IMPORTANT POINT
No relief can be given on a time-barred complaint.

JUDGMENT

Sangita Dhingra Sehgal, President—The facts of the case as per the District Commission record are as under:

“...he has purchased three Mediclaim Policies of OP 1 details whereof are given in para 4 of the complaint as under:

(a) Policy No.272200/48/2010/4756 for the period 27.03.2010 to 26.03.2011

(b) Policy No.272200/48/2011/6428 for the period 27.03.2011 to 26.03.2011

(c) Policy No.272200/48/2012/6870 for the period 27.03.2012 to 26.03.2013.

On 03/07/2010 he suffered some problem in his left eye for which he visited Venu Eye Institute & Research Centre, Delhi for treatment. As he was having mediclaim policy of OP 1 he submitted all the documents to Venu Eye Institute for availing cashless treatment under Policy No.272200/48/2010/4756.

On 10/07/2010 TPA sent reply to Venu Eye Institute whereby they rejected cashless benefit proposed to be availed by the complainant. hereafter complainant approached Eye Centre namely Delhi Retina Centre (OP 2) on 17/07/2010 where he was admitted for treatment. Vide his letter dated 23/07/2010 complainant informed OP 1 about his treatment taken on 17.07.2010 but he did not receive any response. Meanwhile some further treatment was received by complaint from OP 2 on 14/08/2010 and 18/09/2010. Complainant sent all the original reports/Medical and vouchers of his treatment to OP 1. OP 1 sought opinion of SPA regarding the claims raised by the complainant and vide mail dated 03/12/2010 complainant’s claim was out rightly rejected by TPA stating that the claim is not admissible under clause 2.3 of the mediclaim policy. Being aggrieved by rejection of his claim complainant approached Delhi Government Mediation and Conciliation Centre and office of Insurance Ombudsman on 20.01.2011.

Complainant’s first case filed before the Delhi Government Medication & Conciliation Centre was rejected by the competent authority on 23.03.2011 due to absence of the officials of OP:—

1. Insurance Ombudsman dismissed the claim of the complainant vide order dated 03.01.2012.

Feeling aggrieved by rejection of his claim by Insurance Ombudsman vide order dated 03.01.2012 complainant filed review petition on 25.06.2012.

2. The instant complaint is accompanied with an application seeking condonation of delay of 352 days in filing the instant complaint. Application as well as complaint is contested by the OPs in view of Section 24-A(1) of the Act.”

2. The District Commission after taking into consideration the material available on record passed the order dated 27.02.2019, whereby it held as under:

3. We have heard Shri Deep Chand Counsel for complainant along with complainant, Shri Bhupesh Chandra Counsel for OP 1.

4. Learned counsel for OP 1 vehemently asserted that the claim is barred limitation under section 24 (A) of the Act which reads as follows: Section 24A in the Consumer Protection Act, 1986 24A. Limitation period.-

“(1) The District Forum, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.

(2) Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub-section (1), if the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period: Provided that no such complaint shall be entertained unless the National Commission, the State Commission or the District Forum, as the case may be, records its reasons for condoning such delay.”

5. OP 1 in the very first paragraph of its written statement has taken an objection that the complaint is barred under section 24 (A) of the Act. It is pleaded that cause of action arose on 03/07/2010. Complainant filed his claim with OP 1 on 23.09.2010 and OP repudiated his claim vide its letter dated 24.11.11. It is further stated that complainant filed a com