Bihar

Gaya

CC.No. 54/2015

Mrs. Anita Singh - Complainant(s)

Versus

The Oriental Insurance - Opp.Party(s)

Ravi Shankar

12 Apr 2017

ORDER

In the court of District Consumer Forum, Gaya

Consumer Complainant Case No.-54 of 2015

Mrs. Anita Sinha wife of Shri Sunil Kumar Sinha, Advocate, resident of Mohalla West Murli Hill Road, Gaya..... Complainant
                                  V/s
1.The Oriental Insurance Company Limited, Registered and Head office at 25/27, Asaf Ali Road, New Delhi-

 2. Syed Mohtashim Akhtar....Male Member

 3. Smt. Sunita Kumari ....Female Member

                                      (2)               Case No.-54-2015

Dated:- 20.12.

                                                                                 1. The instant case has been filed by the complainant Mrs Anita Sinha against the Oriental Insurance Company Limited and others for deficiency in service and to get direction to settle the claim of the complainant amounting ₹1,22, / 48 /

                                  (3)          Case No.-54-2015

The complainant preferred Mediclaim for a sum of ₹ 20,                       3. The opposite parties number 1, 2 and 3 appeared and file their written statement jointly. As per the written statement the complaint petition is not maintainable either in law or on facts. The cause of action arose in the complaint petition is entirely wrong and false. The allegations in the complaint petition is not admitted by the opposite parties. The fact is that the complainant obtained a Happy Family floater

                             (4)                 Case No.-54-2015

policy from opposite party for the period of 1st May                            4.The complainant has filed, Xerox copies of Happy Family Floater Policy Schedule, Receipt, xerox copies of money receipt of Dr Khan Makhan Orthopaedic and sports Med centre and RI, Patna for ₹

                             (5)                 Case No.-54-2015

of ₹

                             5. The main point of determination before the Court is whether the complainant has been succeeded to prove her case regarding deficiency in service on the part of the opposite parties and weather she is entitled to get relief as sought for.

                             6. The admitted facts of the case are as follows:-

 (1) The complainant obtained a Happy Family Floater policy from the opposite party for the period of 1st May

                        7. It appears from the documents available on the case record that the said Policy was renewed and valid till mid night April

                             (6)                 Case No.-54-2015

are available only on the case record, we are considering it only. This claim was regarding the Complainant suffering for right shoulder dislocation and treatment done by Dr Khan Makkah Orthopaedic and sports med Center Patna in its Gaya centre. The Policy was announced on 1st May

                         9. We, therefore, arrived after perusal of evidences on affidavit filed by the both parties and the documents submitted by them on the conclusion that the opposite parties have deficiency in service on their parts regarding the claim date for the incident caused on 6th April

                             (7)                 Case No.-54-2015

entitled to get mediclaim by the Opposite parties under the  said scheme for medicines x-ray, pathological test, surgery anaesthesia, nursing charges and room for which they have filed receipts before this court which is for ₹30,

    Dictated and corrected

Female Member          Male Member                    President

Sunita Kumari                    Syed Mohtashim Akhtar       Ramesh Chandra Singh