Per Smt. Gauri M. Kapse, Hon’ble Member

1. This is an action under Section 35(1)(a) of Consumer Protection Act 2019, the briefly stated case is as follows:
2. The present complaint is filed against the Respondent No. 1 i.e insurance company and through its directors (i.e. Respondent Nos. 2 to 12) who are responsible for and who looks after the day-to-day affairs of the Company.
3. The Respondent Nos. 2 to 12 are jointly and severally liable along with the Respondent No. 1 for the deficiency of service and unfair trade practices done against the Complainant.
4. The Respondent had advertised their policies on website by the name of Policybazaar.com. The Complainant reviewed all the policy offerings of the Respondent and decided to take a policy offered by the Respondent
5. In the year 2019 and 2020, she purchased Pro- Health-Protect Policy bearing No.PROHLN000242425, for the period 24/06/2019 to 23/06/2020 and 24/06/2020 to 23/06/2021 by paying a premium amount of Rs. 10,702.57/- and 11,833.46/- respectively.
6. Thereafter she renewed said policy for the year 2021 by making a payment of amount of Rs.12,961.09/- on 16/06/2021 through Google Pay application for the period 24/06/2021 to 23/06/2022 for the sum insured of Rs.4,50,000/-.
7. The Complainant states that, in the 1^st year (i.e. 2019-2020) and 2^nd year (i.e. 2020-2021) of purchasing the policy, the Respondent had sent the link to make the payment of the premium of the policy, and thereafter the they issued the policy to the Complainant within 3 working days. She had made the above payments within due date for making the payment, to avoid lapse of policy.
8. In the third year (i.e. 2021-2022) of renewal of the said policy, the Respondent sent the link to the Complainant for making the payment. She made the payment of Rs.12,961.09/- towards the premium amount on 16/06/2021, through Google Pay application. The Complainant submits that due date for making the payment was 23/06/2021. The Complainant submits that the amount of Rs.12,961.09/- was debited from the bank account of the Complainant. She never received any notification regarding transaction failure while making the said payment through Google Pay application, hence, the payment was successfully done by the Complainant.
9. Thus, she wrote email dt.18/06/2021 to the Respondent, asking them that there is no update on the payment confirmation and policy from the Respondent.
10. The Complainant states that on the same day i.e. 18/06/2021, the Respondent informed the Complainant that her policy is active with them, and she would receive the soft copy of her policy within 3 working days from the date of issuance (18/06/2021 is the date of issuance). The Complainant states that the Complainant received the soft copy of the policy on her email on 21/06/2021 from the Respondent.
11. The Complainant submits that upon renewal of the policy, the Complainant wanted to avail the benefit of health check-up under the policy, hence she contacted the Opposite Party. The Complainant submits that she made telephonic conversation with the customer care of the Opposite Party on 12/8/2021 bearing the Service Request Number: 12488922, 19/10/2021 bearing the Service Request Number: 2021101800782 and 25/10/21 bearing the Service Request Number: 2021102500263 requesting them to provide her with the health check-up under the policy.
12. The representative of the Respondent informed her that the payment towards the policy premium was done through the credit card, and it was rejected. Hence, her policy was terminated.
13. The Complainant submits that she does not possess any credit card from any bank. Thus, she raised service request regarding her policy to address her grievance of termination of the Policy’ but the representatives gave vague replies, for example, some confirmed her policy is active, whereas some denied the active status of her policy, and thereby dillydallying the health check-up of the Complainant, for which she was entitled under the said policy. The Complainant submits that she had been rigorously following up with the representatives of the Opposite Party, but her efforts were futile.
14. On 03/11/2021, she received an email from the Respondent informing the Complainant that her renewals policy premium receipt has been cancelled in the records of the Respondent and hence the policy gets terminated.
15. The Complainant states that when she enquired about why her policy is rejected, the Respondent told her to enquire with her bank, regarding failure of transactions or reversal of payment. Her Bank i.e. Bank of Baroda confirmed that the payment of the said amount was debited from her account and were never reversed back in her bank account.
16. The Complainant then approached the Respondent with the confirmation from the bank of the payment of the premium amount being debited from her account. The Respondent had sent her back dated letter dt. 20/09/2021 asking her to share her bank details for the refund of the premium amount but the letter was received by the Complainant on 20/11/2021.
17. Thus, Complainant sent notice by email on 23/11/2021 to the Respondent, but   never received any response for the same. Thus, the Complainant has been constrained to file the present complaint with following prayers:
    1. To pay compensation of Rs.7,25,200/- being the value of the car as per the invoice bill
    2. To pay the loss incurred due to accumulation of outstanding sues of the financing bank of Rs.5,33,948/- along with interest from 27/08/2015 till date.
    3. To pay compensation of Rs.1,00,000/- towards the harassment and mental agony with Rs.25,000/- towards litigation costs
18. The Complainants has placed reliance on true copies of following documents:
    1. Master data from the official website of the Ministry of Corporate of Affairs, Copies of the policies, copies of payment made to the insurance company and correspondence between the parties.
19. The Respondent has filed written version wherein it has denied all the allegations leveled in the complaint; the following are the main defenses:
    1. It is the obligation cast upon the Complainant that before the due date of renewal of policy, the Complainant is required to pay the premium amount to the Respondent no.1 and the Opposite party no. 1 should be in the receipt of such premium amount on or before the due date of renewal. That as the Complainant has not taken any efforts to pay the premium amount towards renewal of policy, the Respondent no.1 had no choice, but to terminate the insurance policy.
    2. The Complainant has impleaded the Directors of the Respondent no.1 as Respondent no. 2 to 12. That the Respondent no. 1 is a company and hence, a legal person which can sue as well as be sue in its own capacity. That the Respondent no. 2 to 12 are Directors of the Respondent no. 1, who are not even involved in the subject matter. Also, the Complaint is totally silent on the role of Respondent no. 2 to 12 in the said transaction. Furthermore, the said Respondents have not provided any service to the Complainant in their individual capacity and that the Respondent no. 1 is a proper and necessary party to the Consumer complaint. The Complaint suffers from misjoinder of Parties. That as the said Parties are not necessary Parties, the Complaint may be dismissed against the Opposite party no. 2 to 12.
    3. Hence, on all the above reasons, the Complainant is not entitled to receive any insurance claim, therefore it has prayed for dismissal of case with costs.
20. Both the parties filed their affidavit of evidence and written argument. Heard argument of the Respondent. The Complainant has absent while oral argument.
21. Thus, on the contentions of all the parties, following points arise for determination on which we record findings with the reasons given below:

REASONS FOR FINDINGS

Point No.1 &2 :-

22.  On the basis oral and documentary evidence of both parties, we have to consider whether the Respondent has rightly terminated the insurance policy of the Complainant?
23. The Complainant come with the evidence that, she is the policyholder, purchased a Pro-Health-Protect Policy in 2019 and 2020 and renewed it in 2021. The policyholder made timely premium payments, including Rs.12,961.09/- on 16/06/2021, through Google Pay. The Respondent company initially confirmed the policy's active status but later terminated it, citing a rejected credit card payment, which the policyholder deficiency in service with unfair trade practice.
24. The Respondent come with the evidence that the Complainant failed to pay the premium amount before the renewal due date, leading to policy termination. The Respondent contests the involvement of Directors (Respondent No. 2-12) in the complaint, citing -mis joinder of parties.  
25. Considering the oral and documentary evidence of the parties, it is revealed that, there is documentary evidence as to premium paid through google pay. Secondly, the bank statement and inquiry made with bank which clearly shows that the Complainant has made payment towards premium with in time to the Respondent. The Respondent has not filed any single documentary evidence as to non-receipt of premium payment. Thirdly, the letter dt.20/09/2021 of the Respondent speaks about refund of the policy no.PROHLN000242425 and asking bank details of the Complainant foe NEFT.  This very act of the Respondent shows that they are in receipt of the premium policy.
26.  There is settled position that insurers must prove that premium payment was not received to justify policy termination. Secondly, insurance companies must provide policy documents and renewal notices within a reasonable timeframe. Thirdly, according to the IRDA guidelines issued on 31/03/2009 regarding renewal of health insurance policies, the renewal of policy could be refused in following conditions: 

‘A health insurance policy shall be ordinarily renewable except on grounds such as fraud, moral hazard, or misrepresentation and upon renewal being sought by the insured, shall not be rejected on arbitrary grounds. Specifically, renewal shall not be denied on the ground that the insured had made a claim (or claims) in the previous or earlier years’.

27. Thus, after considering entire evidence it's clear that the termination of the policy by the Respondent is illegal and arbitrary. Hence very act of termination found to be bad in law and unsustainable.
28. In view of the entire evidence and keeping in view of the fact that the Complainant had never claimed any amount since inception of the policy coupled with the provision in the insurance policy for renewal of the lapsed policy, where there is no fraud, misrepresentation, non-disclosure of the material fact by the insured person, we are of the considered opinion that the Respondent be directed to revive/ reinstate the Complainant’s policy by collecting outstanding premiums and late fee and other charges if any and it is made it clear, that the Complainant shall not claim of any medical reimbursement expenses if any during the lapsed period of policy.
29. So far as compensation towards mental torture and costs of litigation, time spent in fighting with the Respondent, amount of Rs.3,20,000/- is allowed on both the heads, it would meet the ends of justice. Hence, we have answered the findings on all the points accordingly and proceed to pass following order:

ORDER

1. Consumer Case No.CC/246/2021 is hereby partly allowed.
2. The Respondent is hereby directed to revive / reinstate the Complainant’s health insurance policy for the period 24/06/2021 to 23/06/2022, as the Complainant had paid the premium.
3. It is made it clear, that the Complainant shall not claim of any medical reimbursement during the lapsed period of policy.
4. The Respondent do pay compensation of Rs.3,00,000/- towards mental agony and Rs.20,000/- towards costs of litigation to the Complainant.
5. Rest of the prayer of the Complainant is dismissed.
6. Complaint stands dismissed against the O.P.No.2 to 12.
7. Copies of this order be sent to both the parties free of costs.