Delhi

East Delhi

CC/1058/2014

TRILOK CHAND - Complainant(s)

Versus

N.I.C - Opp.Party(s)

29 Aug 2023

ORDER

 DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

 

C.C. No. 1058/2014

 

	TRILOK CHAND S/O SH. SARDARI LAL R/O 0/24A, BLOCK-O, WEST PATEL NAGAR, DELHI - 110008	….Complainant
Versus
	1-NATIONAL INSURANCE CO. LTD. OFFICE – B-18, 1ST FLOOR, COMMUNITY CENTRE, JANAKPURI, NEW DLEHI-110058	……OP

 

 

Date of Institution	:	20.11.2014
Judgment Reserved on	:	28.08.2023
Judgment Passed on	:	29.08.2023

 

                       

QUORUM:

 

Sh. S.S. Malhotra	(President)
Ms. Rashmi Bansal	(Member)
Sh. Ravi Kumar	(Member)

 

 

Order By: Shri S.S. Malhotra (President)

 

 

 

 

JUDGMENT

1. By this order the Commission would dispose off the claim of the complainant w.r.t. deficiency in rejecting the medical claim of the complainant. 
2. Brief facts as stated by the complainant in the complaint are that he purchased a health insurance policy for himself vide Policy No. 36/801/48/12/8500005863 valid for the period 30.12.2013 to 29.12.2014 for a sum of Rs.1,00,000/- and against critical illness for an amount of Rs.2,00,000/- and paid premium of Rs.8,231/- to the OP, whereafter he received a computerized policy without terms and conditions.  On 18.07.2013 the complainant was not feeling well and was having pain in chest where after he was immediately taken to Emergency Section at Sir Ganga Ram Hospital and the doctors attended him conducted various diagnostic tests and initially recommended for Angiography but subsequently stated that operation is required to be done immediately and accordingly his operation was conducted by a team of cardiologists on 18.07.2013 itself beside doing Angiography, ETCA and one stunt was also put.  Complainant remained in hospital upto 22.07.2013 and after discharge he lodged a claim with the OP and all the necessary documents were summoned including the bill for Rs.2,57,872/- which bill OP did not settle even upto five months which amounts to deficiency in service. 
3. It is further stated that cause of action has arisen within the territorial jurisdiction of this Commission as OP has office within the jurisdiction of this Commission and as such it is prayed that OP be directed to pay Rs.200000/- i.e. against critical illness along with interest @ 24% p.a., Rs.1,50,000/- towards compensation and Rs.25,000/- towards litigation. 
4. The OP was served and it has filed its reply taking preliminary objections that complainant has no locus to file the present complaint as the name of the insured under the policy is Sachin Sachdeva, whereas complainant is Trilok Chand, this Forum does not have territorial jurisdiction to entertain the present complaint as neither the complainant resides within the territorial jurisdiction of this Commission nor the OP which has been made a party in this complaint, has its office within the territorial jurisdiction of this Commission, and even otherwise another complaint of the complainant against the present OP on same cause of action is pending before the Consumer Forum at ITO and complainant cannot be permitted to pick and choose the Consumer Forum of its choice which amounts to bench hunting and the same cannot be appreciated and even otherwise there is no deficiency in service on the part of the OP as whatever the claim of the complainant was found payable, under the policy has already been released and complainant has concealed the material facts, as Rs.71,000/- were found payable under the policy which has been released to the insured Sachin Sachdeva.  Therefore, complaint otherwise is not maintainable.  Not only this the case filed by the complainant before the Consumer Forum at ITO, complainant has specifically mentioned that he has received the terms and conditions of the policy.  It is further submitted that the complaint of the complainant is not maintainable as the ‘Rt. Fronto-Temporal Parietal Sub Acute Subdual Hematoma’ for which ailment the complainant is seeking reimbursement, is not covered under critical illness therefore the amount for critical illness were not payable which only includes stroke, cancer, renal failure, Major Organ Transplant, Multiple Scierosis, Coronary Artery Surgery, Paralyses and Blindness at Additional Premium and since ‘Rt. Fronto-Temporal Parietal Sub Acute Subdual Hematoma’ is not covered the amount which was payable has already been given and therefore complaint of the complainant be dismissed. 
5. On merit the existence of a mediclaim policy for the complainant for senior citizen is not disputed but it is stated that the name of the policy holder is Sachin Sachdeva and not Trilok Chand. Contents of the preliminary objection are reaffirmed and reiterated and it is prayed that complaint of the complainant be dismissed. 
6. The complainant has filed the Rejoinder thereby denying the contents of the written statement and reaffirming and reiterating                                                                                                                                                                                                                                                  the contents of the complaint. 
7. Complainant has filed evidence of Sh. Trilok Chand and OP has filed evidence of Sh. Ashok Arora, Sr. Division Manager working with the OP having their office at Janak Puri, New Delhi. 
8. The Commission has heard the arguments and perused the record. 
9. Before appreciating in the merits of the case the issue w.r.t. jurisdiction has to be disposed off.  As per the Memo of Parties complainant is resident of West Delhi whereas OP has been stated to be having its office at Janak Puri, New Delhi. The preliminary objection has been taken by the OP w.r.t. territorial jurisdiction in reply to which the complainant in the Rejoinder has stated that the OP works for gain within the territorial jurisdiction of this Commission as one of its branch.  No documents in support of this has been filed on record. 
10. Law with respect to jurisdiction of the Commission on the basis of branch office is well settled and the issue w.r.t. branch office is no more res-integra as the Hon’ble Supreme Court in civil appeal No. 1560/2004 in a case titled Sonic Surgical Vs National Insurance Company Ltd. Wherein it has been held as-

“In our opinion, no part of the cause of action arose at Chandigarh.  It is well settled that the expression ‘cause of action’ means that bundle of facts which gives rise to a right or liability.  In the present case admittedly the fire broke out in the godown of the appellant at Ambala The insurance policy was also taken at Ambala and the claim for compensation was also made at Ambala.  Thus no part of the cause of action arose in Chandigarh”.

It was inter alia held as follows:

Moreover, even if it had application, in our opinion, that will not help the case of the appellant.  Learned counsel for the appellant submitted that the respondent-insurance co. has a branch office at Chandigarh and hence under the amended Section 17(2) the complaint could have been filed in Chandigarh.  We regret, we cannot agree with the learned counsel for the appellant.  In our opinion, an interpretation has to be given to the amended Section 17 (2) (b) of the Act, which does not lead to an absurd consequent. If the contention of the learned counsel for the appellant is accepted, it will mean that even if a cause of action has arisen in Ambala, then too the complainant can file a claim petition even in Tamil Nadu or Gauhati or anywhere in India where a branch office of the insurance co. is situated.  We cannot agree with this contention.  It will lead to absurd consequences and lead to bench hunting.  In our opinion, the expression ‘branch office’ in the amended Section 17 (2)  would mean the branch office where the cause of action has  arisen.  No doubt this would be departing from the plain and literal words of Section 17 (2) (b)  of the Act but such departure is sometimes necessary (as it is in this case) to avoid absurdity. 

11. Further, it is also well settled principal that the jurisdiction is the factor that gives the court the authority to deal with a particular case.  If the Forum does not have territorial jurisdiction to decide a particular complaint then it does not have the power to pass any other order in respect of that case.  Jurisdiction is germane to the judicial hierarchical system and any order passed without jurisdiction is a nullity.  In this regard, the judgment of the Bombay High Court in Pundalik Haribhau Chandekar v. Jagdish Dadaji Bind (supra) has laid down that even delay cannot be condoned if the court does not have the jurisdiction to decide the complaint.  This seems quite logical also that a court which does not have jurisdiction over a particular matter cannot pass any order on any aspect of that matter.
12. Accordingly, the Commission is of the considered opinion that complaint of the complainant is not maintainable before this Commission, and nor the Commission can adjudicate the same and complaint is liable to be returned to the complainant and be returned with all documents in original after keeping the copies, supplied by the complainant. 
13. Therefore, this Commission is not adverting to any of the issue either w.r.t. critical illness or w.r.t. payment by the OP to the complainant or w.r.t. any connected issue pending before the District Consumer Dispute Redressal Commission, New Delhi. 

 

Copy of the order be supplied / sent to the parties free of cost as per rules.

File be consigned to Record Room. 

Announced on 29.08.2023.