Haryana

Karnal

CC/455/2022

Vikas Bedi - Complainant(s)

Versus

Star Health And Allied Insurance Company Limited - Opp.Party(s)

Hardev Singh

23 Feb 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 455 of 2022

                                                        Date of instt.04.08.2022

                                                        Date of Decision:23.02.2024

 

Vikas Bedi age 39 years son of Shri Patanjali Bedi, resident of H.No.1366, Sector-6, Urban Estate, Karnal, Aadhar No.3988 1174 5562.

 

                                               …….Complainant.

                                              Versus

 

1.     Star Health and Allied Insurance Company Limited, SCO No.101, 102 and 103, 2^nd Floor, Batra Building, Sector-17D, Chandigarh 160017, through its Regional Manager.

2.     Star Health and Allied Insurance Company Limited, 2^nd Floor, SCF 137, Urban Estate, Near ICICI Bank, Karnal 132001 (Harana) through its Branch Manager.

 

                                                              …..Opposite Parties.

 

Complaint Under Section 35 of the Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.

              Shri Vineet Kaushik……Member       

      Dr. Suman Singh….…….Member

                   

Argued by: Shri Surinder Kumar, counsel for complainant

                   Shri Mohit Goyal, counsel for the OPs.

 

                    (Dr.Suman Singh, Member)

 

ORDER:   

                

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that in the year 2012, complainant had purchased medical insurance policy from the OPs. In the year on 11.06.2021, the complainant again renewed his medical insurance policy and paid Rs.5981/- to the OPs as premium and the policy period was from 11.06.2021 to 10.06.2022 alongwith the grace period of one month i.e. from 10.06.2022 to 10.07.2022 for further renewal of the insurance policy but due to some unavoidable family circumstances, the complainant could not get renewed his medical insurance policy till 10.06.2022 and on 10.07.2022. Complainant tried to get his medical insurance policy renewed online on the portal of the OP but the same could not be renewed. On 11.07.2022, complainant had deposited premium amounting to Rs.5981/- in the office of OP at Karnal, surprisingly after a week i.e. on 19.07.2022, the complainant received an e-mail informing the complainant to purchase a new policy while denying renewal of previous policy from which the complainant is entitled to get the benefits of all pre-existing disease. Despite several request, the OPs did not renew the policy of complainant. Thus, there is clear deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; etc. On merits, it is pleaded that the insurance policy of the complainant was valid upto 10.06.2022 but the complainant has not renewed the policy within 30 days. The complainant has paid the premium on 11.07.2022, i.e. after grace period, consequently, the policy was not renewed for non-receipt of premium within the grace period. As per condition No.16 (4) of the policy “renewal” at the end of the policy period, the policy shall terminate and can be renewed within the Grace Period of 30 days to maintain continuity of benefits without break in policy. Hence, renewal of policy was denied and advised to purchase a fresh policy. The policy was in lapsation period and customer paid premium on 31.07.2022 of lapsation period. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of e-mail dated 11.07.2022, Ex.C1, copy of collection receipt Ex.C2, copy of e-mail dated 16.07.2022 Ex.C3, copy of customer identity card Ex.C4, copy of rejection and withdrawal of approval Ex.C5, copy of description Ex.C6, copy of screenshot Ex.C7 and closed the evidence on 05.01.2023 by suffering separate statement.

5.             On the other hand, learned counsel for OPs has tendered into evidence affidavit of Sumit Kumar Sharma, Senior Manager, Ex.OPW1/A, copy of policy Ex.OP1, copy of terms and conditions Ex.OP2, copy of proposal form Ex.OP3, copy of IRDA circular Ex.OP4, copy of demand draft and closed the evidence on 31.08.2023 by suffering separate statement.

6.             We have heard the learned counsel for the parties and have gone through the record available on the file carefully.

7.             Learned counsel for the complainant, while reiterating the contents of complaint, has vehemently argued that the complainant is having a family health insurance policy which was valid upto 10.06.2022 but the complainant could not renew the said policy due to unavoidable circumstances within grace period of one month till 09.07.2022. On 11.07.2022, he deposited the premium amount with the office of OPs at Karnal but after a week the OPs sent a e-mail that the policy could not be renewed. Thus, there is deficiency in service and unfair trade practice on the part of OPs and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that the complainant was having one month grace period after expiry of policy but in that tenure also, he failed to deposit the premium amount rather paid the same after expiry of grace period, thus the policy of the complainant could not be renewed. He further argued that there is no deficiency in service and unfair trade practice on the part of OPs and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           The complainant has pleaded that he was having a family health insurance policy which was valid upto 10.06.2022 and after that he was having grace period of one month for deposition of premium of the policy but he could not deposit the same till 10.07.2022 and when on 11.07.2022, he deposited the premium by visiting the office of OPs at Karnal, they returned the same after a week on the ground that the premium has been deposited after the expiry of grace period, therefore, the policy cannot be renewed. The reason cited by the complainant that he could not renew the policy due to some unavoidable circumstances is not justified and without any evidence. Firstly, the complainant could renew his policy before the expiry of the policy i.e. prior to 10.06.2022. He could not renew the same, then also he was having grace period of one month upto 10.07.2022 but during that period also, he had not deposited the premium amount for the reasons best known to him. Moreover, the complainant relied upon e-mail Ex.C1, whereby he tried to deposit the premium online that also after expiry of grace period i.e. 16.07.2022 at 12:10 am. The complainant cannot take shelter of his own fault. The complainant resides in Karnal and he could have deposited the premium in cash by visiting the office of OPs at Karnal, but he did not do so in time, rather deposited the same on 11.07.2022 after expiry of grace period. Admittedly, the premium amount paid by the complainant to the OPs, has already been returned to him. Thus, there is clear cut delay on the part of the complainant and there is no deficiency in service and unfair trade practice on the part of OPs.

11.           Thus, the present complaint is devoid of merits and same deserves to be dismissed and same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

 

Announced

Dated:23.02.2024             

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Suman Singh)

                          Member                          Member