Chandigarh

DF-I

CC/10/2024

RAJNEESH GOEL - Complainant(s)

Versus

TATA AIG GENERAL INSURANCE COMPANY LIMITED, THROUGH SH NEELESH GARG, MANAGING DIRECTOR, - Opp.Party(s)

02 Aug 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

                                     

Consumer Complaint No.	:	CC/10/2024
Date of Institution	:	29/12/2023
Date of Decision	:	02/08 /2024

 

1. Rajneesh Goel, S/o Late Sh. Inderjit Goel, r/o H. No. 2310, Sector-23-C, Chandigarh, U.T. – 160023

COMPLAINANT

 

Versus

 

1. M/s Tata AIG General Insurance Company Limited, 1st Floor, SCO 127-128, Sector 9C, Chandigarh - 160009 through Sh. Neelesh Garg, Managing Director

… Opposite Parties

CORAM :	SHRI PAWANJIT SINGH	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

 

                                                                               

ARGUED BY	:	Complainant in person.
	:	Sh. Sahil Abhi, Advocate for OP

Per Pawanjit Singh, President

1. The present consumer complaint has been filed by the complainant under Section 35 of the Consumer Protection Act 2019 against the opposite parties  (hereinafter referred to as the OP). The brief facts of the case are as under :-

1. It transpires from the averments as projected in the consumer complaint that the complainant planned to visit Singapore from 2^nd February, 2022 to 09^th Februrary 2022. As per Singapore  Government’s requirement, for arriving passengers, it was required to obtain an international travel insurance policy which should cover medical expenses (including covid sickness) of minimum S$30,000/- for his stay in Singapore. Accordingly the complainant obtained Travel Guard International Travel Insurance Policy Annexure A-1 (hereinafter referred to be as subject policy)  from the OP by paying premium amount of Rs.1411/- which was valid w.e.f.2.2.2022 to 9.2.2022. The complainant before leaving India to Singapore tested himself for covid19 as per the travel requirement  on 31^st January 2022  and he was found negative vide report Annexure A-2.  The complainant  on his arrival at Changi Airport Singapore on 3^rd February 2022 was again tested as per Singapore Government guidelines and found negative. The complainant was again tested for covid19  on 7^th Febrauary 2022  before his departure from Singapore to India as per Indian government regulations Annexure A-3, as he was required to carry negative test report  on arrival on India but the complainant was found positive in 8.2.2022 vide report Annexure A-4. Immediately the complainant forwarded the said report to the OP vide mail Annexure A-5. Since the complainant was tested covid19 positive, he was required to undergo mandatory quarantine/self isolation  as per Singapore Government Rule Annexure A-6 for 72 hours and accordingly the complainant stayed in a hotel w.e.f. 8.2.2022 to 14.2.2022 and due to the stay in the hotel room the complainant paid 780S$ (approximately Rs.42,000/-)   being the hotel expenses vide bill Annexure A-7 and had also re-scheduled  the  flight as he was supposed to return on 9^th Februrary 2022 and due to aforesaid quarantine/isolation he returned to India on 14.2.2022 on account of that he had spent Rs.7960/- for the re-scheduled flight. However, the OP rejected the genuine claim of the complainant  and intimated the grounds  for rejection vide Annexure A-9 that  there was no sign and symptoms of the sickness and there is no active line of treatment given . The aforesaid act amounts to deficiency in service and unfair trade practice on the part of OP. OP was requested several times to admit the claim, but, with no result.  Hence, the present consumer complaint.
2. OP resisted the consumer complaint and filed its written version, inter alia, taking preliminary objections of  maintainability, estopple  and jurisdiction. However, it is admitted that the complainant has obtained the subject policy which was valid w.e.f. 2.2.2022 to 9.2.2022  but denied that the claim of the complainant was covered under the subject policy as the complainant had not taken any treatment from any hospital as well as was not having sign of symptoms of sickness. Thus, the claim of the complainant was rightly repudiated being not covered under the subject policy especially when the complainant had not undergone active line of treatment in hospital. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied.  The consumer complaint is sought to be contested.
3. In rejoinder, complainant reiterated  the claim put forth in the consumer complaint and prayer has been made that the consumer complaint be allowed as prayed for.

2. In order to prove their respective claims the parties have tendered/proved their evidence by way of respective affidavits and supporting documents.
3. We have heard the learned counsel for the parties and also gone through the file carefully, including the written arguments on record.
   1. At the very outset, it may be observed that when it is an admitted case of the parties that  the complainant obtained the subject policy from the OP i.e. travel guard international travel insurance policy valid w.e.f. 2.2.2022 to 9.2.2022  as is evident from Annexure A-1  and before travelling to Singapore from India the complainant got himself tested for the Covid19 and was found negative  vide report Annexure A-2  and on his arrival at Singapore he was again tested at Changi Airport Singapore  on 3.2.2022 and found negative with covid-19 and again on 7.2.2022 before leaving to India the complainant was tested again for Covid-19 and was found positive as is also evident from report Annexure A-4, as a result of which the  complainant was required to be quarantine/isolated for 72 hours and he was declared fit to travel back on 11.2.2022 but  the complainant left Singapore on 14.2.2022 for India and the claim of the complainant for his stay in the hotel as well as re-schedule of airlines ticket due to the aforesaid circumstances was rejected by the OP, the case is reduced to a narrow compass as it is to be determined if the OP has wrongly rejected the genuine claim of the complainant and the complainant is entitled for the relief as prayed for or  if the claim of the complainant being not covered under the policy was rightly rejected by the OP.
   2. As per case of the complainant though he was not hospitalized after he was found covid19 positive on 8.2.2022 but he was required to be quarantine/self isolated  for 72 hours as per the Government of Singapore  Guidelines Annexure A-6  which was the only treatment for the Covid19 patient and due to the aforesaid guidelines the complainant stayed in hotel w.e.f. 9.2.2022 to 11.2.2022  as is also evident from Annexure A-7  and as the complainant stayed in the hotel quarantine/self isolated for treatment of the disease, he is squarely covered under the policy and the OP has wrongly repudiated the claim of the complainant.
   3. On the other hand the defence of the OP is that the complainant was found covid19 positive on 8.2.2022  and was asymptomatic  whereas the policy covers only covid-19 cases which are symptomatic in nature and under gone active line of the treatment in hospital but in the case in hand as the covid19 disease of the complainant was not symptomatic and the complainant has not undergone active line of treatment, thus the claim of the complainant is not covered under the policy and the same was rightly repudiated.
   4. As it is admitted case of the parties that the complainant was detected covid-19 positive on 8.2.2022 , which was definitely a disease  and in order to recover  from the said disease as per guidelines of Government of Singapore, the complainant was required to be isolated which was only treatment for the same as per health department and the complainant was required to stay quarantine/self isolation for 72 hours and he was declared fit to travel only on 11.2.2022 as a result of which he stayed in the hotel in Singapore for quarantine/self isolation  w.e.f. 9.2.2022 to 11.2.2022 and thereafter from 11.2.2022  upto the morning of 14.2.2022, it is safe to hold that the stay of the complainant in quarantine/self isolation w.e.f. 9.2.2022 to 11.2.2022  the date when he was declared fit to travel back is duly covered under the subject policy especially when the complainant was compelled to stay in quarantine/isolation for treatment of Covid19 disease and claim of the complainant is payable under the policy.  Though the complainant has also raised claim for stay in hotel w.e.f. the night of 11.2.2022 upto the morning of 14.2.2022  but the same is not maintainable as during the said period the complainant was declared fit to travel back and he was not in isolation. Thus the claim of the complainant from 11.2.2022 to 14.2.2022 is not covered under the policy. However, the complainant is also entitled for the amount spent by him for re-schedule of the flight ticket to the tune of Rs.7960/- under the subject policy. Hence, the OP has wrongly repudiate the claim of the complainant and the aforesaid act of OP amounts to deficiency in service and unfair trade practice on its part.  Hence, the instant consumer complaint deserves to be allowed.
4. In the light of the aforesaid discussion, the present consumer complaint succeeds, the same is hereby partly allowed and OP is directed as under :-
   1. to pay Rs.17000/- [₹9,040/- (SGD 161 x Rs.56.15)  for stay in hotel room during quarantine/isolation period plus Rs.7960/-  expenses spent by complaint for reschedule of flight] to the complainant alongwith interest @ 9% per annum (simple) from the date of repudiation of the claim till onwards
   2. to pay ₹7,000/- to the complainant/s as compensation for causing mental agony and harassment;
   3. to pay ₹7,000/- to the complainant as costs of litigation.
5. This order be complied with by the OP within a period of 45 days from the date of receipt of certified copy thereof, failing which the amount(s) mentioned at Sr.No.(i) & (ii) above shall carry penal interest @ 12% per annum (simple) from the date of expiry of said period of 45 days, instead of 9% [mentioned at Sr.No.(i)], till realisation, over and above payment of ligation expenses.
6. Pending miscellaneous application(s), if any, also stands disposed off.
7. Certified copies of this order be sent to the parties free of charge. The file be consigned.

Announced 2/08/2024 mp			Sd/- [Pawanjit Singh] President
			Sd/-
			[Surjeet Kaur] Member
			Sd/-
			[Suresh Kumar Sardana] Member