Punjab

Ludhiana

CC/19/362

Mrs.Shikha Jain - Complainant(s)

Versus

M/s Max Bupa Health Ins.Co.Ltd - Opp.Party(s)

Narinder Chhibba Adv.

09 Sep 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 362 dated 25.07.2019.                                                        Date of decision:09.09.2023

 

Mrs. Shikha Jain aged 42 years w/o. Sh. Raj Kumar, resident of H. No.958, Phalla Adya, near Dal Bazar, Ludhiana. Mobile No.9815065403.                                                                                                     ..…Complainant

                                                Versus

1. M/s. Max Bupa Health Insurance Co. through its General Manager, Corporate Office, B.I. 1-2, Mohan Cooperative Industrial Estate, Mathura Road, New Delhi-110044.
2. M/s. Max Bupa Health Insurance Co. through its General Manager, Regd. Office, max House, 1, Dr. Jha Marg, Okhla, New Delhi-110020.                                                                                   …..Opposite Parties

Complaint under section 12 of the Consumer Protection Act.

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

SH.JASWINDER SINGH, MEMBER

MS.MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh. Narinder Chhibba, Advocate

For OPs                          :         Sh. V.S. Mand, Advocate

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                           The complainant has invoked the jurisdiction of this Commission by filing the present complaint and raised a consumer dispute by challenging the cancellation of the policy purchased from the opposite parties, having the validity period from 10.04.2019 to 09.04.2020, which was cancelled by the opposite parties vide letter dated 16.05.2019. So, by filing the present complaint, complainant has prayed that the opposite parties be directed restore the medical policy and to pay compensation of Rs.2,0,000/- along with cost of litigation.

2.                Notice was issued to the opposite parties and on 30.09.2019 Sh. V.S. Mand, Advocate filed power of attorney on behalf of the opposite parties and also filed written statement by raising certain preliminary objections regarding maintainability of the complaint, distortion of facts by the complainant etc. In written statement, the opposite parties assailed the claim of the complaint by claiming that the complainant is not entitled to any relief prayed in the complaint and prayed for dismissal of the complaint.

3.                The parties led their respective evidence by tendering affidavits as well as documents and the case was fixed for arguments.

4.                On 08.09.2023, Sh. V.S. Mand, Advocate counsel the opposite parties suffered statement that the opposite parties are ready to settle and pay the claim as per the terms and conditions of the policy, in case the complainant will file the fresh claim along with documents of CMC Hospital and Mohan Dai Cancer Hospital, Ludhiana.

5.                In response to the same, Sh. Narinder Chhibba, Advocate counsel for the complainant has also suffered a statement that during the pendency of the complaint, the opposite parties have renewed the insurance policy and the complainant had already submitted her claim. Further, the complainant will file the claim and documents of CMC hospital and Mohan Dai Cancer Hospital with the OP.   The counsel for the complainant has further prayed for issuance of directions to the opposite parties to decide the claim and to pay the same and also for disposing the complaint accordingly.       

6.                In view of the aforesaid settlement arrived between the parties, the present complaint stands disposed of with the direction that to the complainant to submit fresh claim with the opposite parties along with documents of CMC Hospital and Mohan Dai Cancer Hospital, Ludhiana by the complainant within 115 days from the date of receipt of copy of order and thereafter, the opposite parties will settle and pay the claim as per the terms and conditions of the policy within 30 days from the date of receipt of claim and documents from the complainant. Copy of the order be supplied to the parties free of costs.

7.                File be indexed and consigned to record room. 

 

(Monika Bhagat)           (Jaswinder Singh)         (Sanjeev Batra)               Member                       Member                         President   

National Lok Adalat    National Lok Adalat      Consumer Commission                                                                                     cum Chairman, National                                                                          Lok   Adalat       

Announced in Open Commission                                            Dated:09.09.2023.

Gobind Ram.