Tamil Nadu

North Chennai

CC/120/2015

P.N.Srinivasan - Complainant(s)

Versus

Divisional Manager, United India Insurance Co Ltd - Opp.Party(s)

Party in Person

02 Mar 2018

ORDER

 

                                                            Complaint presented on:  22.07.2015

                                                                Order pronounced on:  02.03.2018

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHENNAI (NORTH)

    2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

        PRESENT: THIRU.K.JAYABALAN, B.Sc., B.L.,        PRESIDENT

              THIRU. M.UYIRROLI KANNAN B.B.A., B.L.,      MEMBER - I

 

FRIDAY  THE 02^nd  DAY OF MARCH 2018

 

C.C.NO.120/2015

 

P.N.Srinivasan,

S/o Late P.K.Narayanan,

Plot No:52, AIBEA Nagar,

Mogappair West,

Chennai – 600 037(TN)

Tel: 044-2653 5720/99529 45930.

                                                                                    ….. Complainant

 

..Vs..

1.Divisional Manager,

United India Insurance Co.Ltd., (UIICL),

(Bancassurance Division),

DO 9, SNS Complex, 1^st Floor,

L.B. Road, Adyar, Chennai – 600 020.

 

2. Regional Manager,

Syndicate Bank, (Regional Office),

Leelavathi Building, First Floor,

69, Armenian Street, Chennai – 600 001.

 

3. Senior Manager,

Syndicate Bank,

Mogappair West Branch,

Mogappair, Chennai – 600 037.

.....Opposite Parties

Date of complaint                                 : 12.08.2015

Counsel for Complainant                      : Party in Person

Counsel for 1^st Opposite Party                 : M/s. S.Arunkumar,

                                                                    M.L.Ganesh & N.Maheswaraiah     

 

Counsel for 2^nd & 3^rd opposite parties      : M/s. P.Sreenivasulu, J.Srinivasan,

                                                                    M.Mohammed Riazudeen

 

O R D E R

 

BY PRESIDENT THIRU. K.JAYABALAN B.Sc., B.L.,

          This complaint is filed by the complainant to direct the 1^st opposite party to issue Synd Arogya Medi –Claim Plan Policy without any break for the period 01.11.2014 to 31.10.2015 instead of 17.02.2014 to 16.12.2015 and also compensation of Rs.75,000/- with litigation expenses u/s 12 of the Consumer Protection Act.1986.

1.THE COMPLAINT IN BRIEF:

          The complainant had taken Synd Arogya Medi-Claim Plan sponsored by the Syndicate Bank to cover its interested staff, in collaboration with the United India Insurance Co.Ltd., in the year 2006. The complainant joined the plan (Scheme) in the year 2006 to benefit his family initially for himself, wife & an unmarried daughter for Rs.500.000/- as sum insured. The policy taken is being renewed periodically by paying the premium for the period 01.11.06 to 31.10.2014. On   27.10.2014 the complainant went to the 3^rd opposite party bank and taken a demand draft for Rs.7,315/- for renewal of the policy with all the policy details on the back side of the demand draft with the request to forward to the 1^st opposite party. Though the policy expires on 31.10.2014, the complainant  had taken the demand draft for renewal in advance on 27.10.2014 itself. The complainant  received the policy for the period 17.12.2014 to 16.12.2015 only for the aforesaid payment of the premium by creating a break in policy. The complainant within the due date paid the amount. It is the bank had not forwarded the demand draft to the insurance company/1^st opposite party. Therefore for the loss committed by the 3^rd opposite party bank this complaint cannot be faulted and further the facilities which he entitled cannot be denied. The complainant wrote letter to the insurance company to issue policy without any break and the same was not done. Hence the complainant filed this complaint to direct the 1^st opposite party to issue a synd Arogya Medi –Claim Policy without any break for the period 01.11.2014 to 31.10.2015 instead of 17.12.2014 to 16.12.2015 and also compensation of Rs.75,000/- with litigation expenses.   

2. WRITTEN VERSION OF THE 1^st OPPOSITE PARTY IN BRIEF:

          The Synd Arogya (Group Health Insurance Scheme) UNI NO.IRDA.NL-HLT.UII.PH.V-14 is for its Account Holders. The complainant obtained said coverage from this opposite party through the 3^rd opposite party herein. The premium was received from the respective Syndicate Bank Branches and Policy was routed through them only to their Account Holders.

          3. The 3^rd opposite party by their letter dated 30.11.2014 forwarded the D.D.No.055604 dated 27.10.2014 drawn on Syndicate Bank, Mogappair Branch, dispatched on 16.12.2014 through Professional Couriers and the same was received by this opposite party on 17.12.2014  for renewal of policy No.010600/48/00000456 (policy period is 01.11.2013 to 31.10.2014).  This opposite party submits that they immediately issued policybearing No.0109002814P107708000 (17.12.2014 to 16.12.2015). The policy was renewed from 17.12.2014, since the payment was received by this opposite party only on 17.12.2014. This opposite party submits that under Sec. 64VB of Insurance   Act,  1938 they are not empowered to give coverage unless and until premium is received. The said Demand Draft was delivered to this opposite party after a period of 30 days, while so the complainant has locus-standi to insist this opposite party to issue fresh policy with effect from 01.11.2014 for the default if any committed by the transaction entered between the complainant and the 3^rd opposite party.

          4. Admittedly  the complainant  paid premium and obtained policy only through the 3^rd opposite party utilizing the benefit extended under the said scheme inclusive  of the low premium charged when compared to the individual. The complainant having agreed to the said mode of arrangement for obtaining policy and subsequently for renewal cannot attribute unfair trade practice against this opposite party. The complainant had renewed the policy from 01.11.2007 to 31.10.2014 and has obtained reimbursement of Rs.4,000/- in January 2013 would testify the fact that there was no latches, delay or deficiency on the part of this opposite party. Hence this opposite party prays to dismiss the complaint with costs.

5.WRITTEN VERSION OF THE2^nd & 3^rd  OPPOSITE PARTIES IN BRIEF:

          At the request of the complainant, this opposite party on 27.10.2014 prepared demand draft of Rs.7,315/- infavour of the 1^st opposite party and gave it to the complainant. The complainant on receipt of the same handed over the same to this opposite party and on receiving the said demand draft this opposite party requested the complainant to handed over copy of the Insurance Policy to them, so as to enable him to send the DD and also the policy to the 1^st opposite party. The complainant informed this opposite party, that he has not bought the policy to hand over the same to this opposite party and thereby assured this opposite party that in a day or two he will bring the policy and handover the same to this opposite party and thereafter this opposite party can send the DD and also copy of the policy to the 1^st opposite party for the renewal of the policy. As undertook and assured by him, the complainant did not bring the Insurance Policy and in view of the same only this opposite party was not able to send the DD and also policy to the 1^st opposite party.

          6. Thereafter, inspection of the branch by its Audit wing of the opposite parties 2 & 3 was commenced and in view of the same, this opposite party was busy with inspection works and due to the same, this opposite party was not able to the follow-up the matter. This opposite party submits that it is the bounden duty of the complainant to entrust the copy of the policy to this opposite party which he failed to do so and hence the complainant is not entitled to throw the blame on this opposite party.

          7. The complainant is not entitled to throw the blame on the opposite parties 2 and 3 for non renewal of the policy form 01.11.2014 to 31.10.2015, by the 1^st opposite party and hence the complainant himself responsible for the same and hence on the ground of lapses, latches and negligence of the complainant, the above complaint filed by the complainant is liable to thrown out. There is no deficiency in the service rendered by this opposite parties  to the complainant and hence on this ground itself the above complaint filed by the complainant is liable to be dismissed.

8. POINTS FOR CONSIDERATION:

          1. Whether there is deficiency in service on the part of the opposite parties?

          2. Whether the complainant is entitled to any relief? If so to what extent?

9. POINT NO :1 

          It is an admitted fact that the complainant is a customer/account holder of the 3^rd opposite party/ bank and the 2^nd opposite party is  the regional office of the 3^rd opposite party/ Syndicate Bank entered arrangements with the 1^st opposite party/ insurance company  in respect of Synd Arogya Mediclaim Plan scheme for its account holder and accordingly the complainant also availed the policy for the period 01.11.2006 to 31.10.2007 on payment of annual premium of Rs.7,315/- and the said policy was periodically renewed  till 01.11.2007 to 31.10.14 and thereafter to renew the policy the complainant taken the demand draft for Rs.7,315/- dated 27.10.14 and requested the 3^rd opposite party to forward the demand draft to the 1^st opposite party for renewal and further he had also returned the policy  details on the back side of the demand draft and further  the 3^rd opposite party has not forwarded the demand draft immediately and belatedly  forwarded after 45 days and the policy was  issued for the period 17.12.2014 to 16.12.2015 with a break.

10. The complainant alleged deficiency against the opposite parties that the 3^rd opposite party has not forwarded the demand draft on 27.10.2014 itself to renew the policy to the 1^st opposite party and belatedly sent the same and the 1^st opposite party issued a break period policy and therefore the opposite parties have committed deficiency in service.

          11. The 1^st opposite party would contend that so soon as he received the demand draft immediately he issued policy for the period17.12.2014 to 16.12.2015 as per the terms and conditions of the Synd Arogya Mediclaim Plan policy and therefore he has not committed any deficiency in service and it is the complainant only has not paid the premium in advance.

          12. The 2^nd & 3^rd opposite parties would contend that though the demand draft was taken on 27.10.2014, the 3^rd opposite party demanded the complainant to hand over the copy of the insurance policy so as to enable them to send the demand draft and  policy to the 1^st opposite party for renewal, the complainant replied that he had not having the policy copy and he will hand over in a day or two and however he did not bring  the insurance policy and hence he could not send the demand draft  for renewal and hence they have not committed any deficiency.

          13. The 1^st opposite party categorically stated in his written version that “The premium was received from the respective Syndicate Bank branch and policy was routed through them only to their account holders”. The 1^st opposite party further stated that the 3^rd opposite party by his letter dated 13.11.2014 forwarded the complainant demand draft for renewal of the policy through courier and the same was received by him on 17.12.2014 and immediately the policy was renewed from 17.12.2014 to 16.12.2015. The above statement and pleading of the 1^st opposite party in his written version clears that the 1^st opposite party/insurer issuing the policy and also renewal of the policy was done only through the Syndicate Bank branch. Therefore, on own admission of the 1^st opposite party, the complainant can renew the policy only through the bank and not directly with the 1^st opposite party.

          14. Admittedly, the complainant taken the demand draft on 27.10.2014 with an instructions to forward the demand draft to the 1^st opposite party for renewal of the policy. The 3^rd opposite party wrote Ex.B3 letter dated 29.12.2014 to the 1^st opposite party that the complainant had tendered demand draft dated 27.10.2014 to him in the meantime inspection of their branch had commenced and due to shortage of staff that the demand draft was pending with them and could be dispatched to the 1^st opposite party during middle December 2014. only and further requested to re-validate the enclosed policy from 01.11.2014 instead of   17.12.2014 as a special case. The above letter leads to a conclusion that it is the 3^rd opposite party who had kept  the demand draft with him due to his branch inspection and shortage of staff and for such failure action on the part of the 3^rd opposite party proves that he had committed deficiency in not forwarding the demand draft for renewal of the policy to the complainant. The 2^nd opposite party who is the regional office of the 3^rd opposite party is also severally liable for the act committed by the 3^rd opposite party and therefore he had also committed deficiency.

          15. The 2^nd  & 3^rd opposite parties filed written version saying that the complainant had not handed over the insurance policy and hence he had not forwarded the same for want of policy. However,  in Ex.B3 letter the 3^rd opposite party categorically stated that he is sending the demand draft without copy of the policy documents to the 3^rd opposite party and on the basis of the letter only the policy was issued even without copy of the policy document.  Therefore, the defence taken by the 2^nd & 3^rd opposite parties that the complainant had not handover the policy copy for not forwarding the demand draft to the 1^st opposite party is a reason invented only for the purpose of the case and the same cannot be accepted in view of that he had accepted in Ex.B3 letter that due to branch inspection and shortage of staff the demand draft was pending with them till middle of December 2014 proves that they have committed deficiency and hence it is held that the opposite parties 2 & 3 have committed deficiency in service.

          16. The 1^st opposite party would contend that as per the terms and conditions of the policy on receipt of demand draft he had issued the policy from 17.12.2014.  The 1^st opposite party categorically admitted in his written version that the receipt of premium and forwarding of the policy was routed through the  Syndicate Bank only to their account holder. Therefore, all the opposite parties are equally liable for the issuance policy on payment of premium to the policy holder. Since the premium was paid to the 3^rd opposite party for transmission of demand draft to the 1^st opposite party and the 3^rd opposite party has also requested to re-validate the policy from 01.11.2014 instead 17.12.2014 should have been considered by the 1^st opposite party and re-validated the same and failure to do the same, the 1^st opposite party also has committed deficiency in service.

17. POINT NO:2

          Since the complainant paid the premium in advance for renewal the 1^st opposite party can be directed to issue a fresh policy for the period 01.11.2014 to 31.10.2015 and thereafter continuously to issue the policy without any break. The 2^nd and 3^rd opposite parties  without reason have not forwarded the demand draft for issuance of the policy and belatedly forwarded the same and due to break in policy was issued by the 1^st opposite party the complainant suffered with mental agony is accepted and for the same, it would be appropriate to direct the 2^nd & 3^rd opposite parties jointly to pay a compensation for a sum of Rs.50,000/- to the complaint, besides a sum of Rs.5,000/- towards litigation expenses.

          In the result the Complaint is partly allowed. The  1^st opposite party is ordered to issue fresh policy for the period 01.11.2014  to 31.10.2015 instead of 17.12.2014 to 16.12.2015 and thereafter to issue the policy continuously without any break and further the 2^nd & 3^rd Opposite Parties jointly or severally are ordered to pay  a sum of Rs. 50,000/- (Rupees fifty thousand only) towards compensation for mental agony, besides a sum of Rs. 5,000/- (Rupees five thousand only)  towards litigation expenses.

The above amount shall be paid to the complainant within 6 weeks from the date of receipt of the copy of this order failing which the above said amount shall carry 9% interest till the date of payment.

          Dictated to the Steno-Typist transcribed and typed by her corrected and pronounced by us on this 02^nd  day of March 2018.

 

MEMBER – I                                                                PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1 dated Different    Policies:2006-07,2013-14 & 2014 -15 3 yrs

Ex.A2 18 & 28^th            Grievance mail addressed to RM, Customer Care Dept,    

         May 2015                  UNI, Chennai

 

Ex.A3 24/04                            Letter & reminder addressed to UNI Adyar on their

 02.06.2015                        Lapses UNI Reply dated 04.06.2015

 

Ex.A4  23.12.2014                  UNI – SMS based letter to the Syn.Bank

 

Ex.A5 29.12.2014                   Bank’s letter to UNI for revalidation

 

Ex.A6 Different             Medical reports of Apollo Clinic

 

Ex.A7 NIL                     Postal Acknowledgements

 

LIST OF DOCUMENTS FILED BY THE 1^st OPPOSITE PARTY :

 

Ex.B1 dated 19.12.2014         Policy schedule along with terms & conditions

 

Ex.B2 dated 23.12.2014         Letter by complainant

 

Ex.B3 dated 29.12.2014         Letter by the 3^rd opposite party

 

Ex.B4 dated 02.01.2015         E-mail correspondence by the 1^st opposite party

 

Ex.B5 dated 10.02.2015   E-mail correspondence by the 1^st opposite party

 

Ex.B6 dated 12.02.2015         E-mail correspondence by the 1^st opposite party

 

Ex.B7 dated 24.04.2015         Letter by complainant

 

Ex.B8 dated 04.06.2015         Reply letter by 1^st opposite party

 

Ex.B9 dated 26.08.2015         Letter by 1^st opposite party to Professional Courier

 

 

 

 

MEMBER – I                                                               PRESIDENT