CONSUMER DISPUTES REDRESSAL FORUM (CENTRAL)
ISBT KASHMERE GATE DELHI
CC/422/2016
No. DF/ Central/ Date
Mannu Krishan Malhotra,
S/o Dr. K.L. Malhotra
R/o A-40, New Friends Colony,
New Delhi-110065. …..COMPLAINANT
VERSUS
National Insurance Company Ltd.
Through its Auth. Signatory/Sr. Divisional Manager
At- Division No. XXI, 4th Floor,
Pal Mohan House,
5/67, Padam Singh Road,
Karol Bagh, New Delhi-110005.
Raksha TPA Pvt. Ltd.
C/o Escorts Corporate Centre,
15/5, Mathura Road, Faridabad, Haryana. …..OPPOSITE PARTIES
Quorum : Ms. Rekha Rani, President
Ms. Manju Bala Sharma, Member
Dr. R.C. Meena, Member
ORDER
Ms. Rekha Rani, President
Instant complaint has been filed by Sh. Mannu Krishan Malhotra (in short the complainant) under Section 12 of the Consumer Protection Act, 1986 as amended inter-alia pleading therein that complainant had availed mediclaim policy bearing no. 354500/48/13/8500000760 from National Insurance Company Ltd. (OP1) for himself as well as his family members continuously for the last several years. He got medical policy renewed from 12.08.2013 to 11.08.2014. In September 2013, he suffered from abnormal Hemangioma on his right hand middle finger. The doctors advised him immediate surgery which was scheduled for 03.10.2013. Complainant informed Raksha TPA Pvt. Ltd. (in short OP2) regarding cashless surgery. OP2 approved a cashless amount of Rs. 30,000/- out of the total claim of Rs.60,000/-. Complainant was admitted in the hospital on 03/10/3012 and was discharged on 04.10.2013. Hospital raised a final bill of Rs. 56,536/- which included pre and post hospitalization charges. OPs repudiated the claim. Complainant issued legal notice dated 22.08.2016 to both the OPs but they did not bother to pay the expenses. Hence, the instant complaint was filed seeking direction to the OPs to pay to the complainant Rs. 56,536/- with interest @18% per annum from the date of deposit till realisation, Rs. 1,00,000/- as compensation for causing mental agony and Rs. 25,000/- as litigation expenses.
On receipt of notice OPs appeared and contested the claim vide their reply. It is stated that claim is barred by limitation as the complainant was treated on 03.10.2013 and the claim was repudiated by the OPs vide their letter dated 14.11.2013 sent to complainant via registered post whereas the instant complaint was filed on 22.11.2016 i.e. after 2 years of repudiation of the claim. On merits the claim was repudiated with reference to clause no. 2.6 of the policy stating that the claim was not found payable as no hospitalization for 24 hours was required and the treatment could be done in OPD.
Both parties adduced evidence by way of affidavits. We have heard Sh. K.V. Rai, counsel for complainant and Sh. P.S. Tomer, counsel for OP.
OPs have submitted that the claim is barred by limitation. It is stated that complainant was treated on 03.10.2013 and was discharged on 03.10.2013 and was informed about the repudiation of the claim vide letter of OP1 dated 14.11.2013 by registered post. In Para 6 Page 3 of his complaint, complainant himself pleaded that ‘both OPs lastly repudiated the claim vide letter dated 14.11.2013’. Instant complaint was filed on 22.11.2016 i.e. more than 2 years after the cause of action arose.
In Para 1 of his rejoinder, complainant has tried to explain the delay by stating that the cause of action arose from the date of last correspondence i.e. August 2015 when he had e-mailed the OPs claiming reimbursement of treatment expenses and also got legal notice issued on 22 August 2016 for reimbursement of the claim.
Section 24A in the Consumer Protection Act, 1986
24A. Limitation period.—
‘‘(1) The District Forum, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.
(2) Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section (1), if the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period: Provided that no such complaint shall be entertained unless the National Commission, the State Commission or the District Forum, as the case may be, records its reasons for condoning such delay.’’
Limitation does not extend by writing letters to OPs seeking reimbursement or by issuing legal notice.
Law and equity aid the vigilant and not the indolent. If statute provides for specific limitation for filing a claim, it vests right with the OP on expiry of said limitation period which right should not be defeated by casual condonation of huge, unexplained delay (Anshul Aggarwal Vs. New Okhla Industrial Development, IV (2011)CPJ 63 (SC).
In Ramlal Vs Rewa Coalfields Ltd , AIR 1962 Supreme Court 361, it was observed that diligence of the party or its bonafides are relevant facts to determine whether or not delay is reasonably and sufficiently explained.
In M Balakrishnan vs M. Krishnamurthy VII (1998) SLT 334 the Hon’ble Supreme court observed as under:
“Rule of limitation are not meant to destroy the rights of parties. They are meant to see that parties do not resort to dilatory tactics, but seek their remedy promptly. The object of providing a legal remedy is to repair the damage caused by reason of legal injury. Law of limitation fixes a life-span for such legal remedy for the redress of the legal injury so suffered. Time is precious and the wasted time would never revisit. During efflux of time newer causes would sprout up necessitating newer persons to seek legal remedy by approaching the courts. So a life span must be fixed for each remedy. Unending period of launching the remedy may leading to unending uncertainty and consequential anarchy. Law of limitation is thus founded on public policy. It is enshrined in the maximum interest ‘‘reipublicae up sit finis mum (it is for the general welfare that a period be putt to litigation).The idea is that every legal remedy must be kept alive for a legislatively fixed period of time.”
In Office Of The Chief Post Master General & Ors Vs Living Media India Ltd.& Anr., II (2012) SLT 312 it was held by the Apex Court that unless there is
In R. B. Ramalingam Vs R. B. Bhavaneshwari . 2013 (1) CCC 525 (NS)2009 (2) Scale 108 it was observed that the true guide to condone delay is whether the petitioner has acted with reasonable diligence in prosecution of his petition.
In Cicily Kallarackal Vs Vehicle Factory , IV (2012) CPJ 1 (SC)=VIII (2012)SLT 585, Hon’ble Supreme Court observed that while dealing with the application for condonation of delay special courts/ tribunals must keep in mind the special period of limitation prescribed under the statue(s) and further that condoning inordinate delay without any sufficient cause would amount to substituting the period of limitation in place of the period prescribed by the Legislature when the statures so prescribes.
In Nirkari Industries Vs Noida Industrial Authority IV (2016) CPJ 121 the Hon’ble NCDRC did not entertain a complaint, since not filed within a period of two years from the date of cancellation of letter, since barred by limitation.
In C.H. Vittal Ready Vs. The Manager, District vide order dated 04.12.2002 the Hon’ble NCDRC observed as under:
“Condonation of delay when it is the complaint has to be taken very seriously and that is why proviso to sub section (2) of Section 24A mandates recording of reasons. It must be understood that a suit filed in a Civil Court after the period of limitation prescribed under the Limitation Act has to be dismissed and there is no provision for condoning the delay on the ground of any sufficient cause being shown for not filing the suit within the period of limitation. This is the law which is in force since 1908 when the Limitation Act, 1908 came into force and same is the position of the Limitation Act, 1963. Sub section (2) of Section 24Ais a departure to the well settled law that a suit beyond the period of limitation prescribed under the Limitation Act has to be dismissed. A Consumer Forum has, therefore, to guard itself against the misuse of sub-section (2) of Section 24A and should not be quick to condone the delay unless cogent and verifiable reasons exist to condone the delay.”
In BaswarajVs. Spl.Land Acquisition Officer 2013 (14) SCC 81 the Hon’ble Supreme court held that it is settled legal proposal that law of limitation may harshly affect a particular party so it has to be applied with all its rigour when the statute so prescribes.
In Esha Bhattacharjee vs Raghunathpur Nafar Academy (2013) SCC 649 the Hon’ble Supreme court held that concept of liberal approach has to encapsule the concept of reasonableness and it cannot be allowed an unfettered free play.
In Sanjay Sidgonda Patil Vs National Insurance Co. Ltd & Ors, the Apex Court while dismissing the Special Leave to Appeal (Civil) No. 37183 of 2013 decided on 17.12.2013, upheld the order of the National Commission wherein delay of 13 days was not condoned.
Punjab State Commission in Pradeep Kumar Son of Shri Haridwar vs. Life Insurance Corporation First Appeal No. 1289 of 2009 dated 10.05.2013 had held that it is a settled law that the limitation for filing of the complaint starts form the date of knowledge of the repudiation of the claim to the person, who submit the claim as held by the Hon’ble State Consumer Disputes Redressal Commission, Panchkula in case “HUDA through it Administrator and Anr. Versus Raj Pal Singh”, 2010 (1) CLT 567.
Apex Court in Hameed Joharan Vs. Abdul Salam, (2001) 7 SCC 573 2001 Indlaw SC 21137 made the following observations:-
“Law courts never tolerate an indolent litigant since delay defeats equity - the Latin maxim vigilantibus et non dormientibus jura subveniunt (the law assists those who are indolent). As a matter of fact, lapse of time is a species for forfeiture of rights......"
In Para 6 of the complaint it is pleased that
“OPs lastly repudiated the claim vide their letter dtd. 14-11-2013 with a fake observation of treatment under day care by referring the clause 2.6 of the policy”
The instant case was filed on 22.11.2016. His claim was repudiated on 14.11.2013. The complainant woke up after 3 years to file the instant claim.
Accordingly, in view of the aforesaid, the complaint is dismissed as barred by limitation. Copy of this order be sent to the parties as statutorily required. File be consigned to record room.
Announced on _____ Day of _____ 2019.
