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Time of India
7 hours ago
- Health
- Time of India
Medisep beneficiaries can approach consumer court without using internal grievance redressal mechanism: State consumer dispute redressal commission
Kochi: Beneficiaries of Medisep, the health insurance scheme for Kerala govt employees and pensioners, have the right to directly approach the consumer dispute redressal commission without utilising the insurance company's internal grievance redressal mechanism, the state consumer dispute redressal commission said. Tired of too many ads? go ad free now The state commission dismissed an appeal challenging the order of Ernakulam district consumer dispute redressal commission. The district commission previously ruled that the condition requiring complaints related to Medisep be resolved through a three-tier grievance redressal mechanism, based on the agreement between govt and insurance company before approaching the court, was a violation of consumer rights. The Oriental Insurance Company filed an appeal against this. In a complaint filed by C D Joy, 78, a retired headmaster from Karukappilli, Ernakulam, regarding the denial of an insurance claim under Medisep, the insurance company argued that one cannot directly approach the consumer court without going through the govt's internal grievance redressal mechanism. The state commission, with a bench comprising president Justice B Sudheendra Kumar and judicial member D Ajith Kumar, upheld the district commission's order rejecting the argument. On Jan 7, 2024, Joy was taken to a nearby hospital due to severe chest pain. During the initial treatment, the complainant's heart stopped functioning for a while. Due to the emergency, the complainant was referred to a private hospital and was treated as an inpatient. The complainant spent an amount of Rs 2,16,000 on the treatment. The complainant submitted a claim to the insurance company, which was rejected. The state commission, while hearing the case, appointed an amicus curiae who submitted that since no statutory body was constituted under any act to exclusively deal with matters relating to claims under the Medisep scheme, the complainant had every right to file the consumer complaint before the district commission without resorting to the in-house mechanism envisaged under the said scheme. The commission also clarified in its order that, under Section 100 of the Consumer Protection Act, 2019, any consumer can approach the consumer courts pointing out deficiencies in service and unfair trade practices.
New Indian Express
3 days ago
- Health
- New Indian Express
‘Medisep beneficiaries can approach consumer forum'
THIRUVANANTHAPURAM: Beneficiaries of Medisep, the health insurance programme for Kerala government employees and pensioners, are free to approach the consumer disputes redressal commission, the State Consumer Disputes Redressal Commission (SCDRC) has ruled. The commission rejected the argument by the Oriental Insurance Company, insurance provider of Medisep, that complaints against the scheme should be submitted to the Medisep Grievance Redressal mechanism before approaching the consumer commission. The case pertained to a petition filed by a 78-year-old retired headmaster before the Ernakulam district commission. He challenged the rejection of a claim for Rs 2.16 lakh which he spent on heart treatment. Oriental challenged the maintainability of the petition, citing that the beneficiary should have approached the grievance redressal cell first. The district commission rejected Oriental's argument, following which the company filed an appeal before the state commission. The SCDRC bench, comprising its president Justice B Sudheendra Kumar and judicial member Ajith Kumar D, considered the appeal. It observed that Section 100 of the Consumer Protection Act, 2019, provides that the provisions in the act are in 'addition to and not in derogation' of the provisions of any other law. Therefore, the commission has jurisdiction over complaints relating to Medisep claims, it said.
New Indian Express
23-06-2025
- Climate
- New Indian Express
Consumer panel rules rain damage covered under flood clause in insurance policy
THIRUVANANTHAPURAM: The State Consumer Disputes Redressal Commission (SCDRC) has ruled that damage due to heavy rain can be considered as a peril falling under the 'flood and inundation' clause in an insurance policy. An SCDRC bench comprising president Justice B Sudheendra Kumar, judicial member Ajith Kumar D and member K R Radhakrishnan made the ruling citing Supreme Court orders, while considering the appeal plea filed by a Palakkad native against the district commission's denial of compensation. The bench directed the firm, United India Insurance Co Ltd, to pay Rs 32,500 as losses and Rs 5,000 as costs. The complainant had availed a Standard Fire and Special Perils policy from the firm after paying a one-time premium of Rs 5,898.90. It covered the residential building, compound wall and well belonging to him. During the term of the policy, the compound wall collapsed in heavy rain. A surveyor assigned by the firm assessed the loss at Rs 32,500. However, the company rejected the claim saying rain or heavy rain was not a peril covered under the policy. It said coverage is for destruction or damage directly caused by storm, cyclone, typhoon, hurricane, tempest, tornado, flood or inundation excluding those from earthquake, volcanic eruption or other convulsions of nature. The district commission had upheld the company's argument.
New Indian Express
12-05-2025
- Business
- New Indian Express
Panel directs builder firm to refund customer who didn't get promised flat
THIRUVANANTHAPURAM: The Kerala State Consumer Disputes Redressal Commission has directed a builder company to give full refund and compensation to a customer who did not get the promised apartment. The commission rejected the company's argument citing insolvency proceedings before the National Company Law Tribunal (NCLT). The complainant, a Thiruvananthapuram native, had booked a 3-bedroom apartment in a project proposed at Karakulam village in the district. The total cost was Rs 55,17,277. As per the agreement, construction had to be completed within 18 months from the date of agreement i.e., March 18, 2017. Though the complainant paid Rs 43,00,123, the work was not carried out by the builder. The builder also did not respond to the communications sent by him. The complainant had availed a housing loan of Rs 41 lakh at 8.5 per cent rate of interest from the Punjab National Bank Housing Finance. The former managing director of the company filed an affidavit before the SCDRC along with the order passed by the NCLT Kochi branch. He cited that the NCLT has appointed an Insolvency Resolution Professional and they are incapacitated in participating in the proceedings of the company. The SCDRC bench comprising its president Justice B Sudheendra Kumar, judicial member Ajith Kumar D and member KR Radhakrishnan heard the case. Advocates Ponnan Alex and Sreevaraham NG Mahesh appeared for the petitioner. The commission, however, observed that Section 3 of the Consumer Protection Act, stipulates that an aggrieved consumer can approach the Consumer Disputes Redressal Commission in addition to the existing remedies. Proceedings pending before the NCLT is not a bar for the complainant to approach the commission for redressal of grievances, it said. The commission found deficiency in service on the part of the builder. It directed the company to refund Rs 43 lakh with 9 per cent interest besides Rs 3 lakh as compensation and Rs 20,000 for litigation costs. Case file Apartment project at Karakulam in Thiruvananthapuram Consumer paid Rs 43 lakh He availed a housing loan for Rs 41 lakh @ 8.5 pc interest Builder failed to deliver apartment Commission's direction to builder firm Refund Rs 43 lakh at 9 per cent interest Rs 3 lakh compensation Rs 20,000 as litigation costs
