To-day is fixed for admission hearing.

Complainant’s advocate files hazira.

Heard the Ld. advocate for the Complainant. Perused the complaint and the documents thereto.

The case of the complainant is, in brief, that her husband was a holder of PNB-Orient Mediclaim Policy with the OP No.2, Burdwan,-713101 valid from 15.05.2018 to 14.05.2019. The complainant was admitted to Mitra’s Clinic & Nursing Home, Siliguri, on 10.08.2018 for treatment till 13.08.2018 and the treatment cost Rs. 23,831/-. The complainant provided the OP No.3, Kolkata, 700001 with all the documents in favour of the insurance claim.  The OP No.3 did not refuse the claim but sought for some other treatment related papers. The complainant treating the such seeking of papers again as a mala fide and without responding thereto, sent a legal notice to the OPs, but in vain. Hence is the case.

The very nomenclature of the policy suggests a tie-up in between PNB (Punjab National Bank) and Oriental Insurance Company and being a policy for Bank a/c holder of PNB only, the becoming of an a/c holder with PNB provides for eligibility for coverage under such group Health Insurance. The complainant’s husband is an a/c holder of PNB Siliguri Branch, i.e. OP NO.1, and that is why the complainant could come under the coverage of the said mediclaim policy.  The concerned bank is not an insurance company itself, nor does its being tied up with an insurance company impose any liability on any Branch to pay up the claim of the insured. The office which caused eligibility cannot be a cause of action.

Hence, complainant’s sending letter claiming the insurance money to, or serving a legal notice on, the OP No.1(as one of the addresses) is supersuperfluous/redundant.  The Forum is thus of the opinion that Siliguri Branch of PNB has been made one of the OPs so that the complainant appears to be within the territorial jurisdiction of this Forum. It is the OP No. 2 & 3 from whom the cause of action has actually arises but they are beyond the territorial area of Siliguri.  Thus the case is hit by the Section 11(2) of the C.P. Act. 1986 and hence not admitted.