Punjab

Ludhiana

CC/16/856

Harsimran Singh - Complainant(s)

Versus

Oriental Bank of Commerce - Opp.Party(s)

Yashbir Chaudhary Adv.

31 Aug 2021

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, LUDHIANA.

                                                Complaint No: 856  dated 28.12.2016                                                      

  Date of decision: 31.08.2021. 

Harsimran Singh son of Sh.Upjinder Singh resident of House No.1333, Machhiwara, Ludhiana, Punjab-141115.

                                                                                      ..…Complainant

                                                Versus

1.Oriental Bank of Commerce, Machhiwara, District Ludhiana-141114.

2.Oriental Insurance Company Limited, Regd. & Head Office A-25/27, Asaf Ali Road, New Delhi-110002.

                                                                                      …..Opposite parties 

Complaint under Section 12 of the Consumer Protection Act.

QUORUM:

SH. K.K. KAREER, PRESIDENT

SH. JASWINDER SINGH, MEMBER

 

COUNSEL FOR THE PARTIES:

For complainant             :         Sh.  Amit Tandon, Advocate.

For OP1                         :         Sh. Bharat Bhushan Sharma, Advocate.

For OP2                         :         Sh. Rajeev Abhi, Advocate

ORDER

PER K.K. KAREER, PRESIDENT

1.                Shorn of unnecessary details, the case of the complainant is that the complainant and his family members were covered under Oriental Bank Mediclaim Policy No.233902/48/2015/1030 for the period from 12.06.2014 to 11.06.2015. The policy was further renewed from 12.06.2015 to 11.06.2016. As the policy was going to expire on 11.06.2016, the complainant had paid the renewal premium on 25.05.2016 through the bank account of father of the complainant namely Upjinder Singh. The father of the complainant was maintaining an account with Oriental Bank of Commerce, Machhiwara Branch and a demand draft was got issued out of the said account. The payment of premium for renewal of the policy was made by the OP1 to OP2 on 25.05.2016 by way of bank draft as the father of the complainant was also having a mediclaim policy No.233902/48/2017/1228.  Surprisingly, the policy in the name of Upjinder Singh was renewed for the period from 12.06.2016 to 11.06.2017 but the policy in the name of the complainant was not renewed without any reason. In the meantime, Angad Singh, son of the complainant fell ill, who was also covered under the policy, was admitted for treatment in Cosmo Hospital, Sector-62, Phase-VIII, Mohali. When the complainant raised the claim for hospitalization and medical treatment charges incurred by him on the treatment of his son Angad Singh, he came to know that the policy has not been renewed. The complainant was kept in dark about non-renewal of the policy by the OPs. On enquiry, the complainant came to know from the bank that the OP2 had returned the draft in the account of Upjinder Singh on 20.07.2016 i.e. after a period of 2 months and that to without any rhyme or reason. This amounts to deficiency of service on the part of the OPs due to which, the complainant has suffered a great loss. The complainant is entitled to recover a sum of Rs.14,830/- spent by him on the treatment of his son Angad Singh. The complainant even served a legal notice dated 07.09.2016 calling upon the OPs to pay him a sum of Rs.14,830/- along with compensation of Rs.1 lac and litigation expenses of Rs.10,000/- but to no avail. Hence this complaint whereby it has been requested that the OPs be made to pay a sum of Rs.1,15,830/- along with interest @18% per annum.

2.                The complaint has been resisted by the OPs. In the written statement filed on behalf of the OP1, it has been pleaded that the complaint is not maintainable and the same is liable to be dismissed. No cause of action has arisen to the complainant to file complaint against the OP1. According to the OP1, Upjinder Singh was having a saving fund account in the bank. He had also obtained Oriental Bank Mediclaim Policy from the OP2 effective from 12.06.2016 to 11.06.2017. The complainant was also having a mediclaim policy from the OP2 also effective from 12.06.2016 to 11.6.2017. On the request of Upjinder Singh, the OP1 issued demand draft for the premium amount of Rs.6960/- for the renewal of the policy and sent the same to the OP2. On the request of Upjinder Singh, the account holder, the OP1 prepared another demand draft of Rs.6960/- for the renewal of the policy of the complainant. Thereafter, the policy of Upjinder Singh was renewed upto 11.06.2017 but the demand draft in respect of the policy of the complainant was returned and the said amount was duly credited in the account of Upjinder Singh on 20.7.2016. The complainant was very much in the knowledge that his policy had not been got renewed w.e.f. 12.06.2016 to 11.06.2017 and, therefore, he is not entitled to any relief under the said policy. The rest of the allegations made in the complaint have been denied as wrong and in the end, a prayer for dismissal of the complaint has also been made.

3.                In separate written statement filed on behalf of the OP2, it has been pleaded that the complainant is not a consumer as he has never hired the services of the OP2. The complainant has never approached for the renewal of his insurance policy nor any premium was received from him or from the OP1 on his behalf for the renewal of the policy and as such the policy was not renewed beyond 11.06.2016. It has further been pleaded that the OP2 never received any amount from the OP1 through NEFT or otherwise for the renewal of the policy. Only a sum of Rs.6960/- was received by the OP2 from the account of Upjinder Singh vide collection No.2137001053 on 27.05.2013 for renewal of the policy and insurance policy in the name of Upjinder Singh was renewed from 12.06.2016 to 11.06.2017, whereas the policy in the name of the complainant was never renewed as the renewal premium was not received. The complainant, is, therefore, estopped from filing the present complaint. As the policy was not renewed, as per Section 64-VB of the Insurance Act, no risk was covered under the policy and therefore, the complainant is not entitled to any relief from the Commission. It has also been denied that the complainant is entitled to claim Rs.14,830/- in respect of the treatment of his son. The rest of the allegations made in the complaint have been denied as wrong and in the end, a prayer for dismissal of the complaint has also been made.

3.                In evidence, the complainant submitted his affidavit as Ex. CA along with documents Ex. C1 to Ex. C8 and closed the evidence.

4.                On the other hand, the OP1 submitted affidavit Ex. OPA of Sh.Devinder Singh Talwar, Senior Branch Manager of OP1 along with document Ex. OP1 and closed the evidence.

5.                Similarly, OP2 submitted affidavit Ex.RA of Sh.Sanjiv Kumar, Branch Manager of OP2 along with documents Ex.R1 to Ex.R5 and closed the evidence.

6.                We have heard the arguments advanced by the counsel for the parties and have also gone through records as well as written arguments submitted by the complainant and OP2.

7.                During the course of arguments, the counsel for the complainant has contended that two demand drafts were given/handed over to the OP1 for the renewal of the policy of the complainant and that of his father, but the OPs did not renew the policy of the complainant whereas the policy in the name of father of the complainant was duly renewed. The counsel for the complainant has further contended that even the demand draft was not returned to the complainant and the amount of demand draft was debited in the account of father of the complainant on 25.05.2016. It has also been pointed out that the amount of the demand draft in respect of the policy of the complainant was credited in the account of the complainant’s father only on 20.07.2016. According to the counsel for the complainant, OP1 is an agent of OP2. The policy was also purchased through OP1. Therefore, the OPs are jointly and severally liable for their acts of negligence which caused loss to the complainant as his policy was not renewed and he could not claim the treatment expenses of his son Angad Singh.

8.                On the other hand, the counsel for the OP1 has argued that unless and until the premium of the policy is paid, the risk is not covered as per section 64-VB of the Insurance Act, 1939. The counsel for OP1 has further contended that since the amount of the premium in respect of the policy was never received by OP1, the police was bound to lapse for non-payment of the premium and in respect of the lapsed policy, no claim could be lodged. Moreover, the complainant has not led any evidence that any claim was lodged with OP1. The counsel for OP1 has further contended that no evidence or document has been placed on record that the insurance company returned the premium amount. The counsel for OP1 has further contended that this Commission could not decide the controversy involved in the present case relating to the liability of the principal for the acts of the agent. In support of his arguments, the counsel for OP1 has relied upon case titled as Somnath Iyer & Sadasivayya Messrs. Premier Life and General Insurance Co. Ltd. AIR 1058 Mysore 53(V 45 C 15) whereby it has been held that while filling up the proposal form, the agent normally ceases to act as agent of the insurer but becomes the agent of the insured and no agent can be assumed to have authority from the insurer to write the answers in the proposal form.

9.                The counsel for OP2 has argued that the amount of the draft was credited back in the account of the father of the complainant on 20.07.2016 whereas the son of the complainant was admitted in the hospital on 22.08.2016. The counsel for OP2 has further contended that between 20.07.2016 and 22.08.2016, no steps were taken by the complainant to get the policy renewed. Therefore, the complainant is not entitled to any relief particularly with regard to the medical expenses of his son as he did not take any steps to renew the policy even after the amount was returned and deposited in the account of the father of the complainant on 20.07.2016.

10.              We have weighed the rival contentions of the counsel for the parties.

11.              The grievance of the complainant in this case is that he got issued demand draft to get his medi-claim policy renewed, which was expiring on 11.06.2016. The demand draft  was got issued and paid on 25.05.2016 In fact, the father of the complainant namely Upjinder Singh had also obtained a similar policy, which was also due for renewal on11.06.2016. In this regard, two demand drafts were got prepared, one in the name of the complainant and other in the name of complainant’s father Upjinder Singh. The demand drafts were got issued from the account of Upjinder Singh. The policy of Upjinder Singh was renewed whereas the policy in the name of the complainant was not renewed without any reason with the result that when the complainant’s son, who was also covered under the policy, fell ill and was admitted for treatment in Cosmo Hospital Sector 62, Phase-VIII, Mohali, his claim was rejected on account of non-renewal of the policy. It has also been claimed by the complainant that the complainant was kept in dark about the non-renewal of his policy and he came to know from OP2 that the amount of premium was deposited in the account of Upjinder Singh on 20.07.2016 after a period of two months and in this regard, no information was given to the complainant. On behalf of OP1, it has been claimed that there is no deficiency of service on its part. According to OP1, it prepared demand draft for Rs.6,960/- for the renewal of the policy and similarly, at the request of Upjinder Singh, the account holder, OP1, prepared another demand draft and sent both the demand drafts for renewal of the policies to OP2. Thereafter, the policy of Upjinder Singh was renewed, but the demand draft of Rs.6,960/- in respect of the policy of the complainant was returned and the said amount was credited in the account of Upjinder Singh.

12.              On the other hand, OP2 has claimed that the complainant never approached OP2 for the renewal of the policy nor any premium was received. It has been claimed in the written statement that only an amount of Rs.6,960/- was received from the account of Upjinder Singh for renewal of his policy and no other amount of Rs.6,960/- in respect of the policy of the complainant was received and therefore, the policy of the complainant was not renewed.

13.              From a perusal of the written statements of OP1 and OP2, it emerges that they have taken contradictory stands. It is the definite stand of OP1 that the demand draft of Rs.6,960/- in respect of the policy in question was also forwarded to OP2, but the same was returned by OP2. At the same time OP2 has totally denied having received any demand draft of Rs.6,960/- in respect of the policy of the complainant. However, the fact remains that two demand drafts were got issued from OP1, which were admittedly sent by OP1 to OP2 for   renewal of the policy for the complainant and his father Upjinder Singh. It is worthwhile to mention here that OP1 is the agent of OP2. It is mentioned in the policy Ex. C1 itself that OP1 OBC Machhiwara is the agent and broker and the policy was obtained through OP1. Since the demand draft in respect of the policy was got issued from OP1, who also happened to be an agent of OP2 and it has been specifically claimed by OP1 that both the demand drafts were sent to OP2, this clearly amounts the deficiency of service on the part of OP1 as well as OP2. If OP1 had sent the demand drafts to OP2, then the policy of the complainant should also have been renewed and despite receipt of the demand draft, the policy was not renewed by OP2. This would be a deficiency of service on the part of OP2. If the demand draft of the complainant was not sent by OP1 to OP1, then it is a deficiency on the part of OP1. Admittedly, the amount of the demand draft was credited back into account of Upjinder Singh only on 20.07.2016 i.e. almost after two months and no information in writing was given to the complainant that the amount was being returned or that his policy had not been renewed and both the OPs kept mum about this. Since there is a relationship of agent and principal between OP1 and OP2, in our considered view, both are liable for deficiency of service and due to their acts and omissions as well as negligence, the complainant suffered as his policy was not renewed with the result that he could not claim the benefit of the policy when his son was hospitalized, even though it happened even after the amount of renewal premium was credited into the account of father of the complainant. In the given circumstances, in our considered view, it would be just and proper if the OPs are directed to pay compensation of Rs.25,000/- and Rs.5,000/- as litigation expenses to the complainant on account of deficient and negligent services rendered by them.

14.              So far as the case law relied upon by the counsel for OP2 is concerned, the same is not applicable to the facts and circumstances of the present case as in the cited case, it  has only been held that when the agent fills the proposal form on behalf of  the insured, he becomes the agent of insured and does not act as the agent of the insurer.

15.              As a result of above discussion, the complaint is partly allowed  with an order that the OPs shall jointly and severally pay a sum of Rs.25,000/- (Rupees Twenty Five Thousand) as compensation along with litigation expenses of Rs.5,000/- (Rupees Five Thousand only) to the complainant within a period of 30 days from the date of the receipt of the copy of this order. Copies of order be supplied to parties free of costs as per rules. File be indexed and consigned to record room. 

16.              Due to rush of work and spread of COVID-19, the case could not be decided within statutory period.

                             (Jaswinder Singh)                            (K.K. Kareer)

                    Member                                           President

 

Announced in Open Commission.

Dated:31.08.2021.

Gobind Ram.