Date of Filing: 13.06.2016.                                                                            Date of Final Order: 10.07.2017

Sri Anumpam Bhattacharyy, Presiding Member.

The instant complaint has been filed by the complainant U/S 12 of C. P. Act, 1986 praying for refund of Rs.16,264/- along with interest in respect of payment of thee policies and compensation of Rs.5000/- for mental harassment.

The complainant’s case, in brief, is that the complainant had medi-claim policy No. 313400/48/2014/1262 on 22.8.13 for assured sum of Rs.3 lakhs by making payment through OP No.3-Bank by Cheque No. 000003 dt. 12.8.13 of Rs.4620/- for renewal of that policy enhancing the assured sum to Rs.4 lakhs paid Rs.5780/- by Cheque No. 000008 dt. 4.8.14 through OP No.3 but getting the policy being No. 313400/48/2015/1283 it is found that the same is a separate policy and has no relation with the earlier first policy. Again renewed the policy in the same way through Op No.3 Bank by Cheque No. 000011 dt. 12.8.15 Rs. 5864/- . But, the complainant has not yet got that policy certificate in spite of several attempts from OP No.3 and even after writing letter to OpNo.1 Insurance Co.  Hence, the instant complaint case.

The written version filed by Op No.1 Insurance Co, in brief, is that the Op No.1 has denied the allegation of the complainant that the policy certificate was not issued in spite of payment of premium in time and that there is deficiency in service on the part of the OP No.1 Insurance Co. The  first medi-claim policy No. 313400/48/2014/1262 was issued for the period from 22.8.13 to 21.8.14 after receiving the policy premium amount and on the subsequent year another policy was issued having No. 313/48/2015/1283 which was valid from 22.08.2014 to 21.8.15.Thereafter, next policy No. 313400/48/2016/2304 for the period from 21.12.15 to 20.12.16 has been discontinued because endorsement schedule for renewal of the said policy was received and accepted by the Oriental Insurance Co. Ltd on 10.12.2015. But the Oriental Bank of Commerce never paid the extra premium amount. The policy was issued on 21.12.2015 as the date of collection of Cheque No. 4036007302 was on 21.12.2015. The policy has been sent to the Oriental Bank of Commerce immediately. There is no unfair Trade Practice or deficiency of service or laches on the part of the Opposite Party. The complainant is not entitled to get any compensation from this Opposite Party and the complaint is liable to be rejected. Hence, the instant written version.  

The written version filed by OP No.3 Bank, in brief, is that cheque No. 000003 dt. 12.8.13, Cheque No. 000008 dt. 4.8.14 and Cheque No. 000011 dt. 12.8.15 amounting to Rs. 4620/-, 5780/- and Rs.5864/- respectively had been deposited through proper channel to oriental Insurance Co. by this OP. Accordingly policy certificate vide No. 313400/48/2014/1262 and 313400/48/2015/1283 were also delivered to the complainant. This OP also delivered policy certificate having premium of Rs.5864/- to the  complainant but that was refused by him . Now, this policy certificate is in the custody of this OP. There are no deficiencies on the part this OP No.3. As regards relief No.2, this Op No.3 has no nexus or responsibility. The case is liable to be dismissed. Hence, the instant written version filed by OP No.3.

Considering the pleadings of the parties the following points have been raised for the disposal of the case.

                                                                                 Points for Decision.

1. Whether the complaint is maintainable in its present form and in law?
2. Whether the complainant has locus standi to file the present case?
3. Whether the complaint is barred by law of limitation?
4. Whether the complainant is entitled to get relief as prayed for?
5. To what other relief/reliefs the complainant is entitled to get?

                                                                          Decision with Reasons.

            Point Nos. 1 to 5.

            All the points are taken up together for the sake of convenience.

            The instant complaint is praying for refund of Rs.16,264/- the premium paid in three years along with interest and  for compensation  and litigation cost amounting to  Rs.5,000/-.

            The complainant’s main case is that the complainant made payment of premium in consecutive three years for renewal of the medi claim through OP No.3 –Bank in time but the complainant has not received the third policy certificate inspite of several attempts and all the policies are discontinued and new one.

On the other hand, the OP No.1 Insurance Co case is that the 1^st Policy for period from 22.8.13 to 21.08.14 and 2^nd Policy are continued, only 3^rd policy was discounted being the cheque sent by OP No.3 was collected on 21.12.15 and policy No. 313400/48/2016/2304 for the period from 21.12.15 to 20.12.16 was issued on 21.12.15  being the extra  premium was  not paid by OP No.3 Bank for  such discontinuation.

                In this regard the Op No.3’s case is that cheque No. 000003 dt. 12.8.13, No. 000008 dt. 4.8.14 and No. 000011 dt. 12.8.15 amounting to Rs. 4620/-, 5780/- and Rs.5864/- had been deposited through proper channel to oriental Insurance Co. by this OP. accordingly policy certificate vide No. 313400/48/2014/1262 and 313400/48/2015/1283 were also delivered to this petitioner. This OP also delivered policy certificate having premium of Rs.5864/- to the petitioner but that was refused by the petitioner. Now, this policy certificate is in the custody of this OP. There is no deficiencies on the part this OP No.3As regards relief No.2, this Op No.3 has no nexus or responsibility.

            To prove the complainant’s case the complainant has adduced his evidence –on-affidavit along with relevant documents in support of his case.

            In this case the complainant himself has advanced argument. During hearing argument he has produced two original policies.

            The complainant’s main case is that the complaint paid the premium in time and for the laches of the OPs the policy has been discontinued and third policy has not been delivered to the complainant.

            Admittedly, the third policy has not been delivered to the complainant and the same is lying with the custody of OP No.3 Bank and during hearing argument the same was shown before this Forum.

            On the  basis of averment of the written version filed by Op No.3 Insurance Co. as well as the argument advanced by their Ld. Lawyer it is clear that both the polices are continued and there is no question of discontinuation.

            The first policy is for the period from 22.8.2013 to 21.8.2014 and the second policy is also for the period from 22.8.14 to 21.8.15 though the payment of second premium made by the complaint by a Cheque No. 000008 dt. 4.8.2014 through OP No.3 Bank.

            The 3^rd policy was issued for the period from 21.12.15 to 20.12.16.

            The complainant paid the third premium for the policy by a Cheque No. 000011 dt. 12.08.15 .

            The OP No.3 Bank has filed several relevant documents in support of their case during hearing argument by firisti.

            The OP No.3 Bank has filed Xerox copies of their Dak Despatch Register and Peon to show the movement of cheques.

            Though the complainant’s case is against both second and third premium but from the document, the original policy certificate as well as from the written version filed by Op No.1, it is clear that the second policy is not a new policy, it is continued policy with the original policy being issued from the period from 22.8.14 to 21.8.15 where the first policy is for the period from 22.8.14 to 21.8.15.

            Admittedly, the third policy has been issued for the period from 21.12.15 to 20.12.16.

            The dispute is who is responsible for the discontinuation of the impugned policy.

            The complainant’s case is both the OPs are responsible.

            The OP No.1-Insurance Co’s case is that the Op no.3 is responsible being the Cheque was issued by the complainant but the Op No.3 has caused the delay in sending the cheque and immediate after collection of the cheque on 21.12.15 the OP No.1 Insurance Co. has rightly issued the policy for the period from 21.12.15 to 20.12.16.

            In this regard the Ld. lawyer for theOpNo.3-Bank has advanced argument challenging the argument advanced by both the complaint himself and the Ld. lawyer for the Op No.1 insurance Co. relying upon the Dak-Despatch Register and Peon Book and also a separate document containing Xerox copy of D.D. dated 13.08.2015 for Rs.5864/- the premium amount for third year renewal of the original medi-claim policy and below that draft there is one note in  writing with the request to change the date of the draft with current date and below that with a gap there is signature of the complainant.

            This document is without any seal and signature and fact relating to this document is not in the pleading to shift the liability of the OP No.3-Bank in the matter.

            From the Peon Book, it appears that the concerned D.D. No. 242391 for Rs.5864/- was despatched to the complainant, Swapan Kumar Bhattacharyya on 13.8.15 instead of sending the same to OP No.1 Insurance Co.

            It is clear that for delay in encashment of the premium of Rs.5864/- on 21.12.2015 the OP no.3 Bank is solely responsible.

            From the written version filed by the Op No.1 Insurance Co. it appears that there is provision for extra premium for continuity of the policy for such delay but the Op No.3 Bank has not paid such extra premium amount.

            In the written version filed by Op No.1-Insurance Company, they have admitted claim as to continuity of the instant medi-claim policy No.313400/48/2014/1262 with the second year subsequent Policy No.313400/48/2015/1283 and the complainant has also filed relevant documents as to the necessary correspondences to that effect.

            Relying upon the above materials, we find no dispute as to continuity of the instant medi claim upto 2^nd premium for the period from 22.8.14 to 21.8.15.

            Regarding the discontinuity of the policy at the time of 3^rd year renewal it is clear that the OP No.3 bank is responsible and there is provision to continue the policy by making payment of extra premium and as such we are of the view that the OP No.3 Bank is to pay that extra premium to continue the policy and if the same is not permitted as per rules of the Medi-Claim Policy of the Insurance Company, then alternatively, the OP bank  is duty-bound to refund the three successive  premiums so paid  by the complainant amounting to Rs. 16264/-along with interest @7% p.a. from the date of filing of this case till realization.

            Considering the harassment, we are of view that the OP is to pay cost of Rs.2, 000/- .

            Considering the above as a whole we find that all the points are disposed of in favour of the complainant in part.

            Hence,

                                                                Ordered

that the Consumer Complaint No. 93/2016 be and the same is hereby allowed on contest in part.

            The complainant is entitled to get his medi-claim policy renewed with effect from 22.08.2015 to 21.08.2016 alternatively; he is entitled to get refund of the total amount of three consecutive   premiums as has been paid by him amounting to Rs. 16264/-along with interest @7% p.a.  from the date of filing of this case till realization from the OP No.3 Bank.

            The OP No.3-Bank is directed to approach the OP No.1 Insurance Co. for renewal of the medi-claim policy of the complainant with effect from 22.08.2015 to 21.08.2016 by paying extra premium within 30 days from the date of this order, if the OP No.1-Insurance Company so charges.

            The OP No.1-Insurance Company is to  consider the case of the complainant  for continuity of the policy by taking extra premium from the OP No.3 Bank for the purpose and issue continued valid policy certificate, if the Rules of the medi-claim policy so permits within 30 days from the date of depositing the extra premium.

            If the rules of the Medi-claim policy do not permit, the OP No.3-Bank is directed to refund   the total amount of three consecutive   premiums as has been paid by the complainant, amounting to Rs. 16264/-along with interest @7% p.a.   from the date of filing of this case till realization,  to the complainant within 60 days from the date of this order.

            In default on the part of the Op No.3 Bank, a fine @Rs.50/- per day is to be imposed upon the OP No.3 Bank and the amount so accumulated shall be deposited in the Consumer Legal Aid Account.

Let a plain copy of this order be made available and be supplied free of cost, to each of the parties on contest in person, Ld. Advocate/Agent on record, by hand under proper acknowledgment / be sent forthwith under ordinary post  to the concerned parties as per rules, for information and necessary action.