Haryana

Karnal

CC/558/2024

Gursharan Singh - Complainant(s)

Versus

Star Health And Allied Insurance Company Limited - Opp.Party(s)

Lovepreet Singh Babbar

06 Dec 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                          Complaint No. 558 of 2024

                                                          Date of instt. 19.11.2024

                                                          Date of Decision 06.12.2024

 

 

Gursharan Singh son of Shri Hazara singh, resident of Ranjeet Nagar, Gonder District Karnal. Mobile No.94666 90003. Aged 29 years.

                                                 …….Complainant

                                              Versus

 

1. Star Health and Allied Insurance Company Limited, having its branch office at 2^nd floor, SCF-137, Sector-13, Urban Estate, Karnal.
2. Star Health and Allied Insurance Company Limited, 1^st floor, Himalya House 23, Kasturba Gandhi Marg, New Delhi through its Manager.

                                                                    …..Opposite Parties.

 

      Complaint u/s 35 of the Consumer Protection Act, 2019

 

Before      Sh. Jaswant Singh…….…President 

                Ms.Neeru Agarwal……President

        Ms. Sarvjeet Kaur…………..Member

 

 Present: None for the complainant.

                                        

                (Jaswant Singh President)

 

ORDER:                    

 

                Today the case is fixed for consideration on the point of admissibility of complaint. None has put into appearance on behalf of complainant.

2.             The complainant has filed the present complaint U/s 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that complainant purchased a Family Health Insurance Policy from the OPs, vide policy no.P/211114/01/2021/060624, valid from 07.01.2021 to 06.01.2022. Suddenly, complainant was suffering from Pneumania in right side, hence he was taken to Dr. G.D. Sharma, M.D. (Med.) Physician, Director P.R.P Multispecialty Hospital, Kidney Centre & Blood Bank, Karnal and where many tests has been done and she  remained indoor patient from 29.11.2021 to 03.12.2021 and spent huge amount of Rs.113462/- approximately alongwith medicines, tests etc. Intimation regarding the said treatment was given to the OPs. After discharge from the hospital, complainant lodged the claim with the OPs and submitted all the required documents for reimbursement of Rs.113462/- but OPs did not pay the said amount despite repeated visits and requests. Due to this act and conduct of OPs complainant has suffered mental pain, agony and harassment. Then complainant sent a legal notice to the OPs but it also did not yield any result. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

3.             Today, none has put in appearance on behalf of complainant. Position remained the same on 21.11.2024. As per Section 36(2) of the Consumer Protection Act, 2019, the admissibility of the complaint is ordinarily be decided within twenty-one days from the date on which the complaint was filed. The present complaint has been filed on 19.11.2024 and period for deciding the admissibility of the complaint is going to be expired. Hence, there is no reason to adjourn the complaint further for the same purpose

4.              In the present complaint, the complainant has alleged that he has taken treatment from P.R.P. Multispecialty Hospital, Kidney Centre & Blood Bank, Karnal and remained indoor patient from 29.11.2021 to 03.12.2021 and spent an amount of Rs.113462/- but the complainant has not placed on file any such documents from which it can be ascertained that complainant was hospitalized in the said hospital and spent an amount of Rs.113462/-.  Complainant has annexed with the complaint only copy of insurance policy and copy of legal notice and except these documents there is nothing on the file from which it can be ascertained that complainant was hospitalized and spent an amount of Rs.113462/- on his treatment. The complainant has alleged that he was hospitalized from 29.11.2021 to 03.12.2021. It reveals that the present complaint is barred by limitation.  Limitation for filing a complaint has been described under Section 69 of Consumer Protection Act, 2019 which is reproduced as under:-

1. The District Commission, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.
2. Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section (1), if the complainant satisfies the District Commission, the State commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period:

Provided that no such complaint shall be entertained unless the District Commission or the State Commission or the National Commission, as the case may be, records its reasons for condoning such delay.

 

6.             As per aforesaid Section of Consumer Protection Act, the limitation for filing a complaint is of two years from the date on which the cause of action has arisen. The cause of action in the present complaint has been arisen on 03.12.2021, when complainant has taken the treatment.  Complainant sent the legal notice on 05.08.2024. The present complaint has been filed by the complainant on 19.11.2024, i.e. after the lapse of two years. Complainant has sent the alleged legal notice to the OPs on 05.08.2024, there is no correspondence between the parties from 03.12.2021 to 05.08.2024. Only serving the legal notice dated 05.08.2024 does not mean to extend the limitation period for filing the present complaint. Hence, the present complaint is barred by limitation. Moreover, there is no separate application with the complaint to condone the delay and no sufficient cause has been shown by the complainant for not filing the complaint within limitation period prescribed in Consumer Protection Act, 2019. Hence, as per the provision of Section 69 of Consumer Protection Act, 2019 the present complaint is hopelessly time barred and the same is liable to be dismissed.

7.             Thus, in view of the above discussion, the present complaint is not maintainable before this Commission and deserves to be dismissed and same is hereby dismissed in limine being barred by limitation. Complainant is at liberty to file the present complaint on the same cause of action in Court of competent jurisdiction, if so desired. Parties concerned be communicated of the order accordingly and file be consigned to the record room.

Announced
Dated: 06.12.2024    

 

                                                                     President,     

District Consumer Disputes

Redressal Commission, Karnal.

 

(Neeru Agarwal)                      (Sarvjeet Kaur)        

          Member                                    Member