Punjab

Faridkot

CC/16/310

Manjit Kaur - Complainant(s)

Versus

The Secretary Revenue department - Opp.Party(s)

Satwinder Kaur Bhullar

19 May 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FARIDKOT

 

Complaint No. :      310

Date of Institution:  21.10.2016

Date of Decision :   19.05.2017

 

Manjit Kaur aged about 68 years w/o Harjit Singh Kalsi, r/o House No.144 Street No. 2, Talab Mohalla, Faridkot, District Faridkot through her husband Harjit Singh Kalsi, advocate, Faridkot.                                                                                        

 ...Complainant

Versus

1. The Secretary, (Revenue Department), Punjab, Chandigarh.
2. The Secretary, (Medical Department), Punjab, Chandigarh.
3. State of Punjab through District Collector/Deputy Commissioner, Faridkot.
4. Vice Chancellor, G G S Medical College and Hospital, Faridkot.
5. M D India, Health Care Centre (APA) Pvt Ltd Phase – I, Plot No. 138, Mohali.
6. The Oriental Insurance Company Ltd, Oriental House, Asaf Ali Road, A-25/27, New Delhi.
7. Branch Office, the Oriental Company Ltd. Near Jublee Cinema, Faridkot District Faridkot.

                      ....OPs

Complaint under Section 12 of the

Consumer Protection Act, 1986.

 

 

Quorum: Sh. Ajit Aggarwal, President,

                Sh P Singla, Member.

 

Present: Sh Satwinder Kaur Bhullar, Ld Counsel for complainant,

              Sh Satnam Singh Gill APP on behalf of OP-1 and 3,

              Sh Rajneesh Garg, Ld Counsel for OP-2 and 4,

              Sh Deep Chand Goyal, Ld Counsel for OP-5 to 7.

 

ORDER

(Ajit Aggarwal, President)

                                          Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 against OPs seeking directions to OPs to make payment of insurance claim worth Rs.9,000/- pertaining to mediclaim of complainant and for further directing OPs to pay Rs 50,000/- as compensation for harassment, inconvenience, mental agony and litigation expenses of Rs.5000/-.

2                                            Briefly stated, the case of the complainant is that complainant got conducted the operation of her eye from Guru Gobind Singh Medical College and Hospital, Faridkot and spent Rs.9000/-on her treatment. It is submitted that she is entitled to get reimbursement of amount paid on her treatment being wife of retired employee. Complainant submitted all the requisite documents alongwith bill to OP-5, but till date, complainant has not received the claim amount from Ops. Both complainant and her husband made several requests to Ops over telephone to make payment of her insurance claim, but they said that claim of complainant has been passed, but amount of claim has been inadvertently deposited in some other account in HDFC Bank. Complainant submitted that she has no account in HDFC Bank and then, they gave their account number in state Bank of Patiala, Branch Faridkot to Ops, but till now, they have not received any amount on account of treatment of complainant from Ops. They have also served legal notice to Ops requesting them to make payment of insurance claim, but all in vain. All this amounts to deficiency in service and trade mal practice on the part of OPs and has caused harassment and mental agony to her. She has prayed for directions to Ops to pay Rs.50,000/- as compensation besides Rs.5500/- as cost of litigation besides main relief. Hence, the present complaint.

3                                             The counsel for complainant was heard with regard to admission of the complaint and vide order dated 8.11.2016, complaint was admitted and notice was ordered to be issued to the opposite party.

4                                            On receipt of the notice, OP-1 and 3 appeared in the Forum through Government Pleader and filed written statement taking preliminary objections that  complainant is not the consumer of answering Ops as complainant has not paid any amount to them nor they have rendered any services to complainant. complaint filed by complainant is of civil nature and even this Forum has no jurisdiction to hear and try the present complaint. It is averred that only OP-5 is personally liable to pay compensation regarding health insurance of complainant as OP-5 was under contract of Government of Punjab. It is further averred that on receiving the notice from complainant, they sent letter to Deputy Commissioner Office, Faridkot and then, OP-1 issued memo no.13/18/2007 MA 2(5) 8697 to OP-5 to do the needful and to compensate the complainant but to no effect. There is no deficiency in service on the part of answering Ops. However, on merits, they have denied all the allegations levelled by complainant being wrong and incorrect and prayed for dismissal of complaint with costs.

5                                              OP-2 and 4 also appeared in the Forum through counsel and filed reply and took the same objections which were also taken by Op-1 and 3 in their reply. It is asserted that complainant is not their consumer as they have neither received any consideration from her nor rendered any services to her. It is asserted that liability for insurance claim if any, then it is of OP-5. OP-5 has the whole responsibility for making payment of amount spent by her on her treatment. It is asserted that complainant has wrongly dragged them into present litigation and even complaint is bad for misjoinder of necessary parties. All the other allegations have been denied being wrong and incorrect and prayer for dismissal of complaint is made.

6                                        OP-5 to 7 also filed reply wherein they asserted that claim of complainant has been satisfied as they have made payment of Rs.6000/- to complainant against lodged claim of Rs.9000/- on 13.12.2016 via CCN MD10009922 and this amount of Rs.6000/-has been duly credited in the account of complainant bearing no. 55100645017, IFSC Code : STBP0000051 and thus, complaint has become infructuous and is therefore liable to be dismissed.  All the other allegations levelled by complainant are denied being wrong and incorrect and reiterated that there is no deficiency in service on the part of Ops. Prayer for dismissal of complaint is made.

7                                              Parties were given proper opportunities to prove their respective case. The complainant tendered in evidence his affidavit Ex.C-1 and documents Ex C-2 to C-18 and then, closed his evidence.

8                                               In order to rebut the evidence of the complainant, ld counsel for opposite party 1 and 3 tendered in evidence, affidavit of Harbans Singh as Ex OP-1,3/1 and  documents Ex OP-1,3/2 to 4 and then, closed the evidence. Counsel for OP-5 to 7 tendered in evidence affidavit of Ashwani Kumar as Ex OP-5 to 7/1 and then, evidence of OP-5 to 7 was closed by order of this Forum. Counsel for OP-2 and 4 tendered in evidence affidavit of Dr Rajiv Joshi as Ex OP-2,4/1 and then, closed the same on behalf of OP-2 and 4.

9                                         We have heard the arguments addressed by all the parties and have also gone through the evidence and documents led by the parties.

10                                  Ld Counsel for complainant argued that complainant got conducted the operation of her eye from Guru Gobind Singh Medical College and Hospital, Faridkot and spent Rs.9000/-on her treatment. It is submitted that she is entitled to get reimbursement of amount paid on her treatment being wife of retired employee. Complainant submitted all the requisite documents alongwith bill to OP-5, but till date, complainant has not received the claim amount from Ops. Both complainant and her husband made several requests to Ops over telephone to make payment of her insurance claim, but they said that claim of complainant has been passed, but amount of claim has been inadvertently deposited in some other account in HDFC Bank. Complainant submitted that she has no account in HDFC Bank and then, they gave their account number in state Bank of Patiala, Branch Faridkot to Ops, but till now, they have not received any amount on account of treatment of complainant from Ops. They have also served legal notice to Ops requesting them to make payment of insurance claim, but all in vain. All this amounts to deficiency in service and has caused harassment and mental agony to her. She has prayed for accepting the claim alongwith compensation and litigation expenses. Ld counsel for complainant has stressed on documents Ex C-1 to 18.

11                                         To controvert the  arguments of complainant counsel, ld counsel for OP-1 and 3 argued that  complainant is not the consumer of answering Ops as complainant has not paid any amount to them nor they have rendered any services to her. Complaint filed by complainant is of civil nature and even this Forum has no jurisdiction to hear and try the present complaint. It is averred that only OP-5 is personally liable to pay compensation regarding health insurance of complainant as OP-5 was under contract of Government of Punjab. It is further averred that on receiving the notice from complainant, they sent letter to Deputy Commissioner Office, Faridkot and then, OP-1 issued memo no.13/18/2007 MA 2(5) 8697 to OP-5 to do the needful and to compensate the complainant but to no effect. There is no deficiency in service on the part of answering Ops. However, on merits, they have denied all the allegations levelled by complainant being wrong and incorrect and prayed for dismissal of complaint with costs.

12                                     Ld Counsel for OP-2 and 4 argued before the Forum that complainant is not their consumer as they have neither received any consideration from her nor rendered any services to her. It is asserted that liability for insurance claim if any, then it is of OP-5. Op-5 is has the whole responsibility for making payment of amount spent by her on her treatment. It is asserted that complainant has wrongly dragged them into present litigation and even complaint is bad for misjoinder of necessary parties. All the other allegations have been denied being wrong and incorrect and prayer for dismissal of complaint is made.

13                                  Ld Counsel for OP-5 to 7 argued that claim of complainant lodged by complainant has been satisfied as they have made payment of Rs.6000/-to complainant against the lodged claim of Rs.9000/-on 13.12.2016 via CCN MD10009922 and this amount of Rs.6000/-has been duly credited in the account of complainant bearing no.55100645017, IFSC Code : STBP0000051 and thus, complaint has become infructuous and is therefore liable to be dismissed.  All the other allegations levelled by complainant are denied being wrong and incorrect and reiterated that there is no deficiency in service on the part of Ops. Prayer for dismissal of complaint is made.

14                                      From the careful perusal of record and above discussion, it is observed that case of the complainant is that she got conducted her operation of eye from Guru Gobind Singh Medical College and Hospital, Faridkot and paid Rs.9000/-for her treatment. After the treatment, she submitted all the requisite documents alongwith bill for treatment to Ops for obtaining insurance claim from Ops, but till now, they have not paid anything to complainant. Despite repeated requests by complainant and her husband, they have not made payment of claim amount, rather they assert that her bill has been passed and her claim amount has been inadvertently deposited in some other account in HDFC Bank, though complainant has no account in HDFC Bank. Thereafter, complainant gave her State Bank of Patiala Account number to Ops, but despite repeated requests, they have not made payment to complainant. In reply Op-1, 2, 3 and 4 have denied all the allegations of complainant being wrong and incorrect and asserted that entire responsibility for insurance claim is of OP-5 and only OP-5 can make payment of claim sought as they have neither rendered any services to complainant nor they have taken any consideration from her and thus, she is not their consumer. OP-5 to 7 argued before the Forum that claim sought by complainant have been paid in her account and her claim stands satisfied and thus, there is no deficiency in service on their part. Meanwhile, ld counsel for OP-5 to 7 brought our attention to the fact that earlier Ops paid the amount of claim of Rs.9,000/- inadvertently to some account of HDFC Bank in place of account of complainant, but now, they have made payment of Rs.6000/-in full settlement of her claim into her bank account at State Bank of Patiala. This Forum is of opinion that if it is presumed that OP-5 to 7 have wrongly deposited the payment of Rs.9000/-in the account of someone else in HDFC Bank than in the account of complainant, then this time also they should have made payment of full claim amount of Rs.9000/-as sought by complainant. There is no plausible reason expressed by OP-5 to 7 for deducting or reducing the claim amount from Rs.9000/-to 6000/-. Moreover, it is also noticed that OP-5 to 7 credited the amount of Rs.6000/-in the account of complainant only during the proceedings of the complaint case and not before the institution of legal proceedings.

15                                      From the careful observation of record and evidence put forward by complainant and in view of arguments advanced by respective parties, this Forum is of considered view that there is deficiency in service on the part of OP-5 to 7 in not making payment of full claim amount and they have no right to reduce the claim amount from 9000/-to 6000/-without any plausible reason though it is admitted by them that earlier they made payment of Rs.9000/-on account of amount spent by complainant on her treatment wrongly to some other account. Complainant has succeeded in proving her case and hence, complaint in hand is hereby allowed against OP-5 to 7 and stands dismissed against OP-1 to 4. OP-5 to 7 are directed to make payment of remaining amount of Rs.3000/-to complainant alongwith interest at the rate of 9% per anum from the date of filing the complaint till final realization. OP-5 to 7 are further directed to pay Rs.3000/-to complainant as compensation on account of harassment and mental agony suffered by her besides Rs.2000/-as litigation expenses. Compliance of this order be made within one month from the date of receipt of the copy of the order, failing which complainant shall be entitled to proceed under Section 25 and 27 of the Consumer Protection Act. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 19.05.2017                 

 

  Member                            President

                                                  (P Singla)                      (Ajit Aggarwal)

         

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Complaint No. :     310/2016

 

Manjit Kaur     Vs     Secy Punjab

 

 

 

Present: Sh Satwinder Kaur Bhullar, Ld Counsel for complainant,

              Sh Satnam Singh Gill APP on behalf of OP-1 and 3,

              Sh Rajneesh Garg, Ld Counsel for OP-2 and 4,

              Sh Deep Chand Goyal, Ld Counsel for OP-5 to 7.

                   Arguments heard. Vide our separate detailed order of even date, complaint in hand is hereby allowed against OP-5 to 7 and stands dismissed against OP-1 to 4. Copy of order be given to parties free of cost under rules. File be consigned to record room.

Announced in Open Forum

Dated : 19.05.2017                 

 

  Member                            President