By Smt. Rajani.P.S, Member:
The complainant’s case is as follows: The complainant had taken a Hospital Care Policy No.05216204 for 20 years from the respondent on 31.3.07. He had given authorization to debit the premium amount of Rs.519/- from his mother’s account No.0720101027749 of Canara Bank, Thrissur through ECS facility. Accordingly the premium amount was debited in each month. But on 29.8.09, he received a message in his mobile that the above said policy has been lapsed. On 31.8.09 he met the 1st respondent and appraised his grievance. Subsequently he given a notice to the respondent Company and requested to give a proper reply within 7 days otherwise will take legal actions. As he didn’t get any reply he met the 1st respondent again on 10.9.09. But she stated that the reply has already been sent to him on 8.9.09. After one week as he didn’t receive any letter he again met the 1st respondent. Immediately the office given him a copy of the letter duly affixing the seal and it was stated therein that in June 2009 there was an amount of Rs.3000/- in his policy so that the premium amount was not debited. Further stated that on 26.8.09 the amount of Rs.3000/- was refunded to him and hence the policy got lapsed and any transaction was not possible. He was directed to remit Rs.1555/- towards the premium and Rs.28/- against reinstatement fee immediately. But there was no clear reply to his notice dtd. 31.8.09 but only directed to follow the steps for reinstatement of policy. Again he sent a notice to the 4th respondent and to that reply also no proper reason was stated for the policy lapsed in otherwords directed to remit Rs.2068/- as premium and reinstatement charge along with medical check-up report on my own expenses. He again sent notice on 20.10.09 but no reply so far. The above said acts of the respondents show willful cheatings. The company has pre-determined in making any policy lapsed with malafide intentions. The company has created the same situation and lapsed his policy on previous occasion on 1.8.07 without debiting the premium amount from his authorized account. However when he requested to revive the policy or otherwise will take legal actions, then the 1st respondent revived the policy and given assurance that the same will not be repeated in future. Hence it seems that the company is habituated to make such situations without properly debiting the premium from the authorized account and making lapsing of the policy by throwing the fault and burden over the customer. Whenever the ECS facility is there and sufficient amount also in his account, non-use of the facility by the respondent company and lapsing the policy is nothing but denial of natural justice. He suffered mental agony and financial constraints due to the irresponsible acts of the respondents and which is to be punished. Hence the complaint.
2. The respondents remained exparte.
3. To prove the case of the complainant he filed affidavit and produced Exts. P1 to P3 documents.
4. According to the complainant, he had taken a Hospital Care Policy from the respondent on 31.3.07 for 20 years. He had given authorization for company to debit the premium amount of Rs.519/- from his mother’s account No.0720101027749 of Canara Bank, Thrissur through ECS facility. Accordingly the amount was debited in each month. But on 29.8.09 he received a message in his mobile phone that his policy has been lapsed. The reason for the same was not mentioned. After that he repeatedly contacted the respondents directly and through letters requesting the reason for the lapsing of the policy. The respondent never gave a proper reply to his request but directed to follow the steps for reinstatement of policy. The respondent directed him to remit Rs.2068/- as premium and reinstatement charge along with medical check up on his own expenses. The respondent company has created similar situation on 1.8.07 and when responded, the respondent had given assurance that the same will not be repeated in future. Whenever there is an ECS facility and also sufficient amount in the account, the non-usage of the facility and lapsing policy shows deficiency in service.
5. There is no evidence to the contrary.
6. In the result the complaint is partly allowed and the respondents are directed to revive the lapsed policy without debiting any amount during the lapsed period and to waive the penalty amount and not to insist for medical examination. The respondent is also directed to pay Rs.1000/- (Rupees one thousand only) as compensation and Rs.300/- (Rupees three hundred only) as costs. Comply the order within two months from the date of receipt of copy of order. If not the compensation amount will carry 12% interest from the date of this order.
Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the open Forum this the 4th day of November 2011.
