DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.
Complaint No. 220
Instituted on: 22.05.2017
Decided on: 03.10.2017
Lalit Kumar Goyal aged 50 years son of Shri Ram Sarup, @15B/266, Tehsil Mohalla Kotla Street, Dhuri, Tehsil Dhuri, District Sangrur now residing at Kothi No.6, Ekta Vihar, Totapuri Road, New Grain Market, Dhuri, Tehsil Dhuri, Distt. Sangrur.
…Complainant
Versus
1. Kiranjeet Kaur W/o Jagjit Singh R/O VPO Mamatpur, Tehsil Dhuri, District Sangrur.
2. Star Health and Allied Insurance Company Ltd. through its Area Manager, Gagan Complex, 1st Floor-2716, Pakhowal Road, Gurdev Nagar, Backside Park Plaza, Ludhiana.
3. Star Health and Allied Insurance Company Ltd. through its Managing Director 1, New Tank Street, Vallvar Kottam, High Road, Nungambbakkam, Chennai 600034.
..Opposite parties.
For the complainant : Shri Vinay Jindal, Adv.
For OPs 2&3 : Shri Rohit Jain, Adv.
For OP No.1 : Exparte.
Quorum: Sukhpal Singh Gill, President
Sarita Garg, Member
Vinod Kumar Gulati, Member
Order by : Sukhpal Singh Gill, President.
1. Shri Lalit Kumar Goyal, complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that OP number 1 being the authorized agent of OP number 2 and 3 approached the complainant at Dhuri and asked to get medi claim policy of OPs, namely, Family Health Optima Insurance Policy, as such, the complainant purchased the policy from the OP number 1 at Dhuri for Rs.5,00,000/- by paying the requisite premium. The complainant also completed all the formalities at Dhuri to purchase the policy in question.
2. The grievance of the complainant is that on 1.3.2017, he suffered severe pain in his right lower limb as such he was taken to Dayanand Medical College and Hospital, Ludhiana by his family members, where he remained admitted for treatment upto 9.3.2017 and spent an amount of Rs.78,442/-. The complainant requested the hospital authorities to provide the cashless treatment, but they refused to do so. Further case of the complainant is that thereafter he submitted all the documents to the OPs for payment of the claim, but the OPs repudiated the claim of the complainant vide letter dated 15.4.2017 on the ground of suppression of material facts. Thus, alleging deficiency in service on the part of the Ops, the complainant has prayed that the OPs be directed to pay to the complainant an amount of Rs.78,442/- along with interest @ 18% per annum from 1.3.2017 till realisation and further claimed compensation and litigation expenses.
3. In reply filed by the OPs, preliminary objections are taken up on the grounds that the complainant has no locus standi to file the present complaint, that the complaint is not maintainable, that the complainant has not come to the Forum with clean hands, that the complainant has not submitted all the documents, that the proposal form for getting the policy in question was filled at Ludhiana by the complainant and policy was issued from Ludhiana branch of the OPs, so this Forum has got no jurisdiction to try and decide the present complaint. On merits, it is admitted that the policy in question was issued to the complainant for Rs.5,00,000/-. It is admitted that during the subsistence of the insurance policy, he took treatment and submitted the medical bills for reimbursement, but the claim of the complainant was repudiated by the Ops on the ground that the complainant has non disclosure of previous ailment from the OPs knowingly at the time of getting the medical policy in question, as such the claim was rightly repudiated by the OPs. The other allegations levelled in the complaint have been denied.
4. Record shows that the OP number 1 did not appear despite service, as such was proceeded exparte on 10.07.2017.
5. The learned counsel for the complainant has produced Ex.C-1 to Ex.C-61 copies of the documents and affidavits and closed evidence. On the other hand, the learned counsel for Ops number 2 and 3 has produced Ex.OP2&3/1 to Ex.OP2&3/14 copies of documents and affidavits and closed evidence.
6. At the outset, the learned counsel for Ops number 2 and 3 has contended vehemently that the policy in question was purchased by the complainant at Ludhiana and the proposal form for the same was filled in at Ludhiana on 5.11.2016, a copy of which on record is Ex.OP2&3/2, as such the learned counsel for Ops number 2 and 3 has contended that this Forum has got no territorial jurisdiction to hear and try the present complaint. The learned counsel for Ops number 2 and 3 has further drawn our attention towards the copy of proposal form Ex.OP2&3/2 dated 5.11.2016, which clearly depicts the signatures of the complainant, Lalit Kumar and further it shows that the place of filling of the proposal form as Ludhiana. On the other hand, the stand of the complainant is that the proposal form was filled up at Dhuri within the territorial jurisdiction of this Forum by the OP number 1 and further to support this contention, the complainant has produced sworn affidavit of Smt. Kiranjeet Kaur Ex.C-2 wherein she has stated that she has been working as agent of the Ops in the area of Dhuri from June 2016 and she got the signatures of the complainant on the proposal form at Dhuri. But, we are unable to go with the contention of Smt. Kiranjeet Kaur that the proposal form was filled in at Dhuri, whereas a bare perusal of the form Ex.OP2&3/2 clearly reveals that the proposal form in question was filled in at Ludhiana and further there is no cutting of any type on the proposal form. As such, we are of the considered opinion that the proposal form in question was duly filled in at Ludhiana as is evident from the copy of proposal form Ex.Op2&3/2 on record. It is worth mentioning here that the complainant has not produced any cogent, reliable and trustworthy evidence to show that the agreement was signed here at Dhuri or in the territorial jurisdiction of District Sangrur. Further it is worth mentioning here that Smt. Kiranjeet Kaur was arrayed as OP number 1 being the agent of the OPs number 2 and 3, where she chose to remain exparte. Further she filed an affidavit Ex.C-2 in support of the case of the complainant and tendered the affidavit Ex.C-2. There is no explanation from the side of Smt. Kiranjeet Kaur that why she did not appear and filed written reply to the complaint. As such, we feel that the complainant and OP number 1 has connived with each other to make the case of the complainant a success. Reliance can be placed on Sonic Surgical versus National Insurance Company Limited 2010(1) CLT 252, wherein the godown of the appellants caught fire at Ambala and the claim petition under section 17 was filed before the Consumer Forum, UT, Chandigarh and the insurance policy was taken at Ambala and the claim for compensation was made at Ambala. No part of cause of action arose at Chandigarh, hence, it was held by the Hon’ble Supreme Court of India that the Consumer Forum UT Chandigarh has no territorial jurisdiction. The same is the position in the present case, as the complainant got filled the proposal form at Ludhiana and further the Ops have no office within the territorial jurisdiction of Sangrur, as such, we are of the considered opinion that the complaint should be filed within the territorial jurisdiction of Ludhiana.
7. In view of our above discussion, we dismiss the complaint of the complainant only on the ground that this Forum has got no territorial jurisdiction to try and decide the present complaint. However, the complainant is at liberty to seek remedy before the competent court of law, if he so desired. A copy of this order be issued to the parties free of cost. File be consigned to records.
Pronounced.
October 3, 2017.
(Sukhpal Singh Gill)
President
(Sarita Garg)
Member
(Vinod Kumar Gulati)
Member
