[2025:RJ-JP:31283] HIGH COURT OF JUDICATURE FOR RAJASTHAN BENCH AT JAIPUR S.B. Civil Writ Petition No. 12131/2025 Star Health And Allied Insurance Company Limited, Having Its Registered And Corporate Office At 1 New Tank Street, Valluvar Kottam High Road, Nungambakkam, Chennai-600034 And Its Corporate Claims Department Office At No. 15, Sri Balaji Complex, 1St Floor, Whites Road, Royapettah, Chennai-60014 Through Its Constituted Attorney. ----Petitioner Versus 1. Brijendra Gangal, Aged About 64 Years, R/o B-2, Adarsh Nagar, Hiran Magari, Sector-4, Udaipur-31001 2. The Insurance Ombudsman, Ground Floor, Jeevan Nidhi- Ii, Bhawani Singh Road, Jaipur-302005 ----Respondents For Petitioner(s) : Mr. Prakhar Agrawal For Respondent(s) : HON'BLE MR. JUSTICE SAMEER JAIN Judgment 12/08/2025 1. Present petition is filed assailing the impugned award dated 09.06.2025 passed by Ombudsman. It is submitted by the learned counsel for the petitioner that the quantum qua insurance is Rs. 1.84 lakhs, approximately. It is further submitted that without placing reliance upon Clause 26 of the petitioner’s insurance policy (Page no. 47), the authority has passed the impugned order and while passing the impugned order the concerned authority has solely considered that once primary sanction is given qua treatment they should compensate the respondent for robotic surgery also. [2025:RJ-JP:31283] (2 of 2) [CW-12131/2025] 2. It is further submitted that medi-claim insurance matters are technical in nature and Ombudsman has settled the issue sans placing reliance upon the requisite terms and conditions. 3. Having heard the learned counsel for the petitioner and upon perusal of the impugned award dated 09.06.2025, this Court is of a view that the present petition is not maintainable for the following reasons: 3.1. That Ombudsman is a forum wherein the complaints, grievance of the claimant/policy holders are resolved. Hence, the consideration of the dispute is per-se done before the appropriate forum. 3.2. That the petitioner has not made any objections qua the maintainability and proceedings prior to passing of the impugned order. Moreover, no objections were made at the relevant time vis-a-vis clause 26 i.e. the arbitration clause. 3.3 That in light of the provisions of Rule 17 of Insurance Ombudsman Rules, 2017 wherein categorical directions are given qua consideration and passing of award; and the said are duly complied with, in the matter at hand. 4. Taking note of the aforementioned, as matters involves meager sum of Rs. 1.84 lakhs approximately, this Court finds no reason to interfere with the present petition. 5. In view of the above, the present petition is dismissed. Pending applications, if any, shall stand disposed of. (SAMEER JAIN),J JKP/14