Date of Filing:18.07.2008<br /> Date of Order:26.11.2008<br /> <br /> <br /> <br /> BEFORE THE II ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM SESHADRIPURAM BANGALORE-20<br /> <br /> Dated: 26TH DAY OF NOVEMBER 2008<br /> PRESENT<br /> <br /> <br /> <br /> Sri S.S. NAGARALE, B.A, LL.B. (SPL.), President.<br /> Smt. D. LEELAVATHI, M.A.LL.B, Member.<br /> Sri BALAKRISHNA. V. MASALI, B.A, LL.B. (SPL.), Member.<br /> <br /> <br /> <br /> <br /> COMPLAINT NO: 1597 OF 2008<br /> <br /> Mr. M.N. Prakash,<br /> No. 609, A-4 Wing,<br /> Thungabhadra Block, <br /> National Games Village,<br /> Koramangala,<br /> Bangalore 47 Complainant<br /> <br /> V/S<br /> <br /> The Branch Manager,<br /> ICICI Lombard General Insurance,<br /> 62/1, II Floor, Prestige Corniche,<br /> Richmond Road,<br /> Bangalore-25. Opposite Party<br /> <br /> ORDER<br /> By the President Sri. S.S. Nagarale<br /> <br /> This is a complaint filed under section 12 of the Consumer Protection Act 1986.<br /> The brief facts of the case are that, he was offered Health care insurance policy by opposite party covering himself and his wife. Policy amount of Rs.22,500/- was paid by his daughter during her visit to India during July-2007. His daughter Divya Prakash is a NRI working at London and she is the proposer of the policy. Policy was covering father and mother of the proposer for two years covering a period from 31/07/2007 to 29/07/2009. While issuing the policy father’s name is included and mother name of the proposer is not included in the policy. This mistake was brought to the notice of ICICI Lombard, Koramangala Branch, Bangalore, they agreed to issue revised policy covering both the parents. The ICICI had issued new policy instead of including Mrs. Geetha’s name in the original policy. This complainant came to know when he saw debit of Rs.16,500/- from his daughter’s account with ICICI Bank. This deduction was made without the knowledge of his daughter. When objected for deduction, policy was cancelled which was in the name of Mrs. Geetha. While canceling the policy opposite party did not credit the full amount of Rs.16,500/- . Instead they credited only Rs.11,550/- on 01/11/2007. This short credit is highly objectionable. Hence full amount should be credited back. Even after long persuasion, the ICICI Lombard did not bother to issue joint health policy. Complainant was constrained to give a written complaint to cancel the original health care policy and refund the full amount. Further complainant had made complaint through telephone and the same was registered vide complaint No.1803081675 dated 18/03/2008 and vide No.300408288 dated 30/04/2008. On verifying the status of complaint through telephone complainant was informed that policy would be cancelled and an amount of Rs.27,417/- would be refunded within 7 working days. Even after lapse of 2 months the complainant neither received the refund nor any communication. Therefore, he has filed complaint before the District Consumer Disputes Redressal Forum.<br /> 2. Notice issued to opposite party. Opposite party put in its appearance through advocate and filed defence version stating that, the opposite party admits that the policy was issued in favour of complainant for the period from 30/07/2007 to 29/07/2009. Complainant’s daughter has submitted proposal form covering the health care policy of her father. Accordingly, she has paid premium of Rs.22,500/- and hence policy has been issued. On the basis of proposal form No. RIS 0014311 submitted by daughter of complainant, policy was issued covering mother of the proposer. A sum of Rs.16,500/- premium has been charged as per the table and the said amount has been debited to account of the proposer. On request of the complainant policy has been cancelled on 13/10/2007 after deducting prorate premium. Remaining amount has been refunded to the proposer. There was no proposal form from the proposer requesting to issue policy in joint name. The proposer herself has given second proposal for issue of policy in the name of her mother. It is submitted by the opposite party that opposite party is ready to cancel the policy of the complainant also but premium amount will be deducted on prorate basis for the period in which the policy was existed until the request for cancellation. There is no deficiency of service on the part of the opposite party since the opposite party acted as per the terms and conditions of the policy. Therefore, claim is not maintainable. <br /> 3. Both the parties filed affidavit evidence. Arguments are heard.<br /> 4. The point for consideration is:-<br /> “Whether the complainant is entitled for refund of the amount as sought by him?” <br /> REASONS<br /> 5. The daughter of the complainant Mrs. Divya Prakash is a NRI working at Landon, she had proposed ICICI Lombard Health Care Policy. It is the case of the complainant that policy was to cover father and mother of the proposer, but while issuing the policy father’s name alone was included and mother name of the proposer is not included in the policy. Sum of Rs.22,500/- was paid as premium. The argument of the complainant that in the first policy both the parents should have been included cannot be accepted because the opposite party has produced proposal form signed by daughter of complainant. Two proposal forms one for the father and another for the mother have been signed by the proposer. Therefore, in the face of two proposal forms it cannot be said that the first policy should have covered both the parents of the proposer. The policy taken in the name of Smt. M.P. Geetha, mother of the proposer, for a premium amount of Rs.16,500/-. The complainant has cancelled the said policy issued in the name of Mrs. M.P. Geetha and the opposite party credited sum of Rs.11,550/- on 01/11/2007 as per the Bank statement. The request of the complainant that opposite party should have credited the entire amount of Rs.16,500/- cannot be accepted. The opposite party deducted sum of Rs.4,450/- on prorate basis. The policy got cancelled as per non telesales cancellation grid. Opposite party has produced the detail calculation memo. Therefore, the complainant should not have any grievance in respect of the second policy. As regards the first policy is concerned sum of Rs.22,500/- has been recovered as premium amount. The complainant wants cancellation of the policy bearing No.4034/RIS/RIS0014311/00/000 and refund of the entire premium amount of Rs.22,500/-. For the cancellation of this policy the opposite party has no objection. As per the submissions made by the learned Advocate for the opposite party the said policy has also been cancelled and the complainant will be paid refund on prorate basis. The premium for the first year will be Rs.13,500/- (60% of the total premium) and premium for second year will be Rs.9,000/- (40% of the total premium). 50% of the first year premium will be Rs.6,750/-. The total amount which is liable to be refunded to the complainant will be Rs.15,750/-. In the written argument it has been submitted by the opposite party that as per the request of the complainant a sum of Rs.22,500/- has been refunded to the complainant’s daughter’s account without her permission. But by mistake while putting so this opposite party has not deducted the prorate basis premium and for that this opposite party is on process to get back the same from the complainant. So by this argument also, it is clear that there is absolutely no dispute or objection on the part of opposite party to refund the premium on prorate basis. As worked out above the total amount which is liable to be refunded to the complainant’s daughter’s account comes to Rs. 15,750/-. The above calculation was arrived only on the basis of the calculation submitted by the opposite party in respect of the other policy which was issued in the name of mother of the proposer. Therefore, the complainant is entitled for refund of Rs.15,750/- from the opposite party. In the result, I proceed to pass the following:-<br /> ORDER<br /> <br /> 6. The Complaint is partly allowed. The opposite party is directed to refund Rs.15,750/- to the complainant or re-credit the said amount to the account of complainant’s daughter Mrs. Divya Prakash within 30 days from the date of this order with intimation to this Forum. <br /> 7. The complainant is entitled to Rs.1,000/- towards costs of the present proceedings from opposite party.<br /> 8. Send the copy of this Order to both the parties free of costs immediately as a statutory requirement. <br /> 9. Pronounced in the Open Forum on this 26TH DAY OF NOVEMBER 2008. <br /> Order accordingly,<br /> <br /> <br /> PRESIDENT<br /> We concur the above findings.<br /> <br /> <br /> MEMBER MEMBER<br /> <br /> Rhr. <br />