Haryana

Kurukshetra

CC/275/2021

Munish Goel S/o Subhash Goel - Complainant(s)

Versus

Sarva haryana Gramin Bank - Opp.Party(s)

Sanjay Gupta

15 Mar 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL  COMMISSION, KURUKSHETRA.

                                                     Complaint Case No.275 of 2021.

                                                     Date of institution: 16.09.2021                                                                 

                                                      Date of decision: 15.03.2022                                                    

                         

Munish Goel son of Shri Subhash Goel resident of house No.309, Sector 13, Urban Estate, Kurukshetra.

                                                                …Complainant.

                        Versus

1.Sarva Haryana Gramin Bank Branch office Pipli Road, Kurukshetra through its Branch Manager.

2.Care Health Insurance Limited (Formerly known as Religare Health Insurance Company Limited), Unit No.604-607, 6^th Floor, Tower-C, Unitech Cyber Park Sector -39, Gurugram/Gurgaon- 122001 through its Authorized Signatory.

3.Ajay Verma Area Head of Care Health Insurance Limited for Kaithal, Kurukshetra c/o Sarva Haryana Gramin Bank, Branch office Pipli Road, Kuruksehtra.         

                                                           ….Opposite parties.

               

                Complaint u/s 35 of the Consumer Protection Act.

Before:      Smt. Neelam Kashyap, President.

                Sh.  Issam Singh Sagwal, Member.

       

Present:     Sh.Sanjay Gupta Advocate for the complainant.

                Sh.Rajesh Kaushik Advocate for OP No.2.

                OP No.1 and 3 ex parte.

ORDER

                This is a complaint under Section 35 of the Consumer Protection Act, 1986 has been moved by Munish Goel  against Sarva Haryana Gramin Bank   etc.-Opposite Parties.

2.            It is stated in the complaint that the complainant is having his saving bank account with the OP no.1 and the OP No.3 is the employee of OP No.2.  Due to allurement given by the Ops, the complainant purchased the  insurance policy from the Ops and the OP No.3 got signatures of the complainant on some papers and also got photo copies of the documents.  The premium amount of Rs.10,801/- was deducted from the saving account  No. 81990100024451 of the complainant.  The  complainant received the welcome message on 21.6.2021 from the Ops but the complainant found that his name is wrongly mentioned in the welcome message and after pointing out this mistake, the complainant intimated this mistake to OP No.3 who came at the shop of  complainant on 25.6.2021 and got installed the Care app of the company and opened the app of the company on the phone of the complainant and then after going through the app, the complainant found more and more mistakes in the particulars of the complainant.  After going through the app as shown in the app, the complainant made seven complaints on line  for correction of the said mistake.  On receipt of the complaints only two mistakes have been rectified by the company but rest of the mistakes have not been  rectified by the company. On 27.6.2021, the complainant supplied formal application alongwith relevant documents for correction of the said mistake to the OP No.3 and several times approached the Ops but nothing has been done. Due to said deficient services, the complainant opted to  withdraw the policy and applied for the same during the free look period on 7.7.2021 through e-mail  to customer care of the health company for which complaint No.2107073142 was sent  through SMS  on the same day but  till today the original documents have not been received by the complainant. On receipt of the complaint for cancellation of the policy, the Ops treated the  cancelled request  w.e.f. 7.7.2021 and  on 18.7.2021 refunded the sum of Rs.8101/- only and retained the balance amount of Rs.2700/- which amounts to deficiency in services on the part of the Ops. Thus, the complainant has filed the present complaint alleging deficiency in services on the part of the Ops and prayed that the Ops be directed to  refund the amount of Rs.2700/- to the complainant alongwith compensation for the mental harassment caused to him and the litigation expenses.

3.             Notice of the complaint was given to the Ops. OP No.1 failed to appear and contest the case despite due service. Therefore, the OP no.1 was proceeded against ex parte vide order dated 13.12.2021.

4.             Likewise the OP No.3 had also failed to appear and contest the case despite due service, therefore, OP No.3 was also proceeded against ex-parte vide order dated 10.11.2021.

5.             OP No.2 appeared and filed written statement disputing the claim of the complainant. It is submitted that the complainant took the insurance policy for the sum assured Rs.7,00,000/- and paid the premium of Rs.10,801/-.The complainant approached the company with several requests regarding change in particulars and other details.  Changes were made as per the request of the complainant and endorsement certificate dated 5.7.2021, 11.7.2021, 25.7.2021, 27.7.2021, 31.7.2021 and 1.08.2021 were issued. During the endorsement, the complainant approached the company with a request to cancel the policy and invoke the free look period vide mail dated 7.7.2021. The company refunded  the premium of Rs.8101/- ( 75% of the premium) on pro rata basis vide letter dated 19.07.2021 as per clause No.7(11) (i) of the policy. The insured cannot claim anything more than what is covered by the insurance policy… the terms and conditions of the contract have to be construed strictly. Thus, it is submitted that there is no deficiency in services on the part of the Ops and prayed for dismissal of the present complaint.

6.             The complainant in support of his case has filed affidavit
Ex.CW1/A and tendered documents Ex.C-1 to Ex.C-19 and closed his evidence.

 

7.             The OP No.2 in support of its case has filed affidavit Ex.RW1/A and tendered documents Ex.R0-1 to Ex.R-7 and closed its evidence.

8.             We have heard the learned counsel for the parties and have gone through the case file very carefully.

9.             The learned counsel for the complainant while reiterating the averments made in the complaint has argued that  on the allurement given by the Ops, the complainant purchased the  insurance policy from the Ops and the OP No.3 got signatures of the complainant on some papers and also got photo copies of the documents.  The premium amount of Rs.10,801/- was deducted from the saving account  No. 81990100024451 of the complainant.  It is argued that the  complainant received the welcome message on 21.6.2021 from the Ops but the complainant found that his name is wrongly mentioned in the welcome message and after pointing out this mistake, the complainant intimated this mistake to OP No.3 who came at the shop of  complainant on 25.6.2021 and got installed the Care app of the company and opened the app of the company on the phone of the complainant and then after going through the app, the complainant found more and more mistakes in the particulars of the complainant.  After going through the app as shown in the app, the complainant made seven complaints on line  for correction of the said mistake.  On receipt of the complaints only two mistakes have been rectified by the company but rest of the mistakes have not been rectified by the company. On 27.6.2021, the complainant supplied formal application alongwith relevant documents for correction of the said mistake to the OP No.3 and several times approached the Ops but nothing has been done. Due to said deficient services, the complainant opted to withdraw the policy and applied for the same during the free look period on 7.7.2021 through e-mail  to customer care of the health company for which complaint No.2107073142 was sent  through SMS  on the same day. But the Ops treated the  cancelled request  w.e.f. 7.7.2021 and  on 18.7.2021 refunded the sum of Rs.8101/- only and retained the balance amount of Rs.2700/- which amounts to deficiency in services on the part of the Ops. Thus, the complainant has filed the present complaint alleging deficiency in services on the part of the Ops and prayed that the Ops be directed to  refund the amount of Rs.2700/- to the complainant alongwith compensation for the mental harassment caused to him and the litigation expenses.

10.            On the other hand, the learned counsel for the OP No.2 has argued that the complainant took the insurance policy for the sum assured Rs.7,00,000/- and paid the premium of Rs.10,801/-.The complainant approached the company with several requests regarding change in particulars and other details.  Changes were made as per the request of the complainant and endorsement certificate dated 5.7.2021, 11.7.2021, 25.7.2021, 27.7.2021, 31.7.2021 and 1.08.2021 were issued. During the endorsement, the complainant approached the company with a request to cancel the policy and invoke the free look period vide mail dated 7.7.2021. The company refunded  the premium of Rs.8101/- ( 75% of the premium) on pro rata basis vide letter dated 19.07.2021 as per clause No.7(11) (i) of the policy.

11.            In this case on the allurement of the Ops, the complainant purchased the  insurance policy from the Ops and the OP No.3 got signatures of the complainant on some papers and also got photo copies of the documents.  The premium amount of Rs.10,801/- was deducted from the saving account  No. 81990100024451 of the complainant.  The  complainant received the welcome message on 21.6.2021 from the Ops but the complainant found that his name is wrongly mentioned in the welcome message and after pointing out this mistake, the complainant intimated this mistake to OP No.3 who came at the shop of  complainant on 25.6.2021 and got installed the Care app of the company and opened the app of the company on the phone of the complainant and then after going through the app, the complainant found more and more mistakes in the particulars of the complainant.

12.            During course of arguments mark “A” has been  placed on the file. In this documents E-mails from 25.6.2021  have been shown. In the e-mails the Ops have acknowledged the receipt of requests of the complainant.  The Ops have also assured to correct the date of birth and also PNA number.  As per e-mail, the Ops assured to complete the same within three working days, meaning thereby original document/policy has not been received by the complainant till then.   The complainant opted to withdraw the policy and applied for the same during free look period on 7.7.2021.  When the complainant applied for cancellation of the policy within free look period, then there was no justification of deducting the amount of Rs. 2700/- out of Rs.10801/- premium amount. Therefore, clause 7 (ii) (i) is not applicable to the present case.  When the Ops have not  supplied the policy and have not corrected the particulars sent to the complainant through SMS, then in our mind deficiency in services and unfair trade practice has been committed by the Ops and the complainant is entitled to refund of Rs.2700/- alongwith compensation  unfair trade practice on the part of the Ops.  The complaint qua OP no.1 and 3 deserves to be dismissed.

13.            For the reasons recorded above, we accept the present complaint and direct the OP No.2 to refund the sum of Rs.2700/- to the complainant. The OP No.2 shall also pay the sum of Rs.5000/- to the complainant as compensation for the unfair trade practice and deficiency on the part of the OP no.2. The OP No.2 is further directed to make the compliance of this order within a period of thirty days from the date of preparation of certified copies of this order, failing which the complainant shall be  entitled to initiate proceedings u/s 71 of the Consumer Protection Act. The complaint qua OP No.1 and 2 stands dismissed.  Certified copy of this order be supplied to the parties concerned as per the rules and the file be consigned to the record room after due compliance.

 

Announced in the open Commission.

Dated: 15.03.2022.     

                                                                                President.

 

 

                                Member             Member.