C.C.No. 19 / 2008


BETWEEN:

Marri Siva Rao, S/o.late Venkata Rama Chandra Rao, Hindu,
Aged 69 years, Members of the Branch Managers Club, L.I.C.Agent,
L.I.C.of India, Door No.3-7-45/6, Katthera Street, Srikakulam Town and Dist. ...Complainant.

AND:

01) M/s.Medi Assist India Private Limited, rep.by its Managing Director,
No.797, Annapoorna, 10th Main, 4th Block, Jayanagar, Bangalore-550011.
02) The Sales Manager, Sales Department, L.I.C.of India, Jeevan Prakash,
Divisional Office, Dwarakanagar, Visakhapatnam Town and District.
03) The Senior Branch Manager, L.I.C.of India,
Women’s College Road, Srikakulam Town and District. …opposite parties.

This complaint coming on 23-01-2009 for final hearing before us in the presence of Sri P.V.Ramana Dayal, Advocate for complainant and opposite party No.1 called absent and Sri B.Simhachalam, Advocate for opposite party Nos. 2 and 3 and having stood over to this day for consideration, this Forum made the following:

O R D E R

This is a complaint filed under Section 12 of the Consumer Protection Act, 1986 and facts of the case briefly are as follows:
Complainant obtained medi claim policy from opposite party No.1 situated at Bangalore. There is tie-up between opposite party NO.1 and opposite party No.2 regarding medi claim insurance. Earlier he claimed an amount of Rs.15,000/- for his heart operation and he received the same through opposite party No.2. Subsequently he underwent eye operation on 9-9-2006 and he claimed Rs.5,359-70ps, but the opposite parties have not settled the claim. Hence complaint is filed for a direction to the opposite parties to pay Rs.5,359-70ps and Rs.80,000/- towards compensation and Rs.5,000/- towards costs.

2) Opposite party No.1 remained absent. Opposite party No.2 filed counter stating that the complainant did not submit any claim form towards eye operation expenses at any time and this opposite party had not received any claim form from the complainant with regard to eye operation. It is further stated that opposite party NO.2 is not liable to pay any amount to the complainant.
Opposite party No.3 filed memo adopting the counter filed by opposite party No.2.

3) Complainant and opposite party Nos.2 and 3 filed affidavits. Exs.A1 to A19 are marked on behalf of the complainant. No documents are marked on behalf of the opposite parties.
Heard complainant and opposite party Nos.2 and 3.
Point for consideration is:
Whether there is deficiency in service on the part of the opposite parties.

4) POINT:
Opposite party No.1 remained absent. Opposite party No.2 stated in the counter that the complainant did not submit any claim form with regard to his eye operation. It shows that the claim of the complainant was not routed through opposite party No.2. Earlier the complainant claimed an amount of Rs.15,000/- for his heart operation and the claim was routed through opposite party No.2 and it was settled for Rs.14,895/-.

5) Ex.A14 dated 10-9-2006 is Medical Certificate issued by Dr.P.L.N.Raju showing that the complainant had undergone surgery on his left eye. Ex.A15 is claim form addressed to New Indian Assurance Company Limited. New India Assurance Company Limited is not a party to this complaint. Ex.A16 is letter dated 20-9-2006 addressed by the complainant to opposite party No.1 claiming Rs.5,000/- and odd. Ex.A17 is another letter dated 5-2-2007 addressed by the complainant to opposite party No.1 requesting to settle the claim. Ex.A18 is another letter dated nil addressed by the complainant to opposite party NO.1 requesting to settle the claim. Ex.A19 is notice dated 9-7-2007 issued on behalf of the complainant to opposite party NO.1 claiming Rs.5,359-70 ps. with interest and compensation of Rs.10,000/-.

6) Complainant has not filed the medi claim policy obtained by him from opposite party No.1. It appears that opposite party No.2 is facilitator between the complainant and opposite party No.1. Earlier the complainant had routed his claim for his heart operation through opposite party No.2 and it was settled by opposite party No.1. This time the complainant had not routed his claim through opposite party No.2. So opposite party No.2 pleaded inability to act on the claim of the complainant. Opposite party Nos.2 and 3 are not liable to pay medi claim of the complainant and the complainant has not claimed anything from opposite party Nos.2 and 3 prior to filing

this complaint. Complainant had not issued any notice to opposite party Nos.2 and 3 claiming medi claim amount. Complainant has not filed medi claim policy obtained by him to verify whether opposite party No.1 is liable to pay the medi claim amount claimed by the complainant. There is no basis or evidence to hold that opposite party No.1 is liable to pay the amount claimed by the complainant. We therefore hold that there is no deficiency in service on the part of the opposite parties. Hence we answer the point accordingly.

In the result, complaint is dismissed. No costs. Advocate’s fee is fixed at Rs.500/- (Rupees five hundred only).