Delhi

North East

CC/348/2022

Ashwani Kumar Mishra - Complainant(s)

Versus

Bajaj Allianz General Insurance Co. Ltd. - Opp.Party(s)

09 Apr 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

Complaint Case No. 348/22

 

 

 

In the matter of:

 

	1.     2.	Sh. Ashwani Kumar Mishra S/o Lt. Sh. Durga Dutt Mishra   Smt. Rama Mishra W/o Sh. Ashwani Kumar Mishra   Both R/o H.No. A 2/5, Azad Gali, Main Road, Mauj Pur, PO Area Maujpur, North East, Delhi-110053		Complainants
		Versus
		Bajaj Allianz General Insurance Co. Ltd. Through its Manager/Director Regd. Office Bajaj Allianz House, Airport Road, Yerwada, Pune 411006 (India)   Also at:- Twelve Floor, Doctor Gopal Dass Bhawan, 28 Bharakhamba Road, Connaught Place, New Delhi-01		Opposite Party
			DATE OF INSTITUTION:            30.08.22 JUDGMENT RESERVED ON:     02-02-24 DATE OF ORDER:                          09.04.24		30.08.22 02.02.24 09.04.24

 

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

Adarsh Nain, Member

 

 ORDER

Ms. Adarsh Nain, Member

The Complainant has filed the present complaint under Section 35 of the Consumer protection Act, 2019.

Case of the Complainant                                                                 

1. The case of the Complainant as revealed from the record is that at the behest of Opposite Party i.e. Bajaj Allianze General Insurance Company Ltd., Complainant No.1 and 2 decided to purchase the policy. The Complainants purchased Health Insurance Policy bearing no. OG22 2001 8433 0000 0610 in his name Mr. Ashwani Kumar Mishra and in the name of his wife Smt. Rama Mishra for treatment of the Complainant and his wife for the amount of Rs. 5,00,000/- each. The Complainant No.1 made payment of Rs. 39,916/- through credit card and said amount was deducted from HDFC Credit Card of the Complainant No.1 on 11.06.21. Subsequently, Complainants sent a request through email for cancellation and refund of premium policy NR OG 22 2001 8433 0000 0610 dated 28.08.21 with a cancelled cheque and NEFT Mandate form to Opposite Party while filing up all the necessary details. Thereafter Complainant No.1 received reply from Opposite Party dated 24.09.21 wherein it was mentioned “We would like to inform you that as per confirmation from our concern team case is pending from bank end, they will update.” On 17.11.21 Complainant No.1 received another email wherein it was specifically mentioned that “Dear Sir/Mam, Your refund request number 1301367 has been approved in system. Online refund will be credited in 8 to 10 working day. Please find below payee details for your reference PID/IMD code payee name approved refund amt. request reference No. 218699698/10014704 Ashwani Kumar Mishra 25945 1301367 warm regards, Bagic Finance (HO) This is an automated email. Please do not reply to this email.” Thereafter Complainant received many messages regarding refund but no refund was received by Complainants. The Complainant 1 had also sent legal notice to Opposite Party dated 16.09.17 through speed post and Opposite Parties gave reply dated 26.10.17 and the silence of the Opposite Parties on key issues admittedly shows the negligence on their part. Hence, this shows deficiency in service on behalf of Opposite Parties. The Complainants have prayed to direct the Opposite Parties to make the payment of Rs. 39, 916/- along with interest @ 18 % p.a. and Rs. 25,000/- for mental harassment and litigation expenses.  

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement. Opposite Party while admitting the subject policy, submits that request of cancellation of policy was processed by Opposite Party. It is further submitted that as per terms and conditions of policy, 65% of the premium amount was refunded and transaction from the end of Opposite Party was initiated but due to NEFT details problems, the transaction failed. Opposite Party further submits that they are ready to refund Rs.25,945/- in accordance with policy terms (65% of the premium amount), upon being provided correct details of the Complainant. In view of BOVE, Opposite Party prays for the dismissal of the present complaint.

 

 

Rejoinder to the written statement of Opposite Party

3. The Complainants filed rejoinder to the written statement of Opposite Party wherein the Complainants have denied the pleas raised by the Opposite Party and has reiterated the assertion made in the complaint.

Evidence of the Complainant

4. The Complainants in support of their complaint filed their affidavit wherein they have supported the averments made in the complaint.

Evidence of the Opposite Party

5. In order to prove its case, Opposite Party filed affidavit of Ms. Eileen R Tirkey, AR of Opposite Party wherein the averments made in the written statement of Opposite Party have been supported.

Arguments & Conclusion

6. We have heard the Complainant and Ld. Counsel for the Opposite Party. We have also perused the file and the written arguments filed by the parties.
7. The case of the Complainants is that Opposite Party issued the subject health policy to them and received premium of Rs. 39,916/- from them. The Complainant sent request for cancellation but till date the request has not been processed as the premium amount has not been refunded. It is also the case of the Complainants that the Opposite Party has admitted that Opposite Party was preparing to refund the whole invested amount of Rs. 39,916/-which could not be processed due to technical error and now the Opposite Party is ready to refund only 65% of the premium amount which is Rs. 25,945/- as per the terms of the policy. On the other hand, the defence of Opposite Party is that they received the cancellation request and they initiated the refund transaction but the same could not be completed due to some problem in NEFT details. It is also argued that they are ready to refund Rs. 25,945/-in accordance with policy terms (65% of the premium amount), upon being provided correct details of the Complainant. It is also their stand that the Complainants cannot be granted complete refund as that would amount to violation of terms and conditions of the policy.
8. Opposite Party admittedly could not process the refund of premium of the subject policy to the Complainants. It is the contention of the Opposite Party that the refund transaction was initiated but could not be processed due some error NEFT details of the Complainant. However, Opposite Party has not produced any evidence in support of their contention as to what was the error specifically. The defence of Opposite Party cannot be accepted in absence of any evidence in that regards, hence, they were deficient in providing services.
9. So far as the amount to be refunded is concerned, the contention of the Complainants is that there is admission on the part of Opposite Party that they initiated refund of complete amount of premium while the Opposite Party disputes this fact and contends that under the terms of policy, that the Complainants were they were  ready to refund Rs.25,945/-in accordance with policy terms (65% of the premium amount), upon being provided correct details of the Complainant. The Complainant refers to the message sent by the Opposite Party regarding approval of refund as admission on the part of Opposite Party. On perusal of the said document, we do not find any mention of complete refund. On the contrary, Opposite Party has produced in their defence, copy of terms and conditions of the policy which clearly provides that up to three months, 65% of premium to be refunded. Since, the Complainants admittedly requested for cancellation after 2.5 months, they were always entitled to 65 % of the premium amount.
10.  In view of above facts and discussion, we are of the considered view that Complainants were entitled to the refund of 65 % of the premium amount under the valid policy and Opposite Party failed to pay the refund, hence liable for deficiency in services towards the Complainants.
11. Thus, the present complaint is allowed and Opposite Party i.e. Bajaj Allianz General Insurance Company Ltd is directed to pay to the Complainants  Rs. 25,945/- (65% of the premium amount) along with interest @ of 9% per annum from 28.08.2021 which is the date of receipt of cancellation request by Opposite Party till recovery. Opposite Party is further directed to pay to the Complainants Rs. 15,000/- towards compensation and litigation cost along with interest @ 9 % per annum from the date of this order till its recovery.

 

 

12. Order announced on 09.04.24.

Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

 

(Anil Kumar Bamba)         Member

(Adarsh Nain)      Member

(Surinder Kumar Sharma) President