M.C.No.270 of 2022

F.A No. 102 of 2022

         Heard learned counsel for the appellant and the respondent on the point of limitation. There is 91 days delay.

2.      Learned counsel for the appellant submitted that due to ex parte hearing, they could not obtain the copy of the impugned order and after obtaining the copy, he filed the appeal.  So, he prayed to condone the delay.

Learned counsel for the respondent has no objection to it.

Considered the submission it appears that during corona period the case was heard. As per order the Hon’ble Supreme court of India passed in Suo Moto Writ (Civil No) 3 of 2020 the limitation  has been  extended. Therefore, we condone the delay and decide the matter on merit on the request of both parties.

First Appeal No. 102 of 2022

        Heard the learned counsel for both sides.

2.   The case of the complainant in nutshell is that the complainant had purchased one CORONA RAKHYAKA POLICY from the O.P through UCO Bank,Sadasibapur Branch bearing policy No.CRP-2C-20-7516121-00-000  covering  the period from 22.07.2020 to 02.05.2021 on payment of due premium. During currency of the policy the complainant has suffered from  covid disease,  was admitted to Covid Care Center at Gobindpur on 04.09.2020 and was discharged on 13.09.2020. Thereafter,  the complainant submitted claim form before OP No.1 through OP No.2 claiming a sum of Rs.2,50,000/-  but O.P.no.1  repudiated the claim on the ground that the claim has not come under the purview of policy condition and the hospitalization was not justified. Alleging deficiency in service on the part of the OPs,  the complainant filed the complaint.

3.   O.P.no.2  appeared and filed written version. O.P.No.1 was set ex parte.

4.     After hearing of both parties, the learned District Commission, Dhenkanal passed the following order:

“xxx   xxx   xxx

The complaint petition is allowed exparte against O.P.no.1 and dismissed as against O.P.no.2. The O.P.no.1 is directed to pay a sum of Rs.2,50,000/- (Rupees two lakhs fifty thousand) only to the petitioner with interest @12% per annum from the date of filing of the case till it is paid to her. The O.P.no.1 is further burdened with the cost of litigation of Rs.5,000/- (Rupees five thousand) only. The order is to be complied within 30 days from the date of receipt of this order.”

5.    Learned counsel for the appellant submitted that he has not received any notice from the learned District Commission, Dhenkanal during corona period. Therefore, he submitted to set aside the ex parte impugned order by remanding the matter to the learned District Commission to dispose of the matter on merit.

6.      Learned counsel for the respondent vehemently opposed the remand and submitted that knowingly the appellant did not attend the learned District Commission. Therefore, he submitted for dismissal of the appeal.

7.      Considered the submission of both parties and perused the impugned order.

8.     No doubt the complainant purchased the  insurance policy  from  O.P No.1. The only plea taken by O.P.no.1 that the  policy does not cover claim of the complainant. After going through the pleadings and documents, we found it just and proper to remand the matter to the learned District Commission for fresh disposal on merit. Therefore, the appeal is allowed on remand to the learned District Commission, Dhenkanal for disposal on merit afresh. Both parties are directed to file evidence on affidavit and the matter should be heard afresh. Therefore, we allow the appeal by remanding the matter to the learned District Commission, Dhenkanal subject to payment of cost of Rs.5,000/- by the appellant to the complainant before the learned District Commission, Dhenkanal on 23/11/2022. On payment of this cost the matter should be heard and disposed of. Learned District Commission should give opportunity to the appellant for filing written version, also both parties to adduce evidence, if any and dispose of the case in accordance with law within 60 days from the date of receipt of this order. Parties are directed to appear before the learned District Commission on 23.11.2022 to receive further instruction from it.