It has Become A Rehabilitation Centre for Retirees

 

GURDEEP SINGH F/o. Kuldeep singh v. STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED Through its Managing director District Consumer Disputes Redressal Commission (Jul 29, 2026)

 GURDEEP SINGH F/o. Kuldeep singh v. STAR HEALTH AND ALLIED INSURANCE COMPANY LIMITED Through its Managing director District Consumer Disputes Redressal Commission (Jul 29, 2026) SUMMARY Factual and Procedural Background The complainant purchased a Family Health Optima Insurance Plan in 2021 (Policy No. initially P/231115/01/2022/010702; later Policy No. 11240350375902) covering four family members, with consecutive renewals thereafter. On 10.08.2023 the complainant's son, Master Agam Kahlon, became seriously ill and was admitted to Zonal Hospital, Dharamshala (10.08.2023– 12.08.2023) and thereafter to City Hospital, Matour, Kangra (12.08.2023– 17.08.2023). Diagnosis: Acute Febrile Illness with Thrombocytopenia and Transaminitis. The complainant incurred medical expenses (bills summarized as Rs.58,729/-) and submitted a reimbursement claim (Claim No. CIR/2024/231115/0649164). The opposite parties repudiated the claim by letter dated 20.09.2023 on the ground that hospitalization was not medically necessary (reliance on Code Excl 36). The complainant filed the consumer complaint (instituted 12.03.2025). Final hearing was on 09.07.2026 and the order was pronounced on 29.07.2026. Legal Issues Presented 1. Whether the hospitalization of the insured (Master Agam Kahlon) from 12.08.2023 to 17.08.2023 was medically necessary. 2. Whether the opposite parties' repudiation of the claim under Code Excl 36 (exclusion for hospitalizations not medically necessary) amounted to a valid denial or constituted deficiency in service. 3. Whether the complainant is entitled to reimbursement of the claimed medical expenses and ancillary relief (interest, compensation, litigation costs). Arguments of the Parties Complainant's Arguments The son was seriously ill and was hospitalized (initially at Zonal Hospital from 10.08.2023; thereafter at City Hospital from 12.08.2023 to 17.08.2023) on the advice of treating doctors. Medical records and discharge summaries (including certificate by Dr. Venkateshan Madhavan) support the need for hospitalization. The complainant incurred total expenses of Rs.58,729/- and sought reimbursement, interest and compensation; he filed an affidavit corroborating the admissions and treatment. Opposite Parties' Arguments Admitted policy subsistence and renewals but denied deficiency in service. Based on internal scrutiny by their in- house medical team, concluded that the hospitalization was not medically necessary and the patient could have been managed on an outpatient basis. Repudiated the claim under Code Excl 36 of the policy. Produced a bill assessment sheet (Annexure R-8) reflecting a lower amount (Rs.33,727/-), though the sheet is unsigned and unsupported by affidavit. Table of Precedents Cited No precedents were cited in the provided opinion.Court's Reasoning and Analysis The court reviewed the policy history, hospitalization records, discharge summaries and oral/written evidence. It relied on the treating doctor's certificate (Annexure A-40) and the complainant's affidavit (Ext. CW-1) showing continuous admission beginning 10.08.2023 and treatment with IV fluids and IV antibiotics. The court noted a borderline blood pressure reading (100/60– 102/60 mmHg) and held that indoor treatment was necessary. The court observed that the opposite parties did not file any affidavit from their medical team to support their in- house conclusion and that the insurer's medical team cannot substitute the treating physician's judgment on medical necessity. The unsigned and unaffirmed bill assessment (Annexure R-8) was given no weight. On the evidence, the complainant's proofs of expenditure were accepted as superior. Holding and Implications COMPLAINT ALLOWED Direct consequences ordered by the court: The opposite parties are jointly and severally directed to pay Rs.58,729/- to the complainant. Interest at 9% per annum to be paid from the date of the complaint until realization. Compensation of Rs.20,000/- awarded to the complainant for mental harassment. Litigation costs of Rs.15,000/- awarded to the complainant. Pending applications disposed of; copies of the order to be provided free of cost and uploaded on the Commission's website; file consigned to record room. No broader legal precedent or novel legal principle was declared in the opinion; the decision addresses the parties' dispute and the direct relief ordered above.ALLOWED BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION KANGRA AT DHARAMSHALA, H.P. Date of Institution: 12.03.2025 Date of final hearing: 09.07.2026 Date of Pronouncement: 29.07.2026 Consumer Complaint No.-DC/18/CC/75/2025 IN THE MATTER OF Gurdeep Singh S/o Sh. Kuldeep Singh , R/o Deep Bhawan, Sarswati Nagar, Upper Barol, Dharamshala, Tehsil Dharamshala, District Kangra, H.P. (Through: Mr. Rakesh Mehra, Advocate) ….........Complainant Versus 1. Star Health & Allied Insurance Company Limited, Registered & Corporate Office: 1, New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai - 600034. Through its Managing Director. 2. Star Health & Allied Insurance Company Limited, Branch Office: E-12/8, 4th Floor, Shree Vrindaven Tower, Sanjay Palace, Agra Town, Uttar Pradesh - 282002. Through its Branch Manager. (Through: Ms. Disha Gupta, Advocate) ……....Opposite Party(s) CORAM: President: Mr. Hemanshu Mishra Members: Ms. Arti Sood & Sh. Narayan Thakur Present:- Mr. Rakesh Mehra, Ld. counsel for complainant. Ms. Disha Gupta, Ld. counsel for opposite parties.PER: Mr. Hemanshu Mishra, President :- O R D E R Facts giving rise to filing of this complaint are that upon the active persuasion of an authorized agent of the OPs, complainant purchased a 'Family Health Optima Insurance Plan' in the year 2021. The policy was initially registered under No.P/231115/01/2022/010702 for the period from 11-08-2021 to 10-08-2022, covering four family members: the complainant, his wife Smt. Ritu Singh and his two sons, Master Agam Kahlon and Master Kanish Kahlon. The coverage was subsequently renewed continuously over the following years, with the premium increasing accordingly. It is averred that on 10th August 2023, the complainant's son, Master Agam Kahlon, fell severely ill with a running high fever and intense throat pain. He was initially rushed to the Zonal Hospital, Dharamshala. Finding no substantial improvement there, he was discharged on request on 12-08-2023 and immediately admitted to City Hospital, Matour, District Kangra, H.P., on the explicit medical advice of the treating doctors. The patient remained hospitalized as an indoor patient from 12-08-2023 to 17.08.2023. The final medical diagnosis recorded in the discharge summary was Acute Febrile illness with Thrombocytopenia (TCP) and Transaminitis. The complainant incurred a total expenditure of Rs.58,729/-. The claim intimation was sent via email on 15.08.2023 and a formal reimbursement request with all relevant cash memos and lab reports followed. However, the OPs arbitrarily repudiated the claim vide a letter dated 20-09-2023. Left with no option, the complainant filed this complaint seeking reimbursement of Rs.58,819/- along with 12% interest, Rs.50,000/- as compensation for mental harassment and Rs.20,000/- as litigation expenses. 2. Upon notice, opposite party(s) appeared through counsel and contested the complaint by filing reply. On merits, while admitting the subsistence and consecutive renewals of the Family Health Optima Insurance policy, the OPs vehemently denied any deficiency in service. The core defense raised by the OPs is that upon internal scrutiny of the medical files and investigation charts by their inhouse medical team, it was concluded that the patient's hospitalization was not medically necessary. The OPs contended that the patient's vital parameters and investigation reports were within normal limits and that the medical condition could have safely been managed at home on an OPD basis. Consequently, the claim was rejected under Code Excl 36 of the policy terms and conditions, which explicitly excludes coverage for hospitalizations deemed medically unnecessary. 3. The complainant has filed rejoinder denying the contents of the reply filed by opposite party(s) and reiterating those of complaint. 4. The parties were called upon to produce their evidence in support of their contentions and accordingly the parties have adduced their respective evidence. 5. We have heard learned counsel for the parties and also gone through the case file carefully. 6. Admittedly, the complainant purchased a Family Health Optima Insurance Plan from the opposite party on 11.08.2021. The said policy was effective w.e.f. 11.08.2021 to 10.08.2022. Thereafter, the complainant renewed the said policy on 11.08.2022, 11.08.2023, and 11.08.2024. It is also not disputed that the complainant's son, Master Agam Kahlon, remained hospitalized w.e.f. 12.08.2023 to 17.08.2023 in City Hospital, Kangra, and upon intimation by the complainant, Claim No. CIR/2024/231115/0649164 was registered against Policy No. 11240350375902. 7. The opposite party, based upon the opinion of their medical team, repudiated the claim on the ground that the insured patient could have been treated as an outpatient, and hospitalization of the insured patient was not warranted for the above diagnosis. They referred to Code Excl 36 of the above policy, which states that the company is not liable to make any payment under this policy in respect of any hospitalization that is not medically necessary or does not warrant hospitalization. Consequently, the opposite party repudiated the claim on 20.09.2023. 8. A perusal of the record reveals that vide Annexure A-40, Dr. Venkateshan Madhavan, M.D. Medicine, City Hospital, Kangra, certified that Master Agam was diagnosed with acute febrile illness and thrombocytopenia. On examination, his BP was borderline at 100/60 mmHg. Thus, he was hospitalized from 12.08.2023 to 17.08.2023 and was managed with IV fluids and IV antibiotics for the same. 9. On 20.10.2023, the complainant submitted a written request to the opposite party to review the rejection of the claim, further stating that the patient was admitted from 10.08.2023 to 12.08.2023 in Zonal Hospital, Dharamshala as well. This is further corroborated by the affidavit filed by the complainant (Ext. CW-1), wherein he specifically deposed that his son fell seriously ill with a high fever and severe throat pain, and was admitted to the Zonal Hospital on 10.08.2023. As there was no improvement and his health deteriorated, the son was discharged on request on 12.08.2023, and on the same day, was admitted to City Hospital, Matour, District Kangra, H.P. on the advice of the treating doctors for proper and regular medical management to recover from the illness, remaining admitted until 17.08.2023. The discharge summary of Zonal Hospital, Dharamshala is Annexure A-5, wherein the brief history mentions fever for five days accompanied by throat pain, rhinorrhea, and headache. BP was recorded as 102/60 mmHg, which aligns with the certificate Annexure A-40. 10. We are of the opinion that the patient required hospitalization on 12.08.2023, as he had been continuously admitted since 10.08.2023 at the Zonal Hospital, and because his blood pressure was recorded at 102/60 mmHg (which was borderline), indoor hospital treatment was necessary. The opposite party has not attached any affidavit from any member of their medical team. Even otherwise, it is not for the insurance company's medical team to decide who should be treated as an indoor patient or who should be treated at home for any illness. It is the treating doctor who must make that decision, and once he has issued a certificate stating that treatment was required in the hospital, the repudiation of the claim is completely wrong, illegal, and amounts to a deficiency in service. 11. The complainant has attached medical bills for the entire expenditure incurred during the treatment; the summary is Annexure A-7, and the bills are Annexures A-8 to A-30 & A-39, totaling Rs. 58,729/-. On the other hand, the opposite party has annexed Annexure R-8 (Bill Assessment Sheet - Member Payment), which reflects an amount of Rs. 33,727/-; however, the said bill assessment sheet is unsigned. No affidavit in support of Annexure R-8 has been filed. Even in his affidavit (Ext. OPSW- 1), Mr. Sumit Kumar Sharma, Sr. Manager, has not uttered a single word regarding Annexure R-8. The complainant has produced superior evidence, having deposed that he incurred a total expenditure of Rs. 58,729/-. Hence, the complaint deserves to be allowed. 12. Accordingly, the complaint is allowed, and the opposite parties are jointly & severally directed to pay an amount of Rs.58,729/- to the complainant, along with interest @ 9% per annum from the date of the complaint until its realization. Apart from this, the opposite parties are jointly and severally directed to pay compensation to the complainant to the tune of Rs.20,000/-, besides litigation costs quantified at Rs.15,000/- 13. Applications pending, if any, stand disposed of in terms of the aforesaid order. 14. A copy of this order be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The order be uploaded forthwith on the website of the Commission for the perusal of the parties. 15. File be consigned to record room along with a copy of this order. (Hemanshu Mishra) President (Narayan Thakur) (Arti Sood) K.D* Member Member

Insurance Company's Medical Team Cannot Override the Treating Doctor's Decision

 

The India desks of three different countries

 

The India desks of three different countries are reportedly functioning with considerable activity and strategic interest in India. While two of these desks are already actively engaged in pursuing their respective objectives, the third appears to be waiting in anticipation of obtaining some future advantage or “dividend” from the prevailing circumstances.

Among the areas receiving particular attention, West Bengal appears to occupy a significant position. The State is metaphorically described as having been made “fertile for their cultivation,” suggesting that certain circumstances have allegedly created a favourable environment for external interests to establish influence, pursue objectives, or derive strategic benefits.

However, the statement also emphasises that the situation should not be viewed with apprehension alone. Mr. Adhikari is at the helm, providing leadership and direction at a critical juncture. His team, according to the statement, has demonstrated tremendous performance, effectiveness and determination in dealing with the challenges before them.

Thus, the overall message combines strategic alertness with confidence in strong leadership and effective teamwork. Despite the alleged external attention towards India and particularly West Bengal, the author expresses faith in Mr. Adhikari and his team and concludes with a patriotic affirmation: “Jai Hind.”

A Salute to Parijat Chanda, Advocate

 

# A Salute to Parijat Chanda, Advocate

### Chief Public Prosecutor, District South 24 Parganas at Alipore

The appointment of **Parijat Chanda, Advocate**, as the **Chief Public Prosecutor for the District South 24 Parganas at Alipore**, on **11th August, 2026**, is indeed a moment of great pride and distinction. It is a responsibility that carries with it not merely a position of authority, but a profound duty towards the administration of criminal justice and the rule of law.

Advocate Parijat Chanda is known for his **gracious and dignified behaviour, courteous disposition, professional integrity and outstanding knowledge of law**. His ability to understand legal issues with clarity, coupled with his experience and commitment to the profession, makes him eminently suited to shoulder such an important responsibility in the justice-delivery system.

What makes this occasion even more remarkable and memorable is the fact that **11th August is also his date of birth — 11.08.1980**. Thus, the day on which he has been entrusted with this distinguished responsibility coincides with the day on which he entered this world. Such a coincidence makes the occasion truly auspicious and unforgettable. It is, in every sense, a remarkable birthday gift earned through years of professional dedication, learning and service to the legal fraternity.

The office of the Chief Public Prosecutor demands much more than knowledge of statutes and precedents. It requires **wisdom, fairness, courage, patience, integrity and an unwavering commitment to justice**. A Public Prosecutor is an important officer of the Court, whose ultimate responsibility is not merely to secure convictions, but to assist the Court in arriving at the truth and ensuring that justice is done in accordance with law. The confidence reposed in Advocate Parijat Chanda therefore reflects the recognition of his professional competence and his capacity to discharge this solemn responsibility.

His **pleasant behaviour and approachable personality** are equally valuable qualities. The legal profession is not confined to arguments and judgments; it is also about relationships, mutual respect, understanding and maintaining the dignity of the institution. His conduct and professional temperament have helped him earn the respect of colleagues and members of the Bar.

As he assumes this important office, one may reasonably hope that his **knowledge of law, professional experience, balanced approach and commitment to justice** will contribute meaningfully to the effective functioning of the prosecution system in South 24 Parganas.

**11th August, 2026, therefore, shall remain a doubly memorable day in the professional and personal journey of Parijat Chanda, Advocate — a day of responsibility, recognition and celebration.**

On this auspicious occasion, I extend my **heartiest congratulations and warmest wishes** to him. May he discharge his new responsibility with distinction, wisdom and courage, and may his tenure as Chief Public Prosecutor strengthen the cause of justice and public confidence in the legal system.

**My sincere salute to Advocate Parijat Chanda on this remarkable enrichment of his professional journey and on his assumption of such a significant responsibility in the process of justice delivery.**

**Congratulations and best wishes on this memorable occasion.**

*With highest regards and best wishes,*

**Ashok Kumar Singh**

*Advocate*

*High Court at Calcutta*

Ganesh Chaturthi 2026

 

questionnaire

 BEFORE THE LEARNED DISTRICT CONSUMER DISPUTE REDRESSAL COMMISSION, SOUTH 24 PARGANAS. DC/304/CC/136 of 2025 Rajiv Kumar Singh & Anr. .... Complainants Versus M/s Development Corporation Pvt. Ltd. & Ors. ....... Opposite Parties Frne copy 2915/26 Questionnaire on behalf of the Opposite Party No. 1 and 2 put to the Complainants of the instant complaint 1. Mr. and Mrs. Singh are you well acquainted with the facts and circumstances of the instant case? 2. How and from whom did you come to know about the Project "Solaris Joka Phase 1"? 3. 4. Did you put your signature on the Agreement for Sale? If your answer to the preceding question is "yes", then please tell whether you signed the Agreement for Sale after reading and understanding the contents written therein? 5. Please specifically mention the status of the Opposite Party No.1 and 2 according to your understanding? 6. You have described the Opposite Party No.1 and 2 as Landowners in your petition of complaint. Is it true or untrue? 7. From the date of making application for purchasing the flat till filing of this instant case, please state with which Opposite Party did you communicate and/or corresponded? 8. date? 9. In which Opposite Party's favour did you make the payments till Which type of Flat did you apply for?