Delhi

North West

CC/823/2015

ANOOP GUPTA - Complainant(s)

Versus

NATIONAL INSURANCE CO.LTD. - Opp.Party(s)

15 Feb 2018

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, NORTH-WEST

GOVT. OF NCT OF DELHI

CSC-BLOCK-C, POCKET-C, SHALIMAR BAGH, DELHI-110088.

 

CC No: 823/2015

 

D.No._____________________                               Dated: _________________

 

IN THE MATTER OF:

 

ANOOP GUPTA S/o SH. G.S. GUPTA,

R/o B-1/21, RAJASTHALI APPARTMENT,

PITAM PURA, DELHI-110034.          … COMPLAINANT

 

 

Versus

 

1. NATIONAL INSURANCE CO. LTD.,

    (THROUGH ITS BRANCH MANAGER),

    NEW SUBZI MANDI AZADPUR BRANCH,

    17-18, INDRAPRASTHA BHAWAN, 2^ND FLOOR,

    AZADPUR, DELHI-110033.

 

2. BANK OF INDIA,

    (THROUGH ITS BRANCH MANAGER),

    PITAM PURA BRANCH, 52,

    HARSH VIHAR, ROAD No. 44,

    PITAM PURA, DELHI-110034.                         … OPPOSITE PARTY(IES)

 

 

 

CORAM :SH. M.K. GUPTA, PRESIDENT

                SH. BARIQ AHMED, MEMBER

      MS. USHA KHANNA, MEMBER                                        

                                                            Date of Institution: 03.08.2015

Date of decision: 15.02.2018

 

SH. M.K. GUPTA, PRESIDENT

ORDER

1.       The complainant has filed the present complaint against the OP under the Consumer Protection Act, 1986 thereby alleging that

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          there is a joint venture between both the OPs for insurance ofMediclaim Policies and the scheme is known as BOI National Swasthya Bima Yojna and the complainant’s Mediclaim policy has been issued under this scheme and the complainant is insured with OP-1 for the last 14 years continuously and the last policy bearing no. 360801/48/14/8500001080 for Rs.5,00,000/- was expiring on 19.06.2015 and its annual renewal premium of Rs.7,182/- was remitted online on 03.06.2015 by OP-2 for credit of OP-1 company’s account no. 92060100003568. The complainant further alleged thatwhen the complainant did not receive the renewed policy in normal course and the complainant wrote to    OP-2 on 26.06.2015 seeking details of transaction and the OP-2 noted its reply on the letter itself but did not provide the UTR number and the complainant then wrote to OP-1 on 29.06.2015 attaching a copy of letter dated 26.06.2015 requesting to issue the policy but no response. The complainant sent an e-mail on 30.06.2015 to Grievances Cell, H.O. through in built system, seeking remedy which was registered under serial no. 150119678 but in vain. The complainant further alleged that the complainant again wrote a letter dated 08.07.2015 enclosing therewith a) copy of bank’s transaction slip showing details of remittance of Rs.7,182/- and b) copy of the bank’s pass book showing the related debit entry

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          dated 03.06.2015 and requested again for issuance of policy but no response and the complainant further sent an e-mail on08.07.2015 to Sh. N.K. Bhardwaj, Regional Manager, D.O.-II, New Delhi requesting to OP to use his good offices but no reply. The complainant further alleged that the complainant finally sent an   e-mail to OPs on 22.07.2015 requesting to issue the policy immediately but the OP failed to issue the renewed policy even after the payment of premium for over 50 days and as such there is unfair trade practice and deficiency in service on the part of OPs.  

2.       On these allegations the complainant has filed the complaintpraying for direction to the OPs to the effect that old policy stands renewed from 20.06.2015, OP-1 to issue the new policy immediately and till such time to re-imburse medical expenses to the complainant alongwith interest @ 18% p.a. as well as OP-1 be held for deficiency in service with a fine of Rs.50,000/- and has also sought compensation of Rs.10,000/- for causing harassment etc. and Rs.1,000/- towards litigation cost. The complainant has also sought to OP-2 be held for deficiency in service in not providing UTR number of the remittance.

3.       OP-1 has been contesting the complaint and has filed written statement. In the written statement, the OP-1 submitted that there is no deficiency in service and no cause of action in favour of the

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          complainant and is liable to be dismissed. OP-1 further submitted that the policy was duly provided to the complainant and still policy is again supplied alongwith the reply. Whereas OP-2 did not chooseto contest the case as no relief has been sought against OP-2.

4.       The complainant filed rejoinder and denied the submissions of the OP-1 and furthersubmitted that the OP-1 has taken a misleading plea.

5.       It is not out of place to mention here that during the proceedings i.e. on 03.05.2016, Counsel for OP-1 supplied again the policy to the complainant and the complainant has been contesting the case only on the ground of deficiency in service for delay in providing the policy.

6.       In order to prove his case the complainant filed his affidavit in evidence and has also filed written arguments. The complainant also placed on record copies of letters dated 26.06.2015&29.06.2015 written by the complainant to the OP-2 and also filed copy of letter dated 08.07.2015 written by the complainant to OP-1 for renewal of Mediclaim policy, copy of NICL/Bank details& copy of bank statement of account to the effect that an amount of Rs.7,182/- towards the premium of the policy has been debited in the account of the complainant on 03.06.2015and credited in the

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          account of OP-1 and copies of e-mail communication dated08.07.2015 & 22.07.2015 sent by the complainant to OP-1 for renewal of Mediclaim policy.

7.       On the other hand, Sh. S. Rai, A.O. of OP-1 filed his affidavit in evidence which is as per line of defence taken by OP-1 in the written statement.

8.       This forum has considered the case of the complainant as well as OP in the light of evidence and documents placed on record by the complainant. The documents and evidence of the parties shows that OP-1 has not provided the policy to the complainant immediately after receiving the premium from the bank i.e. OP-2. Though in its written statement OP-1 has taken a defence to the effect that the policy was duly provided to the complainant, but has failed to prove any document to show as to on which date the policy was provided to the complainant.However, in the written arguments the complainant submitted that when he did not receive the policy he visited Policy Issuing Branch of OP-1 on 29.06.2015 and 08.07.2015 and submitted the documents in support of payment and OP-1 issued the renewed policy only on 31.07.2015 which was received on 03.08.2015 and the complainant was without any insurance cover for a period of two months despite

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          having paid the premium well in time. It shows that there is no genuineness in the defence of OP-1and it further shows that OP-1has supplied the policy after a delay. It is immaterial that the complainant has not filed any Mediclaim during the intervening period.OP-1 after receiving the premium towards the Mediclaim policy was legally obliged to immediately supply copy of policy to the complainant. As such it can be said that there is a deficiency in service on the part of OP-1. Thus, we are of opinion that the complainant has proved his case of deficiency in service on the part of OP-1.Accordingly, OP-1 is held guilty of deficiency in service.

9.       Accordingly, OP-1 is directed as under:

i)        To pay to the complainant an amount of Rs.2,500/- as compensation towards mental agony and  harassment caused to the complainant which includes cost of litigation.

10.     The above amount shall be paid by OP-1 to the complainant within 30 days from the date of receiving copy of this order failing which OP-1 shall be liable to pay interest on the entire awarded amount @ 10% perannum from the date of receiving copy of this order till the date of payment. If OP-1 fails to comply the order within 30 days from the date of receiving copy of this order, thecomplainant may approach this Forum u/s 25 of the Consumer Protection Act, 1986.

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11.   Let a copy of this order be sent to each party free of cost as per regulation 21 of the Consumer Protection Regulations, 2005. Thereafter file be consigned to record room.

Announced on this 15^th day of February, 2018.

 

 

BARIQ AHMED                         USHA KHANNA                         M.K. GUPTA

   (MEMBER)                               (MEMBER)                          (PRESIDENT)