Case No. 148/2015   

IN THE MATTER OF

Manu Yeeshu  S/o Vinod Kumar Flat No. 25 Sankalp Apartment, Shyam Sunder Mill near Raghuveer Puri Police Chawke Aligarh

                             (Through: Advocate  K.P. Misra)

                                           V/s

1. Bajaj Allianz (registered office) GE Plaza, Airport Road Yerawada, Pune
2. Bajaj Allianz (Aligarh Branch office) 612A/2Ist Floor, Begpur Kanjaula Ramghat Road, Aligarh

(Through: Advocate Diwakar Agrawal)

CORAM

 Present:

1. Shri Hasnain Qureshi, President
2. Shri Alok Upadhyaya, Member
3. Smt. Purnima Singh Rajpoot, Member

PRONOUNCED by Shri Hasnain Qureshi, President

JUDGMENT

1. The present complaint has been filed by the complainant before this commission for  the following reliefs-

1.  The Ops be directed to renew the policy since the year 2008.
2. The Ops be directed to pay Rs.300000/as compensation for harassment.

2. Complainant stated that the he had obtained health insurance policy from Op of which the payment of annual premium Rs.2357/ is for the year 2008. In the year 2009 and 2010 policy was renewed with the payment of premium Rs.2315/ in each year. In the year 2011 the agent received Rs.2702/ for renewal of the policy and he gave the copy of the policy with serial no. 0227677925 which was in hand writing. In the year 2012 the policy was got renewed on payment of Rs.2753/.In the year 2013 complainant had fallen ill and he submitted the medical bills for Rs.40384/which was not paid. On 17.6.2013 complainant was informed by the letter that the policy is two years old and the illness is not covered within it and so the payment could not be made. Complainant faced hardship and  he was harassed for the month June till the month of October. Complainant came to know that the policy serial was changed and serial no. 0103758295 was given at the time of obtaining the policy and on the pretext of renewing the policy, another policy with serial no. 02227677925 was given whereas the policy relates to the year 2008 and the policy was stated to run from the year 2011 instead of the year 2008.
3. OP sated in WS that the policy was issued to the customer as per his desire after explain the terms and conditions of policy. When the complainant reported his illness medical expenses, the matter was assigned to the claim processing team for settlement of the claim as per mediclaim policy. The claim was settled at Rs.29967/ and the said was paid to the complainant as complainant has received the amount he ceases to be a consumer. Complaint is liable to be dismissed.
4.  Complainant has filed his affidavit and papers in support of his pleadings. And Ops have also filed his affidavit and papers in support of his pleadings.
5. We have perused the material available on record and heard the parties counsel.
6. The first question of consideration before us is whether the Policy no. 0103758295 was renewed from the year 2009 and thereafter? If so its effect.
7. Complainant has stated that initially he had obtained the policy no.0103758295 on payment of premium of Rs. 2357/ supported by proposal dated 22.7.2008 annexure 1. Complainant further stated that in the year 2009, 2010,2011,2012,2013, 2014 and 2015 the premium was paid to renewed the policy. Complainant has filed premium receipt annexure 2 to 6 pertaining to the year 2008 to 2012. Thus there is sufficient proof that the policy which was obtained in the year 2008 that was renewed till the year 2012. Thus there was no occasion to sanction another policy in the year 2011. Thus it is held the policy obtained by the complainant in the year 2008was renewed thereafter. Complainant is entitled for validating the policy since the year 2008. 
8. The question formulated above is decided in favour of  complainant.
9. We hereby direct the OP to validate the policy 0103758295 initially granted to the complainant and to treat the policy since the year 2008and thereafter. We also direct to the op to pay the complainant  Rs.20000/ as harassment.
10. Ops  shall comply with the direction within 45 days failing which  shall be prosecuted for non-compliance in accordance with section 72 of the Act for awarding punishment against him.
11. A copy of this judgment be provided to all the parties as per rule as mandated by Consumer Protection Act, 2019. The judgment be uploaded forthwith on the website of the commission for the perusal of the parties.
12. File be consigned to record room along with a copy of this judgment.