S.C.VYAS,PRESIDENT (ORAL) - (1.) THIS appeal has been preferred by the complainant of Complaint Case No. 316/05, decided by District Consumer Disputes Redressal Forum, Raipur (hereinafter called "District Forum" for short) vide Order dated 30.5.2008 and dismissed on the ground that there was no material to show any deficiency in service on part of the O.Ps.
(2.) THE facts of the case are that the appellant purchased Mediclaim Policy through respondent No. 1 from respondent No. 2 for a period from 21.11.2004 to 7.6.2005 and later on such policy was provided by another General Insurance Company IFFCO Tokiyo General Insurance Co. Ltd. for a period from 8.6.2005 to 7.6.2006. Appellant was ill from 7.5.2005 and was required to be admitted in a hospital at Bombay for checkup and treatment, since 2.6.2005 till 4.6.2005. Then he came back to Raipur and was taking treatment prescribed by the Physician of that hospital at Bombay. It was advised to the complainant by the physician of Bombay hospital to take medicines for few more months after discharge from the hospital. He continued the treatment for some more time and was also examined by Dr. B. Bandhopadhyay in the meantime. Those treatment papers along with claim application were filed, before the respondent Insurance Company. The claim was allowed but only for the medicines, which were prescribed by the hospital at Bombay. But so far as the fees of Dr. B. Bandhopadhyay and medicines purchased at Raipur, are concerned the claim was disallowed. Complaint has been filed in respect of direction to the Insurance Company for payment of that amount also, which has been disallowed.
(3.) WE have heard arguments of all parties and considered the material placed by them before District Forum and also before this Commission at the time of hearing. At the outset it is to be noted that the Mediclaim policy provided by respondent No. 2 to the appellant, has not been produced by any of the parties and it has been declared that, that policy has lost during transition and it is not available at present. On the direction of this Commission a letter was also written by complainant to respondent No. 1 for providing a copy of Mediclaim policy, but in reply, at the place of providing copy of the policy, it was informed that the matter being sub judice, no information in this regard can be provided. This letter and arguments of learned Counsel of all the parties, clearly shows that neither original policy nor its copy is available with any of the parties. In absence of Mediclaim policy it is difficult to ascertain the real terms and conditions of that policy.;