Haryana

Kaithal

339/19

Navneet Goyal - Complainant(s)

Versus

Punjab National Bank - Opp.Party(s)

Sh.S.S Mangal

19 Feb 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL

 

                                                               Complaint Case No. 339 of 2019.

                                                               Date of institution:   10.10.2019.

                                                               Date of decision:      19.02.2024.

 

Navneet Goyal Advocate s/o Shri Janardass Goyal, r/o H.No.1330/11, New Model Town, Ambala Road, Kaithal.

                                                                                      …Complainant.

                                                       Versus

 

1. Punjab National Bank, Karnal Road, Kaithal, through its Branch Manager,
2. The Oriental Insurance Company Limited, Sabharwal Market, Railway Road, Kurukshetra, through its Senior Manager.
3. The Oriental Insurance Company Limited, Branch Office Kaithal, through its Branch Manager.
4. Raksha Health Insurance TPA Pvt. Ltd., through Regional Manager 14/3, First Floor, Mathura Road, near Mewala Maharajpur Metro Station, Faridabad.

...Opposite Parties.

 

          Complaint under Section 35 of the Consumer Protection Act

 

 

CORAM:   SMT. NEELAM KASHYAP, PRESIDENT.

                   SMT. SUMAN RANA, MEMBER.

                   SHRI SUNIL MOHAN TRIKHA, MEMBER.

                  

Present:       Shri S.S. Mangal, Advocate for the complainant.   

                   Shri K.K. Kheterpal, Advocate for Opposite Party No.1.

                   Shri M.R. Miglani, Advocate for Opposite Parties No.2 & 3.

                   Opposite Party No.4 ex-parte.

                  

ORDER  -  NEELAM KASHYAP, PRESIDENT:

                   Complainant has filed this complaint under Section 12 of Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’), against the OPs.

2.                In the complaint, complainant alleged that he is account holder with OP No.1 and was insured under PNB-Oriental Medi-claim policy 2017 Group Health Insurance Product with OPs No.2 & 3 vide policy No.261303/48/2019, Member ID No.055619498673 w.e.f. 04.04.2018 to 03.04.2019 after paying premium amount of Rs.8850/-. That under the said policy, his family members were also covered. That on 22.10.2018 his wife Sunita Goyal (wrongly typed as Sunia in complaint) was admitted to Jindal Institute of Medical Sciences Hisar for treatment and applied for cashless treatment and OP No.4 denied the same and suggested for raising of bill afterwards. That her wife Sunita Goyal remained under treatment from 22.10.2018 to 02.03.2019 at said hospital and Chest Care Clinic, Patiala. That he submitted the bills of her treatment to the tune of Rs.53244/- to OP No.4, who settled the bill to the tune of Rs.9352/- only and rejected the rest of the claim, without assigning any plausible reason. That he made repeated requests to OPs to pay the balance claim amount, but they failed to pay the same. The above act of OPs, amounts to gross deficiency in service, on their part, due to which, he suffered huge physical harassment, mental agony as well as financial loss, constraining him, to file the present complaint, against the OPs, before this Commission.

3.                Upon notice of complaint, OPs No.1 to 3 appeared before this Commission and filed their respective written statements, whereas, OP No.4 failed to appear, before this Commission, on the date fixed i.e. 25.11.2019, despite receipt of notice from this Commission, as such, OP No.4 was proceeded against ex-parte, on that date, by this Commission.

4.                OP No.1, in its written statement stated that the present complaint is bad for mis-joinder of party, as OP No.1 is not necessary party as the matter in dispute is not related to OP No.1. Complainant had got a medi-claim policy from OPs No.2 & 3. He has not got any medi-claim policy renewed through OP No.1, as such, OP No.1 has no concern with the policy and the dispute if any is inter-se between complainant and OPs No.2 & 3 and prayed for dismissal the present complaint against it.

5.                OPs No.2 & 3, in their written statement admitted the policy in question. It is further stated that the complainant has no locus standi to file the present complaint as claimant is Sunita Devi, who should had filed the complaint, so complaint is not maintainable which has been filed by her husband, hence, complaint is bad for non-joinder of necessary party as Sunita Devi was necessary party in the complaint. It is further stated that the complainant submitted medical bills and treatment record with TPA and as per terms and conditions of insurance policy, TPA has approved claim of complainant to the tune of Rs.9352/-, which has paid to TPA, who is ready to pay such amount to the complainant. It is pertinent to mention here that some amount or payment has been deducted by TPA, which was not payable and falsely obtained such bill in collusion with hospital authority.

Thus, there is no question of any deficiency in service, on the part of OPs No.2 & 3, and prayed for dismissal the present complaint.

6.                To prove the case, complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Annexure-C1 to Annexure-C47.

7.                On the other hand, OP No.1, in its evidence tendered affidavit Ex.RW1/A and document Annexure R-2. OPs No.2 & 3 tendered into evidence affidavits Ex.RW2/A, Ex.RW2/B and document Annexure R-1.

8.                We have heard the learned counsel for the parties and perused the record carefully.

9.                At the outset, the learned counsel for OPs No.2 & 3 has raised strong objections that present complaint is bad for non-joinder of party, as claimant Sunita Devi should have filed the present complaint instead of complainant Navneet Goyal, hence the present complaint is not maintainable and same be dismissed on this very ground.

10.              From the perusal of policy document Mark-Z, it is coming out that the complainant Navneet Kumar had purchased the said medi-claim policy, in which, he (complainant) along with his wife namely Sunita Goyal, daughter Stuti Goyal and son Shubham Goyal was also covered. By way of filing the complaint is hand, complainant is claiming/demanding the balance medi-claim amount regarding the treatment, taken by her wife Sunita Goyal, who was also covered under the said medi-claim policy in question, therefore, it was incumbent/mandatory for the complainant either to file the present complaint in the name of her wife Sunita Goyal or made her party (co-complainant) in the present complaint. No doubt, the policy in question Mark-Z is in the name of complainant Navneet Kumar, but even then it was mandatory/necessary for the complainant to implead said Sunita Goyal, as party, in the present complaint or he should have to file the present complaint in her, but the complainant did not do so, reason best known to him, and in the absence of that, the present dispute cannot be decided fairly. As such, the objection raised by learned counsel for OPs No.2 & 3, in this regard has force.

11.              In order to support his contentions, learned counsel for the complainant has placed reliance upon case laws titled M/s Spring Meadows Hospital (Noida) and Another Versus Harjot Ahluwalia through K.S. Ahluwalia and Another, 1998 (1) CPC, 423 (SC) and Narain Steel Traders, Iron Merchants & Commission Agents Versus Central Bank of India and others, CPC 1994(2) 244 (State Commission, Punjab Chandigarh). From perusal of above case laws, we found that in these case laws, the Superior Fora has defined the definition of Consumer to the effect that “definition of a consumer is wide enough to include not only a person who hires the services but also the beneficiary of such services”. However, it is pertinent to mention here that in the case in hand, this Commission is not denying the fact that said Sunita Goyal does fall under the definition of “Consumer” being beneficiary of services of OPs, but contrary to it, complainant has neither filed the present complaint on the name of said beneficiary i.e. Sunita Goyal nor made/impleaded her as a party (co-complainant), in the present complaint, being beneficiary of OPs and in the absence of that, the issues involves in the present complaint, cannot be decided fairly.

12.              Keeping in view the above facts and circumstances of the case, we are of the considered view that the present complaint is bad for non-joinder of necessary party i.e. Sunita Goyal, hence, the same is liable to be dismissed, on this very ground, because, it will be futile exercise to proceed further with the present complaint on merits.

13.              Hence, due the reasons stated hereinbefore and without making any comment on the merits of the case, present complaint is dismissed for non-joining of necessary parties, leaving the parties to bear their own costs of litigations. However, the complainant shall be at liberty to file afresh complaint, on the same cause of action, if so desired, and in that eventuality, complainant will be entitled to the benefit of Section 69 “Limitation Act” of Consumer Protection Act, 2019, and the time taken during the pendency of this complaint, shall be exempted. A copy of this order be sent to the parties free of cost. File be consigned to the records, after due compliance.     

Announced in open Commission:

Dt.:19.02.2024.

                                                                                      (Neelam Kashyap)

                                                                                      President.

 

(Sunil Mohan Trikha).             (Suman Rana).              

Member.                                  Member.

 

Typed by: Sham Kalra, Stenographer.