DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, NORTH-WEST,
GOVT. OF NCT OF DELHI
CSC-BLOCK-C, POCKET-C, SHALIMAR BAGH, DELHI-110088.
CC No: 1022/2014
D.No._________________________ Dated: _________________
IN THE MATTER OF:
Smt. RAMA ARORA,
W/o SH. NARINDER ARORA,
R/o 2423, HUDSON LINE,
KINGSWAY CAMP, DELHI-110009. … COMPLAINANT
Versus
1. ORIENTAL BANK OF COMMERCE,
(THROUGH ITS MANAGER),
115-117, MALL ROAD, GTB NAGAR,
NEAR VIKRANT RESTAURANT,
KINGSWAY CAMP, DELHI-110009.
2. ORIENTAL INSURANCE CO. LTD.,
(THROUGH ITS MANAGER),
88, JANPATH, GROUND FLOOR,
NEW DELHI-110001. … OPPOSITE PARTY (IES)
CORAM: SH. M.K. GUPTA, PRESIDENT
SH. BARIQ AHMED, MEMBER
MS. USHA KHANNA, MEMBER
Date of Institution: 02.09.2014
Date of decision: 20.05.2019
SH. M.K. GUPTA, PRESIDENT
ORDER
1. The complainant has filed the present complaint against the OPs under Section 12 of the Consumer Protection Act, 1986 thereby alleging that the complainant was having a saving account with OP-1 bearing account no. 02802010004650 and as per the policy
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from OP-2, the premium of the same was paid to OP-1 by cheque and the same is being forwarded to OP-2 by the bank i.e. OP-1 and OP-1 for the reason best known to them did not forward the premium to OP-2 for the period of 2013-2014 although the complainant duly paid the same to OP-1 by cheque and the same has been duly debited from the account of the complainant as per statement of account for the period of 2013-2014 and premium for period of 2014-2015 has been paid to OP-1. During the period of February-March-2014, the complainant was admitted in Hospital for the operation and informed the hospital that the complainant is having Mediclaim Policy and the number of the same was duly intimated to the concerned hospital and to the great surprise of the complainant, it was revealed by the officials of the hospital that the policy of the complainant has been lapsed and accordingly the complainant cannot avail the benefits of Mediclaim and the complainant has to made entire payment of the bill amount to the hospital in case. Thereafter, the complainant made various request to OP-1 regarding her Mediclaim Policy why the policy has not been renewed for the period of 2013-2014, although the complainant has made payment of premium to OP-1 and for the best reason known to them, the same was not forwarded by OP-1 to OP-2 for renewal for the period 2013-2014 and accordingly both OPs have thus committed deficiency in service due to which the complainant has
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to suffer and since the complainant paid the premium to OP-1 for the renewal of the policy for the period of 2013-2014, accordingly the complainant is entitled for the Mediclaim benefits and there is a deficiency in service on the part of OPs. The complainant further alleged that the complainant served a legal notice dated 03.05.2014 through his counsel to OPs but OPs failed to release the claim despite repeated requests of the complainant and approach of OPs amounts to deficiency in services and unfair trade practice.
2. On these allegations the complainant has filed the present complaint praying for direction to OPs to grant compensation for deficiency in service on the part of OPs to the tune of Rs.3,00,000/- which also include the amount spent by the complainant in the treatment in hospital and to pay the cost of the present complaint.
3. OPs have been contesting the complaint and filed separate reply/written statement. OP-1 in its reply submitted that the complaint is not maintainable and is liable to be dismissed and there is no deficiency in service on the part of OP-1. OP-1 further submitted that the complaint relates to the services obtained by the complainant from OP-2 which are not in preview of OP-1 and OP-1 has been unnecessarily dragged into litigation by the complainant and OP-1 is neither the principal nor the agent of OP-2 and it has only provided the premises for use to OP-2. OP-1 further denied that the premium of Mediclaim policy was paid to OP-1 by cheque
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and the same is being forwarded to OP-2 by OP-1.
4. OP-2 in its written statement submitted that the complainant has not been issued any Mediclaim Insurance Policy for the claim under complaint because of non-payment of the premium amount to OP-2 for the year under which the claim has been sought. OP-2 further submitted that the complaint is not maintainable and is liable to be dismissed because there is no privity of contract.
5. The complainant has filed separate rejoinder to reply of OPs and denied the contentions of OPs.
6. In order to prove her case, the complainant filed her affidavit in evidence and also filed written arguments. The complainant also placed on record copy of Oriental Bank Mediclaim Policy schedule bearing no.272900/48/2013/646 for the period from 20.04.2012 to 19.04.2013 (mid-night) issued by OP-2, copy of Risk Details of the policy issued by OP-2, copy of receipt dated 20.04.2012 of Rs.6,830/- issued by OP-2, copy of passbook showing statement of account of the complainant for the period from 09.01.2012 to 17.04.2014 issued by OP-1, copy of discharge summary dated 05.04.2014 issued by RG Stone, Urology & Laparoscopy Hospital, copies of receipts no. 109995 dated 05.04.2014 for a sum of Rs.40,000/-, cash bill no.14-15/109999-14-15/82398 dated 05.04.2014 for a sum of Rs.3,000/-, receipt no. 109997 dated 05.04.2014 for a sum of Rs.20,000/- cash bill no. 13-14/101040-
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13-14/75374 dated 19.11.2013 for a sum of Rs.521/-, cash bill no.14-15/109858-14-15/82278 dated 03.04.2014 of a sum of Rs.512/- in respect of various tests issued by RG Stone Urology & Laparoscopy Hospital, copy of cash memo no.46824 dated 20.11.2013 for a sum of Rs.346/- for purchase of medicine, copy of retail invoice dated 21.11.2013 for a sum of Rs.318.78 issued by Penta Medicos, copy of receipt no.72147 dated 19.11.2013 for a sum of Rs.3,600/- issued by Saral Diagnostic Centre, copies of retail invoice no. 4600 dated 30.04.2014 of Rs.3,510/-, no.4573 dated 26.04.2014 of Rs.242/-, no.4599 dated 10.03.2014 of Rs.2,119/-, no.4564 dated 19.11.2013 of Rs.6,921/-, no.4801 dated 07.05.2014 of Rs.2,185.50 & no.4613 dated 12.01.2014 of Rs.11,502/-, copy of legal notice dated 03.05.2014 sent by the complainant through his Counsel to OPs by Regd. A.D. alongwith copies of courier receipt and acknowledgement cards and copies of postal receipts, copy of e-mail communication dated 25.02.2014 to OP-2 and copy of reply dated 10.03.2014 sent by OP-2 through e-mail thereby demanding copy of policy of the previous year and copy of discharge summary placed on record by the complainant shows that complainant was hospitalized in the hospital on 04.04.2014 and was discharged on 05.04.2014 for the treatment/removal of B/L renal Calculi with right lower ureteric calculus.
7. On the other hand, Sh. Hardeep Kapoor, Branch Manager of OP-1
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and Sh. Bipin Kumar, Senior Divisional Manager of OP-2 filed their separate affidavits in evidence. OP-2 also filed copies of letters dated 21.05.2014 & 17.06.2014 sent by OP-2 to OP-1 thereby demanding detail of premium paid like cheque/DD no., dated and amount. OPs have also filed written arguments.
8. This forum has considered the case of the complainant as well as OPs in the light of evidence and documents placed on record by the parties. The copy of statement of account of the complainant as reflected in the bank passbook shows that OP-1 has debited an amount of Rs.6,830/- on 05.04.2013 towards Mediclaim deposited by cheque no. 505236. Thus, it clearly shows that OP-1 has debited the premium amount of Rs.6,830/- in the account of the complainant. But has not forwarded the same to OP-2. Moreover, OP-1 has also kept silence after receiving letters dated 21.05.2014 & 17.06.2014 from OP-2. Thus, this Forum is of opinion that the Mediclaim policy of the complainant issued by OP-2 for the period from 20.04.2013 to 19.04.2014 (mid-night) cannot be lapsed and claim sent by the hospital to OP-2 should not have been refused. Accordingly, both the OPs are held guilty of deficiency in service.
9. Thus, holding guilty for the same, we direct both the OPs jointly or severally as under:
-
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by the complainant to the hospital.
ii) To pay to the complainant an amount of Rs.25,000/- as compensation for harassment and mental agony suffered.
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10. The above amount shall be paid by both the OPs jointly or severally to the complainant within 30 days from the date of receiving copy of this order failing which both the OPs shall be liable to pay interest on the entire awarded amount @ 10% per annum from the date of receiving copy of this order till the date of payment. If OPs fail to comply with the order within 30 days from the date of receiving copy of this order, the complainant may approach this Forum u/s 25 of the Consumer Protection Act, 1986.
11. Let a copy of this order be sent to each party free of cost as per regulation 21 of the Consumer Protection Regulations, 2005. Thereafter file be consigned to record room.
Announced on this 20th day of May, 2019.
BARIQ AHMED USHA KHANNA M.K. GUPTA
(MEMBER) (MEMBER) (PRESIDENT)
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UPLOADED BY :- SATYENDRA JEET
