MAY-20 Settled in court
- Posted by CERC India
- Posted in May
Pay mediclaim – Chewing tobacco not the only reason for oral cancer
Kirit Patel of Vadodara District, had a Mediclaim policy for Rs. 3 Lakhs from National Insurance Co.Ltd. He was diagnosed and treated for oral cancer in March 2017 at an expenses of of Rs. 2,13,906. His claim was rejected by the insurance company and TPA Paramount Health Service on the basis that he had a Tobacco chewing habit which had caused his cancer.
Kirit approached the Vadodara Consumer Forum.The insurance company said that Kirit is a habitual tobacco chewer for 15 years which led to cancer. It did not provide any evidence that the cancer was caused due to tobacco chewing. Also, the exclusion of treatments of illnesses due to use of intoxicating substances did not include tobacco chewing. The court said that tobacco chewing is not the only factor leading to cancer. Many persons who have never consumed tobacco, get cancer whereas persons habitual to tobacco use may not have develop cancer.
Verdict
The forum found the insurance company and TPA deficient in providing its services. It directed the insurance company to pay Rs. 2,13,906 with 9 % interest, Rs. 5,000 towards compensation for hardship and mental agony and Rs. 2,000 for litigation costs.
Point of Law : Insurance company cannot reject mediclaim for oral cancer treatment of a patient who is habitual of tobacco consumption, based on the presumption that the cancer is caused by tobacco use.
 [Source: The order of the District Consumer Disputes Redressal Forum, Vadodara Addl., dated 9 August 2019 on Complaint No. CC/17/754]
Basement parking is not garage but a common area
DLF Universal Ltd., the developer of DLF Capital Greens, New Delhi constructed 2870 residential apartments in 23 towers in three phases. The allottees had disputes with the developer for issues including Club Charges, Car parking charges and Compensation for delayed possession. They approached the National Commission.
On club charges, the commission held that a club is meant for providing sports and recreational facilities to members and is part of the common areas and facilities.
Considering that the allottee undergoes immense agony and harassment and has to visit the developer’s office repeatedly for delay in possession, the Commission ordered DLF to pay compensation in the form of 7% interest per annum from the expected date of possession to the date it was actually offered.
NCDRC also stated that basement parking is not a garage despite all its security.The Developer argued that basement parking was superior to standalone garage as it was equipped with security personnel and cameras and gave full protection and shelter to the car. The Commission said that the term ‘garage’ means a covered space with a roof and at least three covered sides, provided for the exclusive use of the apartment owner. Others have no right to use that space. Also, the basement and any parking areas are part of common areas and facilities.
Verdict
The Commission ruled that the developer cannot recover charges for the club area and car parking from the allottees. It directed that the car parking and club charges, if already paid to the developer, shall be refunded to allottees within three months, Â failing which an interest of 9% from the date of the order to refund date will be charged.
Point of Law: Basement parking is not a garage. The term ‘garage’ means a covered space with a roof and at least three covered sides, provided for the exclusive use of a particular apartment owner.
[Source: The order of the National Consumer Disputes Redressal Commission, New Delhi dated 3 January 2020 on multiple consumer complaints of year 2015 to 2019]
