Haryana

Karnal

CC/360/2024

Amit Kumar - Complainant(s)

Versus

Reliance General Insurance Company Limited - Opp.Party(s)

Subhash Kashyap

23 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                          Complaint.No.360 of 2024

                                                          Date of instt.19.07.2024

                                                          Date of Decision:23.07.2024

 

Amit Kumar son of Shri Imrit Pal, resident of Village Khera, Tehsil Indri, District Karnal.

 

          ...…Complainant.

                                        Versus

1.     Reliance General Insurance Company Limited City Centre, Ist Floor, Opposite I.B. College, Near Vyasya Bank, G.T. Road, Panpat through its Branch Manager.

2.     Reliance General Insurance Company Limited, City Centre, MXWX+6R8, Saini Colony, Sector-12, Karnal, through its Branch Manager.

3.     Reliance General Insurance Company Limited IRDAI registered and Corporate Office Reliance Centre, South Wing, 4^th Floor Santacnuz (E) Off Western Express Highway, Mumbai 4000055 through its Managing Director.

                                                                        ....Opposite parties.

  Complaint under Section 35 of Consumer Protection Act, 2019.

Before    Sh. Jaswant Singh………President. 

                Sh. Vineet Kaushik……… Member.

                Mrs.Sarvjeet Kaur…………Member

 

                               

Present:   Shri Subhash Kashyap, counsel for complainant.

                                                         

               Complaint present today. It be checked and registered.

                Brief facts of the complaint are that complainant purchased Criti Medical Insurance Policy from the OPs for a sum assured of Rs.2,00,000/-. On 22.10.2022, complainant fell ill and after conducting test, the complainant admitted in the hospital from 23.10.2022 to 30.10.2022 and spent Rs.61,000/- to Vardha Health Care Multispeciality Nursing Home, Sector-2, Kurukshetra. Thereafter, the complainant lodged his claim with the OPs and submitted all the requisite documents but on 23.01.2023, the OPs has repudiated the claim of complainant on the false and flimsy grounds and prayed for directing the OPs to pay Rs.2,00,000/- as per terms of the policy and Rs.50,000/- on account of mental agony and Rs.11,000/- as litigation expenses.

                Arguments on the point of admissibility of the complaint heard.

                Learned counsel for complainant has argued that the claim of the complainant has been repudiated on the false and baseless grounds, thus, the OPs be directed to pay Rs.2,00,000/- as per terms of the policy, Rs.50,000/-  on account of mental agony and harassment and Rs.11,000/- as litigation expenses.

                A careful perusal of the file reveasl that the complainant has spent Rs.61,000/- on his treatment but he has claimed Rs.2,00,000/- in the prayer para.  

                On inquiry, learned counsel for the complainant has replied that earlier also he has filed complaints on the same grounds and in that complaints on receipt of notice from the Commission, the OPs had compromised the matter and paid the amount as claimed in those complaints, whereas the expenditures of the treatment were also less in those complaints.

                It appears that the complainant and officials of the OPs are colluded with each other and on receiving the notice from this Commission, they get the matter compromised and paid the extra amount, which was received from public at large by the OPs company.                    Furthermore, the policy under which the complainant has lodged his claimed has come into force on 21.04.2023 and the claim was lodged on 13.10.2023 i.e. only within six months which is also a early claim. It also appears that the complainant has lodged a claim on the false grounds only in order to grab the money from the OPs.  Thus, the claim of the complainant has been rightly repudiated by the OPs.

                Hence, in view of the above discussion, the present complaint is devoid of merits, deserves to be dismissed and same is hereby dismissed at limine. Parties concerned be communicated of the order accordingly and file be consigned to the record room.

Dated:23.07.2024.            

                    President,

District Consumer Disputes

Redressal Commission, Karnal.

(Vineet Kaushik)       (Saravjeet Kaur) 

    Member                     Member