Haryana

Kurukshetra

CC/83/2019

Hanu Sharma - Complainant(s)

Versus

E- Meditek - Opp.Party(s)

Rohtash Jangam

22 May 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KURUKSHETRA.

                                                     Complaint Case No.83 of 2019.

                                                     Date of institution: 05.03.2019.

                                                     Date of decision: 22.05.2019.

 

Hanu Sharna S/o Vijay Partap R/o H.No.1675, Ward No.8, Near Saini Poul School, Vishnu Colony Kurukshetra.

        …Complainant.

                        Versus

1. E-MEDITEK, Plot no. 577, Udyog Vihar, Phase-V, Gurugram(Haryana)-122016, through Manager.
2. United India Insurance Company Ltd, Sector-17, Urban Estate Kurukshetra through its branch Manager.

….Opposite parties.

Before:      Smt. Neelam Kashyap, President.

                Ms. Neelam, Member.

                Sh. Sunil Mohan Trikha, Member.

       

Present:     Sh. Rohtash Jangam, Advocate for complainant.

                Opposite parties already exparte.

               

ORDER

                This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Hanu Sharma against the E-MEDITEK & others, the opposite parties.

2.         Brief facts of the present complaint are that complainant purchased individual medi-claim policy vide Policy No.1126002816P115530611. During the validity of aforesaid insurance policy, the complainant was diagnosed for right renal calculi from Medline Hospital, Karnal. He remained indoor patient in this hospital w.e.f 22.05.2017 to 23.05.2017 and a sum of Rs.30,700/- was incurred by him on his aforesaid treatment. It is further averred that complainant was insured through aforesaid insurance policy and he claimed for reimbursement of aforesaid expenses. Ops had approved sum of Rs. 19950/-. This amount is to be credited in the account of complainant the details of which already supplied to Op No.1. It is further averred that complainant had been waiting for the claim settlement amount which was to be credited in his account. The Ops informed the complainant that a sum of Rs.19950/- credited in his account in June, 2017 but it is surprised to see the statement of account of complainant that he never received such amount in his account. The complainant made numerous requests to Ops through various emails but OP relied that concern of complainant has been assigned to the concern department and they request him to allot them some time to get back to him with relevant information but after this email of 06.07.2017 more than six months has elapsed complainant has neither received any amount in his account nor received any information from Ops. Hence, this complaint seeking direction to the ops to pay the loss of Rs.19,950/- along with interest @ 18% p.a and also to pay an amount of Rs.50,000/- on account of pain and suffering and litigation expenses. 

3.             Opposite parties did not appear despite notice sent through registered cover and were proceeded against exparte.

4.             Learned counsel for complainant tendered affidavit Ex.CW1/A and documents Ex.C1 to Ex.C14.

5.             We have heard learned counsel for the complainant and have perused the case file carefully.  

6.             The complainant in order to prove his case has furnished copy of policy cover note Ex.C-1 which clearly shows that complainant has taken medi-claim policy from the Ops. Ex.C-2 shows that OPs have approved the claim of the complainant with amount of Rs.19,950/-. Complainant has written many e-mails which is Ex.C-3 to Ex.C-10 to the Ops but Ops did not deposit the approved claim amount in the account of complainant which clearly amounts to deficiency in service and unfair trade practice on the part of ops.

7.             In view of the above, we allow the present complaint and direct the opposite parties to pay a sum of Rs.19,950/- to the complainant within a period of 45 days from the receipt of copy of this order, failing which the complainant will be entitled to interest @9% per annum from the date of order till actual realization. We also direct the ops to further pay a sum of Rs.10,000/- to the complainant as compensation for harassment including litigation expenses. A copy of this order be supplied to the parties free of cost.  File be consigned to record-room after due compliance.     

Announced in open Forum:

Dt.: 22.05.2019

                                                                        (Neelam Kashyap)

                                                                        President.

 

 

(Sunil Mohan Trikha)            (Neelam)       

        Member                             Member