STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA
Date of Institution: 25.06.2018
Date of final hearing: 27.07.2023
Date of pronouncement: 24.08.2023
First Appeal No. 802 of 2018
IN THE MATTER OF:-
- Vinod Kumar Bansal S/o Late Shri Pyare Lal, age 71 years, R/o L 1/5. DLF, Phase-2, Gurgaon-122008.
- Smt. Kiran Aggarwal, w/o Sh. Vinod Kumar Bansal, age 67 years, R/o L 1/5. DLF, Phase-2, Gurgaon-122008.
- Sh. Gaurav Bansal S/o sh. Vinod Kumar Bansal, age 39 years, R/o L 1/5. DLF, Phase-2, Gurgaon-122008.
- Smt. Neeti Jain Bansal W/o Sh. Gaurav Bansal, age 35 years, R/o L 1/5. DLF, Phase-2, Gurgaon-122008.
- Sh. Kunal Bansal S/o Vinod Kumar Bansal, age 34 years, R/o L 1/5. DLF, Phase-2, Gurgaon-122008.
Versus
- Max Bupa Health Insurance Company Limited, Block- B1/2, Mohan Cooperative Industrial Area, Mathura Road, New Delhi-110044, through Managing Director Ashish Malhotra.
- Max Bupa Health Insurance Company Limited, though Manager 102, First Floor, Vipul Agora Mall, MG Road, Gurugram, Haryana-122001.
- Jagmohan Kumar Maurya (Agent), H.No. 26, Prakash Colony, V.P.O. Daad, Pakhowal Road, Ludhiana, Punjab-141003.
…..Respondents
CORAM: Naresh Katyal, Judicial Member
Argued by:- Sh. Sushant Kareer, counsel for the appellants.
Sh. S.C. Thatai, counsel for respondents No. 1 & 2.
Service of respondent No. 3 already dispensed with vide order dated 04.12.2018.
ORDER
NARESH KATYAL, JUDICIAL MEMBER:
Unsuccessful complainants have assailed legality of order dated 09.05.2018 passed by District Consumer Disputes Redressal Forum-Gurgaon (In short “District Consumer Commission”) vide which their complaint has been dismissed in limni, for want of territorial jurisdiction.
2. Briefly stated the facts: complainants obtained Medi-claim Policy (No.30356992201400) w.e.f. 29.08.2014 to 29.08.2015; from OP No. 1 & 2 by submitting proposal from, signed at Ludhiana on 19.08.2014. Name of Branch Office has been mentioned at Ludhiana in policy, which covered complainant No. 1-Vinod Kuamr Bansal, his wife (complainant No.2-Kiran Aggarwal), Sh. Gaurav Bansal- son (complainant No.3), Smt. Neeti Jain (wife of Gaurav Bansal)-complainant No.4 and Kunal Bansal S/o Vinod Kumar Bansal (complainant No.5). Premium of Rs.77,920/- was paid. Complainants were insured vide Policy (renewed) No. 30356992201501 dated 29.08.2015 for 2015-2016 and Rs.84,168/- was paid as premium. Complainants were again insured vide policy (renewed) No.30356992201602 dated 29.08.2016 to 28.08.2018 (two years period) and Rs.1,75,498/- was paid as premium. Sum Assured was Rs.40,00,000/-.
3. On 29.09.2017 & 30.09.2017, complainant No.1 had undergone health check-up and medical reports were normal. On 12.11.2017, he was admitted in Max Hospital, Block-B, Sushant Lok, Gurugram with history of fever and chills associated with decrease urination and productive cough for last three days. His base line creatinine increased from 1.5 to 2.1 in last one month. He was diagnosed as suffering from: Septic Shock-Eonephritis-AKION? CKD; EHT_HYPOGL YCEMIA; EHT3 CAD-AF- ? ACS (TROP-1 CPK MB+ CPK_ALL HIGH/EF LOWER to 45%) – LRTI; Anemia-Hypoproteinemia. Discharge Summary of Complainant No. 1 reflects above medical diagnoses.
4. It is pleaded that complainant No.1 remained hospitalized from 12.11.2017 to 27.11.2017 and paid Rs.7,04,020.80 to hospital. On 13.11.2017, in response to intimation by hospital and request for approval of Medi-claim; OPs issued letter mentioning that: interim amount of Rs.41,325/- has been approved (after deduction) for treatment of complainant No.1. On 15.11.2017, OPs sent letter to Max Hospital-Gurgaon vide which pre-authorization request of complainant was denied. It had been mentioned in letter that: previous authorization also stand cancelled. It has been pleaded that baseless pleas have been taken by OPs to reject the claim. As per medical record and discharge of complainant No.1 maintained in hospital; he was suffering from diabetes Melitus Type-II for last six-seven years and that too not in continuity and not from 30 years, as per plea of OP No. 1 and 2 to repudiate the claim. On above facts, by asserting cause of action, complaint was filed by complainants.
5. Learned District Consumer Commission-Gurgaon vide impugned order dated 09.05.2018 has dismissed the complaint, in limni, at its admission stage, for want of territorial jurisdiction.
6. Feeling aggrieved, complainants have filed this appeal and notice in appeal was issued to OPs/respondents. Sh. S.C. Thatai represented OP No. 1 and 2 (insurer). Arguments of both parties have been heard at length.
7. Learned Counsel appearing for appellants/complainants has only urged on point of territorial jurisdiction of District Consumer Commission-Gurgaon on pedestal that complainant No. 1 had taken treatment from Max Hospital-Gurgaon from 12.11.2017 to 27.11.2017. Branch office of OP No. 1 and 2 is situated in Gurgaon. Cover note in relation to policy was issued in Gurgaon. Payment was required to be made by OPs to complainants in Gurgaon. Above facts, in totality would confer territorial jurisdiction upon District Consumer Commission-Gurgaon. Hence, it is urged that finding of District Consumer Commission that it has no territorial jurisdiction to try and decide the complaint is legally unsustainable.
8. Per contra, learned counsel for appearing OPs/respondent No. 1 and 2 has supported the impugned order dated 09.05.2018 and urged that complainants should have file complaint at Ludhiana, from where, Medi-claim policy was initially issued in the year 2014.
9. The only poser before this Commission is that whether District Consumer Commission-Gurgaon has territorial jurisdiction to try and decide the complaint or not? In this regard, few admitted facts needs to be mentioned. These are:-
(i) Proposal from was filed at Ludhiana on 19.08.2014 (Annexure A-1 appended with appeal).
(ii) Policy dated 27.08.2015 (Annexure A-2) was issued by Branch Office of OP No. 1 and 2 stationed at Ludhiana. Premium receipt of the gross premium amount of Rs.84,168/- reflects that it has been issued on 27.08.2015 at New Delhi office of OP No. 1 and 2. Earlier thereto on 30.08.2014 gross premium of Rs.77,920/- is paid as per receipt dated 30.08.2014 issued from New Delhi office of OP No. 1 and 2.
(iii) Annexure A-4 is the details of policy No. 30356992201602 commenced from 29.08.2016 to 28.08.2018. It was renewed for two years and gross premium amount of Rs.1,75,498/- was paid at the office of OP No. 1 and 2 at New Delhi on 28.09.2017.
10. These facts would largely establish that no material transaction has taken place within jurisdiction of District Consumer Commission, Gurgaon. Complainants have invoked jurisdiction of District Consumer Commission, Gurgaon primarily on the ground that he (complainant No. 1) had obtained medical treatment from Max Hospital, Sushant Lok –Gurgaon. This circumstance, ipso-facto will not confer any territorial jurisdiction on District Consumer Commission-Gurgaon. More so, gross premium in relation to Medi-claim policy, which was repeatedly being renewed, had been paid at New Delhi office of OP No. 1 and 2 and not in the branch office of OP No. 1 and 2 stationed at Gurgaon. Hence, in wake of above facts; District Consumer Commission-Gurgaon has no territorial jurisdiction to adjudicate on the complaint filed before it. While holding so, this Commission gains strength from law laid down by Hon’ble Apex Court in “Sonic Surgical Versus National Insurance Company Ltd.” Civil Appeal No. 1560 of 2004 decided on 20.10.2009 in which it has been held as under:-
“In our opinion, no part of the cause of action arose at Chandigarh. It is well settled that the expression ‘cause of action' means that bundle of facts which gives rise to a right or liability. In the present case admittedly the fire broke out in the godown of the appellant at Ambala. The insurance policy was also taken at Ambala and the claim for compensation was also made at Ambala. Thus no part of the cause of action arose in Chandigarh.”
Hon’ble Apex Court has also dealt with amended Section 17(2) of Consumer Protection Act, 2003 and observed in later part of judgment in following terms:-
“The aforesaid amendment came into force w.e.f. 15.3.2003 whereas the complaint in the present case has been filed in the year 2000 and the cause of action arose in 1999. Hence, in our opinion, the amended section will have no application to the case at hand. Moreover, even if it had application, in our opinion, that will not help the case of the appellant. Learned counsel for the appellant submitted that the respondent-insurance company has a branch office at Chandigarh and hence under the amended Section 17(2) the complaint could have been filed in Chandigarh. We regret, we cannot agree with the learned counsel for the appellant. In our opinion, an interpretation has to be given to the amended Section 17(2) (b) of the Act, which does not lead to an absurd consequence. If the contention of the learned counsel for the appellant is accepted, it will mean that even if a cause of action has arisen in Ambala, then too the complainant can file a claim petition even in Tamil Nadu or Gauhati or anywhere in India where a branch office of the insurance company is situated. We cannot agree with this contention. It will lead to absurd consequences and lead to bench hunting. In our opinion, the expression ‘branch office’ in the amended Section 17(2) would mean the branch office where the cause of action has arisen. No doubt this would be departing from the plain and literal words of Section 17(2)(b) of the Act but such departure is sometimes necessary (as it is in this case) to avoid absurdity. [vide G.P. Singh's Principles of Statutory Interpretation, Ninth Edition, 2004 P. 79] In the present case, since the cause of action arose at Ambala, the State Consumer Redressal Commission, Haryana alone will have jurisdiction to entertain the complaint.”
11. The ratio of law laid down in this judgment is obliviously the guiding principle for the purpose of deciding territorial jurisdiction of District Consumer Commission and it is squarely applicable to the facts of this case. It would provide complete answer to the contention of learned counsel for appellants, based on territorial jurisdiction of District Consumer Commission-Gurgaon and the answer is in ‘Negative’ that; District Consumer Commission- Gurgaon has no territorial jurisdiction. Consequently, there is no manifest error in the observation of District Consumer Commission-Gurgaon in its order dated 09.05.2018 holding that it does not have territorial jurisdiction. This order dated 09.05.2018 is affirmed and maintained. Appellants have been rightly non-suited, right at admission stage of complaint, when their complaint has been dismissed in limni.
13. Application(s) pending, if any stand disposed of in terms of the aforesaid judgment.
14. A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
15. File be consigned to record room.
Date of pronouncement: 24th August, 2023
Naresh Katyal
Judicial Member
Addl. Bench-II
