Per – Hon’ble Mr. Dhanraj Khamatkar, Member
This appeal filed by the Appellant/original Opponent No.3 – Navi Mumbai Municipal Corporation (hereinafter referred to as the ‘Municipal Corporation’ for the sake of brevity) takes an exception to an order dated 12/12/2012 passed by the Additional District Consumer Disputes Redressal Forum, Thane in Consumer Complaint No.211 of 2008, Mr. B. C. Patil Vs. National Insurance Company Ltd. and Others. Facts leading to this appeal can be summarized as under:-
[2] Respondent No.1/original Complainant – Mr. B. C. Patil (hereinafter referred to as ‘the Complainant’ for the sake of brevity) had filed a consumer complaint under the Consumer Protection Act, 1986 stating therein that the Complainant being a senior citizen became a member of Senior Citizens Arogya Bima Yojana floated by the Municipal Corporation and the Respondent No.2/original Opponent No.1 – National Insurance Company Ltd. (hereinafter referred to as ‘the Insurance Company’ for the sake of brevity) during the period 2004-2007. As per the insurance scheme one-third of the premium was to be paid by the senior citizen i.e. beneficiary member. Accordingly, the Complainant paid the premium amount of his share on 04/10/2007 and the remaining amount was to be paid by the Municipal Corporation. During the policy period, the Complainant got ill and he was required to incur expenses of `14,335/- for the treatment. Thereafter, he was admitted to a hospital and had to undergo a by-pass surgery. Accordingly, he incurred total expenses of `1,51,711/- for medical treatment. He lodged a claim with the Insurance Company. However, the Insurance Company did not sanction the claim and hence, he filed a consumer complaint praying that the Opponents may be directed to pay him an amount of `25,000/- towards reimbursement of insurance amount as per the policy besides compensation of `1,50,000/- towards mental agony and harassment together with interest thereon.
[3] Insurance Company contested the claim of the Complainant by filing its written version before the District Forum inter-alia contending that the allegations made in the complaint are not true and are frivolous. It is contended that the original Opponent No.2 – Caps Insurance Services Pvt. Ltd., is not their agent and the Opponents Nos.2 and the Municipal Corporation had not deposited the premium amount of their share in time and hence, the insurance policy was not renewed and as such, Insurance Company is not liable to settle the insurance claim preferred by the Complainant. On these main grounds and other grounds as set out in the written version, Insurance Company prayed that the complaint may be dismissed so far it relates to the Insurance Company.
[4] Municipal Corporation also contested the claim of the Complainant by filing its written version before the District Forum inter-alia admitting that they floated the insurance scheme for the benefit of senior citizens. As per the agreement executed between the Municipal Corporation and the Insurance Company, the Insurance Company had appointed the Opponent No.2 – Caps Insurance Services Pvt. Ltd., as an agent. Opponent No.2 had demanded the remaining amount of premium and accordingly, on 30/01/2008 Municipal Corporation had paid the amount as per the agreement between the Insurance Company and the Municipal Corporation. It is further contended that as the Insurance Company and its agent viz. the Opponent No.2 had not communicated to the Municipal Corporation that the insurance policy was not renewed before 03/07/2007, Municipal Corporation is not liable for not renewing the policy. Municipal Corporation had communicated to the Insurance Company to accept the premium amount from time to time. On these grounds, the Municipal Corporation alleged that there was no deficiency in service on its part and prayed that complaint as against the Municipal Corporation may please be dismissed.
[5] Respondent No.3/original Opponent No.2 in its written version filed before the District Forum stated that they are not responsible for the allegations made by the Complainant in his complaint and prayed that complaint against them may be dismissed.
[6] The District Forum after going through the complaint, written versions filed by the Opponents, evidence adduced by the parties on affidavits and pleadings of their respective advocates came to a conclusion that there is deficiency in service on the part of the Insurance Company and the Municipal Corporation and partly allowed the consumer complaint directing the Insurance Company to pay to the Complainant an amount of `25,000/- towards reimbursement of insurance amount. Further, the Insurance Company and the Municipal Corporation were jointly and severally directed to pay to the Complainant an amount of `50,000/- by way of compensation towards mental agony and costs of the litigation. All these amounts were directed to be paid within a period of forty-five days, failing which the amounts were to carry interest @ 9% p.a. Consumer complaint stood dismissed as against the Opponent No.2. Being aggrieved by the said order, the Municipal Corporation has preferred this appeal.
[7] We have heard Adv. Jitendra Oak on behalf of the Appellant/Municipal Corporation, Respondent No.1/original Complainant in person and Adv. Smt. Sneha S. Dwivedi on behalf of the Respondent No.2/Insurance Company. We have also perused the record.
[8] Admittedly, the Municipal Corporation had floated an insurance scheme for the senior citizens and there was an agreement between the Municipal Corporation and the Insurance Company. It is also admitted by the Municipal Corporation that the Complainant was a member of the scheme. It is also an admitted fact that the Complainant had filed his claim. However, admittedly, the claim was repudiated on the ground that the insurance policy was not renewed. As per the agreement, the responsibility of renewing the insurance policy is of the Municipal Corporation and the Insurance Company. As per the agreement, it was incumbent upon the Insurance Company to inform in advance to the Complainant about renewal of the insurance policy. Similarly, as per the scheme floated by the Municipal Corporation, it was the responsibility of the Municipal Corporation to accept the amount of premium for renewal of the insurance policy and to deposit the amount with the Insurance Company and to maintain the accounts and to take steps for filing the claims with the Insurance Company, if required. So, the entire scheme was to be implemented by the Municipal Corporation in consultation with the Insurance Company. As the Municipal Corporation had floated the scheme, it was its responsibility to ensure whether the premium required for the renewal of the insurance policy has been paid or not. Municipal Corporation had paid the amount of its share in the premium. However, it was a late payment. Amount paid by the Complainant was accepted by the Insurance Company. Implementation of the scheme was a joint responsibility of the Municipal Corporation and the Insurance Company. Thus, for non-renewal of the insurance policy, both, Municipal Corporation as well as the Insurance Company are equally responsible. There is a clear-cut case of deficiency in service on their part. The District Forum after going through the facts of the case and evidence adduced by the parties has rightly passed the order and we do not find any infirmity in the order passed by the District Forum.
[9] During the course of arguments Learned Counsel for the Insurance Company made a statement at the Bar to the effect that the Insurance Company has already paid an amount of `25,000/- to the Complainant towards reimbursement of insurance amount and has thus, complied with the order passed by the District Forum. On behalf of the Appellant/Municipal Corporation it is stated that they have already deposited the decretal dues with the State Commission.
Hence, we pass the following order:-
ORDER
Appeal stands dismissed.
No order as to costs.
Pronounced on 12th December, 2013
