Chandigarh

StateCommission

A/63/2019

Mrs. Meghna Dixit - Complainant(s)

Versus

SBI General Insurance Company Limited - Opp.Party(s)

Lt. Col. K. G. Sharma Adv.

03 Jul 2019

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

 

 

Appeal No.	:	63 of 2019
Date of Institution	:	03.04.2019
Date of Decision	:	03.07.2019

Mrs. Meghna Dixit, aged about 40 years, wife of Sh. Jatin Dixit, R/o House No.Q7/11, D.L.F. Phase-2, Qutab Enclave, Near Sikandarpur Metro Station, Gurugaon (Gurugram), Haryana 122002 through her attorney Lt. Col. Krishan Gopal Sharma (Retd.) s/o late Sh. L. R. Sharma R/o House No.612, Gillco Vallas, Gillco Valley, Kharar, Sector 127, S.A.S. Nagar, Mohali.

…..Appellant/Complainant.

Versus

1]  SBI General Insurance Company Limited, State Bank of India, SCO No.335-336, First Floor,  Sector 35-B, Chandigarh.

2]  SBI General Insurance Company Limited, State Bank of India, Main Branch, SCO No.43-48, Banking Square, Sector 17, Chandigarh.

3]  SBI General Insurance Company Limited, “Natraj” 101, 102 & 103, Junction of Western Express Highway & Andheeri Kurla- Road, Andheri (East) Mumbai 400069.

...Respondents/Opposite Parties.

 

Appeal under Section 15 of the Consumer Protection Act, 1986  against  order  dated  26.12.2018 passed by District   Consumer Disputes Redressal Forum-II, U.T. Chandigarh  in Consumer Complaint No.386 of 2018.

 

BEFORE: MRS. PADMA PANDEY, PRESIDING MEMBER.

                MR. RAJESH K. ARYA, MEMBER.

 

Argued by:

 

Lt. Col. K. G. Sharma (Retd.), Advocate for the appellant.

Sh. H. P. S. Ghuman, Advocate for the respondents.

 

PER  RAJESH  K.  ARYA, MEMBER

                This appeal has been filed by the complainant against order dated 26.12.2018 passed by District Consumer Disputes Redressal Forum-II, U.T., Chandigarh (in short ‘the Forum’) vide which, her complaint bearing No.386 of 2018 was dismissed.

2.             The case of the appellant/complainant is that she took Health Insurance Policy No.0000000006161471 from Main Branch of State Bank of India, Sector 17, Chandigarh (Annexure C-1), which was due for renewal on 28.3.2018. It was stated that no reminder for renewal of the said policy was sent by the respondents/opposite parties nor any of their official was present at the branch to assist the appellant/complainant. It was further stated that later on one insurance official of the respondents/opposite parties visited the complainant and took the cheque for the premium amount and also got the paper signed but subsequently, the said cheque was returned on the pretext that the computer system was not accepting the backdated cheque (Annexure C-3).  It was further stated that the appellant/complainant was also advised to buy a new policy but she did not accept that.  Being aggrieved, the appellant/ complainant sent legal notice to the respondents/opposite parties to renew the policy but to no avail.

3.             The respondents/opposite parties, while contesting the complaint, in their written statement, stated that the liability to get the policy timely renewed was on the part of the insured/ complainant for which 30 days grace period was also provided.  It was further stated that renewal notice dated 3.1.2018 was duly sent to the appellant/complainant and even their official contacted the appellant/complainant for renewal of the policy but the same was refused on the pretext that the complainant was looking for other option with other insurers for portability. It was further stated that after the expiry of the grace period, father of the appellant/ complainant called the official of the respondents/opposite parties for renewal premium but by that time the grace period had already expired. 

4.             The Forum by referring to Clause 16 of the Insurance Policy, dismissed the complaint by observing in Paras 6 & 7 of its order as under:-

“6]       The complainant was apprised and issued a notice dated 3.1.2018 regarding renewal of the policy by SBI General Insurance Company   (Annexure C-3), but despite that she did not paid the renewal premium amount to the Opposite Parties even during the grace period of one month after the expiry of the health insurance policy. The Health Insurance Policy in question, as such, for want of premium amount for renewal of the policy, stands expired by way of efflux of time.

7]       The complainant was at liberty to pay the renewal premium of said insurance policy to the Opposite Parties by way of cash, electronic mode, RTGS or through Online payment etc., but she failed to do so.  The complainant because of laches on her part lost the privilege of continuity of insurance policy due to non-payment of renewal premium amount, as such, the present complaint for issue of direction to the Opposite Parties for renewal of the policy with retrospective dated i.e. 28.3.2018 is untenable.  The facts in issue do not warrant issue of any dictate for renewal of policy from back date.” 

5.             In our opinion, the findings arrived at by the Forum are not based on true appreciation of facts and law. It went on to base its findings on Clause 16 of the Insurance Policy, which, inter-alia, stipulate that the Insurer shall not be bound to give notice that renewal premium is due and further the Insurer may exercise an option not to renew the Policy on the ground of fraud, misrepresentation or suppression of any material fact either at the time of taking the Policy or any time during the currency of the earlier policies. A grace period of 30 days was allowed for renewal of the Policy. The Forum also observed that despite issuance of renewal notice dated 03.01.2018 to the appellant/complainant, the renewal premium amount was not paid even during the grace period of one month after expiry of health insurance policy.

6.             Though denied in the written statement, yet it is a fact as admitted by the Counsel for the respondents/opposite parties during the course of arguments before us that the health insurance policy, in question, was obtained by the appellant/complainant from an official of the respondents/opposite parties sitting in the premises of State Bank of India, Main Branch, Sector 17, Chandigarh. It means that State Bank of India has tie up arrangement under Bancassurance with SBI General Insurance Co. Ltd., which is its own subsidiary company. When the Bank offers its customers visiting its Branch the insurance products of its subsidiaries, it becomes the responsibility/duty of the Bank to provide necessary after sale support, guidance and services.

7.             The respondents/opposite parties have pleaded in their written statement that SBI General Insurance Company is not having any branch office at SCO No.43-48, Bank Square, Sector 17, Chandigarh. Even if we accept the aforesaid plea of the respondents/opposite parties, it cannot be ignored that the insurance policies are being sold by the Insurance Companies through Bank by internal arrangement/understanding, because, easily, the Insurance Companies can catch hold of new customers coming to the Bank.Their main object is always to achieve the given targets by selling as much as policies. In this case also, admittedly, the policy, in question, was sold to the appellant/complainant by an official/representative of the respondents/opposite parties sitting in the premises of State Bank of India, Main Branch, Sector 17, Chandigarh. Once a policy is sold to the appellant/complainant by the representative/official of the respondents/opposite parties, it was the duty of the said representative to assist the appellant/ complainant and properly guide her at every stage and particularly, remind the appellant/complainant at the time of the renewal of the policy in question.

8.             Not only above, the plea of the respondents/opposite parties that during the grace period, one of their employee, namely, Sh. Munish called the complainant and asked for the renewal premium but the complainant asked him to contact her father in that regard, who when contacted, refused for renewal premium stating that he was looking for other option with other insurers for portability, seems to be afterthought and not tenable. The appellant/ complainant who resides at Gurgaon had specifically stated in her complaint that despite writing number of emails and visits of her parents, nothing happened. She further stated that during May 2018, one insurance official from State Bank of India visited the residence of her parents for collecting the payment of premium amount of Rs.10,502/- to renew the policy. He also gave a renewal policy document which was signed backdated 03.01.2018 and told her parents to sign a back dated cheque as a formality so as to cover grace period up-to 28.04.2018, which was duly given to him. However, the next day, the said person returned the cheque alongwith the policy renewal notice document as the computer system was not accepting the backdated cheque. The averments made appear to be correct and authentic. The complainant has also placed on record of Forum, photocopy of the said cheque as (Annexure C-2).

9.             Admittedly, the appellant/complainant approached State Bank of India, Main Branch, Sector 17, Chandigarh for renewal of policy, from where the same was purchased, well within the stipulated period but no official of the respondents/opposite parties was present there to assist her. Also, staff of State Bank of India, Sector 17 Brach neither accepted the renewal premium nor extended any assistance, guidance and support to the appellant/ complainant or to her parents. The appellant/complainant and her parents were made to run from pillar to post in order to get the policy renewed. However, when as per advice of the person of the respondents/opposite parties for renewal premium in order to get the policy renewed, the parents of the appellant/complainant gave a backdated cheque, which was returned by the said person, saying that the computer was not accepting the said backdated cheque. Firstly, not sending any message qua pending renewal of policy and secondly, sending their official with Renewal notice dated 03.01.2018 (Annexure C-3), to collect the renewal premium by way of backdated cheque and then not accepting the same, is a clear cut deficiency in rendering service.

10.           Moreover, during the course of arguments, the Counsel for the respondents/opposite parties miserably failed to prove on record by way of any cogent and convincing documentary evidence, the delivery of aforesaid Renewal Notice dated 03.01.2018 (Annexure C-3) to the appellant/complainant. Thus, it is established that the aforesaid renewal notice dated 03.01.2018 was never received by the appellant/complainant before the renewal due date i.e. 28.03.2018 and in the absence of any such notice having been received by the appellant/complainant, she could not be denied the continuity benefits (PEDs and other waiting period). The Policy, in question, lapsed as it was not renewed in time because the respondents/opposite parties did not assist the appellant/complainant properly at the time of her need and further no renewal notice or message was sent to her by the respondents/opposite parties, as stated above. The respondents/opposite parties cannot take shelter of Clause 16 of the Insurance Policy once they themselves are at fault in providing due service to the appellant/complainant.

11.           For deficiency in rendering service and unfair trade practice on the part of the respondents/opposite parties and suffering mental harassment & physical harassment on that account, the appellant/complainant are entitled to compensation.

12.           In our considered opinion, the Forum wrongly dismissed the complaint of the appellant/complainant and as such, the impugned order passed by it deserves to be set aside and the complaint is liable to be partly allowed.

13.           For the reasons recorded above, we allow the appeal and set aside the impugned order dated 26.12.2018 passed by District Forum-II, U.T., Chandigarh in Consumer Complaint No.386 of 2018. The complaint is partly allowed and the respondents/opposite parties are directed in the following manner:-

(i)          To renew the policy, in question w.e.f. 28.03.2018 alongwith continuity benefits, by accepting a fresh cheque for the renewal premium from the appellant/ complainant within a period of 30 days from the date of receipt of certified copy of this order.

        The appellant/complainant will pay the renewal premium within the aforesaid period of 30 days.

(ii)        To pay compensation in the sum of Rs.10,000/- on account of mental agony, physical harassment and deficiency in service and Rs.5,000/- as litigation costs, to the appellant/complainant, within 30 days from the date of receipt of a certified copy of the order, failing which, the said amounts shall carry interest @9% p.a. (simple), from the date of filing the complaint till realization.

(iii)      State Bank of India shall ensure proper services to the customers who are sold insurance and other cross-sell products under tie up arrangements with its own subsidiaries. It must ensure presence of respondents/opposite parties’ officials/ representatives in their Branch/premises for accepting renewal premiums and other documents etc. where these products are sold to their customers who trust State Bank of India.

14.           Certified copies of this order, be sent to the parties, free of charge.

15.           The file be consigned to Record Room, after completion.

Pronounced.

03.07.2019.

 (PADMA PANDEY)

        PRESIDING MEMBER

 

 

(RAJESH  K. ARYA)

MEMBER

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