BEFORE THE TELANGANA STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD.

FA.NO.837 OF 2023 AGAINST ORDERS IN CC.NO.23 OF 2023, DISTRICT CONSUMER COMMISSION-I, HYDERABAD Between:

M/s.Star Health & Allied Insurance Company Ltd., Rep. by its Manager, 1, 3-6-111/8 and 3-6-111/9, 3rd Floor, Far East Plaza, Himayatnagar, Hyderabad – 500029 – Ph: 1800 425 2255.

..…Appellant/Opp.Party No.1 And

1. Sri Anil Chawla, S/o.Late Sri Hari Sharan Chawla, Aged about 75 years, Occ: Self-employed, Ph: 9000107720, 040 48520807 Email: anilchawlaarchitect@rediffmail.com 2. Smt.Alka Chawla, W/o.Sri Anil Chawla, Aged about 77 years, Occ: Home Maker, Both are R/o.6-3-713/A/6UGF, Sapphire, Amrutha Hills, Punjagutta, Hyderabad – 500082, Khairatabad, Mobile No.8885679544.

…..Respondents/Complainants

3. Punjab National Bank, Rep. by its Manager, 4/1/427, Bank Street, Troop Bazar, Abids, Hyderabad – 500001, Ph: 040 24743748, 1800 180 2222.

…..Respondent/Opp.Party No.2 Counsel for the Appellant/Opp.Party No.1 : M/s.G.S.G.Radha Krishna Counsel for the Respondents/Complainants: M/s.Papaiah Peddakula Counsel for the Respondent/Opp.Party No.2: M/s.MV Subbaraju QUORAM:

HON’BLE SMT.MEENA RAMANATHAN…IN-CHARGE PRESIDENT &

HON’BLE SRI V.V.SESHUBABU, MEMBER-JUDICIAL TUESDAY, THE TWENTY SECOND DAY OF APRIL TWO THOUSAND TWENTY FIVE *******

Order : (Per Smt.Meena Ramanathan, Hon’ble In-charge President)

1. This appeal is filed by the Appellant/Opposite Party No.2 under Section 41 of Consumer Protection Act, 2019, praying this Commission to allow this appeal by setting aside the order dated 10.10.2023 in CC.No.23/2023 on the file of District Commission-I, Hyderabad and granting stay of the order and be pleased to pass such other order/orders as deem fit and proper in the circumstances of the case in the interests of justice.

2. For the sake of convenience, the parties are described as arrayed in the complaint.

3. Briefly stated, the facts are that – the Complainant obtained health insurance – PNB Oriental Royal Mediclaim Health Insurance Policy from the Oriental Insurance Company, offered to the account holders of Punjab National Bank, in the year 2016. The same was ported to The New India Assurance Company (NIAC) Ltd., in 2018 through the Bank Manager, PNB, Raj Bhawan Road Branch, Hyderabad. Thereafter, NIAC Ltd., exited from the panel of Punjab National Bank in 2020, when the porting of the policies happened. The policy of the Complainants was moved from NIAC Ltd., in 2020 and was ported to Star Health and Allied Insurance Company (SHAAIC) Ltd., the Opposite Party No.1 herein through Mr.Rajesh Gupta, Manager PNB, Bank Street Branch, Hyderabad. At that time, the necessary information including existing diseases and ailments as required by Opposite Party No.1 was provided to them along with previous health insurance policies through Mr.Rajesh Gupta, Manager PNB.

4. The policy was effective from 16.12.2020 to 15.12.2021 with inception year being valid from 2016 as per the policy document and ID cards issued by Opposite Party No.1 as it was being continued from the previous Health Insurance Policies from PNB Oriental Royal Mediclaim Policy (PNB ORMP) and thereafter NIAC Ltd. The policy premium of Rs.24,865/- was paid by the Complainants on 20.11.2020 to Opposite Party No.1 directly from the PNB Savings Account of the first Complainant. Thereafter, the policy was renewed from 16.12.2021 to 15.12.2022 and policy premium of Rs.28,341/- was paid by cheque from the same account on 16.11.2021 and the same was encashed by the Opposite Party No.1. The policy details are as follows:

PNB-ORMP No: 431801/48/2017/5112: 16.12.2016 to 15.12.2017 PNB-ORMP No: 431801/48/2018/5544: 16.12.2017 to 15.12.2018 The NIAC No: 61290034180400000289: 16.12.2018 to 15.12.2019 The NIAC No: 61330534190400000112: 16.12.2019 to 15.12.2020 And the latest was issued by SHAAIC as below:

Star Health and Alliance Insurance Company : P/131127/01/2021/014146 – 16.12.2020 to 15.12.2021 (Amount Rs. 7.5 lakhs)

Star Health a