Haryana

Karnal

CC/222/2017

Om Parkash - Complainant(s)

Versus

PNB Met Life Insurance Company Limited. - Opp.Party(s)

Naveen Khertpal

18 May 2018

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                     Complaint No. 222 of 2017

                                                    Date of instt. 14.07.2017

                                                     Date of decision 18.05.2018

 

Om Parkash son of Shri Dhanoo Ram, resident of House no.34, New Moti Nagar, Karnal.

                                                                                 ……..Complainant.

                                        Versus

1. PNB Metlife Insurance Company Limited, 2^nd floor, SCO 223, sector-12, Karnal, Haryana-132001, office phone 0-0184-4033751 email.

2. PNB Metlife Insurance Company Limited, Registered Office: Brigade Seshmahal, 5 Vani Vilas Road, Basavangudi, Banglore-560004, Karnatka.

 

 

     ..…Opposite Parties.

 

 Complaint u/s 12  of the Consumer Protection Act 1986.

 

Before     Sh. Jagmal Singh……….President.

                   Sh.Anil Sharma…….Member.

 

Present:  Shri Naveen Khatterpal Advocate for complainant.

                 Shri Naveen Sharma Advocate for OPs.

            

ORDER:

 

                (JAGMAL SINGH, PRESIDENT)

 

                This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986, on the averments that complainant had taken a loan from Punjab National Bank Karnal for the construction of his house. The said bank had got insured the complainant from the OPs in the year 2014, vide policy no.21445765 with a premium of Rs.3421/- per year for the term of 5 years. The first premium of Rs.3421/- was deducted from his account no.6704000100014030 on 4.11.2014. The second installment of premium of Rs.3421/- was deducted on 7.11.2015 and the third installment of premium was deducted on 3.11.2016. When the complainant got completed his passbook, the complainant came to know that on 9.3.2017 the OPs have deposited Rs.3425/- in his account without any information. When the complainant contacted the OPs, it was told that only one installment has been deposited by the complainant and the amount of installment has been increased to Rs.3500/-. The OPs sought an application from the complainant which was given by the complainant on 5.4.2017. On 17.4.2017 complainant went to the office of OPs and enquired about his case then OPs asked the complainant to deposit Rs.3502/- again and accordingly the complainant deposited the same on 17.4.2017. The OPs again on 5.5.2017 deposited Rs.3421/- in the account of the complainant and the complainant again contacted the OPs who again asked for deposit of Rs.3500/- and the complainant deposited the said amount again on the same day i.e 5.5.2017 with an undertaking form. Thereafter, the OPs asked the complainant for getting himself medical examination. On 6.6.2017 the complainant received a letter dated 29.05.2017 from the OPs vide which the renewal of the policy was refused. On 9.6.2017 the complainant made a complaint to Grievance Redressal Officer of the OPs but on 19.06.2017 OPs informed the complainant that his policy has been lapsed. The OPs have wrongly refused to renew the policy of the complainant when the complainant was paying installment regularly and hence the complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed written statement raising preliminary objections with regard to maintainability and cause of action. On merits, it is submtited that on the basis of the application provided by the complainant in the Application Form no.671431294, certificate of insurance bearing no.21445765 was issued in favour of Punjab National Bank, stipulating for an annual premium of Rs.3420/- payable for a period of 5 years against sum assured of Rs.4,00,000/- (decreasing cover option). It is further submitted that considering the medical history the complainant, the policy was not reinstated and the premium amount of Rs.7002/- was refunded to the complainant through cheque bearing no.747220 on 24.07.2017.  OP has acted in accordance with the terms and conditions of the policy contract. Hence there was no deficiency in service on the part of the OPs and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.C1 and documents Ex.C2 to Ex.C9 and closed the evidence on 20.11.2017.

4.             On the other hand, OPs tendered into evidence affidavit of Rajeev Sharma Ex.OP1/A and document Ex.OP1 and closed the evidence on 7.3.2018.

5.             We have heard the learned counsel for both the parties and perused the case file carefully and have also gone through the evidence led by the parties

6.             It is the case of the complainant that he had taken a loan from PNB Karnal for the construction of his house and the said bank had got insured the complainant from the OPs in the year 2014, vide policy no.21445765 with a premium of Rs.3421/- per year for the term of 5 years. The first premium of Rs.3421/- was deducted from the account of complainant bearing no.6704000100014030 on 4.11.2014. The second installment of Rs.3421/- was deducted on 7.11.2015 and the 3^rd installment was deducted on 3.11.2016. It is further alleged that when the complainant got completed his passbook, the complainant came to know that on 9.3.2017 the OPs have deposited Rs.3425/- in his account without any information. When the complainant contacted the OPs, it was told that only one installment has been deposited by the complainant and the amount of installment has been increased to Rs.3500/-. The OPs sought an application from the complainant which was given on 5.4.2017. It is further alleged that on 17.4.2017 the OPs asked the complainant to deposit Rs.3502/- again and accordingly he deposited the same on the same day. On 5.5.2017 the OPs again deposited Rs.3421/- in the account of the complainant and the complainant again contacted the OPs who again asked for deposit of Rs.3500/- and the complainant deposited the said amount again on 5.5.2017 with an undertaking form. It is further alleged that the OPs asked the complainant for getting himself medical examination. It is further alleged that on 6.6.2017 the complainant received a letter dated 29.05.2017 from the OPs vide which the renewal of the policy was refused. On 9.6.2017 the complainant made a complaint to Grievance Redressal Officer of the OPs but on 19.06.2017 OPs informed the complainant that his policy has been lapsed. It is further alleged that the OPs have wrongly refused to renew the policy of the complainant when the complainant was paying installment regularly.

7.             On the other hand, it is contended by the OPs that on the basis of information provided by the complainant in application form bearing no.6704000100014030 the insurance policy in question was issued in favour of PNB and the premium amount of Rs.3420/- payable for a period of 5 years against the sum assured of Rs.4,00,000/-.  It is further contended that considering the medical history the complainant, the policy was not reinstated and the premium amount of Rs.7002/- was refunded to the complainant through cheque bearing no.747220. The OPs have acted in accordance with the terms and conditions of the policy contract. There was no deficiency or negligence or unfair trade practice on the part of the OPs.

8.             To prove his case the complainant produced the documents Ex.C2 to Ex.C9 besides his affidavit Ex.C1. The complainant produced copy of an application Ex.C3 written by him to the OPs that the premium has been deducted regularly from his account and on 9.3.2017 the OPs have deposited an amount of Rs.3425/- in his account.  When this fact came to the knowledge of the complainant, the complainant enquired the matter from the OPs and asked the OPs that information be given to the complainant that why the said amount was deposited in his account. The complainant asserted that the stand of the OPs regarding the lapse of the policy in question is contradictory. In this regard the complainant has placed on the file a letter dated 29.5.2017 Ex.C4 written by the OPs to the complainant wherein it is mentioned that after careful evaluation of all the information, statements and declaration furnished in the Declaration of Good Health form and in your medical reports, the OPs regret to inform that they were unable to consider the request for reinstatement of the policy in view of personal medical history of PTCA and elevated blood sugar levels.  The complainant has also produced another letter dated 19.06.2017 Ex.C5 written by the OPs to the complainant wherein the complainant was informed that the status of the policy is lapsed due to non-receipt of premium since 8.12.2015. From these documents i.e. Ex.C4 and Ex.C5 it is clear that the stand of the OPs regarding the discontinuation of the policy in question of the complainant is contradictory. On one hand the OPs stated that they are unable to consider the request for each statement in view of medical history of the PTCA, whereas on the other hand the OPs stated the policy was lapsed due to non-receipt of premium since 8.12.2015. It is pertinent to mention here that the OPs have refunded the premium amount in the account of complainant on 9.3.2017 and thereafter got deposited from the complainant Rs.3502/- on 17.4.2017 and Rs.3500/- on 5.5.2017. The complainant has also produced two receipts Ex.C8 and Ex.C7 dated 17.4.2017 and 5.5.2017 vide which the OPs  have received Rs.3502/- and Rs.3500/- respectively. The complainant has also produced the photostat copy of statement of account Ex.C9 which shows that Rs.3421/- each time were deducted on 4.11.2014, 7.11.2015 and 3.11.2016 from the account of the complainant. From the documents Ex.C4, Ex.C5, Ex.C7, Ex.C8 and Ex.C9 it is clear that the stand of the OPs is contradictory. As already stated above in letter Ex.C4 the OPs alleged that they were unable to reinstatement of the policy in view of personal history of the PTCA whereas in Ex.C5 they stated that the policy lapse due to non-receipt of the payment since 8.12.2015. The OPs has produced in their evidence only affidavit and certificate of insurance. From the pleadings it is admitted case of the parties that the policy was issued in November, 2014. The OPs have got medical examination of the complainant after the issuance of the policy. The OPs have not placed on record any copy of the medical history of the complainant as alleged by them in Ex.C4. The contention of the OPs has no force that no premium was received since 8.12.2015 because from the copy of passbook Ex.C9 of the complainant it is clear that the amount of premium has been deducted from the account of complainant for payment to the OPs. Moreover, the OPs have not placed any account statement of the complainant. In these facts and circumstances of the case, we are of the considered view that the OPs are liable to continue the policy of the complainant for the period for which the same was issued and the complainant is bound to deposit the remaining installments of premium as well as for payment of amount which was return by the OPs. Hence the OPs are deficient.

9.             Thus, as a sequel to above discussion, we allow the present complaint and direct the OPs to continue the policy of the complainant for the period for which the same was issued and the complainant is bound to deposit the remaining installment of premium as well as for payment of amount which was return by the OPs to the complainant. We further direct the OPs to pay Rs.5500/- to the complainant on account of mental agony, harassment and litigation expenses. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:18.05.2018

                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

                      (Anil Sharma)

                          Member