Jharkhand

Bokaro

CC/8/2021

Wakil Rajak - Complainant(s)

Versus

The Manager, Md India Health Insruance T.P.A Pvt. Ltd - Opp.Party(s)

M.P. Vishwakarma

10 Feb 2023

ORDER

District Consumer Disputes Redressal Commission, Bokaro

Date of Filing-18-02-2021

Date of final hearing-10-02-2023

 Date of Order-10-02-2023

Case No. 8/2021

      Wakil Rajak, S/o- Late Bihari Rajak,

       R/o- Qr.No. 1264, Sector-4/G, Sector-4,

       District- Bokaro, At Present Qr.No. 4194,

       Sector-12/E, Sector-12, Bokaro Jharkhand

Vs.

1. The Manager, Md India Health Insruance T.P.A Pvt. Ltd,

Near Railway Booking Counter, Sector-1, B.S.City, Bokaro

2. The Manager, The New India Assurance Co. Ltd.

C-27, Sheela Sadan, City Center, Sector-4, B.S.City,

District- Bokaro, Pin-827004

3. The Nodal officer, SAIL Group Medicalim Scheme,

Adm. Building, Bokaro Steel Plant, B.S.City,

District- Bokaro Pin 827001

 Present:-

                             Shri Jai Prakash Narayan Pandey, President

                  Smt. Baby Kumari, Member

 

PER- J.P.N Pandey, President

-Judgment-

1. None turned up on behalf of complainant on repeated call. Ld. Counsel for the O.P. (New India Assurance Co. Ltd.) is present and he files photo copy of papers and argued the case.  It reveals from the record that this case is pending at the stage of argument in which complainant is absent since long therefore, in the given facts as per provision of Section 38 (3) (c) Consumer Protection Act. 2019 case has been taken up for decision on merit on the basis of materials available on record.

 

2. Complainant has filed this case with prayer for direction to O.Ps. for payment of Rs. 28,751/- the medical expense  already paid with interest and to pay Rs. 10,000/-  as compensation and Rs. 10,000/- as litigation cost.
3. Complainant’s case in brief is that he is a retired SAIL, BSL employee and as per policy of the company he opted for Mediclaim policy for himself and his wife. He was provided MIN No. 4741542 which was valid at the relevant time. Further case is that due to accident the complainant has purchased materials and medicines from the market from 29.01.2019 to 08.07.2019 on different dates as per advise of the doctor for which he paid total Rs. 28,751/- but  inspite of repeated requests O.Ps. have not paid  claim. Thereafter legal notice was issued but claim was not settled.  Hence this case has been filed with above mentioned prayer. 
4. O.P. No.2 New India Assurance Co. Ltd.  appeared and has filed W.S. mentioning therein that alleged claim pertains to date between 29.01.2019 to 08.07.2019 for which this O.P has not issued insurance policy, hence case is liable to be dismissed against the O.P.
5. Point for consideration is whether complainant is entitled to get relief as claimed ?
6. On perusal of the papers annexed with the complaint petition it appears that the complainant has not filed any paper to show that during the relevant period O. P. New India Assurance Co. Ltd. was liable to pay the amount. On the other hand O.P. has filed paper to show that SAIL/BSL Bokaro has admitted the fact that this O.P. New India Assurance Co. Ltd. has issued policy effective from 11.07.2019 to 10.07.2020. In this way it is apparent that during the relevant period O.P. insurance co. was not liable for the alleged claim.
7. In light of above discussion we are of the view that complainant has not proved his case for grant of any relief as prayed. Accordingly this point is being decided against the complainant.
8.  In light of above discussion case is dismissed on merit and parties shall bear their own costs.

 

   (J.P.N. Pandey)

                                                                                      President

                                                                                               

 

 

                                                                               (Baby Kumari)

                                                                                                   Member