Complainant and o,.p. nos.1 and 2 are present. None appears on behalf of o.p. no.3. Matter is taken up for hearing. Heard ld. Counsels. Order follows.

            The only issue involved in this case whether the complainant is entitled to compensation as prayed for in the following back drop.

            Admittedly petitioner is holding a mediclaim policy being no.030500/48/04/03312 for the period from 28.2.05 to midnight 27.2.06 covering an amount Rs.360000/-cashless. Complainant had to visit Chennai Sankarnetralay on 6.9.05 for check his eye whereby he was advised for immediate photodynamic therapy by Dr. Tarun Sharma of Sankarlayay. At that point of time petitioner was in need of financial help to meet such medical expenses as per direction of attending doctor and thereby petitioner applied to o.p. no.3 Family Health Plat Ltd. through Sankarnetralay Medical Research Centre on 6.9.05 for cashless help as complainant was not prepared financially for such medical expenses. On the same day o.p. no.3 denied cashless service facility on the ground that the cashless facility cannot be provided PED although petitioner is a bona fide policy holder. There was no reason denying such cashless facility with reference to the policy. Thereby the petitioner was compelled to come back from Chennai as he could not arrange the expenses for operation without required medical treatment. It is alleged by the petitioner o.p. no.3 arbitrarily with malafide motive had refused to provide cashless benefit in terms of the policy which was amounted to deficiency in service on the part of the o.p. no.3. There was no fault on the part of the petitioner in payment of premium in connection with the above policy.

            After coming back to Kolkata Dr. Tapas Samanta started I-MP (IPG-DYE mediated photo-thrombosis) which was stated as uregent and immediate measure on 17.9.05 followed by transpupillary therapy therma therepy.

            For the above treatment petitioner submitted a claim with the o.p. nos.1 and 2 who has disposed of the claim on payment of Rs.8085/- and 10580/- on different dates. Hence petitioner has filed this case claiming compensation against o.p. no.3 since they refused cashless benefit arbitrarily and motivatedly.

            O.p. nos.1 and 2 had filed w/v contending interalia that they hd sisposed of the claim submitted by the petitioner. They had no nexus with the refusal of cashless benefit by o.p. no.3. No w/v was filed by o.p. no.3 nor they appeared before this forum even after service of notice. The contention of the petitioner as alleged in the petition of complaint are not disputed and denied by the o.p. no.3. It is submitted by ld. Counsel for the o.p. nos.1 and 2 that they have no responsibility in regard to the refusal of cashless benefit of o.p. no.3. They  have disposed of the claim of the petitioner immediately after receiving of the same.

            It is appearing from the materials on record refusal of cashless benefit by the o.p. is totally arbitrarily unethical although petitioner is holding valid policy for cashless treatment of his eye which has been refused by o.p.  no.3. Therefore the consumer complaint succeeds and petitioner is entitled to relief and the consumer complaint is awarded in the following terms.

            O.p. no.3 is directed to pay compensation Rs.5000/- (Rupees five thousand) only for their deficiency in service and litigation cost Rs.1000/- (Rupees one thousand) only within two months from date, failing which it will carry an interest @ 8% p.a. till realization.

            Let copy of this order be supplied to the parties free of cost.