CONSUMER DISPUTES REDRESSAL FORUM – X

GOVERNMENT OF N.C.T. OF DELHI

Udyog Sadan, C – 22 & 23, Institutional Area

(Behind Qutub Hotel)x

New Delhi – 110 016

Case No. 560/2010

MR. SUBHODH VATS

S/O LATE SHRI MADAN MOHAN SHARMA

R/O 3305, SECTOR-23

GURGAON, HARYANA

………. COMPLAINANT

Vs.

1. RELIANCE GENERAL INSURANCE

CUSTOMER SERVICE,

570, NAIGAUM CROSS ROAD,

NEXT TO ROYAL INDUSTRIAL ESTATE

WADALA, MUMBAI-4000031

2. THE MANAGER,

RELIANCE GENERAL INSURANCE,

1308-1310, 13^TH FLOOR,

ANSAL TOWER, NEHRU PLACE,

NEW DELHI-110018

3. THE MANAGER,

OPTIMA INSURANCE BROKERS PVT. LTD.

59, 1^ST FLOOR, ARJUN NAGAR, KOTLA MUBARAK PUR,

NEW DELHI-110003

………….RESPONDENTS

Date of Order: 28/08/2018

O R D E R

Ritu Garodia-Member

            The complainant purchased a health policy from OP in December 2008 and paid a premium of Rs. 5,153/-.  At the time of renewal in December 2009, the complainant paid a sum of Rs. 4896/- vide cheque dated 16/12/2009.  OP acknowledged the payment vide receipt dated 16/12/2009.

            The complainant received a letter from OP dated 14/01/2010 in which the policy was not renewed due to short fall in premium to the extent of Rs. 2,834/-. It is submitted that the said letter contained the policy for a motor vehicle instead of health policy.  A legal notice was issued to OP on 18/01/2010.  The complainant prays for refund of premium with interest or renewal of policy.  The complainant has placed on record letter dated 11/11/2009, receipt dated 16/12/2009 and letter by OP dated 14/01/2010.

            OP1 & 2 in its reply has stated that the policy was issued to the complainant in the year 2009 for the period of one year and same has expired before filing of the complaint.   Thus the complainant is not maintainable.  It is further stated that the policy was duly renewed and issued.

            Order dated 4/06/2012 shows that counsel for complainant gives up all the right to pursue his complaint against OP3 as being unnecessary.

            We have considered the pleadings and material on record.  It is admitted by OP1 and OP2 that the complainant has taken a health policy in December 2008 after payment of premium of Rs. 5,153/-. It is also admitted that the complainant had paid a sum of Rs. 4,896/- for renewal and receipt was issued for the same.  It is also admitted by OP that a letter dated 14/01/2010 was sent to the complainant informing him of the short fall in premium to the extent of Rs. 2,834/-.  It is submitted that the renewed policy was sent to the complainant.

            The complainant has denied receiving any policy in his evidence by way of affidavit.  Letter dated 11/11/2009 from OP runs as under:

Dear Mr. SUBODH VATS

We thank you for choosing Reliance General Insurance for your insurance needs.  We wish to remind you that your Healthwise Insurance Policy is due for Renewal.

Your Policy Expiry Date- 16/12/2009 & Renewal Premium- Rs. 4896.00(Incl of Service Tax)

This Renewal Notice is generated considering your claims available with us as on 30/09/2009.  The premium mentioned on this renewal notice is subject to change based on the actual claim status, as on the expiry date of the current policy.  In case of claim reported subsequently. Renewal advantages mentioned in Brochure, would be withdrawn and the renewal premium may subject to loading.

            The letter clearly states that premium of Rs. 4,896/- is due towards renewal of policy. The receipt dated 16/12/2009 shows Rs. 4,896/- has been received by OP. The letter dated 14/01/2010 runs as under:

Document required for Policy Issuance

We take this opportunity to thank you for choosing Reliance General Insurance Health Policy vide proposal no:/ cover note no: 130908002392 dated 18/12/2009 which proposal to cover the below mentioned details.

However we are unable to complete your policy issuance procedure due to the below mentioned requirement specified herein below-

Short Fall of premium of Rs. 2,834/- Due To Claim in your last year policy

            This letter shows that the short fall in premium to the extent of Rs. 2,834/- is due to the claim made in complainant’s last year policy.  OP has not filed any details of the claim.  This letter shows that risk details are motor registration number, engine number, chassis number and vehicle model.

            It is crystal clear that there is some in error on the part of OP insurance company where they have demanded details of vehicle in health policy and states that inadequate sum was paid as premium despite explicitly demanding the renewal premium of Rs. 4,896/- in letter dated 11/11/2009.

            OP1 and OP2 have also stated that the renewed policy was sent to the complainant.  Nonetheless, copy of the renewed policy has not been placed on record nor any details has been mentioned in pleadings filed before this form.  The complainant has time and again reiterated that he has not received any policy. 

            Hence we find OP1 and OP2 guilty of deficiency in service and direct it to refund Rs, 4,896/- with 9% interest from the date of filing till payment.  We also award compensation of Rs. 10,000/- for harassment inclusive of litigation expense.

            Let the order be complied with within one month of the receipt thereof. The complaint stands disposed of accordingly.

Copy of order be sent to the parties, free of cost, and thereafter file be consigned to record room.

    (RITU GARODIA)                              (H.C SURI)                                (A.S YADAV)

          MEMBER                                         MEMBER                                 PRESIDENT