DISTRICT CONSUMER DISPUTES REDRESSAL FORUM (CENTRAL) ISBT KASHMERE GATE DELHI
CC/ 403/2016
No. DF/ Central/
R.L. Jalla (Senior Citizen)
R/o D-6, Pamposh Enclave,
New Delhi - 110048
.....Complainant
VERSUS
1. The Oriental Insurance Company Limited
UGF 8, 11,12,13 Arunachal Bhavan,
Barakhamba Road, New Delhi – 110001
And
4E/14, Azad Bhawan, Jhandewalan,
Delhi - 110055
Registered Office :-
Oriental House,
P.B. No. 7037, A – 25/27
Asaf Ali Road, New Delhi – 110 002
…..Opposite Party 1
2. Delhi Retina Centre
Through Its Director
4802, Bharat Ram Road,
24, Darya Ganj, New Delhi – 110002 ....Opposite Party 2
Quorum : Ms. Rekha Rani, President
Mrs. Manju Bala Sharma, Member
Shri R.S. Nagar, Member
ORDER
Rekha Rani, President
1. The instant complaint is filed by Shri R.L. Jalla (in short the complainant) against The Oriental Insurance Company Limited and Delhi Retina Centre (in short OPs) U/s 12 of the Consumer Protection Act 1986 as
amended up to date (in short the Act) pleading therein that he has purchased
three Mediclaim Policies of OP 1 details whereof are given in para 4 of the complaint as under:
- Policy No. 272200/48/2010/4756 for the period 27.03.2010 to 26.03.2011
- Policy No. 272200/48/2011/6428 for the period 27.03.2011 to 26.03.2011
- Policy No. 272200/48/2012/6870 for the period 27.03.2012 to 26.03.2013.
On 03/07/2010 he suffered some problem in his left eye for which he visited Venu Eye Institute & Research Centre, Delhi for treatment. As he was having mediclaim policy of OP 1 he submitted all the documents to Venu Eye Institute for availing cashless treatment under Policy No. 272200/48/2010/4756.
On 10/07/2010 TPA sent reply to Venu Eye Institute whereby they rejected cashless benefit proposed to be availed by the complainant.
Thereafter complainant approached Eye Centre namely Delhi Retina Centre (OP 2) on 17/07/2010 where he was admitted for treatment. Vide his letter dated 23/07/2010 complainant informed OP 1 about his treatment taken on 17.07.2010 but he did not receive any response. Meanwhile some further treatment was received by complaint from OP 2 on 14/08/2010 and 18/09/2010. Complainant sent all the original reports/Medical prescription and vouchers of his treatment to OP 1. OP 1 sought opinion of TPA regarding
the claims raised by the complainant and vide mail dated 03/12/2010 complainant’s claim was outrightly rejected by TPA stating that the claim is not admissible under clause 2.3 of the mediclaim policy.
Being aggrieved by rejection of his claim complainant approached Delhi Government Mediation and Conciliation Centre and office of Insurance Ombudsman on 20.01.2011.
Complainant’s first case filed before the Delhi Government Medication & Conciliation Centre was rejected by the competent authority on 23.03.2011 due to absence of the officials of OP 1.
Insurance Ombudsman dismissed the claim of the complainant vide order dated 03.01.2012.
Feeling aggrieved by rejection of his claim by Insurance Ombudsman vide order dated 03.01.2012 complainant filed review petition on 25.06.201.
2. The instant complaint is accompanied with an application seeking condonation of delay of 352 days in filing the instant complaint.
Application as well as complaint is contested by the OPs in view of Section 24 A (1) of the Act.
3. We have heard Shri Deep Chand Counsel for complainant along with complainant, Shri Bhupesh Chandna Counsel for OP 1.
4. Learned counsel for OP 1 vehemently asserted that the claim is barred by limitation under section 24 (A) of the Act which reads as follows :
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.’’
5. OP 1 in the very first paragraph of its written statement has taken an objection that the complaint is barred under section 24 (A) of the Act. It is pleaded that cause of action arose on 03/07/2010. Complainant filed his claim with OP 1 on 23.09.2010 and OP repudiated his claim vide its letter dated 24.11.11. It is further stated that complainant filed a complaint before
the Insurance Ombudsman which was also dismissed vide order dated 03.01.2012. It is stated that the complainant has filed the complaint after 4 years and 06 months and that this period cannot be condoned by this forum.
Complainant has submitted that his claim is within limitation and that he was running from pillar to post for redressal of his grievances.
Para 26 page 16 of the complaint deals with limitation. It reads that cause of action for filing the instant complaint arose on 03/07/2010 when complainant approached TPA of OP 1 for availing cashless facilities for his treatment in Venu Eye Institute. It is further stated that cause of action also arose on 22.09.2010, 15.04.2011 and 30.08.2011 when he wrote letters to OP 1 for reimbursement of his medical bills. It is stated that cause of action further arose on 24.11.11 when OP 1 repudiated his claim. It is further stated that it also arose on 29.06.2012 when he made another claim with OP 1. It is stated that it also arose on 10.11.2014 when he sent final reminder to OP 1. It is also stated that cause of action continues till OP 1 does not reimburse his claim.
6. Complainant himself has stated in para 26 page 16 of his complaint that on 24/11/11 OP 1 had rejected his claim. Therefore, cause of action accrued to the complainant to file this complaint on 24.11.11.
In para 18 page 11 of his complaint complainant has pleaded that vide order dated 03/01/12 Insurance Ombudsman dismissed his claim. So even if
2 years period is presumed to start from 03.01.2012 the complaint was not filed within 02 years.
7. Complainant submitted that he filed review application before Insurance Ombudsman on 25.06.2012 (para 19 of the complaint) which means he waited for about 05 month to file the review application before the Insurance Ombudsman. When we asked learned counsel for complainant regarding the fate of review application filed before Insurance Ombudsman complainant who was present in person stated that he was orally told that the review application is not maintainable.
8. Limitation does not get extended if the complainant files applications here & there at a time which is convenient to him. Insurance ombudsman dismissed the complaint on 03.01.2012. Complainant waited for more than 5 months and filed review application on 25.06.2012. The instant complaint was filed on 07.01.2015. There is no reasonable explanation as to what prevented the complainant from approaching this forum in time.
9. Limitation does not start or end with writing letters here and there. Complainant is not illiterate. He knew where he had to go for redressal of his grievances. 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).
10. 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.
11.
“ 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 maxim
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.”
12. 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
13.
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15. 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.
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“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.”
17. In Baswaraj Vs. 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.
18.
19. 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.
20. Complainant has himself has pleaded in para 26 page no. 16 of his complaint that OP 1 repudiated his claim on 24/11/2011 therefore cause of action to file the instant complaint arose on 24/11/2011. He further pleaded in page no. 11 of his complaint that Insurance Ombudsman dismissed his claim on 03/01/2012. The instant complaint was filed on 07/01/2015. The delay in filing the same is not explained. The complaint is therefore 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 this 27th Day of February 2019.
