In the Court of the
Consumer Disputes Redressal Forum, Unit -I, Kolkata,
8B, Nelie Sengupta Sarani, 4th Floor, Kolkata-700087.
CDF/Unit-I/Case No. 67 / 2010 .
1) Sri Swapan Bhowmik,
27, Broda Street, Kolkata-700019. ---------- Complainant
---Versus---
1) The Manager, SBI Cards & Payments Services Pvt. Ltd.,
Fortuna Building, 234/3A, A.J.C. Bose Road, Kolkata-20.
2) M/s. Royal Sundamram Alliance Insurance Co. Ltd.,
Corporate Claim Department, Sundaram Towers,
45 & 46, Whites Road, Chennai-600014. ---------- Opposite Parties
Present : Sri Sankar Nath Das, President.
Dr. Subir Kumar Chaudhuri, Member.
Smt. Sharmi Basu, Member
Order No. 26 Dated 24/08/2012.
The petition of complaint has been filed by the complainant Sri Swapan Bhowmik against the o.ps. SBI Cards and Payments Services Pvt. Ltd. and another. The case of the complainant in short is that complainant is a credit card holder of o.p. no.1 being credit card no.4317 5750 1468 2612 which is changed to 4317 5759 7955 5596. Being a credit card holder complainant was induced and advised by the said Co. to take and purchase a Hospital Cash Insurance Policy from o.p. no.2 which o.ps. claim that the policy is a social benefit oriented policy. O.p. no.1 had told complainant that by purchasing the said policy he would get the advantage of Hospitalization benefit. O.p. n o.1 has got close nexus with o.p. no.2 in launching the said scheme. O.p. no.2 offered that they would pay Rsw.1000/- per day during the total period of stay of hospitalization.
Complainant being advised by o.p. no.1 purchased the Hospital Cash Insurance Master Policy no. HCSB ILOOO5 under coverage of certificate no.CS 00007280000103 through the credit card of SBI and paid Rs.3117/- as premium which is inclusive of service tax and cess for the 2nd year which is a renewed policy. The said policy is a Hospital Care (Cash) Insurance policy purchased for complainant and for his wife Smt. Chhabi Bhowmick and daughter Subhamita Bhowmick which was renewed on 2.10.08 charged through the SBI card. The said policy is a renewed policy for the third term i.e. another full term of one year with the payment of premium of Rs.3117/-.
Complainant had written a letter dt.25.3.09 claiming the hospital benefit of his wife due to her admission in the KPC Hospital staying in the hospital for 15 days for which they issued a health card of orthopaedic department, but the same was not heeded by o.p. no.1 who repudiated the claim on the ground of disease pre-existing.
Wife of complainant had pain and difficulties at her left lower limb after a fall. Soon after, when consulted she was admitted in the KPC Hospital for necessary treatment to relieve of her pain and for cure. Wife of complainant had a sudden fall which caused severe pain and difficulty in walking. As such, she was advised for hospitalization and she was treated at KPC Hospital and was confined for fifteen days and thereafter, she was released from the said hospital. O.p. no.2 shall have to pay Rsw.1000/- per day and claimed Rs.15,000/- to o.ps. which was wrongfully and illegally repudiated on the plea of diseases pre-existing. Hence, the case has been filed by complainant with the prayer contained in the petition of complaint.
O.p. no.1 had entered its appearance in this case by filing w/v and denied all the material allegations labeled against it and prayed for dismissal of the case. O.p. no.2 did not contest the case by filing w/v.
Decision with reasons:
We have gone through the pleadings of the parties, evidence and documents in particular and we find that o.ps. had sufficient negligence in discharging their duties being a service provider to its consumer / complainant and complainant is entitled to relief.
Hence, ordered,
That the petition of complaint is allowed on contest without cost as against o.p. no.1 and with cost as against o.p. no.2. O.p. no.2 is directed to reimburse all the hospitalization cash policy of Rs.1000/- per day for stay and treatment in the hospital for 15 days i.e. Rs.15,000/- (Rupees fifteen thousand) only and is further directed to pay to the complainant compensation of Rs.7000/- (Rupees seven thousand) only for his tremendous harassment and mental agony and litigation cost of Rs.5000/- (Rupees five thousand) only within 45 days from the date of communication of this order, i.d. an interest @ 9% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.
Supply free certified copy of this order to the parties as per section 21(1) of the Consumer Protection Regulation.
