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Disputes often arise in the police over the issue of limits. As a result the affected have to suffer. Recently, a legal issue regarding scope of work was also raised in Ahmedabad City District Consumer Court. Finally, the Consumer Court has given a very important judgment regarding the right field. Ahmedabad City (Main) Consumer Disputes Redressal Commission judgment states that cases of group mediclaim policy holder patients cannot be tried in city district courts and even if there is a small amount claim, it will be mandatory to file it before the National Consumer Disputes Redressal Commission, New Delhi.
The Consumer Commission issued a notice against the insurance company
An employee of LIC located in the satellite area of Ahmedabad city has purchased New India Insurance Co. through LIC for himself and his family. Ltd. had taken Group Mediclaim Insurance Master Policy. During this policy, right lung cancer victim of the complainant’s father Punjabhai Darji (age 77) sadly passed away. A total of 10 different claims were rejected by the insurance company for medical expenses of varying amounts ranging from Rs.16,000 to Rs.40,000. So Mukesh Parikh, President of Consumer Protection and Action Committee filed a case in Ahmedabad City (Main) Consumer Disputes Redressal Commission. In which the consumer commission filed a complaint and issued a notice against the insurance company.
The District Commission has no jurisdiction to hear the complaint
The lawyer of the insurance company appeared for the complaint and submitted a preliminary objection application raising the issue of jurisdiction and the cases presented in Ahmedabad city could not proceed. After the hearing of this objection application, the lawyer of the insurance company submitted that the complainant is an employee of LIC and LIC is employed by New India Insurance Co. Ltd. Have a tie-up with. LIC employees hold Group Mediclaim insurance master policy and LIC has reimbursed the insurance company Rs.97,60,96,000 plus GST for premium. Hence the District Commission has no jurisdiction to hear the complaint.
Millions of policy holders cannot file cases in their own city
During the hearing, Consumer Protection and Action Committee President Mukesh Parikh argued before the Consumer Commission that the complainant is an employee of LIC and his father was dependent on him. A premium of Rs.26,885 was drawn from the salary and the claim amount is Rs.30,433. Total all 10 claims amount is also less than Rs.3 lakhs and hence the Consumer Commission has jurisdiction to hear complaints and try cases when the amount of employee’s premium and claim amount is less than Rs.50 lakhs. If the insurance company’s pilimonary objection is accepted and accepted, then lakhs of policy holder patients of the country will not be able to file a case in their city-district. All are forced to file a complaint in the National Commission-Delhi to seek justice for even small claims, which is almost impossible.
New Delhi’s push to file a complaint
Even if the insurance company rejects the claim due to being economically viable, or gives incomplete compensation, the policy holder has to file a complaint with the Compulsory National Commission, New Delhi, if the premium amount in the patient group mediclaim policy is more than Rs.10 crore, this will create confusion and chaos. In view of the rigid rules and illogical provisions without applied mind, the complaining consumers cannot approach the consumer court of the district.
Same situation in all the states of the country
Due to the judgment of the consumer court, a situation has arisen that whether the patient holding a group mediclaim policy is from Ahmedabad city or Kolkata, Mumbai or Chennai, complainants from remote areas of the country have to compulsorily go to the National Commission, New Delhi to file a complaint. If the premium of compensation less than Rs.10 crore has been paid to the insurance company, whether the customer is from Rajkot or Navsari, Valsad in the state. Not everyone can file a case in their own district court and is forced to file a complaint in the Ahmedabad State Commission. A similar situation is happening in all the states of the country.
Millions of consumers have now been hit with a huge shock
Mukesh Parikh, president of Consumer Protection and Action Committee, further said that many nationalized banks including State Bank of India, Canara Bank, Bank of Baroda and cooperative sector banks tie up with insurance companies for the benefit of their account holders (customers). As the premiums are low, customers join the scheme and get health insurance policies through banks. Millions of such consumers have now been hit with a crushing blow. A tragic and sad reality has arisen that the customer cannot reach the court and justice is not provided.
There is an urgent need to change such rigid rules of the Consumer Protection Act
The President of the Consumer Protection and Action Committee has finally said that this extremely shocking and painful and catastrophic judgment will be challenged first in the Gujarat State Consumer Disputes Redressal Commission. At the same time, petitions were sent to the Chief Justice of the Supreme Court of India, the President of the National Commission and the Minister of Consumer Affairs of the Central Government and the MPs as well as the Prime Minister, warning against changing such rigid rules of the Consumer Protection Act without applying the mind and without thinking and understanding what the effects would be. will be urged.
A dangerous and serious blow to the consumer movement
He said that on the one hand the government is doing massive publicity and dissemination of Jago…Kashtra…Jago, but on the other hand the consumer movement of Gujarat and the country is affected by reckless decisions and reckless judgments where conscious consumers cannot come forward to complain, consumers cannot approach the court. A dangerous and serious blow has been struck. This has sent a negative message to the consumer world.
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