DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD

Dated this the  12^th day of January,  2022

Present       :   Sri.Vinay Menon V.  President

                    :   Smt.Vidya A., Member                                                      Date of Filing: 23/03/2021

     CC/56/2021

Kanthy Ramachandran,

W/o.Ramachandran.U.P.,

Mala Nivas, Kadukkamkunnam,

Malampuzha, Palakkad – 678 651

(By Party in Person)                                                               -           Complainant

                                                                                      Vs

 1.        The Manager

            HDFC Ergo General Insurance Co. Ltd.

              2^nd Floor, Chicago Plaza,

              Rajaji Road, Near KSRTC Bus Stand,

              Kochin – 682 034

2.         The Manager

            HDFC Ergo Health Insurance Co. Ltd.

              Central Processing Centre,

              2^nd & 3^rd Floor, Ilabs Centre, Plot No.404-405,
             Udyog Vihar, Phase III, Gurgaon – 122 016               -           Opposite Parties

            (By Adv. M/s. Saji Issac & Ullas Sudhakaran)

O R D E R 

By Sri. Vinay Menon V., President

1. Undisputed pleadings revolve round the complainant’s claim for her husband’s treatment expenses.    The claim was repudiated on the ground that there was non disclosure of material facts at the time of availing the policy from the opposite party.  Facts of the complaint are not being dwelled into.
2. Subsequent to rejection of her claim,  the complainant approached the insurance Ombudsman for redressal of her grievance.  The learned   Ombudsman dismissed the complainant’s claim by way of a detailed order after considering the pleadings and merits based on the documentary evidence.   The complainant approached this Commission as her complaint was dismissed by the learned Ombudsman. 
3. This Commission took the issue of res judicata for preliminary hearing.
4. The Insurance Ombudsman is a statutory body constituted under the Insurance Act with its own  Rules regulating its conduct. The Ombudsman is authorized empowered and competent to take cognizance of  the facts of present case.  The learned Ombudsman has made an indepth  appreciation of the facts and circumstances of the case before dismissing the claim of the complainant. Whatever be the finding of the learned Ombudsman, the finding is made by a statutory authority competent to arrive at such a conclusion. The finding of the Ombudsman does not leave space for this Commission to consider whether there is deficiency in service or unfair trade practice on the part of the opposite party.  The entire liability is cast upon the complainant for non disclosure of material facts.   
5. Any finding of this Commission contrary to the finding of the learned Ombudsman would lead to absurdity and impropriety and  embarrass  the due process of law. Further, such a tendency to approach one Forum after another until one avails one’s desired result or outcome would only lead to multiplicity of litigation and is an abuse of the  process of law.
6. We hold that this present complaint filed before us is barred by res-judicata. The complaint is dismissed thus.

 Pronounced in open court on this the 12^th day of January, 2022.

                                                                                      Sd/-

                                                                                                   Vinay Menon V

                                                 President

 Sd/-

Vidya.A

                    Member      

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.