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SANGITA DHINGRA SEHGAL, BIMLA KUMARI
R. L. Jalla – Appellant
Versus
Oriental Insurance Co. Ltd. – Respondent
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 w
No relief can be given on a time-barred complaint.
Limited Scope of Second Appeal/Revisional Jurisdiction – Its jurisdiction to intervene in Second Appeals (akin to Revisional Jurisdiction) is extremely narrow. When the District Forum and State Commi....
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