DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the  26^th day of  June, 2023 

Present      :    Sri. Vinay Menon V., President

                  :   Sri. Krishnankutty N.K., Member                               Date of Filing: 28/02/2023  

                         CC/63/2023

Mubaraq.M.,

S/o. Musthafa

Kunnathu House, Panniyampadam,

Muttikulangara (PO), Palakkad- 678 594                               -                       Complainant

(By Adv. Jayan C. Thomas)

                                                                                                Vs

1. M/s.Digit General Insurance Ltd.,

Atlantis, 95, 4^th B Cross Road,

Koramangala Industrial Lay out,

5^th Block,  Bangalore – 560 095

2. M/s.Digit General Insurance Ltd.,

Atlantis, 95, 4^th B Cross Road,

Koramangala Industrial Lay out,

5^th Block,  Bangalore – 560 095

Rep.by Managing Director/Manager/

Authorised signatory  

3. M/s.Digit General Insurance Ltd.,

Branch Office Centre A 664971,

7^th Floor, Alappatt Heritage Village,

MG Road, Ernakulam – 682 035       

Rep.by Manager/ Authorised signatory                     -                       Opposite parties

(O.P.s  by Adv. P.Prasad)

O R D E R   O N  M A I N T A I N A B I L I T Y

By  Sri. Vinay Menon V., President

1. Complainant, a beneficiary of a policy issued by the O.P. Insurance company is aggrieved by the repudiation of his medi-claim by the company. This complaint is filed aggrieved by the repudiation.

2.         O.P. filed version stating, inter alia,  that the complainant had already filed a complaint before the Insurance Ombudsman and an Award was passed by the Ombudsman on the same set of facts. Based on this pleading, this Commission posted the matter for preliminary hearing  on the question of bar of Res-judicata.   Heard the parties.

3.         Along with the version, the O.P. had filed a copy of the Award bearing No. IO/KOC/A/HI/0643/2022-23  dated 22/03/2023. Details of the policy under question is as follows:

            Complainant                                       ::          Mubaraq M.

            Policy No.                                            ::          D041153895

            Date of Commencement                    ::          26/07/2021

            Period of Coverage                             ::          26/07/2021 to 25/07/2022

4.         The Insurance Ombudsman has, after extensive perusal and appreciation of the facts and circumstances involved, dismissed the claim of the complainant. This Award is a detailed Award passed based on the merits of the case.

5.         This CC is also based on the same set of facts and circumstances, without any mention of the dispute pending before the Insurance Ombudsman.

6.         Even though the reliefs under Consume Protection Act is available over and above the reliefs already available in other Statutes, this Commission is not inclined to delve into a finding based on meticulous appreciation of pleadings and evidence and on merits passed by a Statutory Authority competent to adjudicate upon the facts and circumstances of the case. The complainant has a remedy to approach the Hon’ble High Court of Kerala under Art. 227 of the Constitution of India.

7.         Any re-appreciation of the evidence by this Commission would be unwarranted and may lead to absurdity.

8.         Hence we dismiss the Complaint as being barred by Res-judicata.

                  Pronounced in open court on this the  26^th  day of June, 2023.      

                                                                                                                              Sd/-

                                                                                                            Vinay Menon V

                                                                President

      Sd/-                                              Krishnankutty N.K.

                                                                                                                     Member

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.