Date of Filing: 24/02/2015

  Date of Order: 13/11/2017

ORDER

BY SRI.SYED ANSER KHALEEM, PRESIDENT

1.     This is the complaint filed U/S 12 of the Consumer Protection Act 1986 alleging the deficiency in service on the part of the O.Ps and prays for orders to direct the O.Ps. to renew the policy for the year 2015 for having collected the premium from the complainant towards the renewal of the insurance policy and to direct the O.ps to pay a sum of Rs.2,00,000/- towards compensation and to pay Rs.5,00,000/- towards mental agony  along with costs of the proceedings.

2.     The brief facts of the complaint are that,  complainant applied for insurance from O.P.No.1 and 2, wherein O.P No.1 is the regional office of insurance company and O.P No.2 is registered office and through O.P No.3  the complainant got obtained insurance policy.  It is stated that the policy covers the following risk coverage i.e. coverage of life, health coverage, optional critical illness and towards all the accidental risk.  It is stated that 3^rd O.P being the premium collector has directly deducted the premium from the account of the complainant and the same has sent to the O.p No.1 and 2 who inturn  will cover the medical expenditure for the various health hazards and all the accidental coverage. It is stated that the policy being a coverage being year to year basis for a sum f Rs.2,00,000/-, the complainant agreed to pay a premium of Rs. 3,798/- every year to cover the medical expenditure that are likely to come about through his banker.  It is stated that O.P.No.2 collected a sum of Rs. 3,800/- instead of Rs. 3,798/- towards premium for the year  2014 for the complainant and to his wife from their respective accounts. It is also alleged that after hue and cry excess amount Rs.2/- credit back to their account  by the Ops and collecting the excess amount shows that how there promptness in giving service. It is stated that complainant and his wife were covered medical facility for the year 2014 from 2.1.2014 to 1.1.2015  and the 3^rd O.P had to renew the policy every year for a continued insurance coverage   based on the standing instruction given by the complainant and his wife from their respective S.B. Accounts.  It is stated that, O.P.No.3 on 2.1.2015 deducted the premium from the SB account of the complainant and his wife towards the renewal of the insurance policy for the year 2015 with the O.p.No.1 and 2 but the O.P No.1 and 2 did not renew the insurance for the complainant even though the same was renewed for the wife of the complainant and the messege was sent to the complainant’s mobile phone.  Thereafter complainant visited the O.p.No.3 branch personally several times explaining the reduction made by the O.p.No.3 towards the renewal of the insurance policy as on 2.1.2015 and inspite on 3.2.2015  the complainant received the another message on his mobile from the O.p.No.1 and 2 that the complainant insurance policy has lapsed and seized due to the non-payment of insurance premium.   It is stated that O.P.no.3 has collected the insurance premium on 2.1.2015 itself  towards the renewal of the insurance policy but the insurance company has not renewed the insurance policy for the current year and hence alleged that it amounts to deficiency in service on the part of the O.Ps.  Hence this complaint.

3.     Upon issuance of notice to O.Ps, O.P.No.1 to 2 remained absent and hence placed ex-parte. However, O.P No 3 appeared through its counsel and filed its version. In the version it is contended that, O.P had collected the insurance premium from the account of the complainant on 2.1.2014 at the first instance and it is denied as true they collected the amount of Rs.3,800/- instead of Rs.3,798/- towards the premium for the year 2014 for the complainant as well as his wife Smt Vijayalakshmi. It is contended that insurance coverage was for the complainant  only and his wife is only a nominee.  It is contended that this O.P having no knowledge about the communications made between the O.p.No.1 and 2. However, O>P.no.3 admits the receipt of letter dated 7.2.2015  said to have been address to the O.p.No.1 and 2  and immediately took up the matter with the O.P.No.1 and 2 seeking clarification and information regarding the alleged lapse of the insurance cover  citing the fact that the 3^rd O.P collected the renewal premium from the complainant on 2.1.2015.  Further contended that O.p.No.3 has no knowledge of health of the complainant and his ailments. It is also admitted that O.P.no.3 having accepted the standing instruction for collecting the yearly premium from the account of the complainant for renewal of the insurance premium subject to availability of the balance in the account of the complainant. Further O.P denies that the allegations of the complainant and ultimately prays for dismissal of the complaint.

4.     In order to substantiate the case of the parties and both parties have filed their affidavit evidence and also we heard the arguments.

5.     On the basis of the pleading of the parties, the following points will arise for our consideration is:-

                (A)   Whether the complainant has proved

                         deficiency in service on the part of the O.Ps?

(B)   Whether the complainant is entitled to

       the relief prayed for in the complaint?

(C)   What order?

6.     Our answers to the above points are:-

POINT (A):       In the Affirmative.

POINT (B):       In the Partly Affirmative.

POINT (C):       As per the final order

for the following:

REASONS

POINT No. (A) & (B):-

7.     On perusal of the pleadings of the parties, it is not in dispute that, the complainant by availing the service of O.P.No.3 and insured with the O.ps  to cover the accidental risk and health risk. It is also not in dispute complainant has given standing instruction to the O.P.No.3 bank  in order to pay the yearly premium from his account.

8.     The sole allegation of the complainant is that though amount is deducted from his account on 2.1.2015  in order to renew the insurance policy for the year 2015  with the O.p.No.1 and 2, but the O.P No.1 and 2  did not renew the insurance of the complainant. 

9.     Per-contra, O.P No.3 contended that, they have deducted the amount of Rs.3,798/- in order to pay the renewal of the insurance and they have clarified with the  O.P.No.1 and 2 regarding the  renewal of the premium, but not confirmed whether the policy is renewed or not. 

10.   It is worth to note that,  despite service of notice O.p.no.1 and 2 being service provider did not appear before the Forum in order to answer the claim made by the complainant.  Further the O.P.No.3 bank admits that they have deducted the amount from the account of the complainant in order renew the policy but the same is not confirmed whether the policy in question is renewed or not. Hence, the facts and the evidence placed on record disclose that O.Ps failed to give clear picture about the policy status and it obviously attract deficiency in service on the part of the O.Ps. In our view and on the basis of available evidence on record we reached to conclusion that the complainant proved deficiency in service on the part of the O.Ps. Under the circumstances, we hereby directed the O.P.No.1 and 2 to renew the policy till date and O.P.No.1 and 2 are directed to collect the amount from the O.P.No.3 bank without levying any penalty to the complainant and if penalty is attracted it is the duty of the O.P.No.3 bank as it undertakes to renew the policy  and hence O.P.No.3 bank has to made good the loss and pay all the required payments to the O.P.No.2 and 3 in order to renew the policy till date.  Further for the acts of O.Ps the complainant made to suffer and wander from pillar to post and hence  O.Ps No.1 to 3 are jointly and severally liable to pay Rs.5,000/- towards the cost of the proceedings.  However, complainant did not place any cogent evidence in order to award huge compensation as claimed in the complaint and hence complainant is not entitle for the compensation. In the light of above discussion we reached to conclusion that the complainant proved deficiency in service on the part of the O.Ps  and hence we answered the Point No.(A) in the affirmative and Point No.(B) in the partly affirmative.

POINT (C):

11.   On the basis of answering the points, in the result, we proceed to pass the following:-

ORDER

1. The complaint is allowed in part with cost.

2. The O.P.No.1 and 2 is hereby directed to  renew the policy till date and O.P.No.1 and 2 further directed to collect the amount from the O.P.No.3 bank  without levying any penalty to the complainant  and if penalty is attracted it is the duty of the O.P.No.3 bank as it undertakes to renew the policy  and hence O.P.No.3 bank has to made good the loss and to pay all the required payments to the O.P.No.2 and 3 in order to renew the policy till date.

3. Further O.P No.1 to 3 are jointly and severally is  hereby directed to pay a sum of Rs.5,000/- towards cost of the litigation.

4. The O.P No.1 to 3 are hereby directed to comply the order of this Forum within 30 days from the date of receipt of this order and submit the compliance report to this Forum within 45 days from the date of receipt of this order.

5. Send a copy of this order to both parties free of cost.

(Dictated to the Stenographer, transcribed and computerized by him, corrected and then pronounced by us in the Open Forum on this the 13^th Day of November 2017)

MEMBER                 MEMBER                PRESIDENT

*RAK `