Haryana

StateCommission

CC/113/2019

GUNWATI - Complainant(s)

Versus

M/S ADITYA BIRLA HEALTH INSURANCE COMPANY LTD. - Opp.Party(s)

SUDHIR GUPTA

29 May 2019

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, HARYANA, PANCHKULA

 

Complaint Case No.113 of 2019

 Date of Institution:22.04.2019

  Date of Decision:29.05.2019

 

Smt. Gunwati wife of Late Sh. Suresh son of Partap Kumar, R/o 241 Pana Rasayan, Rurki-54, Rohtak, Haryana.

 

…..Complainant.

Versus

 

 

1.      M/s Aditya Birla Health Insurance Company Limited, registered office R-Tech Park, 10^th Floor, Nirlon Compund Off Western Express Highway, Goregaon (East) Mumbai-400063, through its Managing Director.

 

2.      M/s Aditya Birla Health Insurance Company Limited, SCO No.2474 and 2475, Sector 22-C, Chandigarh-160022 through its Branch Manager.

 

…Opposite parties

 

 

CORAM:    Mr.Ram Singh Chaudhary, Judicial  Member.

                   Mrs. Manjula Member.

                                     

 

Present:-    Mr. Sudhir Gupta, Advocate for the complainant.

 

ORDER

 

RAM SINGH CHAUDHARY, JUDICIAL MEMBER:

 

1.                Brief facts of the complaint are that Sh. Suresh (deceased) the husband of  complainant purchased an accident care policy  in the month of March, 2018, covering various risks including death due to accident from the opposite parties (in short ‘O.Ps.’). The said policy was valid for one year i.e. 27.03.2018 to 26.03.2019. Thereafter, Suresh (deceased) met with an accident on 17.04.2018 and on the way to hospital he had died. FIR No.111 dated 17.04.2018 was also lodged with the Police Station, Civil Lines, Sonepat and postmortem was also conducted. Thereafter, complainant immediately contacted the O.Ps. and submitted the claim, but nothing has been released by the O.Ps till date. Hence, this complaint.

2.                Learned counsel for complainant had been heard at length. Relevant documents placed on record had also been properly perused. While raising the submissions, it has been argued by learned counsel for complainant that inspite of the fact that it was a case of accidental death and all the documents were submitted with the opposite parties (in short ‘O.Ps’), but still no decision has been taken by the authorities of O.Ps.

3.                As a matter of fact, unless and until some decision is taken by the authorities, no complaint would be filed, but in the interest of justice and equity, this Commission is of the considered opinion that the appropriate directions would be issued to the O.Ps to decide the claim submitted by the complainant and in case, documents are required in that eventuality, complainant is directed to make available those documents to the O.Ps. and then the O.Ps would decide the claim within one month from the date of receiving the copy of this order. It is further clarified that in case, complainant is not satisfied with the decision of O.Ps, in that eventuality, complainant is at liberty to approach the appropriate authority for redressal of her grievance. With these observations, complaint is disposed of accordingly.

 

 

May 29^th, 2019                      Manjula                                 Ram Singh Chaudhary                                                    Member                                 Judicial Member                                                                 Addl. Bench                         Addl. Bench            

           

R.K.