Final Order 1

Order Details: Ex-parte Judgement
Pdf Text: Judgment in 1
Suit No.1647/2021
MHCC010000882020
Presented on : 02.01.2020
Registered on : 07.01.2020
Decided on : 16.09.2023
Duration : 3 Yr, 8 M, 14 D.
IN THE CITY CIVIL COURT FOR GR. BOMBAY AT MUMBAI
SHORT CAUSE SUIT NO. 1647 OF 2021.
Exh. .......
Healthindia insurance TPA ]
Services Pvt. Ltd. ]
A company incorporated under the ]
Companies Act, 1956 CIN ]
U67200MH1997PTC105960 having its ]
registered office at 1114, Raheja Centre, ]
Free Press House Journal Marg, Nariman ]
Point, Mumbai 400 021 and Corporate ]
Office at 406 413, Neelkanth Corporate IT ]
Park Kirol Road, Vidyavihar (West), ]
Mumbai – 400 086 and represented ]
herein through its Constituted Attorney ]
Uma Shankar Yadav ]....Plaintiff.
Vs.
Bhavik J. Doshi
Aged : 37, Occ.: Service/Business, ]
R/at : Room No. 24, Thakur Niwas, ]
Near Upendra Nagar Road, ]
Dahisar (East), Mumbai 400 068. ]..Defendant.
Appearance:
Adv. Manoj Agiwal for plaintiff.
Defendant – Exparte.
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Judgment in 2
Suit No.1647/2021
SUIT FOR RECOVERY OF MONEY
Coram : Shri. U.C.Deshmukh.
Judge.
CR No. : 59.
Date :16th September, 2023.
ORAL JUDGMENT
(Judgment dictated and pronounced in open Court)
This is suit for recovery of an amount of Rs.1,31,613/-with
interest at the rate of 9.00% p.a. from 21.12.2017 to date of its
realization.
Brief facts of the case are as under :
2. It is cast of the plaintiff that it is a private limited company
and it is registered under Insurance Development and Regulatory
Authority of India since 2002. It deals with the Health Insurance as
third party administrator. It specifically deems with the processing of
medical reimbursement of claims of insured persons.
3. The plaintiff specifically contended that the defendant was
insured beneficiary of United India Insurance Company vide policy no.
1204002816P111341793 (insured policy). The plaintiff act as third
party administrator in respect of policy. On 30.11.2016. Ms. Saroj Doshi
was admitted to Shri KVG Jain Manav Seva Kendra. Thereafter,
defendant submitted medical bill of Rs.1,83,488/- on 23.01.2017 for
reimbursement.
4. The plaintiff further contended that as per terms of policy it
submitted claim to the United Insurance company and ultimately the
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Suit No.1647/2021
company approved claim of Rs. 1,24,929/- against the claim of
Rs.1,83,488/-. Accordingly, the plaintiff issued discharge voucher on
10.03.2017. The defendant was put to notice that the claim has been
settled for Rs.1,24,929/-. The defendant was also informed that said
amount is remitted to his bank account.
5. The plaintiff further contented that again on 22.03.2017 an
amount of Rs.1,24,929/- was remitted to account of defendant by
mistake. The plaintiff realized his mistake during the audit on
31.03.2017. Accordingly, he issued letter on 21.05.2019. Even though
the defendant did not reply. Hence, the plaintiff instituted this suit.
6. Despite service of summons the defendant failed to appear.
Hence, suit is proceeded exparty against defendant on 07.09.2022.
7. The plaintiff in support of its claim filed affidavit of
evidence of Mr. Uma Shankar Yadav at Exh.6. along with List of
Documents at Exh.7 and additional list of documents at Exh.8.The
plaintiff has proved the following documents along with Exh.7 and 8
which are as under :
Sr.No. Particulars
1. Notary certified true copy of the Power of
Attorney dated 03.12.2019.
2. Notary certified copy of Aadhar card of the
deponent.
3. Copy of Affidavit of service of Writ of
summons on the defendant dated
14.03.2020.
4. Notary Certified copy of TPA License of
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Suit No.1647/2021
Plaintiff.
5. Copy of the claim discharge voucher No. HI-
UIC-000263500-0.
6. Certificate under Section 65 B of the Indian
Evidence Act, 1872 in support of Document
No. 5.
7. Office copy of the said letter dated
17.05.2019 together with the copy of the
postal booking counterfoil no.
RM58242853In sent to Defendant by
plaintiff.
8 Office copy of the reminder letter dated
9.08.2019 together with the copy of the
postal booking counterfoil no.
EM928677670IN sent to defendant by
plaintiff.
9. Copy of the Track Report downloaded from
the website INDIA POSTS in respect of
RM58242853IN.
10. Copy of the Track Report downloaded from
the website INDIA POSTS in respect of
EM928677670IN.
11. Certificate under Section 65 B of the Indian
Evidence Act, 1872 in support of Document
No. 9 and 10.
12. Original Certificate by the plaintiff company
regarding the Double payment inadvertently
made to the defendant.
13. Statement containing the details of the suits
filed and their present status.
14. Email dated 18.10.2019 from plaintiff CMO
to the Insurance company with copy of
cheque.
15. Certificate under Section 65 B of the Indian
Evidence Act, 1872 in supported of document
No. 12,14,15.
16. Copy of email dated from the insurer to the
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Suit No.1647/2021
plaintiff company seeking details of the
Claims UTR in respect of which the recovery
is being deposited.
17. Copy of email dated 21.10.2019 with its
attachment of detailed excel sheet showing
the duplicate payments made which were
being refunded.
18. Copy of the excel sheet attached to the email
dated 21.10.2019.
19. Copy of the cheque 365384 duly received by
the insurance company.
20. Notary certified true copy of the bank
statement of account no. 031184600000081
for 02.11.2019 issued by Yes Bank Ltd.
21. Particulars of claim.
22. Section 65 B of the Indian Evidence Act, 1872
in respect of email dated 02.07.2020 from
IRDA in which document No. 4 in attached.
23. Original Bank Statement of 02.11.2019.
6. It is submission of Ld. Advocate of plaintiff that on date of
cause of action the defendant was bound to pay an amount of
Rs.1,24,929/-. The evidence of the plaintiff remain unchallenged.
Hence, prayed to decree the suit.
7. Considering the facts, submission of Ld. Advocate for the
plaintiff, documents on record, following points arise for
determination.:
Sr. No. POINTS FINDINGS
1.
Whether the plaintiff is
entitled to recover an amount
of Rs.1,24,929/- at the rate of
9.00% p.a.
....Partly Yes....
with interest @
9.00%pa.
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Suit No.1647/2021
2.
Whether the suit is within the
limitation. ...Yes....
3. What order and decree? Suit is partly decreed.
:: R E A S O N ::
As to point No. 1 to 2.:
7. It is needless to say that as suit proceeded exparte, hence,
the pleading and evidence of the plaintiff has remained unchallenged.
Hence, there is no reason - to discard the case of the plaintiff. In support
of the case of the plaintiff, plaintiff has filed details of his claim
alongwith list (Exh.7) at serial number 12 which fortified its contents
that the plaintiff has transferred an amount of Rs.1,24,929/- vide UTR
No.173A61321G670801. Documents at serial No. 7 on Exh. 07 also
supports contention of the plaintiff that on 22.03.2017 the plaintiff paid
by mistake an amount of Rs.1,24,929/- vide UTR No.
CITIN17758410181. The plaintiff also issued notice to the defendant.
Defendant did not reply. The contents of documents at serial no. 12 and
13 are supported with the document at serial No. 15 which is the
certificate under Section 65B of the Indian Evidence Act. Hence,
plaintiff establish that it paid an amount of Rs. 1,24,929/- twice to the
defendant.
8. Now question arise, whether the suit of the plaintiff is
within the limitation and plaintiff is entitled to recover suit amount with
interest at the rate of 9.00% p.a. from 21.12.2017. The plaintiff has
brought on record that suit amount of remitted to the accounts of
defendant on 22.03.2017 and suit is instituted on 02.01.2020.
Therefore, from the date of payment of amount suit is within limitation.
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Judgment in 7
Suit No.1647/2021
However, there is no justification on the part of plaintiff, how is entitled
for interest at the rate of 9.00% from 21.12.2017. In such case, it is just
and proper to levy the interest at the rate of 6.00% on the suit amount.
Accordingly, point Nos. 1 & 2 are answered in the affirmative.
9. The suit is going to partly decreed. The defendant failed to
pay suit amount. Non payment of loan amount compelled plaintiff to
institute the suit. Hence, the plaintiff would entitle to cost of suit.
Accordingly, in answer to point No. 3, following order is passed :
ORDER
1. Suit No.1647 of 2021 is partly decreed with cost.
2. The defendant ordered to pay an amount of Rs.1,24,929/-
(Rs. One lakh twenty four thousand nine hundred twenty
nine only ) with interest at the rate of 6.00% p.a. from the
date of the suit till its realization.
3. Defendant is directed to pay an amount of decree within two
months from the date of this order to Plaintiff.
4. Decree be drawn up accordingly.
5. Suit No.1647 of 2021 is disposed off accordingly.
(Dictated and Pronounced in Open Court)
(U. C. Deshmukh)
Judge,
City Civil and Sessions Court
Date.:16.09.2023 Greater Bombay (CR 59).
Declared on : 16.09.2023
Dictated on : 16.09.2023
Transcribed on : 16.09.2023
Checked on : 25.09.2023
Signed on : 29.09.2023
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Judgment in 8
Suit No.1647/2021
“CERTIFIED TO BE TRUE AND CORRECT COPY OF THE ORIGINAL
SIGNED JUDGMENT/ORDER.”
Upload Date Upload Time Name of Stenographer
29.09.2023 5.00 p.m. Manasi M. Kadam
Name of the Judge (With Court
Room No.)
HHJ SHRI. U. C. DESHMUKH (CR 59)
Date of Pronouncement of
JUDGMENT /ORDER
16.09.2023
JUDGMENT /ORDER signed by
P.O. on
29.09.2023
JUDGMENT /ORDER uploaded
on
29.09.2023
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