DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

PATIALA.

                                      Consumer Complaint No. 140 of 25.4.2017

                                      Decided on: 29.10.2020

Sagar Mehta, aged about 27 years S/o Sh.Suresh Kumar R/o H.No.2414, Ward No.17,Anand Nagar, Rajpura Town, Patiala.

                                                                   …………...Complainant

                                      Versus

1. Indian Overseas Bank, Branch Rajpura, District Patiala, through its Manager.
2. Universal Sompo General Insurance Co. Ltd., Regd. &Corporate Office: Unit 401, 4^th Floor, Sangam Complex, 127 Andheri Kurla Road, Andheri (East), Mumbai, through its M.D.

                                                                   …………Opposite Parties

                                      Complaint under Section 12 of the

                                      Consumer Protection Act, 1986.

QUORUM

                                      Sh. Jasjit Singh Bhinder, President

                                      Sh.Vinod Kumar Gulati, Member    

ARGUED BY

                                  Sh.Sunil Kumar Garg, Advocate,counsel for complainant.

                                  Sh.Vikas Mittal,Advocate, counsel for OP No.1.

                                   Sh.A.K.Gupta,Advocate, counsel for OP No.2.

 ORDER

                                      JASJIT SINGH BHINDER,PRESIDENT

1. This is the complaint filed by Sh.Sagar Mehta  (hereinafter referred to as the complainant) against  Indian Overseas Bank and another(hereinafter referred to as the OP/s).
2. The brief facts of the case are that the complainant purchased a health insurance policy namely IOB Health Care Plus, bearing No.2817/54618392/00/000 on 9.12.2014 from OP No.1 on his own health alongwith the health of his family members i.e. his wife and parents, with sum assured of Rs.50,000/-.The yearly premium of the policy was Rs.1760/- was paid by the complainant to OP no.1, who is authorized dealer of OP No.2.
3. It is averred that for yearly renewal of the policy, the premium amount  was to be deducted  from the account of the complainant on expiry of policy term by the OPs. Accordingly OP No.1 deducted Rs.1793/- from the account of the complainant on 18.12.2015 and the policy was renewed from 22.12.2015 for one year. It is further averred that the OP No.1 deducted the insurance premium from the account of the complainant.
4. It is further averred that in the month of Mary,2017, the complainant’s father suddenly fell ill and his eye sight became weak and was immediately got immediately examined.The doctor advised him to get operation for curing his eyes. The complainant approached OP No.1 and claimed the amount of operation of his father’s eyes but he was shocked to know that due to demonetizations of money in December,2016, the OP No.1 forgotten to deduct the amount of insurance premium of the health insurance policy of the complainant as a result of which the policy elapsed. It is averred that the complainant got operated his father, but the OPs did not make any insurance claim. Thus there is deficiency in service on the part of OPs, which caused lot of physical agony and harassment to the complainant. Hence this complaint with the prayer  to accept the same by giving directions to the OPs to pay the sum insured of Rs.50,000/-alongwith interest @18% per annum since the date of cancellation of policy till realization and damages of Rs.30,000/- for causing mental agony and harassment and also to pay Rs.15000/-as cost of litigation.
5. Upon notice, OPs No.1&2 appeared through their respective counsel and contested the complaint by filing written replies.
6. In the written reply filed by OP No.1, it raised preliminary objections that the present complaint is not maintainable; that the complainant is not a consumer as defined under the Act; that the present complaint is false and frivolous and has been filed just to extract easy money.
7. It is submitted that the payment of premium  to Universal Sompo was not by way of auto-debit facilility. It  is further submitted that on 19.12.2016, the complainant himself gave written letter to the bank authorities that he wants to discontinue the policy, as such no payment be deducted from his account.
8. On merits, it is denied that premium amount has to be deducted yearly from the account of complainant on the expiry of policy term of OPs .It is further submitted that the payment of premium to Universal Sompo was not by way of auto-debit facility. It is submitted that on the instructions of complainant, the OP No.1 has debited the amount of Rs.1760/- on 9.12.2014 and Rs.1793/- on 18.12.2015 on account of premium of policy and was paid to OP No.2. However, on 19.12.2016, the complainant himself gave written letter to the bank authorities that he wants to discontinue the policy as such no payment be deducted from his account. After denying all other averments made in the complaint, OP No.1 prayed for the dismissal of the complaint.
9. In the written reply filed by OP No.1 it is submitted that the complainant has obtained the insurance policy No.2817/54618392/00/000 covering the persons mentioned in the policy w.e.f.9.12.2014 to 8.12.2015, strictly subject to the terms and conditions of the policy. The said policy was renewed w.e.f.18.12.2015 to 17.12.2016 by the complainant. The treatment in question was taken on March, 2017.As the policy was not renewed after the year 2016, so the treatment  did not fall within the of policy, as such the complaint filed by the complainant is liable to be dismissed.
10. In evidence, the ld. counsel for the complainant has tendered Ex.CA affidavit of the complainant alongwith documents Ex.C1 copy of passbook, Ex.C2 to C4 copies of insurance policy documents, Ex.C5 copy of OPD card and closed the evidence.
11. The ld. counsel for OP No.1 has tendered Ex.OPB affidavit of Dalbir Singh, Officer of Indian Overseas bank,alongwith document,Ex.OP2 copy of authorization letter, Ex.OP3 copy of letter to the complainant by the bank and closed evidence.
12. The ld. counsel for OP No.2 has tendered in evidence Ex.OPA affidavit of Piyush Shanker, AGM, alongwith Ex.OP1 copy of policy with terms and conditions including booklet and closed the evidence.
13. We have heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
14. The ld. counsel for the complainant has argued that the complainant has purchased health insurance policy from OP No.1 with sum assured of Rs.50,000/-. The ld. counsel further argued that alongwith the complainant his wife and parents were also covered and premium was Rs.1760/-.The ld. counsel further argued that policy was to be renewed automatically by the insurance bank as the amount was debited from the account of the complainant. The ld. counsel further argued that suddenly in the month of March,2017,   the complainant’s father fell ill and his eye sight became weak. The complainant immediately got examined his father’s eyes. The ld. counsel further argued that the complainant approached OP No.1 to claim the amount of operation of his father’s eyes but he came to know that OP No.1 did not deduct the amount of insurance premium in the month of December,2016 as a result of which the policy elapsed. The ld. counsel further argued that the OPs be directed to pay the insured amount of Rs.50,000/-alongwith interest.
15. On the other hand, the ld. counsel for OP No.1 has argued that the payment of premium to Universal Sompo was not auto debit facility. The ld. counsel further argued that on 19.12.2016, the complainant himself has written to the bank that he did not want to continue with the policy and no amount as premium be deducted. The ld. counsel further argued that as the complainant himself has written for non deduction of amount, so he is not entitled to any amount.
16. The ld. counsel for OP No.2 has argued that policy was not renewed after 17.12.2016 as such complainant is not entitled to any amount.
17. To prove his case, the complainant has tendered his affidavit,Ex.CA and has deposed as per his complaint.Ex.C1 is the account statement of IDBI Bank. Ex.C2 is the copy of insurance policy, Ex.C3 is the letter of insurance company to the complainant, Ex.C4 is the copy of policy schedule,Ex.C5 is the copy of OPD card of the hospital.
18. On the other hand, Piyush Shanker has tendered his affidavit, Ex.OPA and as per his statement, the complainant himself has discontinued the policy. Ex.OP1 is the policy of OP No.2. Ex.OP3 is the copy of letter for discontinuation of policy written by the complainant to OP No.1 and is duly signed by him.The original letter is also on the file. It was written to the Manager, Indian Overseas Bank, Rajpura ,or discontinuation of policy. In this letter, it is stated that the complainant has purchased policy and amount of Rs.1760/-was deducted till 17.12.2016. Further it is stated that the complainant does not want to continue with the insurance policy  and he is closing the policy.
19. No rebuttal to this document has been proved by the complainant to disprove that he never discontinued the premium after 17.12.2016.Moreover, there is no document on the  file which could show that the premium amount of policy was to be automatically debited from the account of the complainant. So it is clear that as the complainant himself wrote letter to the bank with regard to discontinuation of policy after 19.12.2016, and he got treated his father in March, 2017, so he is not entitled to any amount.
20. So due to our above discussion, complaint is dismissed. Parties to bear their own costs.

The complaint could not be decided within the prescribed period due to heavy pendency of cases.     

ANNOUNCED

DATED:29.10.2020     

                                       Vinod Kumar Gulati             Jasjit Singh Bhinder

                                                Member                                     President