Delhi

East Delhi

CC/468/2023

KULDEEP - Complainant(s)

Versus

CARE HEALTH INS. CO. LTD. & ORS. - Opp.Party(s)

KULDEEP SINGH, ADV.

03 Nov 2023

ORDER

IN THE MATTER OF KULDEEP Vs CARE HEALTH INSURANCE CO. LTD., & ORS.

 

CC No.           468/2023

Date:-            03.11.2023

Present:-      Complainant in Person

 

 

Complainant has filed the present complaint against OP interalia stating that he has taken first policy from Religare Health Policy Vide Policy No. 10062863 on 29.12.2015 and therafter he had been taking/renewing the policy every year from OP from time to time and he lastly got it renewed on 28.12.2021 but the grievance of the complainant is that the OP used to increase the premium of the policy every year and for the current year’s policy for the year 2023-24 premium was demanded as Rs.33,773/- which was Rs. 14018/- more than that of the premium which was paid in the year 2015 and such enhancement of the premium amounts to cheating and fraud being played upon the policyholders. Not only this, the amount of ‘No Claim Bonus’ (NCB) was also being increased without any reason and therefore he has filed the present complaint with the prayer that Respondent be directed to pay Rs. 1,34,830/- i.e. the total payment of premium which the complainant had paid from 2015 upto today, alongwith compensation of Rs. 5 Lakh and Litigation Charges of Rs. 50,000/-.

            On query as to why the complainant is asking for the return of the premium which he had already paid against the policy which he purchased and, for which all these policies he was duly covered w.r.t. his health issues to which the complainant who is appearing in person, submits that this amount has been taken from him by way of cheating and without any information and Insurance company should not do this.

            The Commission is of the opinion that the provision of Consumer Protection Act are neither in the form of writ-jurisdiction nor in the form of as to what should be the business of OP & how it should run or how the price of such policies has to be determined. The provision of Consumer Protection Act are for the benefit of consumers who have hired some goods or have hired some services from OP and such person, then found that there is some deficiency in providing those goods or providing those services, except w.r.t. certain complainants, which are classified as ‘Class Complainants’. There is no specific provision for dealing with such sort of complaints where complainant after having taken the policy for years together & also was duly covered w.r.t. his health against premium, which the complainant has already paid and he availed such services. Therefore Commission is of the opinion that increasement of premium by the OP is governed by IRDA and there appears to no deficiency qua the complainant if the premium is increased, as the contract of insurance is contract in between both parties which they enter on the basis of fair-play and also as per the provision of Indian Contract Act i.e. offer, acceptance and consideration with free mind. Therefore this Commission is of the opinion that the present complaint do not fall within the ambit of Consumer Protection Act. Further the complainant, in view of the enhanced premium has admittedly not opted to take policy of the OP which is his own prerogative and he may enter into fresh agreement w.r.t. policy from any other company or even may negotiate with those company if he so chooses. No insurance company can compel him to take policy from that insurance company alone. Therefore no case is made-out to admit the complaint, the complaint case is of the complainant accordingly rejected.

File be consigned to Record Room.