Delhi

New Delhi

CC/671A/2010

Rattan Singh - Complainant(s)

Versus

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

22 Nov 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-VI

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

I.P.ESTATE, NEW DELHI-110002.

Case No.CC.671A/2010                   

IN THE MATTER OF:

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 Place New Delhi

2. Travel Planners Pvt. Ltd.,

A-244, Mahipalpur Extension,

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

Quorum:

Ms.PoonamChaudhry, President

Shri Bariq Ahmad, Member

Ms. Adarsh Nain, Member

                                                                                                                                Date Of Institution:-18.05.2010                                                                                                                                                                         Date of Order   : -      22.11.2022

O R D E R

POONAM CHAUDHRY, PRESIDENT

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 definition of Consumer Protection Act.
2. It is further alleged that the complainant purchased a travel insurance policy from the Opposite party No.-1 through the opposite party No.-2 vides policy No. 00194550 dated 14.02.2008 for the purpose of travel to the Germany, the product name was EGAG TRAVEL ELITE AGE GOLD 200K.
3. It is further alleged that the complainant along his wife had to visit in Germany. The complainant thus took a mediclaim policy of around USD 2,00,000.
4. The policy was valid for the period from 02.05.2008 to 30.06.2008 or date of Return of Insured (Whichever is earlier) and Rs. 4554/- (Rupees Four Thousand Fifty Four) was paid as a premium on the said policy. The policy covered the Medical Expenses, Evacuation and Repatriation of amount to 2,00,000 USD 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 also alleged complainant went to the Germany on 02.05.2008  and after reaching there on 21.05.2008 he had suffered dental and other medical ailments. The complaint tried to contact the 24 Hours Helpline number (telephone No. 91-11-23358462, Fax No. 91-11-23352701, Email Delhi. Bajaj-
6. It is further alleged the complainant had to undergo the medical treatment in Germany and a sum of EURO 62,87 was incurred which was paid by Mr. Ravinder Kumar in cash. That the complainant had to face a lot of humiliation and harassment at the hands of the opposite party.
7. It is further alleged the complainant returned back to Delhi on 26.06.2008 and after returning the complainant submitted the claim vide overseas travel claim form to opposite party No.-1 vide letter dated 05.11.2008 along with the original prescription and medical bill, photocopy of passport, photocopy of e-ticket and photocopy of insurance policy. The complainant thereafter contacted the opposite party but no response was received regarding the claim.
8. It is alleged the opposite party is the service provider and there has been deficiency in the services on the part of the Opposite parties, which makes them liable to be prosecution under the Consumer Protection Act, 1986.
9. It is alleged that the complainant is consumer and had suffered mental tension, agony, harassment perpetrated by the opposite parties.
10.  It is also alleged that this Forum has jurisdiction to entertain the present complaint because the opposite party/opposite parties are having their registered office within the jurisdiction of this Hon’ble Forum. The complaint is within the period of limitation.
11. It is prayed that Opposite party No.-1 be directed to pay  a sum of Eur 62.87 and opposite parties also be directed to pay the compensation 10% of the insurance amount i.e. USD 20,000 (Rupees Twenty Thousand) Equivalent to INR 10,000,00 approx. to the complainant towards the harassment, humiliation along with mental agony due to the non-working of the telephones mentioned in the policy.
12.  Notice of the complaint was issued to OP No.-1 and 2. OP No.-1 filed reply opposing the complaint. It was alleged that there was no deficiency in service on the part of the OP No.-1 as the claim was repudiated and intimation  of the same had been sent to the complainant vide letter 06.11.2008. The complaint is thus liable to be dismissed.
13.  It was also alleged that there is no relationship of consumer under the Consumer Protection Act, between the complainant and respondent (OP No.-1)  after the claim has already been repudiated, therefore, the complaint is liable to be dismissed.
14. We have heard the Ld. counsel for parties. During the pendency of the complaint, complainant expired and his legal heirs were brought on record.
15. Complainant did not file rejoinder denying the contentions of OP.
16. We are of the view that there was no deficiency of service on part of OP No.-1 and 2. In view of the submissions of OP No.-1 that complainant was insured for USD 2,00,000/- for medical expenses and evacuation and repatriation. However, a sum of USD 100 was deductable from the claim amount. That complainant submitted an overseas travel insurance claim form showing that he has incurred medical expenses Euro 62.87 which after conversion at the relevant rates comes to USD 80.80. After going through the claim the competent authority noted the said amount falls under deductible clause of USD 100, therefore, the claim was not payable, and letter dated 06.11.2008 was sent to the complainant informing the same to him. We accordingly hold that there was no deficiency of service on party of OP no.-1 and 2.
17. The complaint stands dismissed.

No order as to costs.

File be consigned to record room with a copy of the order.

A copy of the order be sent to parties, free of cost.

                                      (POONAM CHAUDHRY)

                                          President

(BARIQ AHMAD)

 Member