DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

SOUTH 24 – PARGANAS , AMANTRAN BAZAR, BARUIPUR,

 KOLKATA-700 0144

      C.C. CASE  NO. __12 _ OF ___2019

DATE OF FILING :_22.1.2019              DATE OF  JUDGEMENT:  08.05.2019

Present                 :   President       :   Ananta Kumar Kapri

                                 Member(s)    :    Jhunu Prasad

COMPLAINANT   :    Amit Das, Vill. & P.O Belsingha, P.S Falta, Dist. South 24-Parganas, Pin-743504.

•  VERSUS  -

O.P/O.Ps                    :  1. National Insurance , Amtala Branch, Baruipur Road, Kanyanagara, Amtala, South 24-Parganas, Pin-743396.

                                     2.    Mr. Parthabrata Das, Masjidpara Road, P.O & P.S Diamond Harbour (Ward no.13), South 24-Parganas, Pin-743331.

_________________________________________________________________

                                                J  U  D  G  M  E  N  T

Sri Ananta Kumar  Kapri, President

           Facts leading to the filing of the instant case by the complainant may be epitomized as follows.

           The complainant opened a Health Insurance Policy being no. 154601501710000479 of O.P-1 i.e National Insurance Co. Ltd. and, therefore, he paid an yearly premium of Rs.7434/- to O.P-2 who is the agent of O.P-1. Premium was paid by the complainant on 13.2.2018. Since then, no health card has been issued in favour of the complainant by the O.P-1. That apart, a mistake has also been committed by the O.Ps in the said policy;  the name of the wife of the complainant is Riti Sengupta , but she has been wrongly described in the said policy as Priti Sengupta , nominee of the complainant. Constant persuasions by the complainant for correction of the mistake have made no positive result and, therefore, the complainant has filed the instant case , praying for refund of Rs.8000/- and also for compensation etc. Hence, this case.

           The O.P-1 has not turned up to contest the case even after service of summons upon him. The case , therefore, proceeds exparte against him.

           It is the O.P-2 who has filed written statement to contest herein. In the written statement filed by him, he has averred that he brought the mistake to the notice of O.P-1 and requested O.P-1 to rectify the mistake committed in the name of the nominee of the complainant. But the O.P-1 did not attach any importance to his request and accordingly, the mistake was not rectified. According to him, he has no deficiency in service on his part and , therefore, he is not liable for the mistake being not rectified.

            Upon the averments of the parties, the following points are formulated for consideration.         

POINT FOR DETERMINATION

1. Is  there any   deficiency in service on the part of the O.Ps as alleged by the complainants?
2. Is the complainant  entitled to get relief or reliefs as prayed for ?

EVIDENCE OF THE PARTIES

          Petition of complaint is treated as evidence of the complainant.

DECISION WITH REASONS

Point no.1 & 2   :

          Heard the complainant in person. Perused the petition of complaint and also written statement filed by the O.P-2. In the written statement filed by the O.P-2, it is admitted that there has been a mistake committed in the insurance policy while describing the name of the nominee of the complainant. It is admitted by the O.P-2 that the actual name of the wife of the complainant, who is his nominee, is Riti Sengupta and her name has been mistakenly described as Priti Sengupta in the policy. O.P-2 is the agent of O.P-1 and it stands proved by the statement of O.P-2 that the name of the wife of the complainant has been wrongly described as Priti Sengupta in the Insurance Policy of O.P-1. O.P-1 should have rectified the mistake suo moto as soon as the same came to his notice, but he did not do so. About a year has passed away from the date of commencement of the policy, but the mistake has not been rectified. This inordinate delay in rectifying the mistake on the part of the O.P nos. 1 and 2 is nothing but deficiency in service on their part. Further, It is found on record that the health card was not also issued in favour of the complainant by the O.P-1. The complainant has filed a petition on 6.5.2019 ,wherein it is stated that the health card has been issued to him by the O.P-1 only after completion of insurance period which expired on 12.2.2019,  vide the copy of policy schedule attached with the complaint. Non-issue of health card by the O.P-1 in favour of the complainant within the insurance period is a gross deficiency in service on the part of the O.P-1 and  that is why the complainant is deemed entitled to relief or reliefs as prayed for and the same is granted accordingly as hereunder.

         In the result, the case succeeds.

         Hence,

                                                      ORDERED

            That the complaint case be and the same is decreed on contest against the O.P:-2 and exparte against O.P-1 with a cost of Rs.5000/- to be paid by the O.P-1 to the complainant.

          The O.P-1 is directed to renew the insurance policy of the complainant having received the requisite premium from the complainant and to issue a health card in favour of the complainant and his wife namely Riti Sengupta within a month of this order, failing which, the O.P-1 will have to pay a sum of Rs.10,000/- as compensation to the complainant.

             Registrar-In-Charge of this Forum is directed to deliver a copy of the judgment free of cost to the parties concerned.

                                                                                                                   President

I / We agree

                                                          Member

          Dictated and corrected by me

                           President