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Clamming up on claim

Left high and dry

I had taken a Group Mediclaim Policy with the Sanjeevani Health Club for my wife and myself with maternity benefits. My policy No. is 311603 MIS/2005/684 and it was issued to me by the Oriental Insurance Co. for the period September 27, 2004 to August 17, 2005. The maternity benefit was up to a limit of Rs 50,000 for the first two children.

After a year, I renewed the policy through the Group Mediclaim Policy covered under the Sanjeevani Health Club Group Mediclaim policy No. 40160000829 with ICICI Lombard General Insurance Co. Ltd for the period August 18, 2005 to August 17, 2006 midnight.

In the meantime, my wife got pregnant and was due to give birth in September/October 2006. As per procedure, I renewed my mediclaim policy and received a notice from Sanjeevani Health Club stating my present and renewed status. I got the policy renewed by giving a cheque 15 days prior to the renewal date.

My policy number is 0302/06/00001560 for the period August 18, 2006 to August 17, 2007 midnight under the United Insurance Co. Ltd through the Sanjeevani Health Club. The policy document also states my previous policy No. which is 40160000829.

My wife gave birth to a child on October 4, 2006 and as required, I submitted my claim papers, together with the necessary original papers. This was done on October 28, 2006.

After waiting for more than five months, when I contacted their office, I was informed by a letter that the claim had been rejected. The reason given was that the claim was submitted after the completion of the maximum time stipulated by the insurance company for the mediclaim policy. But when I furnished proof that, in fact, the claim was submitted on October 28, 2006, they admitted that it was their mistake.

However, now they are saying that the claim stands rejected because a waiting period of nine months is necessary to avail of the maturity benefit. But when I informed them that I had taken the policy two years before and it hadnít been discontinued in the interim, they asked me to submit copies of the earlier policy, documents and FHPL (Family Health Plan Limited) cards issued to me together with the present ones. I submitted the same on April 26, 2007.

In May, they again sent me a letter asking me if the policy was a continuous one. I went to the insurance companyís office, but they sent me back saying that they would answer the Third Party Administrator (TPA) themselves.

Two months have passed and my claim is still pending. When I contacted them once more, they werenít able to give me a proper answer. What should I do under the circumstances'

Vijay Kumar Agarwal,
C/o, Mahendra Kumar Agarwal,}
5A Hathwa Regency,"
10E Hungerford Street,
Calcutta-700017

company response: No response from ICICI Lombard General Insurance Co. Ltd.

nthe expert: Without scrutinising the terms and conditions of the policy, it would not be wise to make any comments on the matter. For proper guidance on relief and redress, do forward copies of the policies to the Helpline column.

Food fiasco

We have been dealing in food products for quite some time now. And we have been selling the products of MTR Foods Ltd at our showroom, located on the ground floor of Bagri Market in Calcutta. However, of late we are facing a lot of problems with regard to stocks and credit notes of MTR Foods Ltd. We have complained to them but they are not attending to the problem. Could you help us in this regard'

Mahendra K. Raja,
For The Singhal Trading Co.,
71 Biplabi Rash Behari Basu Road, Block No. C-216,
Calcutta-700001.

company response: As a professional FMCG company, we follow a transparent and systematic business policy. Also, as a food company, we have laid down certain policies regarding the settlement of damaged / expired stocks at the retail level as well as at the distributorís end.

The procedure is that once the damaged / expired stocks are found in retail, they are withdrawn and the company representative prepares a damage claim for all those damaged / expired stocks in the market along with any other damaged / expired stocks lying with the distributor.

After that, it is the responsibility of the distributor to send it to our C&FA godown in Calcutta and deliver it. The company does not pay anything towards this.

The Singhal Trading Company had shown us a large quantity of damaged / expired stock, most of which was lying unsold in its godown.

Now, as a distributor, they need to visit the market to distribute / sell stocks so that the consumer can get access to what he or she wants to buy. But instead of selling it in the market, the Singhal Trading Company kept the stock in its godown. This resulted in the expiry of the stock and made it unfit for consumption, leading to huge financial losses and a bad name for the company.

Authorised signatory,
MTR Foods Ltd,
No. 4, 17th Cross,
K.R. Road, B.S.K. II Stage,
Bangalore-560070.

the expert: According to the amendment of the Consumer Protection Act in 2002, which came into effect from March 15, 2003, a person who obtains goods for resale or for any commercial purpose cannot claim to be a consumer. In such circumstances, the matter complained of has no relevance and /or relief before the consumer forum.

Refund woes

I got an income tax refund (order No. 444546) dated May 15, 2006 for Rs 5,600 from the ITO, Ward No. 4(s) of Range-4, Patna (Bihar), Office of the Joint Commissioner of Income Tax, Lokmanya Jayprakash Bhawan, Dakbunglow Chowrah, Patna-1. The refund order was, however, not honoured by the State Bank of India, service branch, Gandhi Maidan, Patna-1 since it was not drawn on them. Later, on my bank’s advice (Syndicate Bank, Phoolzhore Branch, Durgapur-10), on July 26, 2006, I sent the original refund order to the ITO, Patna-1, for revalidation. Since then, despite several reminders, there has been no response from ITO, Patna. How do I get my money back'
Benimadhab Nandi,
Alloy Steel Plant,
Durgapur-713208.

Joint Commissioner of Income Tax: No response.

the expert: It is unfortunate that through no fault of his, a consumer has been unnecessarily harassed by the Joint Commissioner of Income Tax, Range-4 (Patna). This is a fit case where a complaint can be lodged before the District Consumer Forum, Patna, against the Joint Commissioner of Income Tax for deficiency in service. In 1994, the Supreme Court (Lucknow Development Authority vs M.K. Gupta) held that in cases where it was found that the exercise of discretion was malafide, the complainant was entitled to compensation for mental and physical harassment. In such cases, the officer can’t claim to be under protective cover.

When a citizen seeks to recover compensation from a public authority for injuries suffered by him due to the capricious exercise of power, and the National Commission finds it duly proved, then it has a statutory obligation towards the same. The taxpayers’ money goes to pay for those entrusted under the Act to discharge their duties in accordance with the law. Therefore, if the commission is satisfied that a complainant is entitled to compensation for harassment or mental agony or oppression, it should direct the department concerned to pay the amount to the complainant immediately. It should also recover the same from those found responsible for such behaviour by dividing it proportionately where there is more than one functionary.

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