Delhi

New Delhi

CC/673/2010

Birbala - Complainant(s)

Versus

M/S. Bajaj Allianz General Insurance Company Ltd. - Opp.Party(s)

13 Jan 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-VI

(NEW DELHI), ‘M’ BLOCK, 1STFLOOR, VIKAS BHAWAN,

I.P.ESTATE, NEW DELHI-110002.

Case No.CC.673/2010                         

IN THE MATTER OF:

Smt. Birbala

W/o Sh. Ratan Singh,

R/o, 977 Sector 23A,

HUDA, Gurgaon, Haryana                               ....Complainant

VERSUS

1. Bajaj Allianz General Insurance Company,

            Having its office at:

          Complainant 31-32, First Floor,

            Connaught Palace New Delhi

2. Travel Planners Pvt. Ltd.,

          A-244, Mahipalpur Extension,

          NH-8, New Delhi.                                      ...Opposite Parties

Quorum:

Ms. Poonam Chaudhry, President

Mr. Bariq Ahmad, Member

                                                                                                                                 Date Of Institution:-19.05.2010                                                                                                                                                                            Date of Order   : -      13.01.2023

O R D E R

BARIQ AHMAD, MEMBER.

1. The present complaint has been filed under Section 11 and 12 of the Consumer Protection Act, 1986 (in brief CP Act). Briefly stated the facts of the case are that complainant is a consumer within the meaning and definition of Consumer Protection Act.
2. It is alleged that the complainant purchase one Travel Insurance policy from the opposite party No.-1 through the Opposite Party No.-2 vides policy no. 00194552 for the purpose of travel to the Germany. The product name was EGAG TRAVEL ELITE AGE GOLD 200K.
3. It is alleged that the policy period was from 02.05.2008 to 30.06.2008 or date of Return of Insured (whichever is earlier) and Rs. 4554/- (Rupees Four Thousand Five Hundred Fifty Four) was paid as a premium on the purchase of the above said policy.
4. It is also stated that the policy covered Medical Expenses, Evacuation and Repatriation of amount to 2,00,000 USD (more than Rs. 80,00,000/-), which included the Emergency Dental Pain Relief upto 500 USD. The policy also had other coverage’s like personal Accident, personal liability etc.
5. It is further stated that the complainant alongwith her husband had to visit her younger son in Germany. The husband of the complainant is retired and they also took a mediclaim policy of around USD 2,00,000. The complainant only took 450 EUR with them as they had to reside with their son.
6. The complainant went to the Germany on 02.05.2008 on reaching there from 24.05.2008 the complainant had suffered with the dental and other medical ailments. The complainant tried to contact the 24 Hours Helpling number (telephone No. 91-11-23358462, Fax No. 91-11-23352701, Email Delhi. Bajaj-
7. It is further stated that the complainant had to undergo the medical treatment in Germany and a sum of Euro 1157.92 was incurred  which was paid by Mr. Ravinder Kumar i.e. the younger son of the complainant in cash. Copy of the treatment and the bills are enclosed herewith.
8. It is alleged that after coming back to India son of the complainant filed a Right to Information Act, application with MTNL regarding the status of the above mentioned telephone number and in response to the same MTNL informed him that the above mentioned phone number is disconnected since 14.12.2007 i.e. much prior to the issuance of the policy in question from the respondent.
9. It is alleged that the act of OP amounts to the deficiency in the service. The complainant had to face a lot of humiliation and harassment from the hands of the opposite party due to their acts and deeds. The complainant after returning back to Delhi on 26.06.2008 approached to the opposite party and complaint about his grievances of non-working of the helping numbers mentioned on the policy but the opposite party did not pay any heed. The complainant thus filed the claim Euro 1157.92 / USD 1460.62 before the opposite party with the original prescription and medical bill with the copy of passport but that claim has not been indemnified by opposite parties. The complainant suffered mental tension, agony, harassment perpetrated by the opposite party no.1.
10. It is prayed that Opposite party No.-1 be directed to pay  a sum of USD 960.62 (INR 47710.00) with interst and opposite parties also be directed to pay the compensation  of 10% of the insurance amount i.e. USD 20,000 (Rupees Twenty Thousand) Equivalent to INR 10,000,00 approx. to the complainant for the harassment, humiliation and mental agony and pain face by the complainant.
11. Notice of the complaint was served on OP. OP no.-1 entered appearance and filed reply contesting the complaint.
12. It was stated that the complainant has failed to show or establish any treatment besides the dental treatment taken by her while abroad. The Opposite Party has already reimbursed the maximum amount payable to the complainant for dental treatment, under the insurance policy.
13. That the complainant has filed a forged copy of page- 2 of the Claim Form and has not filed page 3 of the Claim Form. Copy of the actual pages 2 & 3 of Claim Form submitted by the Complainant are filed herewith as Annexure 'OP-1' (colly). It was stated that there was no cause of action.
14. It was denied that the complainant ever suffered any ailment, for which treatment was required, but for the dental pain treated in Germany. The complainant has failed to state as to what other treatment she underwent besides dental treatment. It was also denied the complainant was not able to contact the Opposite Party. It was alleged that one Ravinder Kumar called the Opposite Party on Toll Free number from Germany and obtained a Reference Number for claim of the complainant.
15. The complainant has not filed copies of all the bills, as claimed in para 6 of the complaint.
16. It was also stated the complainant has not filed alleged copy of the alleged letter dated 05.11.2008. It was alleged that for the claim allegedly submitted on 05.11.2008, the Opposite Party has made payment of the admissible sum vide cheque dated 19.11.2008 as full and final settlement of the claim. Thereafter no further, communication was received from the complainant. It was alleged that the complainant has filed a copy of claim approval note. It was prayed that the case be dismissed.
17. Both the parties have filed their evidences by way of affidavit.
18. We have heard argument advance at the Bar and have perused the record. A copy of the policy and copies of the bill and copy of the claim, these which have been placed on record are for Euro 65.35+57.37+58.71. It is the copy of the remittance made by OP-1 to complainant of Rs.24,830/- (Rupees Twenty Four Thousand Eight Hundred Thirty). Counsel for OP contended that complainant made claim reimbursement of Euro 1157.92 but copy of bill have not filed by complainant so amount of Euro 1227.56. complainant did filed copies of the bill.  The complainant has referred to a letter dated 05.11.2008 in the complaint. It was stated that 05.11.2008, complainant filed claim of Euro 1157.92 before OP but the said letter has not been placed on record.
19. It is to be noted that complainant has not denied that OP no.1 paid Rs.24,830/- (Rupees Twenty Four Thousand Eight Hundred Thirty only) to the complainant. The claim approval letter was supplied to the complainant which has been filed by the complainant in support his claim of 1157.92 Euro .  
20. In view there as the OP No.1 has already paid the claim which has been approved, copy of the approval letter has been filed by complainant. The complainant has not established the case of deficiency in services. We did not found any ground to award any further amount to complainant.

We, therefore, dismiss the complainant leaving the parties to bear their own costs.

This final order be sent to server ( www.confonet.nic.in ).

A copy each of this order each be sent to both parties free of cost by post.

Announced in open Forum on 13.01.2023.

(POONAM CHAUDHRY)

                                                                   President

 (BARIQ AHMAD)

                                                                  Member