Karnataka

Bangalore 4th Additional

CC/11/1121

Sri. Panesh Aged about 31 Years - Complainant(s)

Versus

VP-Claims & Grievance Management, ICICI Prudential Life Insurance Company Ltd - Opp.Party(s)

V.N. Jagadeesh

29 Jun 2011

ORDER

BEFORE THE 4TH ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BANGALORE URBAN
No.8, 7th Floor, Shakara Bhavan,Cunninghum, Bangalore:-560052
 
Complaint Case No. CC/11/1121
 
1. Sri. Panesh Aged about 31 Years
No.7, Girinivasa 11th Cross, Opp. Hanumanthanagar Police Station Ashok Nagar Bangalore-560050
Bangalore
Karnataka
...........Complainant(s)
Versus
1. VP-Claims & Grievance Management, ICICI Prudential Life Insurance Company Ltd
Vinod Silk Mills Compound, Chakravarthy Ashok Road, Ashok Nagar, Kandivali (E) Mumbai-400101
Mumbai
Mumbai
............Opp.Party(s)
 
BEFORE: 
 HONORABLE Sri D.Krishnappa PRESIDENT
 HONORABLE Ganganarsaiah Member
 HONORABLE Anita Shivakumar. K Member
 
PRESENT:
 
ORDER

               Heard the counsel for the complainant regarding admission of this complaint.   This complaint is filed against the Op with allegation that despite there being a valid mediclaim policy issued by the Op to cover the health risk of the complainant, the Op has failed to provide medical facilities and reimbursement of medical expenditure.   On going through Annexure-D, the letter of repudiation under which the claim of the complainant is repudiated is cashless facility but not reimbursement of medical expenditure.   Clause V of that Annexure-D itself make clear that denial of cashless facility will not preclude the complainant to make claim for reimbursement of medical expenditure by producing necessary documents.   The complainant without exhausting that remedy has horridly filed this complaint is not maintainable.  Hence, there is no cause of action to file this complaint.  Thus complainant is dismissed at the stage of admission with liberty to the complainant to file a fresh complaint after tracing that remedy.

 

 

 

 
 
[HONORABLE Sri D.Krishnappa]
PRESIDENT
 
[HONORABLE Ganganarsaiah]
Member
 
[HONORABLE Anita Shivakumar. K]
Member

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