DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BARNALA, PUNJAB.
Complaint Case No : 103/2015
Date of Institution : 04.06.2015
Date of Decision : 12.01.2016
Bikrant Bansal Advocate son of Shri Narinder Kumar Bansal C/o Mohan Tubewell Store, Old Cinema Road, Barnala, Tehsil and District Barnala (Punjab).
…Complainant
Versus
Authorized signatory of Raksha TPA Private Limited, 2nd Floor, SCO No. 181, Sector 7-C, Chandigarh (UT) 160019.
Mr. Pawan Kumar Bhalla Chief Executive Officer Raksha TPA Pvt. Ltd. C/o Escorts Corporate Centre 15/5, Mathura Road, Faridabad Haryana.
The New India Assurance Company Limited, New India Assurance Building, 87 MG Road, Fort, Mumbai 400001.
Branch Manager of The New India Assurance Company Limited, Old Court Road, building upper Allahabad Bank, Mansa.
…Opposite Parties
Ranjana Jain (ID No. 6341614) wife of Shri Rajesh Singla resident of Opp. Mother Teacher School, Astha Enclave, Dhanaula Road, Opp. PSPCL Office, Barnala.
…Proforma opposite Party
Complaint Under Section 12 of Consumer Protection Act, 1986.
Present: Sh. Gagandeep Garg counsel for the complainant.
Authorized person for opposite parties No. 1 & 2.
Sh. A.K. Jindal counsel for the opposite parties No. 3 & 4
Opposite party No. 5 exparte.
Quorum.-
1. Shri S.K. Goel : President.
Sh. Karnail Singh : Member.
Ms. Vandna Sidhu : Member.
ORDER
(SHRI S.K. GOEL PRESIDENT):
The complainant namely Bikrant Bansal has filed the present complaint under Consumer Protection Act, 1986 (hereinafter called as Act) against Raksha TPA Private Limitede and others (hereinafter called as the opposite parties).
2. The facts emerging from the present complaint are that the complainant purchased claim policy No. 36060234142800000063 from the New India Assurance Company (the opposite parties No. 3 & 4) through the opposite parties No. 1 & 2 on 17.11.2014 for the period from 19.11.2014 to 18.11.2015 through Ranjana Jain (the opposite party No. 5). It is further averred that the complainant was suffering from Nebular Corneal Opacity right eye and he consulted with Dr. Pawan Bansal C/o Aarti Laser Centre, 57-E, Tagore Nagar, Ludhiana, who diagnosed on 21.3.2015. The complainant got the treatment from Dr. Pawan Bansal as “Photo therapeutic keratectomy in right eye” on 20.3.2015. The said Doctor charged Rs. 45,000/- from the complainant apart from Rs. 2,386/- for medicines and Rs. 200/- and Rs. 300/- as consultation fee. Thereafter, the complainant submitted the original bills with the opposite parties to get the claim. However, the opposite parties closed the claim file of the complainant taking the objections “treating doctors certificate mentioning probable etiology of the present ailment”. However, the complainant submitted entire prescription and treatment slip with the opposite parties. But the opposite parties declined the claim of the complainant without any basis and reasons. Legal notice was served upon the opposite parties, but they failed to file any reply and thus, the act of the opposite parties has caused a great mental tension, agony and harassment. It is a case of deficiency in service. Hence, the present complaint is filed seeking the following reliefs:-
To pay 47,886/- alongwith interest @ 9% per annum.
To pay Rs. 30,000/- due to mental torture, agony and harassment.
To pay Rs. 10,000/- as litigation expenses.
3. Upon notice of this complaint, the opposite parties No. 1 & 2 filed a joint written version. It is pleaded that the insurance contract is between the insured and the insurer i.e. The New India Assurance Company (the opposite parties No. 3 & 4) and the answering opposite parties are the Third Party Administrative for arranging to process the claim filed by the insured as per the norms and conditions. It is further averred that the medi-claim policy has been closed due to non compliance of the query by the complainant within stipulated time inspite of repeated reminders. Moreover, the present complaint is not maintainable against them as they are not the proper and necessary parties to the present complaint.
4. The opposite parties No. 3 & 4 have filed a joint written version taking legal objections on the ground interalia no locus-standi or cause of action, complaint is frivolous, misuse of process of law and this Forum has no jurisdiction. On merits, it is submitted that the complainant purchased a medi-claim policy from them through the opposite parties No. 1 & 2. The claims are to be settled on the basis of documents supplied by the insured and after duly verification. The opposite parties No. 1 & 2 demanded various documents vide letter dated 5.5.2015 from the complainant. But the complainant failed to submit the requisite documents. Moreover, the opposite parties served a final notice upon the complainant and demanded the documents, which included treating doctor's certificate mentioning probable etiology ailment alongwith a letter attached to within 15 days from the final reminder. The complainant has not provided the same till date and as such there is no fault at the end of the opposite parties. They have denied the other allegations of the complainant and finally prayed for the dismissal of complaint.
5. The opposite party No. 5 was proceeded against exparte vide order dated 9.10.2015 due to non appearance.
6. In order to prove his case, the complainant tendered in evidence his own affidavit Ex.C-1, affidavit of Baljeet Singh Ex.C-2, affidavit of Narinder Kumar Bansal Ex.C-3, copy of file closed for claim Ex.C-4, copy of legal notice Ex.C-5, copy of postal receipt Ex.C-6, copy of letter dated 10.4.2015 Ex.C-7, copy of letter dated 5.5.2015 Ex.C-8, copy of bill Ex.C-9, copy of discharge summary Ex.C-10, copy of letter dated 29.4.2015 Ex.C-11, copy of prescription slip dated 20.3.2015 Ex.C-13, copy of prescription slip dated 21.3.2015 Ex.C-14, copy of bill dated 21.3.2015 Ex.C-15, copy of fee slip dated 21.3.2015 Ex.C-16 and Ex.C-17, copy of policy Ex.C-18, certificate as Ex.C-19 of SBI, copy of statement of account Ex.C-20 and closed the evidence.
7. To rebut the case of the complainant, the opposite parties No. 1 & 2 tendered in evidence affidavit of Vinay Batra Ex.O.P1.2/1 and closed the evidence. The opposite parties No. 3 & 4 tendered in evidence affidavit of M. Dhawal Ex.O.P.3.4/1, copy of reply of legal notice Ex.O.P.3.4/2, copy of insurance policy Ex.O.P.3.4/3, copy of order dated 29.5.2015 Ex.O.P.3.4/4 and closed the evidence.
8. We have heard the Ld. Counsels for the parties and have gone through the documents.
9. At the outset the Ld. Counsel for the opposite parties has contended that this Forum at Barnala has no territorial jurisdiction to entertain and try this complaint as specific objection as to territorial jurisdiction has been taken in the written version filed by them. It was contended that the policy for medi claim has been issued at Mansa and there is no office of the Insurance Company at Barnala. The alleged medical treatment got by the complainant from Ludhiana, therefore no cause of action has arisen at Barnala.
10. On the other hand, the Ld. Counsel for the complainant has submitted that part of cause of action as arisen within the limits of District Barnala, as the payment of cheque was issued in favour of the said Insurance Company from the account of Bikrant Enterprises State Bank of India Branch Barnala and therefore this Forum at Barnala has the territorial jurisdiction to try this case.
11. It is relevant to refer Section 11 of the Consumer Protection Act, which reads as:-
“11. Jurisdiction of the District Forum.-
(1) subject to the other provisions of this Act, the District
Forum shall have jurisdiction to entertain complaints where the value of the goods or services and the compensation, if any, claimed (does not exceed rupees twenty lakhs)
(2) A complaint shall be instituted in a District Forum within the local limits of whose jurisdiction.-
(a) opposite party or each of the opposite parties, where there are more than one, at the time of institution of the complaint, actually and voluntarily resides or carries on business or has a branch office or personally works for gain, or
(b) any of the opposite parties, where there are more than one at the time of the institution of the complaint, actually and voluntarily resides, or carries on business or has a branch office or personally works for gain, provided that in such case either the permission of the District Forum is given or the opposite parties who do not reside or carry on business or have a branch office, or personally work for gain, as the case may be acquiesce in such institution; or
(c) the cause of action, wholly or in part, arises.
12. In the present case, the complainant has sought compensation of Rs.47,886/- alongwith interest. This amount has stated to be spent by the complainant on his treatment during the insurance period. Admittedly, the complainant got the treatment from Dr. Pawan Bansal at Ludhiana. The medi claim policy Ex.C-8 shows that the same has been issued from Mansa Branch. There is no document on the record to show that the policy has been issued at Barnala.
13. The contention of the Ld. Counsel for the complainant is that the policy purchased through Ms. Ranjna Jain (the opposite party No. 5) at his shop at Barnala. However, there is no affidavit of Ms. Ranjna Jain, who alleged to issue the said policy at Barnala is placed on record.
14. It was laid down by the Hon'ble Apex Court of India in case titled Sonic Surgical Vs National Insurance Company Ltd. reported in 2010 (1) CLT 252:
“when the insurance policy was taken at Ambala and the claim for compensation was also made at Ambala and since no cause of action arose at Chandigarh, the State Consumer Disputes Redressal Commission, Chandigarh, has no territorial jurisdiction and State Consumer Disputes Redressal Commission, Haryana alone will have jurisdiction to entertain the complaint. The Hon'ble Apex Court further observed that Expression 'branch office' is amended Section 17(2)(6) would mean the branch office where the cause of action has arisen”.
15. In case titled “M/s Sethi Agriculture Store v/s Gurdev Singh, First Appeal No.1114 of 2011 decided on 20.3.2013, the Hon'ble State Commission, Punjab, while dealing with a case where the seed was purchased from Sirsa and sown in village Sanga, in District Mansa, was pleased to observe that:
“in the present case only the District Forum at Sirsa had the jurisdiction to entertain and try the complaint and the District Forum, Mansa had no such territorial jurisdiction.”
16. As a result of the above discussion and in view of the authorities/pronouncements of the Hon'ble Apex Court and Hon'ble State Commission, we are of the opinion that complainant has miserably failed to prove the territorial jurisdiction of this Forum. Therefore, present complaint is ordered to be returned to the complainant against proper receipt with the liberty to present the same in the appropriate Forum. There is no order as to costs or compensation. Copy of this order be supplied to the parties free of costs. The file after its due completion be consigned to the records.
ANNOUNCED IN THE OPEN FORUM:
12th Day of January, 2016.
(S.K. Goel)
President.
(Karnail Singh)
Member.
(Vandna Sidhu)
Member.
