Maharashtra

StateCommission

A/09/1038

RAVINDERPALSINGH H BHASIN & ORS - Complainant(s)

Versus

ORIENTAL INSURANCE CO. - Opp.Party(s)

K B CHANDWADKAR

24 Sep 2010

ORDER


BEFORE THE HON'BLE STATE CONSUMER DISPUTES REDRESSAL

COMMISSION, MAHARASHTRA, MUMBAI
First Appeal No. A/09/1038
(Arisen out of Order Dated 30/07/2009 in Case No. 186/07 of District Nashik)
1. RAVINDERPALSINGH H BHASIN & ORSYATIN APT. N D PATEL RD. BASHIKMaharastra2. MR. RANJITSINGH HARBANSINGH BHASINYATIN APARTMENT, N.D. PATEL ROAD, NASHIKMAHARASHTRA3. MR. AMARJEETSINGH HARBANSINGH BHASINYATIN APARTMENT, N.D. PATEL ROAD, NASHIKMAHARASHTRA ...........Appellant(s)

Versus
1. ORIENTAL INSURANCE CO.BHAGYASHRI BLDG. 996 SHUKRAWAR PETH NR.BHARAT PETROL PUMP ABOVE GOKHALE HOSPITAL TILAK RD, PUNE 411 002Maharastra2. THE MANAGER, PARAMOUNT HEALTH SERVICES PVT. LTD.BHAGYASHRI BUILDING, 996, SHUKRAWAR PETH, NEAR BHARAT PETROL PUMP, ABOVE GOKHALE HOSPITAL, TILAK ROAD, PUNE 411 002.MAHARASHTRA ...........Respondent(s)

BEFORE :
Hon'ble Mr. S.R. Khanzode PRESIDING MEMBERHon'ble Mr. Dhanraj Khamatkar Member
PRESENT :Mr.K.B. Chandwadkar, Advocate for the Appellants. SHRI A.S. VIDYARTHI, Advocate for the Respondent 1

Consumer Court Lawyer

Best Law Firm for all your Consumer Court related cases.

Bhanu Pratap

Featured Recomended
Highly recommended!
5.0 (615)

Bhanu Pratap

Featured Recomended
Highly recommended!

Experties

Consumer Court | Cheque Bounce | Civil Cases | Criminal Cases | Matrimonial Disputes

Phone Number

7982270319

Dedicated team of best lawyers for all your legal queries. Our lawyers can help you for you Consumer Court related cases at very affordable fee.

ORDER

Per Shri S.R. Khanzode - Hon'ble Presiding Judicial Member:

 

     Heard. Admit and heard forthwith with the consent of both the parties.

 

     In the instant case consumer complaint was filed on 27.08.2007 after the Respondent/Insurance Company repudiated the insurance mediclaim.  The mediclaim pertains to hospitalization and treatment from 16.06.2005 to 01.07.2005 i.e. the date on which late Harbansingh Bhasin died.  Claim was repudiated on the ground of suppression of material facts and that the case of chronic alcoholic abuse resulting into acute or chronic liver disease (alcoholic) is not covered under the policy. In the written version filed, amongst other grounds, point of limitation is also taken.

 

     Referring to the impugned order it can be seen that point of limitation was raised by Respondent/Opposite Party but, same was not at all considered by the District Consumer Disputes Redressal forum, Nashik, i.e. Forum below.  Admittedly, the cause of action would arise in between 16.06.2005 to 01.07.2005 and in any case not later than 01.07.2005, the date on which late Harbansingh Bhasin died.  Consumer complaint which was filed on 27.08.2007, thus, is not filed within two years therefrom and there is no application for condonation of delay is filed.  Therefore, the present complaint itself could not be entertained and barred by limitation.  A reference could be made  to the Apex Court judgement in the matter of Kandimalla Raghavaiah & Co. V/s. National Insurance Co. Ltd. & Anr., reported in III (2009) CPJ 75 (SC).

 

It may be pointed out that the complaint made to Ombudsman, prior to filing of this consumer complaint, stood dismissed.

 

Further, the treating doctor (Dr.Nitin Borse) mentioned that the case of the deceased was of chronic alcoholic abuse – acute or chronic liver disease.  Referring to the clinical history of hospitalization prior to the last illness, and recommendations, the Complainant failed to establish that the deceased was not consuming alcohol.  Even Dr.Ganorkar, advised the deceased to not to consume  alcohol.  Therefore, the repudiation of the claim by the Insurance Company cannot be faulted with. Thus, there is no deficiency in service on the part of the Insurance Company.

 

     For the reasons stated above, we find that the order passed by the Forum below cannot be faulted with.  Thus, we find the appeal devoid of any substance and hence, pass the following order:

 

O  R  D  E  R

 

     (i)       Appeal stands dismissed.

    (ii)       No order as to costs.

 

PRONOUNCED :
Dated : 24 September 2010

[Hon'ble Mr. S.R. Khanzode]PRESIDING MEMBER[Hon'ble Mr. Dhanraj Khamatkar]Member