Date of Filing : 05.04.2014 Date of Disposal : 07.10.2023 BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BENGALURU (PRINCIPAL BENCH)

DATED THIS THE 07th DAY OF OCOTOBER 2023 PRESENT Mr. K.B.SANGANNANAVAR : JUDICIAL MEMBER Mrs M.DIVYASHREE : LADY MEMBER CC-NO.54/2014 R.Swamynatha S/o V.Rangaswamy Chetty.

Aged about 79 years, R/at # 597, Down Bazar Road, Yelahanka Old Town, Bengaluru-64.

Since dead his LR:

Sunder Swamynathan S/o late R.Swamynatha Aged about 47 years R/at C/o V.Sambasivam, No.1421-A, 18^th main, 5^th block, 1st stage, HBR layout, Bengaluru-43.. . ..Complainant/s (By Adv.Sri.G.S.Prasannakumar)

VS

1. St

1.

ar Health and Allied Insurance Co. Ltd.

Branch Office at # 3, III Floor, JVT Towers, VIII-A Main, Sampangirama Nagar, Bengaluru-27.

2. Star Health & Allied Insurance Co. Ltd.

Regd. Office at # 1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai-600034. ... Opposite party/s (By Adv.S.Krishna Kishore)

ORDER

BY Mr.K.B.SANGANNANAVAR : Pri.Dist & Session Judge (R) - JUDICIAL MEMBER.

1. This is a complaint filed U/s.17 of CPA 1986 with a prayer to direct OPs.1 & 2 to pay an amount of USD 39,772.75 (equivalent to INR 23,86,365/- and to pay Rs.10 lakhs as damages along with interest at 18% p.a. from the date of complaint till payment.

2. The brief facts of the case of the Complainant are stated as follows:

This complaint is filed on 05.04.2014 through advocate. The complainant died pending enquiry and his LR is brought on record U/o 22 Rule 3 R/w Sec.151 of CPC. As there was a delay to bring LR was condoned for the reasons sworn in by the said LR as he is settled in USA. He is one Mr. Sunder Swamynathan S/o late R.Swamynatha. He is brought on record as LR of the complainant and he is represented by GPA Mr.V.Sambashivam, aged about 47 years, R/at C/o V.Sambasivam, No.1421-A, 18^th main, 5^th block, 1st stage, HBR layout, Bengaluru-43.

3. It was the case of the Complainant, that during his life time planned for foreign trip to USA scheduled on 04.06.2012 along with his relatives obtained the policy under the name and style Star Travel Protect Insurance from OP.1 and had paid premium amount of Rs.32,914/- to OP.2. This Policy covers for 120 days and covers emergency medical expenses, transportation expenses etc.,. It was his case when he was in USA on 21.09.2012 was felt difficulty in urinating and nausea, which was subsequently with complete inability to walk and bladder control issues. The first aid such as intake of lot of water and juice and home remedies did not bring the Complainant to normalcy, as such he was accompanied by his son Sunder Swaminatha to hospital on 22.09.2012. In this regard a letter was also addressed on 22.09.2012 to the claim department, Cori, USA Inc. by his son. He was treated in Dublin Methodist Hospital and was discharged on 29.09.2012. He was diagnosed and treated for one UTI with Sepsis Secondary to e.coli infection and subsequent to UTI, small bowel obstruction. His son continuously made e-mail correspondences with OPs furnished all requirements to reimburse, however for no reasons insurer prolonged and protracted in considering the claim petition and complaint and finally on 02.07.2023 OPs repudiated his claim on the ground that he has not disclosed that he was having diabetes, hypertension and underwent surgery twice for hydrocephalus in the year 2005 & 2009.

4. It was his case that he was admitted to hospital in USA on

22.09.2012, where never had identified or detected diabetes nor was treated for the same. He was not having hypertension and not had the treatment for the same, more in particular that was diagnosed in USA hospital that he had diabetes and had no connectivity for the alleged diseases. The treatment which he underwent had no interconnectivity for the diabetic, hypertension or surgery. However the OP in order to wriggle out of their liability has attributed untenable reasons has rejected the claim petition which amounts to deficiency in service to a consumer. T