Punjab

Ludhiana

CC/24/20

Sorabh Jain - Complainant(s)

Versus

united india insurance - Opp.Party(s)

Narinder Chhiba

22 Feb 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 20 dated 10.01.2024.                      

                                   Date of decision: 22.02.2024

 

1.Sorabh Jain son of Sh.Avinash Chander Jain,

2.Ekam Jain son of Sh.Sorabh Jain through his father, guardian, next friend Sorabh Jain, who has no adverse interest than that of the minor.

Both residents of House No.B-III-853, Saban Wali Gali, Mohalla Saidan, Ludhiana. Mobile No.98140-11128.                             

                                                                                       ..…Complainants

                                                Versus

United India Insurance Co. through its Regional Manager, Bhai Wala Chowk, Feroze Gandhi Market, Ludhiana.

Second Address:

United India Insurance Co. Divisional Office, 3^rd Floor, Surya Tower, 108, Mall Road Ludhiana.

…..Opposite Party

Complaint under Section 35 of The Consumer Protection Act, 2019

QUORUM:

SH. SANJEEV BATRA, PRESIDENT

MS. MONIKA BHAGAT, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainants           :         Sh.Narinder Chhibba, Advocate

 

ORDER

PER SANJEEV BATRA, PRESIDENT

1.                The complainant no.1 being the father of his minor son namely Ekam Jain(complainant no.2) has invoked the jurisdiction of this Commission by raising a consumer dispute by filing the present complaint with regard to repudiation of the medical insurance claim of complainant no.2 lodged with the OP. The complainant no.1 has stated in the complaint that the complainant no.2 developed health problem and was admitted in the hospital and an amount of Rs.3,16,166/- was incurred as medical expenses on his treatment. The claim was lodged on 13.05.2018 with the OP but the same was not decided. The complainant filed a consumer complaint against the OP against titled as “Saurabh Jain versus United India Insurance Co.” and the OP had disclosed that the claim has been rejected by the OP vide letter dated 16.10.2020 but no copy of the same has been sent to the complainant. It is claimed that the OP has forged and fabricated the documents. The said complaint was withdrawn by the complainant on 01.08.2022. It is claimed that the letter dated 16.10.2020 has never been posted to the complainant. Repudiation/dislodging of the claim of the complainant without any sufficient reason is claimed to be deficiency in service on the part of the OP. By filing the present complaint, the complainant no.1 has prayed for issuance of directions to the OP to pay Rs.3,16,166/- along with interest @12% per annum from the date of due till realization along with compensation of Rs.1,50,000/- to the complainants. The complaint is supported with affidavits of complainant no.1 along with the annexed documents. 

2.                We have heard the counsel for the complainants on the point of admissibility of the complaint and gone through the record.

3.                Counsel for the complainants has reiterated the version of the complaint in their arguments and further prayed for admissibility of the complaint at the preliminary stage.

4.                Perusal of the complaint and annexed documents shows that the complainant no.2 namely Ekam Jain remained hospitalized at PGI, Chandigarh from 14.02.2018 to 28.02.2018 with primary diagnosis i.e. Sagittal Craniosynostosis. The claim for the expenses incurred upon his treatment was lodged with the OP and the same was not settled. Thereafter, a complaint was filed before this Commission which was withdrawn on 01.08.2022.

5.                As per letter Ex.C38, the complainant was again intimated that the claim was not found tenable under the policy clause 4.1 since the disease was congenital (internal & external) which stands specifically excluded from the terms and conditions/scope of the policy.

6.                From the perusal of aforesaid facts from the annexed documents, it is evident that cause of action firstly accrued after 13.05.2018 when the claim was lodged and lastly it accrued on 16.10.2020 when the complainant was specifically informed regarding the earlier repudiation of his claim.

7.                It is settled law that once the cause of action begins to run, it never stops. Certainly cause of action is not recurring in the present case. Section 69 of the Consumer Protection Act, 2019 provides as under:-

“Limitation Period:- (1)The District Commission, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.

2)Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section(1), if the complainant satisfies the District Commission, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period;

Provided that no such complaint shall be entertained unless the District Commission or the State Commission or the National Commission, as the case may be, records its reasons for condoning such delay.”

8.                Although, the complainant no.1 has mentioned in his complaint regarding filing of a complaint but no copy/certified copy of order has been placed on file to show that if any liberty was granted to the complainants to file the second complaint or not. Even if it is assumed that liberty was granted to the complainant for filing another complaint, still the present complaint filed before this Commission is not within time.

9.                In Bharmaputra Biochem Private Limited versus New India Assurance Company & another-2022(1)Apex Court Judgments-327(S.C.) whereby the Hon’ble Supreme Court has made the following observations:-

“The complaint cannot be returned unadjudicated with liberty to file fresh complaint. The complaint can be filed within the period of limitation. Once the period of limitation has expired, the appellant cannot file the second complaint.” 

10.              Further, in SBI versus M/s B.S. Agricultural Industries(I),(Civil Appeal No.2067 of 2022) decided on 20.03.2009, the Hon’ble Supreme Court has made the following observations:-

“(t)he expression, ‘shall not admit a complaint’ occurring in Section 24-A[now, S.69(1) in the new CP Act, 2019] is sort of a legislative command to the consumer forum to examine on its own whether the complaint has been filed within the limitation period prescribed there under.”

It has been further observed by the Hon’ble Supreme Court in the aforesaid case that “(i)if the complaint is barred by time and yet, the consumer forum (Commission) decides the complaint on merits, the forum (Commission) would be committing an illegality and, therefore, the aggrieved party would be entitled to have such order set aside.”

11.              Consequently, the present complaint is time barred and we do not inclined to proceed with the same and hence the same is hereby dismissed summarily at the admission stage itself. Copies of order be supplied to the complainants free of costs as per rules. File be indexed and consigned to record room, but after registering the same.

 

 (Monika Bhagat)                             (Sanjeev Batra)                

Member                                President      

Announced in Open Commission.

Dated:22.02.2024.

Gurpreet Sharma