SOUTH EASTERN COALFIELDS LIMITED Vs. BASANT KUMAR CHHAJED

JUDGEMENT

(1.) This Revision Petition has been filed by the Petitioner/ Opposite Party against the Respondent / Complainant challenging the impugned Order dtd. 27/9/2018 passed by the Chhattisgarh State Consumer Disputes Redressal Commission, Pandri, Raipur, in Appeal bearing No. FA/2018/581. Vide such Order, the State Commission had dismissed the Appeal while upholding the Order dtd. 8/2/2018 passed by the District Consumer Disputes Redressal Forum, Bilaspur, Chhattisgarh, in Case No. CC/172/2017.

(2.) The brief facts of the case are that the Complainant sent an application along with a Draft of Rs.20,000.00 to the Opposite Party after retirement on 31/5/1996 for getting the benefits under Medi-claim on 17/4/2013. The Opposite Party accepted the said application and sent a Card from 6/5/2013 to 5/5/2014 for re-payment of Medi-claim of Complainant and his wife on 18/5/2013. Consequently, the Complainant sent advance intimation on 18/6/2013 to the Opposite Party for getting knee replacement of both the knees of his wife at Greater Kailash Hospital, Indore, which was replied to by the Opposite Party on 7/8/2013 stating that the Greater Kailash Hospital, Indore, is not approved Hospital for Medi-claim Card/Policy. However, after due correspondence, approval letter dtd. 27/8/2014 was issued, in pursuance of which the Complainant sent a claim of Rs.5,07,230.00 with all the documents of Knee replacement of his wife to the Opposite Party on 8/9/2014. But the Opposite Party delivered only a sum of Rs.65,524.00 to the Complainant. Hence, Complaint bearing No. 172/2017 was filed alleging deficiency in services by the Opposite Party, and seeking payment of Rs.5,07,230.00 along with other ancillary reliefs.

(3.) The Ld. District Forum vide its Order dtd. 8/2/2018 proceeded Ex-parte against the Opposite Party as it had failed to appear despite service of notice and hence, allowed the Complaint as it remained unchallenged and directed the Opposite Party to pay the balance amount after deducting Rs.65,524.00 from the Medi-claim amount of Rs.5,07,230.00, Rs.20,000.00 as compensation and Rs.2,000.00 as litigation costs. It is also noted by the Ld. District Forum in its Order that the Complainant had filed a complaint before Mumbai Forum which was dismissed for want of jurisdiction, and Appeal against the said Order was also dismissed by the Hon'ble State Commission. Hence, the present Complaint was filed before the Ld. District Forum.