DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the  17^th day of February, 2023

Present      :   Sri. Vinay Menon V.,  President

                  :  Smt. Vidya A., Member                        

                  :  Sri. Krishnankutty N.K., Member                                Date of Filing: 07/01/2020    

                         CC/3/2020

C.A.Thomas,

Chirayath House,

Kallingalpadam, Panniyankara (PO),

Vadakkancherry, Palakkad – 678 683                                                           -                       Complainant

(By Adv. M/s M.P. Ravi & M.J. Vince)

V/s

1. The Manager,

HDFC Ergo  GIC Ltd.,

1^st Floor, HDFC House,

166, Backbay Reclamation,

HT Parekh Marg, Church Gate,

Mumbai – 400 020

2. The Manager (Legal),

HDFC Ergo GIC Ltd.,

2^nd Floor, Chicago Plaza,

Near KSRTC Bus Stand,

Rajaji Road, Ernakulam – 35

3. The Manager,

HDFC Ergo GIC Ltd.,

West Fort Road, Palakkad – 678 001              -                       Opposite parties  

(By Adv.Ullas Sudhakaran)

O R D E R

By  Sri. Vinay Menon V., President

1. Complaint pleadings, abridged, are to the effect that the complainant is an insured of the opposite party. The complainant suffered a fall from the top of his house and sustained injuries. The complainant had to expend Rs. 8462/- as treatment expenses. The claim submitted by the complainant before the opposite party was repudiated even after providing with the entire documents as sought for by the opposite party.
2. The opposite party filed version. Per version, opposite party pleaded that they had sought for a number of documents, but the complainant had failed to submit these documents.  Claim was filed belated. Thereafter the complainant had sent copies of the said documents instead of originals. Even after repeated demands for the said documents, the complainant failed to hand over the said documents. The opposite party is ready and willing to settle the matter as and when the complainant submits the originals of the documents sought for.
3. The following issues arise for consideration 

1. Whether the complainant has handed over documents as sought for by the opposite party?

2.         Whether there is   deficiency in service/unfair trade practice on the part of the opposite party?

3.         Whether the complainant is entitled to any of the reliefs sought for?

4.         Reliefs, if any?

4. (i)                Complainant filed proof affidavit and marked Exts.A1 to A6.
Ext. A1 was objected to on the ground it is a photocopy. As this Commission is not bound by the Evidence Act, and in the absence of a case that Ext. A1 is forged or fabricated, this objection is overruled.  

   (ii)                 Opposite party filed proof affidavit and marked Ext. B1.

Issue No.1

5. Fall and subsequent hospitalization are not in dispute. The sole question that needs consideration is whether the complainant had handed over the documents.
6. Pleadings and documents produced by the parties, when considered in isolation, does not go far  to answer this question. The complainant maintained that he had handed over the documents, while the opposite party maintained that the complainant had failed to produce the documents as sought for by the opposite party.
7. Entry made in the proceeding sheet of this Commission on 5/8/2021 is as follows:

“Both parties represented. Complainant is directed to hand over copies of hospital records to OP for policy verification purposes and admissibility thereof.               14/9/2021”.

8. Thereafter, non of the parties, especially the complainant, has brought it to the notice of this Commission that the documents were handed over to the opposite parties. Thus it is clear that the complainant has not produced documents that were sought for by the opposite party for verification of the complainant’s claim.

Issue No.2

9. As already state4d in Issue 1, the complainant has failed to produce the documents as sought for by the opposite party. It is the duty of the complainant to assist the opposite party in coming to a conclusion as to the admissibility of the claim. Having failed to do so, there are no bonafides on the part of the complainant in filing this complainant. This  being the fact, we cannot hold that there is deficiency in service on the part of opposite party. 
10. We therefore dismiss the complaint.

            Issue Nos.3 & 4

11. As a consequence of the finding above the complainant is not entitled to any of the reliefs sought for.

Yet in the interest of justice we direct the opposite parties to consider the claim of the complainant, if the complainant files the documents as sought for by the opposite party,  within 60 days of receipt of a copy of this order.

Pronounced in open court on this the 17^th   day of February, 2023.       

                                                                                    Sd/-

                                                                                             Vinay Menon V

                                                      President

                                                            Sd/-

   Vidya.A

                       Member        

         Sd/-                                                       Krishnankutty N.K.

                                                                                                      Member

APPENDIX

Exhibits marked on the side of the complainant :

Ext.A1 –  Copy of Policy Certificate

Ext.A2 – Copy of handwritten hospital expenditure

Ext.A3(a)   -   Copy of notice dated 7/9/19

Ext.A3(b)  - Original acknowledgment card

Ext.A4 – Original reply notice dated 1/10/19

Ext.A5 (a) – Copy of notice dated 18/11/19

Ext.A5(b) – Original of acknowledgment card

Ext.A6(a) – Copy of letter dated 21.10.19

Ext.A6(b) – Original of courier tax invoice dated 21/10/19

Exhibits marked on the side of the opposite party: Nil

Ext.B1 – Copy of policy certificate along with terms and conditions

Court Exhibit:  Nil

Third party documents:  Nil

Witness examined on the side of the complainant: Nil

Witness examined on the side of the opposite party:  Nil

Court Witness: Nil

NB : Parties are directed to take back all extra set of  documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.