Filed on :05.07.2012
Disposed on.24.11.2016
BEFORE THE BANGALORE URBAN II ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SHANTHINAGAR, BANGALORE – 560027
DATED THIS THE 24th DAY OF NOVEMBER 2016
CONSUMER COMPLAINT NO. 1360/2012
PRESENT:
KUM. T. SHOBHADEVI, M.A., LL.B., …. PRESIDENT
SMT V.ANURADHA B.A., LL.B., …. MEMBER
COMPLAINANT/S | 1 | Sri.Rajakumar K.K., S/o.late.V.A.Nair, No.534, 13th Main, 10th Cross, Padmanabhanagar, Banglaore 560 070. (By Adv. Sri.B.L.Sanjeev) |
V/S
OPPOSITE PARTY/IES | 1. | Star Health & Allied Insurance Co. Ltd., Corporate Office, No.1, New tank Street, Vlluvar Kottam High Road, Nungambakkam, Chennai 600 034, And having their branch at No.86, I Floor, 1st Main Road, Chamarajpet, Mysore Road, Bangalore 560 018. (Rep. by Adv. Y.Venkatapathi) |
ORDER
BY KUM. T. SHOBHADEVI, PRESIDENT
This complaint is filed under section 11 and 12 of the Consumer Protection Act 1986.
2. The brief facts of the case is that,
The complainant proposed insurance with the OP vide proposal form No.07795488 and had paid a sum of Rs.7,219/- towards the premium and after the payment of the premium amount the complainant had undergone a detailed health checkup. Even after a lapse of more than 15 days the policy was not issued and hence complainant registered a complaint with the customer care of the OP and pursuant to which the complainant received a cheque for Rs.7,219/- which he had paid towards the premium amount. Though the premium amount was refunded the medical checkup records were not returned to the complainant, hence he sent email requesting to return the records, but OP sent an evasive reply informing the complainant that, as per companies practice they are not supposed to hand over the medical records. All the medical check up records of the complainant is with the OP and every possibility of misuse of the medical records, hence complainant desire to get them back. Inspite of repeated requests OPs failed to return the documents. Complainant also issued legal notice, but no settlement. Hence this complaint.
3. Upon service of notice, OPs appeared and filed their version, stating that the complaint does not fall under the Consumer Protection Act, there is no kind of obligation created to the OPs as the opponent has not received any kind of consideration of charges from the complainant. Complainant has not availed any kind of paid service. Complainant has not paid any amount for tests. He has no right to claim the documents. Complainant being a proposed/insured he was supposed to disclose all the proof pertaining to his health whether it is past or present at the time of filing the proposal form in seeking the policy. Probably complainant suppressed some serious ailment, hence when he was asked to further tests he has not come forward and instead of received the fund of amount he paid as premium towards the proposed insurance policy. Complainant did not subject himself for Serum Creatinine Tests. In the first medical report an exclusion of diabetes disease and conditions aggregated by it was mentioned, hence he was asked to go for an additional test of Serum Creatinine which he did not opt. the test charges incurred by the complainant also are not deducted in the amount refunded. There is no intention or opportunity for the OPs for misusing the medical test reports of any proposer. It is only official need to retain the records. Unless the tests are undergone the OP cannot issue any policy while discharging the duties and obligations as per the IRDA Rules and insurance loss being juristic person. There is no deficiency in service on their part. Hence prayed for dismissal of the case.
4. Perused the documents furnished by both the parties. Arguments are heard.
5. The points that arise for our consideration are:
- Whether the complainants have proved deficiency in service on the part of the Opposite party?
- Whether the complainants are entitled for compensation?
- What order and relief?
6. Our answers to the above points:
- Point No.1 : In the Negative
- Point No. 2 : In the Negative
- Point No. 3 : As per final order for the following;
REASONS
7. POINT NO. 1 AND 2;
Complainant had proposed insurance with the OP, vide proposed form No.07795488 and paid a sum of Rs.7,219/- towards the premium and after the payment of the premium amount complainant undergone a detailed health checkup. When the complainant not received the policy after lapse of more than 15 days complainant registered a complaint with the customer care of the OP and pursuant to which complainant received a cheque for Rs.7,219/- paid towards the premium amount. Complainant case is that, he has not received the medical test report, which he undergone. In support of his complaint he has produced certain Xerox copies, they are,
- Copies of the notice dated 23.12.2011, marked as Document No.1.
- Reply dated 30.01.2012 from the OP, marked as Document No.2,
- Proposed form marked as Document No.3,
- Cheque payment towards the advance premium receipt, marked as Document No.4, 4a,
- Correspondence between the complainant and OP, marked as Document No.5, 5a, 5b and 5c.
8. In support of his case, OP filed some copies of documents, they are;
- Email correspondence marked as Document No. Document A,
- Medical Examination report(to be filled in by the Medical Examiner), marked as Document No.B,
- Proposed form, marked as Document No.C,
9. Complainant in his complaint clearly stated that he received the cheque from the OP for a sum of Rs.7,219/- which he had paid towards the premium amount. He has not given any consideration for the services rendered by the OP. according to OP even though the complainant was asked to undergo, serum creatinine test the complainant has not come forward. Complainant has not paid any kind for the tests conducted, they were met out by the opponents and they require the same for their official record. According to the complainant, OPs may misuse the medical tests report. The reason shown by the complainant is not reasonable. OPs have no necessity to misuse the documents of the complainant. When the complainant has not paid any considerations, he has no right to claim the test reports. Under the above stated circumstances complainant has not proved the deficiency in service on the part of the OPs. Hence we answer the above PointNo.1 and 2 in the Negative.
10. POINT NO.3:- In the result, we proceed to pass the following;
ORDER
The complaint is Dismissed.
Send copy of the order to both the parties at free of cost.
(Dictated to the Stenographer, transcribed and computerized by her/him and corrected and then pronounced by us in the open Forum on this the 24th day of November 2016)
MEMBER PRESIDENT
