The District Consumer Dispute Redressal Commission,Balangir.
Presents:-
1 Smt S.Rath , President
2 Sri H Padhan, Member.
Dated, Bolangir the 04th day of February‘2021
C.C.No-45 of 2018.
Bishnu Prasad Sharma,S/O-Late Mangal Chand Sharma,Aged about .51 R/O-PO/PS/-Kantabanji,Dist-Balangir……………………………………..Complainant.
Vrs
1.United India Insurance Co.Ltd.Adress-24,Whites Road Chennai-60001,Pin91-044-28520161.
2.Good health Insurance TPA Ltd,Plot No-49,Nagarjuna Hills ,Panjjagutta Hydrabad,Pin-500082.
3.Branch Manager Andhra Bank Kantabanji Branch,At/Po/PS/-Kantabanji,Dist-bBalangir Pin-767039…………………………………..Opposite Parties.
Adv. For the Complainant: - Sri S. S. Satpathy,A.Sharma
Adv. For O.P :- None
Date of filing of the Case :- 12.10.2018
Date of Order :- 4.03.2021
JUDGMENT
Smt S.Rath , President (I/c)
Brief Facts of the case;-
The brief facts of the case of the Complainant is that he had purchased one AB Arogyadan Group Medical Insurance Scheme on Dt.17.05.2016 for himself and his Wife and daughter namely Ankita Sharma through his agent Bank i.e Andhra Bank Kantabanji Branch vide an ID No-
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1190779 Br code No-1368 and Policy No-0504002817P104314692 ,good health ID NO-GHUIAB01948799 for the Complainant and good health No-GHUIAB01948800for his wife namely Urmila Sharma which is still subsisting , and that during the subsistence of the said Policy his wife fell ill as such was admitted in the Purohit Nursing Home, Bargarh and during the course of treatment she had undergone with some surgery on Dt.11.07.2017being an indoor Patient and was discharged on Dt.15.07.2017.
During such treatment an amount of Rs.42920/- was spent vide bill No-33 Dtd.15.07.2017 and beside that also some more money was spent in travelling and others.
The facts was reported to the O.P.No-3 and in turn it was also reported to the O.P.No-1 and subsequently on Dtd. 27.07.2017 made a claim for the said amount before the O.Ps through O.P.No-3 in the prescribed form with all relating documents to substantiate his case as required by them which was also acknowledged by the O.P.NO-1 Vide Claim NO-184007 and referred the same to the O.P.No-2.and also thereafter on their further requirement has supplied all the documents time and again vide the annexure mentioned below but surprisingly enough the O.P.No-2 has played foul play by asking for the same repeatedly instead of steeling the claim of the Complainant to which he being helpless reported the matter before the O.p.No-3 but he showed his helplessness so ultimately the complainant served the Opposite Parties with a Notice to settle his claim within seven days but they did not pay any heed to it, which amounts to unfair trade practice coupled with deficiencies of service causing both his wife to himself to undergo with mental ,physical financial stress and harassment, hence he preferred to take the shelter of the Forum to redress his dispute ,
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And in support of his such claim has relied on all the relevant documents vide annexure A1,A2, Annexure B, Annexure C, Annexure D, Annexure E, Annexure F, to H, and annexure 1.
Having gone through the Complaint and it’s accompanied documents and on hearing the Advocate for the Complainant the case was admitted and notice was served on the O.Ps and after a long time their appeared before the Forum but till Dt. 27.08.2019 they did not file any version nor took any steps for a long time consequently they were set ex-partie and posted for hearing but still then they did not turn of as such hearing in ex-parties was taken up on 18.01.2020 on merit of the case.
And on close scrutiny of the complaint and the documents filed by the Complainant and on hearing the learned counsel for the Complainant ,it came to our notice that the complain petition is literally substatiatited by the documents filed by him vide Annexure A,B,C,D,E,F,G.H.and A1 but there is no response nor any rebuttal attempt was taken up by any of the O.Ps, which clearly speaks of the callous attitude on their part and gross negligence to deal with the Claim of the Complainant, which amounts to unfair trade practice coupled with deficiency of service ,in spite of that we took utmost care to scrutiny the documents and claim adduced by the Complainant and and during the course of our observation it reveals from the Documents that these are all genuine and also all those documents were repeatedly supplied with O.Ps and several reminder from the side of the Complainant has been made but still then it was in vain as such we don’t have any other option but to take these documents to be true and genuine and the Claim amount to that effects are also found to be true and genuine hence we took up an unanimous view that the such aforesaid acts of the Opposite Parties are nothing but an example of unfair trade Practice and deficiencies of service for which they all
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are jointly and severally liable .And as such the complaint of the complainant is allowed against the Opposite Parties hence order follows .
Order.
Hence the Opposite Parties are jointly and severally directed to pay an amount of rupees Rs.44,455.97.with an interest @ 7% P.A. also are directed to pay an amount of Rs.7000/-towards the Compensation amount and an amount of Rs.3000/- towards the litigation expenses to the Complainant from the date of filing the case within thirty days of pronouncement of order in default of which the total amount would accrue an interest @ 12% P.A.till the actual realisation of the total amount
Accordingly the Order is pronounced in the open Forum to-day i.e on Dtd. 04th March 2021,in the result the complaint is allowed against the Opposite Parties and the same is disposed off……..
(H.Padhan) (S.Rath)
MEMBER. PRESIDENT(I/c)
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