Haryana

Sonipat

297/2014

NEELAM JHAMP W/O Surender Kumar Jhamp - Complainant(s)

Versus

national Insurance co., 2. National Insurance co. Middleton Street Kolkata,3. Trawell tag - Opp.Party(s)

R.S. Saroha

01 Oct 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.

             

 

                             Complaint No.297 of 2014

                             Instituted on:10.11.2014

                             Date of order:08.10.2015

 

Neelam  Jhamb wife of Surinder Kumar Jhamb, r/o H.No.170R, Model Town, Sonepat.

…Complainant.       

Versus

 

1.National Ins. Co. Ltd. service to be effected through Branch Office at Geeta Bhawan road, near Post office, Sonepat through its Branch Manager.

2.National Ins. Co. Ltd. having its registered office at 3 Middleton Street, Kolkata-700071  through its Divisional Manager/Branch Manager.

3.M/s Trawell-Tag, having its Corporate office Karvet Travel Services Pvt. Lt.d, 26, Madhu Industrial Estate, PB Marg Worli Mumbai-400013 through its Manager.

                                                …Respondents.

 

COMPLAINT UNDER SECTION 12 OF

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Sh. RS Saroha, Advocate for Complainant.

           Sh. HC Jain Adv. for respondent no.1 and 2.

           Sh. SC Jain, Adv. for respondent no.3.

 

Before-    Nagender Singh-President. 

          Prabha Wati-Member.

          D.V. Rathi-Member.

 

O R D E R

 

          The complainant has filed the present complaint against the respondents alleging therein that she had purchased an overseas medi claim policy and the said policy provides cashless facility for hospitalization to the insured.  On 9.9.2013 the complainant sent to Australia and some problem developed in both the eyes of the complainant and she was taken to a local doctor i.e. Eye Specialist and she was treated by her and the complainant has spent ASD 4000 in her treatment.  On 24.3.2014, the complainant filled the claim form from Sonepat to get the claim amount. The complainant has requested  the respondents number of times and has completed all the formalities of the respondents, but of no use and that amounts to a grave deficiency in service on the part of the respondents. So, she has come to this Forum and has filed the present complaint.

2.        The respondents appeared and filed their separate written statement.

          The respondents no.1 and 2 in their written statement has submitted that the complainant was asked to provide the documents to process the claim as mentioned in para no.1 of the written statement.  But despite repeated requests, the complainant has not provided the same to the respondents no.1 and 2.  Thus, the insurance company has closed the claim file of the complainant as no claim vide e-mail dated 3.11.2014.  There is no deficiency in service on the part of the respondents no.1 and 2 and thus, prayed for the dismissal of the present complaint.

          The respondent no.3 in his written statement has submitted that the respondent no.3 has got no authority to process, settle or reject the claim and this authority lies with the respondents no.1 and 2.

3.        We have heard learned counsel for both the parties at length and have also gone through the entire relevant records available on the case file very carefully.

4.        Ld. Counsel for the respondents no.1 and 2 have submitted that the complainant was asked to provide the documents to process the claim as mentioned in para no.1 of the written statement.  But despite repeated requests, the complainant has not provided the same to the respondents no.1 and 2.  Thus, the insurance company has closed the claim file of the complainant as no claim vide e-mail dated 3.11.2014.  There is no deficiency in service on the part of the respondents no.1 and 2.

          Ld. Counsel for the complainant has also argued his case vehemently alleging deficiency in service on the part of the respondents.           

          But in our view the ends of justice would be fully met if the directions are given to both the parties.  Accordingly, we hereby direct the complainant to provide the required documents as mentioned in para no.1 of the preliminary objections and are in her possession, to the respondents no.1 and 2 and the documents which cannot be provided by the complainant, the complainant is directed to furnish the explanation to the respondents no.1 and 2 in this regard.  The complainant is given one month time for doing the same. Similarly, the respondents no.1 and 2 are directed to decide the claim case of the complainant within a period of 45 days which shall be started from the day when the complainant provides the documents to the respondents no.1 and 2 as mentioned in para no.1 of the preliminary objections.

          With these observations, findings and directions, the present complaint stands disposed off.

          Certified copy  of this order be provided to both the parties free of costs.

          File be consigned after due compliance.

 

 

(Prabha Wati)        (DV Rathi)           (Nagender Singh)                    Member, DCDRF,             Member, DCDRF        President, DCDRF,

Sonepat.             Sonepat.             Sonepat.

 

ANNOUNCED- 08.10.2015.