/complainant had fallen sick and was admitted in Shivain Hospital and Maternity Centre wherein aforesaid amount was incurred on his treatment. However, the appellant/complainant repudiated the claim on the ground that appellant/complainant was admitted and got treated in a hospital having less than 5 beds and that the licence of the said hospital was also not renewed. The appellant/complainant had alleged in the complaint that the aforesaid hospital is of 35 beded hospital and there is a certificate by Chief Medical Officer, Ghaziabad vide letter dated 16.08.2012 which shows that the registration of the aforesaid hospital and as such there was deficiency in service on the part of appellant/complainant and had filed a claim for reimbursement of medical expense along with compensation and litigation costs.

3.             The aforesaid complaint, was opposed by the respondent/OP wherein it was alleged that licence of the aforesaid hospital had expired and was not renewed by competent authority. It was also alleged that as per policy the claim was not admissible as the hospital wherein treatment was taken was having less than 5 beds and claim was not genuine.

4.             On behalf of respondent/OP, an affidavit of Sh. Veneet Mehta SE,BM was filed. However, the appellant/complainant did not file any evidence despite opportunities given as such the Ld. District Forum did not believe the averments made in the complaint and dismiss the complaint for lack of evidence.

5.             Aggrieved with the aforesaid order, the present appeal is filed.

6.             Ld. counsel for the appellant/complainant has submitted that the appellant/complainant has a good case on merits and it is submitted that if one opportunity for giving evidence by way of affidavit is given, the appellant/complainant will be able to substantiate its case as such request is made for remanding the matter to the Ld. District Forum.

7              Proxy appearing for counsel for respondent after taking instructions from the main counsel has stated that the respondent/OP has no objection in giving opportunity to appellant/complainant for filing evidence by way of affidavit before the Ld. District Forum.

8              The complaint case has been dismissed by the Ld. District Forum on the ground that the appellant/complainant has not led evidence to prove the stand taken in the complaint. Ld. counsel for appellant/complainant submits that he has necessary material to substantiate his case. Keeping in mind the interest of justice, we feel that appellant/complainant be given chance to substantiate his case on merits.

9.             Accordingly, with the consent of respondent/OP, we accept this appeal and set aside the impugned order and remand back the case to the Ld. District Forum for deciding it afresh after giving opportunity of filing evidence by way of affidavit to the appellant/complainant. The respondent/OP shall also be at liberty to file evidence by way of affidavit in response to affidavit of appellant/complainant.

10.            Appeal stands disposed of accordingly.

11.            Let parties appear before the Ld. District Forum on 23.10.2017. On the said date, the appellant/complainant shall file its evidence by way of affidavit. Thereafter the Ld. District Forum shall proceed further in the matter in accordance with law.

 

                Copy of the order be sent to the parties as well as to Ld. District Forum for necessary information. The Record of the District Forum be also sent back forthwith. Thereafter, the file be consigned to record room.    

                   Pronounced in open Court.

 

(Justice Veena Birbal)

President

 

 

(Salma Noor)

Member