West Bengal

Uttar Dinajpur

CC/18/26

Sushanta Saha - Complainant(s)

Versus

The Oriental Insurance Company Limited - Opp.Party(s)

Proshenjit Roy Choudhury

29 Jun 2018

ORDER

Before the Honorable
Uttar Dinajpur Consumer Disputes Redressal Forum
Super Market Complex, Block 1 , 1st Floor.
 
Complaint Case No. CC/18/26
( Date of Filing : 17 May 2018 )
 
1. Sushanta Saha
Son of Jhantu Ranjan Saha, Vill.: Kshudiram Pally, P.O. & P.S.: Islampur,
Uttar Dinajpur
West Bengal
...........Complainant(s)
Versus
1. The Oriental Insurance Company Limited
Represented by the Branch In Charge, Islampur Branch, Deshbandhupara, (Near Bank of India), P.O. & P.S.: Islampur,
Uttar Dinajpur
West Bengal
2. The Oriental Insurance Company Limited
To be represented by its Branch Manager, Raiganj Branch, Mohanbati, P.O. & P.S.: Raiganj
Uttar Dinajpur
West Bengal
3. M/s MD India Health Insurance TPA Private Limited
Survey No. 14718, Sr. B.O. 46/1, espace, A2 Building (4th Floor), Pune Nagar Road, Vadgaon Sheri, Pune-411014.
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. Swapan Kr. Datta PRESIDENT
 HON'BLE MR. Tapan Kumar Bose MEMBER
 
For the Complainant:
For the Opp. Party:
Dated : 29 Jun 2018
Final Order / Judgement

Today is fixed for admission hearing.

Hd. the Ld. Lawyer of the complainant. On perusal of the record it is found that the complainant filed the case against the Oriental Insurance Co. Ltd. claiming reimbursement of Rs.23,044/- along with compensation and other cost of the suit for dental treatment. But as per policy the dental treatment for which the complainant was treated is not directly attributable to any accident of the injury. As such the claim was repudiated. Moreover, on perusal of the terms and condition of the policy this is found that when a dental treatment is done which is not directly involved in the accident, the reimbursement is not maintainable. On perusal of the petition of complaint it is found that the complainant was treated for the infection in his gum which is not involved with any accident. As such the instant case is not maintainable. Hence, the instant petition is liable to be dismissed.

 

Hence, it is

                                  O r d e r e d

 

that the instant case be and the same is dismissed as not maintainable.

 
 
[HON'BLE MR. Swapan Kr. Datta]
PRESIDENT
 
[HON'BLE MR. Tapan Kumar Bose]
MEMBER

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