THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION

PANAJI-GOA



Present:

Smt. Sandra Vaz e Correia…Presiding Member

Smt. Caroline Collasso, …Member

Appeal No.16/2009

Vijay Kapoor, (Senior Citizen)

F-4 NEST

Chowgule Gardens,

Zuari Nagar, Goa, 403726. … Appellant

(Original Complainant)



v/s



1. The New India Assurance Co. Ltd.,

Channana Complex,

2213 Gurudwara Road,

New Delhi 110005.



2. The New India Assurance Co. Ltd.,

Santa Pelagia Building,

Vasco, Goa 403802.



3. (Through Divisional Office at:

The New India Assurance Co. Ltd.,

Velho Building,

Panjim, Goa 403001. .. Respondents

(Original Opposite Parties)





Appellant present in person.

















Dated: 26-05-2009



ORDER



[Per Smt. Sandra Vaz e Correia, Presiding Member]

1. This appeal is taken up for admission. We heard the appellant Shri Vijay Kapoor in person. He is aggrieved by the dismissal of his complaint by the Consumer Dispute Redressal Forum (District Forum) North Goa by order dated 18-02-2009 in Consumer Complaint no. 97/2008.

2. The complainant purchased a medical insurance policy provided by the opposite party for Rs.1,50,000/- which expired on 01-08-2008. He had been a mediclaim policy holder for about five years prior to that. He was a resident of Delhi but shifted residence to Goa and desired to transfer his medical policy to here. A request was emailed to the opposite party but he received no reply. A letter was sent by registered post on 30-05-2008 to the opposite party requesting to transfer the policy to the branch at Vasco-da-Gama Goa. However, the opposite party neglected to accede to his request resulting in non-renewal of the policy. Right from the time he first purchased the medical insurance policy, the complainant had been requesting for cover of Rs.3,00,000/-, but inspite of going through all the required tests the opposite party approved cover of Rs.1,00,000/- only. His requests for enhanced cover made every year apparently fell on deaf ears and the reason given was that he was “old”. Finally in 2007, the cover was increased by Rs.50,000/- citing some ‘general instructions’ to give minimal cover to persons above 55 years of age. The complainant inter-alia prayed for restraining the opposite party from keeping in abeyance his medical policy; for direction to transfer his medical policy to Vasco Goa within 48 hours; for direction to enhance the cover to Rs.3,00,000/- and for compensation and costs.

3. The opposite parties did not contest the complaint. The District Forum observed and found that the mediclaim policy was typically for one year and the question of transferring the same to Goa does not arise. It was upto the insurance company to decide whether or not to issue fresh policy or the cover to be given to the insured. No deficiency-in-service was found and the complaint was dismissed.

4. We called for and perused the records and proceedings of the lower forum and gave due consideration to the submissions of the appellant. As regards transfer of the medical insurance policy from Delhi to Goa, admittedly it was valid for one year and expired on 01-08-2008. In these circumstances, directing transfer of the expired policy would be unreasonable and an exercise in futility. Insofar as enhancement of insurance cover is concerned, it is entirely within the domain of the insurance company to consider according to their business policies. Consumer fora have jurisdiction to intervene only in case any arbitrariness or discrimination is shown. No such case is made out before us. Besides, although the complainant has relied on three communications to the opposite parties, there is no indication as to whether they were received by the addressees. We did not find any reason to interfere with the order impugned in this appeal.

5. Hence this appeal stands dismissed. No costs.

Pronounced.



[Sandra Vaz e Correia]

Member





[Caroline Collasso]

Member