ORDER

Complaint under  Sec.12 of the CPA 1986 as amended upto date



Per  Nipur Chandna, Member

       The case of the complainant is that he had taken a joint
mediclaim insurance policy of Rs. 2,00,000/- each in the name of his
wife and himself in the year 2006 from the opposite party number 1
which was renewed every year without any lapse and the last policy no.
is 211201/48/2014/312 effective from 16/06/2013-15/6/2014.

           It is alleged by the complainant that OP was always sending
reminder letters for the renewal of the policy to him.  It is further
alleged that as the agent of OP1 always collected the renewal cheque
every year from him, he was worry free for paying his renewal premium
to the OP in time.

     It is stated  by the complainant that being  senior citizen of 82
years old, his movement was very restricted and as such he was
dependent  on the agent for   the renewal of his policy.  It is
alleged by the complainant that for the year 2014-2015 neither OP1 had
sent any renewal notice/ letter to him, nor the agent reminded him of
the renewal and as such he was unable to renew his policy on time. But
as soon as he noticed this fact, he contacted the agent and handed
over cheque no. 049191 dated 24/7/2014 drawn on Punjab and Sindh Bank
to the agent for renewing  the policy for the period 2014-2015. It is
further alleged by  the complainant   that after waiting almost for a
month when he could not get the renewed policy, he contacted the agent
and asked for the policy. The agent replied that the renewal cheque
was misplaced by him and now nothing can be done and the policy cannot
be renewed.

   The complainant tried to convince the agent and showed his
willingness to issue another cheque for renewal but the agent refused
to accept the same. The complainant then contacted the Insurance
Company OP1  over phone  and narrated the facts but nothing was done
by the OPPOSITE PARTY NO.1  to redress his  grievance.

     The complainant ,therefore ,approached this forum for the
redressal of his grievances and prayed for the renewal of his policy.

      OP1 has contested the complaint and filed its written statement.
It has denied any deficiency in service on its part and has prayed for
the dismissal of the complaint.

   Both the parties have filed their evidence by way of affidavit.

     We have heard arguments advanced at bar and have perused the record.

     Some of the facts are not in dispute.  The complainant who is a
senior citizen had taken a mediclaim policy firstly in the year 2006.
He has been renewing the policy year  after year without any break.
The last policy renewed was for the period 16-6-2013  to 15-6-2014.
The complainant had himself admitted that he had forgotten to renew
the policy which was due for 16-6-2014 onward.  He had contacted an
agent for the renewal of the policy after a period of one month when
the policy had  already expired and the grace period of 1 month was
also over. No document has been placed before us which shows that it
was obligatory on the part of the insurance company or its agent to
issue a letter of reminder or approach the insured to seek the renewal
of the policy. However, the complainant had placed on record the
letter showing that he had been reminded  by the insurance company
that the policy was likely to expire and was required to be renewed.
However, no such reminder was sent to the complainant in the year
2014-15.

     Since, the policy had not been renewed and there is a break in
the policy, the complainant would loose the benefit earned by him from
the continuous  purchase of the policy since 2006.

   The C.P. act 1986 has been enacted to safeguard the interest/
rights of the consumers.  It is a social legislation intended to
alleviate the problems being faced by the consumers.

        This is a case where a senior  citizen  aged  more than 80 yrs
is being deprived of the benefit which have been accrued to him since
2006 as he has been continuing to renew his mediclaim policy every
year without a single daysbreak, Therefore , even though we may hold
that there is no deficiency on the part of the OP in not sending any
renewal notice and refusing to renew the policy without any break we
think that the objective of the act would be served by allowing the
benefit of continuity only  of the policy to complainant. We,
therefore, direct the OP as under:-

1. On the payment of required premium,  the OP shall renew the policy
w.e.f. 16-6-2014 to 15-6-2015 & 15-6-2015 -14-6-2016 and give benefit
of continuity in the policy to the complainant.

     However, the OP shall not be liable to pay any claim under  the
mediclaim policy  for the period the same  was not in force.

     The complainant may approach the OP within 15 days for the date
of receipt of this order in order to carry out the formalities and
deposit of premium.

    The order shall be complied within 30 days , failing which the
complainant shall be at liability to approach this forum.

Copy of the order be made available to the parties as per rule.

    File be consigned to record room.

     Announced in open sitting of the Forum on.....................