O R D E R
SUBHASH GUPTA, MEMBER
The complainant has filed the present complaint under section 12 of Consumer Protection Act, 1986 hereinafter to be referred as the ‘Act’ against the Opposite Parties, hereinafter to be called as OPs. The brief facts as alleged in the complaint are that the complainant obtained a mediclaim policy No.040200/48/10/06/00001928 for himself, his wife and his son named Anshul Khorwal insured for a sum of Rs.2,00,000/-. It is alleged in the complaint that on 21.1.2011, the son of the complainant was admitted in Virmani Hospital and discharged on 23.1.2001 as he was suffering from Idiopathic epilepsy. It is alleged in the complaint that claim papers in respect of claim were submitted in the office of OP on 7.2.2011. It has also been pleaded that the complainant received a query letter No.1103QAo2382 dated 18.2.2011 from OP-2 whereby IPD papers with Vitals and Treatment Chart date-wise was asked for by OP-2 to process the case. It has been pleaded that despite number of letters and reminders and visits to the office the OP has not finalized his claim. It has also been pleaded that Virmani Hospital has lost the file of the complainant and it communicated on 5.2.2012 about the same. The complainant has alleged deficiency in service by the OPs and has claimed reimbursement of Rs.10,627/- alongwith Rs.25,000/- towards compensation for the mental agony, physical hardship and inconvenience caused to the complainant.
2. Notice of the complaint was issued to both the OPs who have filed their written statement. It has been pleaded in the reply that as the complainant was asked to furnish all IPD papers with Vital and Treatment Chart Datewise vide letter dated 12.2.2011 which was followed by reminders on 28.2.2011 and 16.3.2011 but due to non-compliance of the query/papers the claim was filed as “No Claim” on 18.3.2011. The OPs have also pleaded in the written statement that no cause of action has arisen against the OPs as the case has been filed after three years and six months from the date of closure of the case, therefore, the complaint is liable to be dismissed.
3. Complainant as well as OPs has filed their evidence by way of affidavits. The existence of the policy has not been denied by the OPs. The complainant has admitted that OP-2 had asked for IPD details from the complainant. It has been also admitted by the complainant that Virmani Hospital has lost the file containing IPD papers; therefore he could not furnish the medical papers to the Insurance Company. The letter dated 5.9.2012 of the Hospital has been filed by the complainant himself. The complainant has also filed copy of letter dated 4.9.2012 addressed to OP-2 vide which OP-2 was requested to settle the matter failing which case will be filed by the complainant in the Consumer Forum. This letter was received by the TPA on 4.9.2012 itself. From the above facts it is apparent that the case of the complainant was closed by the OPs for wants of IPD papers on 16.3.2012 and the complainant also issued notice in the shape of letter dated 4.9.2012.
4. The complaint before this Forum was filed on 3.2.2015 i.e. after the expiry of period of limitation as stipulated u/s 24A of the Act and no application for condonation of delay in filing the same was moved therefore the complaint is barred by limitation. Hence, complaint is dismissed.
Copy of this order be sent to the parties as per rules.
Announced this 12th day of May, 2016.
(K.S. MOHI) (SUBHASH GUPTA) (SHAHINA)
President Member Member
