BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
CACHAR :: SILCHAR
Con. Case No. 24 of 2009
Sri Bachhraj Surana, ………………………………………………………… Complainant.
-Vrs.-
1. United India Insurance Co. Ltd.,
Divisional Office, S.P. Road, Shillong Patty,
Silchar-1. O.P No. 1.
2. Heritage Health Services Pvt. Ltd.,
Nicco House, 5th Floor, 2, Hare Street,
Kolkata-1. O.P No.2.
Present: - Sri Bishnu Debnath, President,
District Consumer Forum,
Cachar, Silchar.
Mrs. Chandana Purkayastha, Member,
District Consumer Forum,
Cachar, Silchar.
Shri Kamal Kumar Sarda, Member,
District Consumer Forum,
Cachar, Silchar.
Appeared: - Sri A Biswas, Advocate for the complainant.
Sri Santanu Nandan Bhattacharjee, Advocate for the O.P.
Date of Evidence……………………….. 23-11-2011
Date of written argument……………… 19-06-2015, 19-05-2017
Date of judgment………………………. 20-07-2017
JUDGMENT AND ORDER
Sri Bishnu Dednath,
- The complainant Sri Bachhraj Surana purchased an Insurance Policy No. 130500/48/06/20/00000881 under Mediclaim Scheme from United India Insurance Co. Ltd., (O.P No.1). The period of insurance was from 30-11-2000 to 22-11-2007. During the validity period of insurance he had undergone treatment in different hospital and submitted relevant papers to the authorized agent of the O.P on 23-08-2007. But the said agent lost the document. Hence, the complainant again submitted claim paper, form etc. as per proceedure but nothing was done by the O.P No.1. Hence, the complainant issued a letter dated 10-11-2008 for early settlement but the O.P No.1 did not do anything. In such circumstances the complainant served a pleader’s notice on 20-01-2009 to O.P No.1, but the O.P No.1 gave an evasive reply.
- Thus, the complainant rather compelled to bring the complaint for award of payment of Rs.53,576/- with interest @ 15% P. A. with effect from 23-08-2007 till recovery and cost of the proceeding.
- During hearing, the O.P No.1 submitted W/S. In the W/S denying its disservice, took a plea that the case is bad for non-joinder of TPA. Accordingly, the complainant added TPA as O.P No.2. But the O.P No.2 did not respond on receipt of the notice. Hence, the case is proceeding exparte against the O.P No.2.
- The complainant did not adduce any evidence in spite of allowing several adjourned dates. The O.P No.1 submitted D.W-1 and produced some relevant documents. The O.P No.1 also during pending of the proceeding on 04-05-2012 deposited cheque of RS. 55,000/- and the complainant received the same vide cheque No. 611503 dated 29-02-2012. However, the complainant by filing Petition No.281 on 24-05-2012 prayed time to amend the complaint due to subsequent event. Accordingly, a formal amendment petition No.387 dated 26-07-2012 submitted vide order dated 26-06-2012. The said prayer has been allowed but the complainant did not take step to amend the complaint and also did not submit any evidence. Of course, the O.P No.1 submitted written argument and the complainant also submitted written argument without adducing any evidence. None has appeared for oral argument. Accordingly, we have perused the complaint, W/S deposition of the O.P, written argument and content of petition No. 243 of the O.P and also taken into consideration the fact of payment of claim amount and extra amount vide order dated 04-05-2012.
- From the above fact, it is of opinion that the O.P No.1 has admitted the claim of the complainant. Thus, without going to the evidence on record to establish the material fact. It is opined that an award can be given for payment of the amount claimed by the claimant on admission. But the Complainant has been compelled to bring this case for award. For which the O.P No.1 is liable to pay cost of the proceeding of a lumpsum amount of Rs. 2,500/- (Rupees Two thousand five hundred) only. Of course, the excess amount paid on 04-05-2012 to be adjusted with the above amount of cost.
- Therefore, the O.P No.1 is asked to pay the balance amount of cost of the proceeding within 45 days from today. If failed 10% interest to be added to the balance amount till realization of the full.
- With the above, this case is disposed of on admission. Supply free certified copy of the judgment to the parties.
Given under the hand of the President and Members of this District Forum and seal of the Office of the District Forum on this the 20th day of July, 2017.
