New India Assurance Co. Ltd. vs VASUDHA VASANTI DHAGAMWAR

THE present appeal, filed by the appellant, under Section 15 of the Consumer Protection Act, 1986 (hereinafter referred to as ''the Act'') is directed against order dated the 5th November, 1999, passed by District Forum-I in Complaint Case No. 1040/70 - entitled Dr. Vasudha Vasanti Dhagamwar v. New India Assurance Co. Ltd.

THE facts, relevant for the disposal of the present appeal, briefly stated are, that the respondent had obtained mediclaim policy from the appellant w.e.f. 31.1.1996. THE respondent developed pain in her back (due to lumber disk lesion) and was hospitalised w.e.f. 5th July, 1996 to 25th July, 1996 at Aashlok Nursing Home, Safderjung Hospital, New Delhi. After her discharge from the hospital, the respondent, on 31.7.1996, preferred a claim for Rs. 15,000/-. THE claim, preferred by the respondent, was repudiated by the appellant vide letter dated the 8th October, 1996 on the ground that during examination on 29.1.1996, the respondent had not disclosed her previous ailment. After the repudiation of the claim by the appellant, the respondent filed a complaint under Section 12 of the Act before the District Forum with the prayer that the appellant be directed to pay to the respondent a sum of Rs. 15,000/- as mediclaim and a sum of Rs. 40,000/- as compensation besides cost of litigation. The claim of the respondent in the District Forum was contested by the appellant. The stand taken by the appellant was that the respondent had failed to make out a case of deficiency in service on the part of the appellant and the claim of the respondent was repudiated by the appellant on the basis of the report of the doctor on their panel.

The learned District Forum, vide order, being impugned in the present proceedings, has directed the appellant to pay a sum of Rs. 15,000/- to the respondent alongwith interest @ 12% p.a. w.e.f. 3.10.1997 till realisation together with Rs. 1,000/- on account of litigation expenses.

FEELING aggrieved the appellant has preferred the present appeal under Section 15 of the Act. We have heard the learned Counsel for the appellant at length on the question of admission of the present appeal and have also carefully gone through the documents/material on record. The order, being impugned in the present proceedings, was passed by the learned District Forum on 5.11.1999. In terms of the provisions contained in Section 15 of the Act, the present appeal should have been filed within a period of thirty days from the date of the order. However, proviso to the above section provides that the State Commission may entertain an appeal even after the expiry of the abovesaid period of thirty days if it is satisfied that there was ''sufficient cause'' for not filing the same within the abovesaid period. Admittedly, the present appeal has not been filed by the appellant within the prescribed period of 30 days. The same has been filed on 10th January, 2000. Alongwith the appeal, the appellant has also filed an application, seeking condonation of delay in filing the appeal. In the above said application dated the 4th January, 2000, seeking condonation of delay in filing the appeal, it is stated that the certified copy of the impugned order was received in the office of the appellant on 9th November, 1989 and after a few days the same was sent to the legal department at the Regional Office of the appellant. It is further stated in the above said application that after perusal of the impugned order certain contradictions were noticed by the appellant and the appellant requested the Counsel to inspect the file of the District Forum. The Counsel inspected the file of the District Forum on 30.11.1999 and thereafter forwarded his observations recommending filing of appeal on the same day. No explanation whatsoever has been given in above said application for delay which took place in filing the present appeal after 30.11.1999.

AS already stated, there is a statutory provision enabling the Commission to entertain the appeal even after the expiry of the statutory period prescribed for filing an appeal, provided the appellant satisfies that there was ''sufficient cause'' for not filing the same within time. The words ''sufficient cause'', occurring in proviso to Section 15 of the Act, are of utmost significance. AS per settled law, culled out from various judicial decisions, the above expression, ''sufficient cause'' though deserves to receive a liberal construction, yet, a just and equitable balance has to be maintained between the right secured by the respondent as a result of the expiry of the prescribed period of limitation and the injustice of depriving the appellant of adjudication of his grievances on the merits of his appeal for causes beyond his reasonable control, which means the cause is bona fide and beyond the control of the appellant. Though no hard and fast line can be drawn as to what affords ''sufficient cause'' in a given case, yet, again as per settled law, any cause which prevents a person from approaching the Court within time is ''sufficient cause''. In doing so, it is the test of a reasonable man in normal circumstances which has to be applied. If the above criterion is applied to the present case, it is noticed that the application, seeking condonation of delay in filing the appeal miserably fails to meet the above requirement because as per appellant''s own case the lawyer had forwarded his observations, recommending filing of appeal on 30.11.1999. As already stated no explanation is forth coming on behalf of the appellant for the delay after 30.11.1999. The present appeal has been filed at a much later stage on 10.1.2000. In the presence of the above facts and the position explained above, in our opinion, whatever liberal interpretation might be put on the words ''sufficient cause'', it would be impossible for us to hold that there was no negligence or want of bona fide on the part of the appellant. In our opinion, the appellant has miserably failed to show ''sufficient cause'' for condoning the delay and, therefore, the application seeking condonation of delay in filing the appeal is hereby rejected.

THE present appeal, filed by the appellant, besides being barred by limitation, is also devoid of substance on merits because as per the case of the appellant, the claim of the respondent was repudiated on the ground that during her examination on 29.1.1996 the respondent had not disclosed her previous ailment. As per the case of the appellant the ailment/disease of the respondent were pre-existing at the time of obtaining the policy and that fact was not disclosed by the respondent at the time of booking the policy. On a perusal of the material/documents on record including the copy of the order, being impugned in the present proceedings it is apparent that the respondent was hospitalised at Aashlok Nursing Home, Safderjung Hospital, New Delhi from 5.7.1999 to 25.7.1999 for pain in her back which was due to lumber disk lesion whereas the earlier ailment of the respondent was ordinary lower back pain which was due to lumber spondylosis (an aging phenomena). In the presence of the above facts, the learned District Forum was fully justified in holding that the appellant repudiated the claim of the respondent on erroneous ground.

THUS, viewed from all angles, the present appeal filed by the appellant, is devoid of substance. The same merits dismissal. Accordingly, the same is dismissed in limine with no order as to costs. Appeal dismissed.