IN THE DISTRICT CONSUMERS’ DISPUTES REDRESSAL FORUM AT MYSORE<br /> <br /> PRESENT: 1. Shri.A.T.Munnoli<br /> B.A., L.L.B (Spl.) - President <br /> <br /> 2. Smt.Y.V.Uma Shenoi<br /> M.Sc., B.Ed., - Member<br /> 3. Shri. Shivakumar.J.<br /> B.A., L.L.B., - Member<br /> <br /> CC 97-2010 DATED 04.06.2010<br /> ORDER<br /> <br /> Complainant Naveen, S/o V.B.Ramachandra, R/at D.No.786, Revenue Land, Hebbal 1st Stage, Mysore-570016.<br /> (By Sri. KAB, Advocate)<br /> Vs. <br /> Opposite Parties 1. Manager, Reliance General Insurance Anil Dhirubhai Ambani Group, Policy Servicing Branch Office at Mysore Trade Centre, L36/D, Opp. To KSRTC Busstand, Bangalore-Nilgiri Road, <br /> Mysore-570001.<br /> 2. Manager, Reliance General Insurance Anil Dhirubhai Ambani Group, Policy Issuing Office at No.570, Naigaon Cross Road, Next to Royal Industrial Estate, <br /> Wadala (W), Mumbai-400031.<br /> (O.P.1 – Exparte and By Sri. K.L.S., Advocate)<br /> Nature of complaint : Deficiency in service<br /> Date of filing of complaint : 24.03.2010<br /> Date of appearance of O.P. : 22.04.2010<br /> Date of order : 04.06.2010<br /> Duration of Proceeding : 1 MONTH 12 DAYS<br /> <br /> <br /> PRESIDENT <br /> <br /> <br /> <br /> MEMBER<br /> <br /> <br /> MEMBER<br /> <br /> <br /> Sri. A.T.Munnoli,<br /> President<br /> <br /> 1. Alleging deficiency in service on the part of the opposite parties insurance company that, policy has not been renewed, though a cheque was given towards the premium for renewal, which the opposite parties lost the same, the complainant has sought to refund the premiums paid, grant compensation of Rs.1,00,000/, medical expenses of Rs.30,000/- and Rs.10,000/- cost of the proceedings.<br /> <br /> 2. The first opposite party has remained absent, is placed exparte in spite of due service of the notice.<br /> <br /> 3. The second opposite party in the version denied deficiency in service alleged, contending that, there is no cause of action. It is stated, there is no question of payment of insured amount and only medical expenditure incurred by the insured, could be reimbursed. Other allegations are denied.<br /> <br /> 4. The complainant has filed his affidavit and produced certain documents. On the other hand, Deputy Manager of the second opposite party has filed his affidavit and produced certain documents. We have heard the arguments and perused the records.<br /> <br /> 5. Now, we have to consider, whether the complainant has proved deficiency in service on the part of the opposite parties and that he is entitled to any reliefs sought?<br /> <br /> 6. Our finding on the point is partly in affirmative, for the following reasons.<br /> <br /> <br /> <br /> REASONS<br /> <br /> 7. The first prayer made by the complainant is to direct the opposite parties to refund the premiums, he had paid amounting to Rs.2,737/-. Admittedly, the complainant had taken mediclaim policies, which were renewed from time to time on payment of the premiums. In view of the nature of the policy/policies, the insured is not entitled for policy amount after maturity, but entitled to the amount spent towards medical expenses during particular year. Hence, in view of the nature of the policies, the complainant is entitled for refund of the premiums, he has paid.<br /> <br /> 8. Another relief claimed by the complainant is Rs.30,000/- towards medical expenses supposed to be incurred. There is no agreement or contract between the parties entitling the complainant, the medical expenses proposed to be incurred. Hence, this prayer cannot be granted.<br /> <br /> 9. Then, a sum of Rs.1,00,000/- is claimed as compensation for deficiency in service, mental agony, financial loss and also, unfair trade practice. The fact that, the complainant had taken mediclaim policy and it was renewed for few years from time to time, is not in dispute. The complainant alleges that, the earlier policy expired on 30.11.2009. Towards renewal of the said policy, he had issued a cheque for Rs.813/- on 27.11.2009. A receipt was also issued on repeated insistence made by the complainant on 30.11.2009. As noted above, first opposite party despite due service of the notice, remained absent, placed exparte. The said allegation made is not denied or disputed. Hence, from the material on record, it is established that towards renewal of the policy, the complainant had given the cheque and that has been lost. If the opposite parties were not willing to renew the policy for any reasons, it was different aspect. There is nothing on record that, in time, loss of the cheque was intimated to the complainant. It is stated by the complainant that, he was ready to issue fresh cheque for renewal of the policy. Under the circumstances, if loss of cheque was brought to the notice of the complainant in time, he could have issued fresh cheque. On account of non-renewal of the policy, the complainant is not entitled for reimbursement of mediclaim. Under the circumstances, there is deficiency in service and it is just to award some compensation to the complainant towards mental agony and inconvenience caused. Accordingly, our finding is partly in affirmative and we pass the following order. <br /> ORDER<br /> <br /> 1. The Complaint is partly allowed.<br /> 2. The opposite parties jointly and severally are directed to pay a sum of Rs.2,500/- as compensation towards mental agony and inconvenience caused, within a month from the date of this order, failing which the amount shall carry interest at the rate of 10% p.a.<br /> 3. Further, opposite parties to pay a sum of Rs.500/- to the complainant towards cost of the proceedings.<br /> 4. Give a copy of this order to each party according to Rules.<br /> (Dictated to the Stenographer, transcribed by her, transcript revised by us and then pronounced in the open Forum on this the day 4th June 2010)<br /> <br /> <br /> <br /> (A.T.Munnoli) <br /> President <br /> <br /> <br /> (Y.V.Uma Shenoi)<br /> Member<br /> <br /> <br /> (Shivakumar.J.)<br /> Member<br /> <br />