Haryana

Karnal

CC/361/2024

Anjali Devi - Complainant(s)

Versus

TATA AIG General Insurance Company Limited - Opp.Party(s)

Subhash Kashyap

23 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                          Complaint.No.361 of 2024

                                                          Date of instt.19.07.2024

                                                          Date of Decision:23.07.2024

 

Anjali Devi wife of Ankit Kumar, resident of Village Budhanpur Khalsa, Tehsil Indri, District Karnal.

 

          ...…Complainant.

                                        Versus

1.     Tata AIG General Insurance Company Limited, Regd. Office 15^th Floor Tower, A Peniusula Business Park, Ganpatrao Kadam Marg Off Senapati Bapat Marg, Lower Parel Mumbai 400013 through its Managing Director.

2.     Tata AIG General Insurance Company Limited, Sector-12, Karnal, through its Branch Manager.

                                                                        ....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 Tata AIG Medicare Insurance Policy from the OPs for a sum assured of Rs.1,20,000/-. On 13.10.2023, complainant fell ill and got admitted in Jindal Multispeciality Hospital Indri, from 13.10.2023 to 19.10.2023 and spent Rs.64,740/-. Thereafter, the complainant lodged her claim with the OPs and submitted all the requisite documents but on 27.12.2023, the OPs had repudiated the claim of complainant on the false and flimsy grounds and prayed for directing the OPs to pay Rs.1,40,000/- 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.1,40,000/- 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.64,740/- on her treatment but she has claimed Rs.1,40,000/- 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