Haryana

StateCommission

A/38/2018

STAR HEALTH AND ALLIED INSURANCE CO.LTD. - Complainant(s)

Versus

SACHIN KUMAR - Opp.Party(s)

SAHIL ABHI

27 Feb 2018

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

 

 

 

 

                                                          First Appeal No  :      38 of 2018

Date of Institution:     11.01.2018

Date of Decision :      27.02.2018

 

 

1.      Star Health and Allied Insurance Company Limited through its Authorized Signatory, 1 New Tank Street, Valluvar, Kottam High Road, Nungambakkam, Chennai.

2.      Star Health and Allied Insurance Company Limited through its Branch Manager, SCO 242, 1^st Floor, Sector 12, Opposite Mini Secretariat, Karnal.    

                             Appellants-Opposite Parties

 

Versus

 

 

Sachin Kumar son of Shri Rohtas, resident of Shop No.37, Anaj Mandi, Village and Post Office Kunjpura, District Karnal.

                                      Respondent-Complainant

 

 

 

 

 

 

 

 

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Shri Balbir Singh, Judicial Member       

                            

 

 

 

Argued by:          Shri Sahil Abhi, Advocate for appellants

                            

 

                                                   O R D E R

 

NAWAB SINGH J.(ORAL)

 

          Star Health and Allied Insurance Company Limited and its functionary-opposite parties (for short, ‘Insurance Company’) are in appeal against the order dated November 14^th, 2017 passed by District Consumer Disputes Redressal Forum, Karnal (for short, ‘District Forum’) whereby it directed the Insurance Company to pay Rs.5,00,000/- and Rs.5500/- litigation expenses to Sachin Kumar-complainant on account of expenses incurred by him on his treatment.

2.      The complainant purchased Family Health Optima Insurance Policy (Annexure C) from the Insurance Company.  The period of insurance was March 04^th, 2014 to March 03^rd, 2015.  The complainant was admitted in Amritdhara Hospital, Karnal on August 10^th, 2014 for kidney problem.  He was discharged on August 12^th, 2014 and incurred an amount of Rs.5,00,000/- on the treatment. 

3.      The only submission raised by learned counsel for the Insurance Company is that the complainant was having kidney problem prior to the purchase of the insurance policy.

4.      On being questioned as to whether there is any medical record in support thereof, learned counsel candidly stated that there is no such record prior to the purchase of the insurance policy.  In view of this, no irregularity is discernible in the impugned order. The appeal consequently fails and is hereby dismissed.

5.      The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the appellants against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

 

 

Announced 27.02.2018

(Balbir Singh) Judicial Member

(Nawab Singh) President

UK