Oral Order: (T. Ashok Kumar, Member)
1. This is an application filed by the petitioner/appellant/complainant praying this Commission to pass orders on the representation dated 01.02.2013 along with letter of Bar Council Chairman dt. 31.01.2013 addressed to OP.1 Insurance Company which are enclosed with the application.2. In the affidavit annexed to the petition, the petitioner has contended that he filed FA 1005/2013 before this Commission questioning dismissal of CC 3/2013 by District Consumer Forum II, Hyderabad and that he filed representation before the first respondent/opposite party to consider his claim by applying Judgment of Honble National Commission passed in R P 3026/2011 dated 29.07.2011 along with letter of Chairman of Bar Council, State of A.P. dt. 31.01.2013 to consider his claim but the OP. 1 did not inform or give message to him till date regarding the same in spite of several demands and requests and hence this petition to direct the first respondent/OP to consider such a representation in the light of the said decision keeping in view of the letter of Bar Council Chairman.3. First respondent resisted the petition by filing counter of its Deputy Manager and contended that questioning the order in IA 108/2013 in CC 3/2013 on the file of District Consumer Forum II, Hyderabad. The complainant filed FA 1005/2013 before this Commission and that in the said orders of the District Forum rejected the complaint of the complainant as barred by resjudicata and that earlier the complainant filed CC 420/2011 on the file of District Consumer Forum I, Hyderabad and that it was dismissed vide orders dt.09.01.2012 as against the said order FA 142/2012 was filed before this commission and the same was also dismissed vide orders dt. 08.10.2012 and then he filed USR No. 70/2013 in the said FA to reconsider the order. But it was also dismissed vide orders dt. 09.04.2013 and after such a dismissal, the complaint filed WP No. 12750/2013 before Honble High Court of A. P. questioning the orders in FA 142/2012 and sought for a direction to OP. 1 to release the insurance amount following the recommendations of the chairman , Bar Council of A. P. referring certain Judgment of the Apex court, national Commission and also sought for renewal of the Insurance Policy and that the said writ petition is still pending before the Honble High Court of A. P. and that while the said matter was thus stood, the petitioner filed CC 3/2013 on the file of District Consumer Forum II, Hyderabad to direct OP. 1 to reimburse Rs.1,70,000/- spent by him for surgery and also expenses of Rs.1,000/- and that on receipt of the notice OP. 1 filed IA 108/2013 in the said complaint narrating all the said events and the said IA was allowed and CC 3/2013 was rejected as barred by resjudicata and then the present FA 1005/2013 is filed by the complainant and that the claim of the complainant was rejected applying the terms and conditions and exclusions of the subject policy and that the complainant approached the Ombudsman aggrieved with such a rejection and thereafter District Forum, State Commission and at all the Forums he was unsuccessful and when challenging the orders of this Commission in FA 142/2012 in a Writ petition filed by him and the same is pending, no relief can be granted as prayed for in the present petition and thus requested to dismiss this petition.4. Heard both sides with reference to their respective contentions in detail.5. There is no dispute that the complainant obtained the Baroda Health Policy bearing No. 55 1107/48/10/8500000134 for the period from 26.4.2010 to 25.04.2011 from Op.1 through OP. 2 bank for an amount of Rs. 3 lakhs on certain terms and conditions, exclusions of the policy.6. According to the complainant, after a few days of taking the policy, he underwent surgery in Kamineni Hospital, King Koti, Hyderabad and spent Rs.1,70,000/- towards medical expenses etc in connection with such surgery and that put forth the claim to OP. 1 basing on the said policy and it was rejected. The OP. 1 contends that as per clause 4 (2) of subject policy, Ops shall not be liable to make any payment under the said policy in respect of any expenses whatsoever incurred by the complainant in respect of any hospitalization expenses incurred in the first 30 days from the first commencement date of insurance cover except in case of injury arising out of the accident. On such repudiation of the claim the complainant filed CC 425/2011 on the file of District Consumer Forum I, Hyderabad and after hearing both sides vide orders dt. 09.01.2012 the said complaint was dismissed. As against the said order, the complainant preferred FA 142/2012 before this Commission and the same was dismissed vide orders dt.08.10.2012. Thereafter the complainant filed a representation in USR 70/2013 in the said FA and it was also dismissed vide orders dt. 09.04.2013 assigning reasons and also basing on the decision of Honble Supreme Court of India in Rajiv Hitendra Pathan and others Vs Achuta Rao Kasinath Karekar and others wherein it is held that œthe State Commission has no power to review its own order and thereafter admittedly the complainant filed W P no. 1275/2013 before the Honble High Court of A P questioning the order in FA 142/2012 and sought for a direction to OP. 1 to release the insurance amount. The OP.1 contended that in the Writ also the complainant sought for such a direction basing on the recommendation of the Chairman, Bar Council of A. P. and the decisions of Honble Apex Court of India and National Commission. As rightly contended by the OP.1 insurance company that when subject matter of this IA is also the subject matter of the said writ petition which is pending before the Honble High Court of A. P. it is not at all permissible for this Commission to pass any orders basing on his representation dated 01.02.2013 made to the Divisional Manager, National Insurance Company, Chikkadapally, Hyderabad and the letter of Chairman, Bar Council of A. P. dated 31.01.2013. Whether the order of the District Forum dated 05.09.2013 made in IA 108/2013 in CC 3/2013 whereby the Forum allowed the said IA and consequently rejected the complaint in CC 3/2013 as barred by resjudicata or not, will be decided while disposing of the appeal in FA 1005/2013 and not in this IA, that too, after disposal of the said Writ Petition depending on the orders of Honble High Court of A. P. in it. Thus, this petition is devoid of merit and liable to be dismissed.
7. In the result, IA is dismissed. No costs.