DISTRICT CONSUMER DISPUTES REDRESSAL FORUM (CENTRAL)
ISBT KASHMERE GATE DELHI
CC/185/2018
No. DF/ Central/
Shri Sunil Kumar
R/o 69/6, Gali No. 17, Adarsh Mohalla,
Mauzpur, Delhi - 110053
……..COMPLAINANT
VERSUS
1. Max Bupa Health Insurance Co. Limited
Corporate Office B1/1-2, Mohan Co-op.
Industrial Area, New Delhi – 110044
Having Branch at 39, 3rd Floor, WEA
Karol Bagh, New Delhi 110005
2. Mr. Ashish Mehrotra
Managing Director & Chief Executive Officer
Max Bupa Health Insurance Co. Limited
Corporate Office B 1/1-2, Mohan Co-Op.
Industrial Area, New Delhi – 110044
3. M/s. Bajaj Finance Limited
4th Floor, Viman Nagar, Finserv Off
Pune –Ahmed Nagar Road
Pune – 411014 (Maharashtra)
.…..OPPOSITE PARTIES
Quorum: Ms. Rekha Rani, President
Mrs. Manju Bala Sharma, Member
ORDER November 2018
Mrs. Manju Bala Sharma, Member
1. Instant complaint has been filed by the complainant U/s 12 of the Consumer Protection Act 1986 as amended up to date (in short the Act) alleging therein that
complainant purchased health Insurance Policy No. 00204600201500 for a sum of Rs. 500000 Lakhs for the period 26/10/2015 to 25/10/2016. On 25/06/2016 the complainant was admitted in the Sanjeevan Medical Research Centre complaining of pain in abdomen and nausea and was discharged on 06/07/2016 for which complainant ledged a claim of Rs. 2,01,640/- being the billed amount with the OP but the same was repudiated by the OP vide email dated 16/09/2016 stating therein that the complainant/patient is known case of hypertension hyper-lipidemia for the past 2-3 years which falls under the exclusion clause of pre-existing diseases whereas the treating Doctor of Dr. Sanjeevan Medical Research has testified in the discharge summary that the disease referred by the Opposite Parties was there only for 2-3 months of regular treatment since January 2016. Pleading deficiency in service on the part of the OPs complainant has prayed that OP be directed to pay Rs. 201640/- along with interest @ 18% till the date of realization, Rs. 1,00,000/- as compensation and Rs. 50,000/- as cost of litigation.
2. Arguments heard on the territorial jurisdiction of this Forum to proceed with the matter. Learned counsel for complainant has argued that since OP has its branch office in Karol Bagh New Delhi, therefore the jurisdiction lies with this Forum. He has relied upon the judgement of Delhi High Court in State District Consumer Courts vs. Lieutenant Governor Delhi writ petition no. 11424 of 2016 and CM No.
44784 of 2016 dated 01/02/2018 and the notification of Minutes of Meeting issued by Food Supplies and Consumer Affairs Govt. of NCT of Delhi dated 30/10/2018.
3. We have gone through the decision of the Hon’ble High Court in State District Consumer Courts case as well as notification of Minutes of meeting issued by Food Supplies and Consumer Affairs (Supra). The relevant portion of the judgement of Delhi Hight Court is reproduced as under :
5. ‘‘ It cannot be denied that judicial discipline mandates that the District Forums shall strictly abide by the decisions of the State Commission, which bind their consideration.
In view thereof, all District Forums shall ensure
that they abide by the principles laid down by the
State Commission in their decision.’’
and the directions issued vide notification (supra) relevant for the purpose of this complaint case is reproduced as under :
- ‘‘Delhi is one District. According to Judgment passed by the Hon’ble High Court of
Delhi dated 01/02/2018 in the matter of Delhi State & District Consumer Courts Practitioner Welfare Association (Regd.)/ v/s Lieutenant Governor & Ors., that Delhi is one District for the purposes of the territorial justification of the District Forums as decided by the State Commission on dated 31st October 2007.
All District Forums shall ensure that they abide by the principles laid down by the State Commission in their decision.’’
A bare reading of the operative part of the judgement of Delhi High Court Supra as well notification it is crystal clear that all District Forum shall abide by the principles laid down by the State Commission in their decision.
4. Our State Commission in Prem Joshi Vs Jurasik Park Inn & Anr. First Appeal No. 488/2017 vide order dated 01.11.2017 has interalia held that:
‘’6. Now coming to the point of Delhi being one district, it may be mentioned that appellant has relied upon decision of this Commission dated 31.10.07 in RP No. 07/18 titled as Singhs Dental Hospital vs. Shri Amrit Lal Dureja and decions of this Commission dated 17.03.10 in FA No. 10/220 titled as Holy Family Hospital
vs. Amit Kumar, decision of this Commission in FA 216/2012 titled as Mahesh Ram Nath vs. the Secretary cum Commissioner (Transport) and other and decision in Saranjeet Singh vs. Anil Kumar Dixit III (2010) CPJ 181.
7. The District Forum distinguished the above decision on the ground that the Hon’ble Lt. Governor of National Capital Territory of Delhi vide notification dated 20.04.99 divided Delhi in 10 districts defining their respective area. Notification was issued for being complied with instead of being flouted.
8. Obviously the purpose of defining jurisdiction was to regularize and distribute the work to bring certainty instead of creating chaos. If all the litigants prefer to chose one forum, that forum would be overburdened and remaining nine forums would become idle.
9. Over and above that we may mention that appellant of FA 216/12 namely Mahesh Ram Nath preferred Revision Petition in National Commission which was registered as No. 2816/2012. The said petition came up for hearing on 17.08.12. National Commission called for report from President of this Commission as to whether there was any demarcation of territorial jurisdiction and if so whether the same was being followed or not and if not for what reasons. On 27.09.12 it was observed that territorial jurisdiction of various district forums of Delhi was a matter of great public importance. Therefore Secretary & Commissioner, Deptt of Consumer Affairs, Govt. of NCT of Delhi was directed to appear in person on 10.10.12 so that position can be clarified as to implementation of the notification. Mr. Shakti Bangar, Asstt. Director assured the National Commission to communicate
directions of the National Commission to officers concerned for compliance. National Commission was informed by some advocate that notification relating to distribution of jurisdiction in various consumer fora functioning in Delhi was not being followed in its letter and spirit. Deptt of Consumer Affairs was directed to furnish reports from all the district forums as to whether they were strictly following the notification and if not, they were to give the number of cases which have been entertained/ decided contrary to the stipulation contained in notification.
10. The Director, Consumer Affairs issued a circular No. F.50(21)/2003/F&S/CA/1053-1054 dated 07.11.12 conveying the feelings of National Commission regarding not following the notification in its letter and spirit. It was also conveyed that National Commission took a very serious view and stated that inspite of
notification promulgated by Govt. of NCT of Delhi on 20.04.99 clearly demarcating jurisdiction district wise, District Forums were violating the order. On the basis of the said letter Registrar of this Commission wrote a letter No. F.1/(Misc.)/SC/2012/5045 dated 08.11.12 advising President, District Forums to strictly comply with the directions i.e. notification.’’
5. The question of territorial jurisdiction is settled by Apex Court in the case of Sonic Surgical Vs. National Insurance Company Ltd (IV) 2009 CPJ 40. In the said judgment it was held that amended section 17 (2) (b) of the Consumer Protection Act has to be interpreted in such a way which does not lead to absurd consequences and bench hunting. It was observed that the expression ‘branch office’ in the amended section 17 (2) would mean the branch office where the cause of action arises.
6. Reference may also be made to decision of National Commission in Revision Petition No 1100/2011 titled as Rajan Kapoor Vs Estate Officer, Huda decided on 04.11.2011 wherein District Forum Panchkula allowed the complaint. In appeal the State Commission found that District Forum Panchkula had no territorial jurisdiction following Sonic Surgical (supra). Order of State Commission directing
return of complaint for being presented to District Forum Ambala was maintained by the National Commission while observing that simply because Head Office of HUDA was in Panchkula , Panchkula District Forum did not have jurisdiction as no cause of action had arisen at Panchkula.
7. In the instant case the policy is issued by the OP from its Mathura Road Branch and the complainant was admitted in Sanjeevan Medical Research Centre, Darya Ganj, Delhi. Since no part of cause of action arose within the area of any of the police stations which come within the jurisdiction of District Forum (Central) as enumerated in the notification the complaint is returned with liberty to file the same in the forum having appropriate jurisdiction after retaining a copy of the same. Copy of this order be sent to the complainant as per rules. File be consigned to record room.
Announced this 19th day of November 2018.
