Orissa

Sambalpur

CC/63/2016

Mrs. Chhabipriya Behera - Complainant(s)

Versus

The Branch Manager (SBI Generla Insurance, Sambalpur) - Opp.Party(s)

Sri R.K. Maharana

01 May 2023

ORDER

PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR

                             CONSUMER COMPLAINT NO. 63/2016

 

Present-Dr. Ramakanta Satapathy, President,

  Sri. Sadananda Tripathy, Member,

 

Mrs. Chhbipriya Behera,

W/O- Santosh Kumar Behera,

R/O-Shivam Colony, Behind Income Tax Office, Ainthapali,

Ps-Ainthapali, Tahl/Dist- Sambalpur.                           ...………..Complainant

Versus

1. The Branch Manager, SBI General Insurance,

Sambalpur, At-1^st Floor, State Bank of India,

Main Branch Sambalpur.

2. The Branch Manager, SBI,

Malti Gunderpur Branch, Ps-Dhama,

Dist-Sambalpur.                                         …………...Opp.Parties

Counsels:-

1. For the Complainant      :-          Sri. R.K.Maharana & Associates
2. For the O.P. No.1            :-          Sri. B.K.Purohit, Advocate,
3. For the O.P. No.2            :-          Sri. S.A. Guru, Advocate

 

Date of Filing:27.07.2016,  Date of Hearing :20.03.2023  Date of Judgement : 01.05.2023

  Presented by Dr. Ramakanta Satapathy, PRESIDENT

1. The complainant purchased a Health Insurance Plan from O.P.No.1 through O.P.No.2, paid premium of Rs.2600/- from A/C No.30346126755 dated 20.10.2015. The O.P.No.1 when within one month not supplied policy bond a letter dated 30.5.2016 was served. The complainant contacted the agent and O.Ps but it was in vain. During policy period of one year the complainant could not avail the benefits of his illness due to non-availability of bond. The O.Ps are deficient in their service.
2. The O.P. No.1 in its version submitted that Group Health Insurance Policy vide Certificate No.3447001 was issued by the Rourkela Branch of Insurance Company on 20.10.2015. The Policy was valid till 19.10.2016 covering one adult, the insured for a sum of Rs.1.00 lakh. The proposal form was received on 29.102015 and policy was issued on 30.10.2015. The original policy was dispatched to the insured on 6.11.2015 along with money receipt No.2510837 dated 30.10.2015. The O.P is not aware of letter dated 20.5.2016. The policy has been dispatched in time .Other allegation of illness, non avaibility of service etc. are denied. There is no deficiency on the part of the O.P.No.1 and prayed for dismissal of complaint.
3. The O.P.No.2 in its version submitted that from A/C No.30346126755 on 20.10.2015 an amount of Rs.2600/- was debited towards health insurance. There is no any relation regarding issuance of bond by the O.P.No.2. There is no cause of action against the O.P.No.2.
4. The complainant has filed account statement, payment of Rs.2600/- to the O.P.No.1 through O.P.No.2 dated 20.10.2015. The letter dated 30.5.2016 addressed to O.P.No.1 and request for supply of policy bond, which is duly received by one Priyaranjan Singh.

The O.P.No.1 filed letter dated 20.10.2015 showing policy No.3447001 in favour of the complainant. The enclosures are shown as certificate of insurance, premium certificate and grievance redressal letter. The Intermediary name is S.B.I. Malti Gunderpur-6422 and amount received shown Rs.2600/-. The O.P.No.1 has filed proposal form No.653513-01 Malti Gunderpur. The receipt is granted by operation Department, Rourkela dated 29.10.2015 and 30.10.2015.

5. From the complaint, version and documents filed by the parties it reveals that both the parties admitted the purchase of Group Insurance Health Policy. The O.P.No.1 received Rs.2600/- from complainant an amount of Rs.2600/- through the O.P.No.2. As per admission of the O.P.no.1 the proposal form was submitted on 20.10.2015. The form was received by insurance company on 29.10.2015 and policy was issued on 30.10.2015. The original policy was dispatched to the complainant on 6.11.2015 along with money receipt No.2510837 dated 30.10.2015. The O.P.No.1 failed to file the documents showing dispatch of original policy bond and money receipt along with acknowledgement of receipt. The entire complaint is based on the point of receipt/non-receipt of policy bond.

From the certificate of Insurance submitted by O.P. No.1 it reveals that the O.P. No.2 is the intermediary having intermediary code No. 0005005 but this fact has not been admitted by the O.P. No.2. To promote the business of insurance Company, Banking organizations work as intermediary, not only promote their Banking business but also earn Commission. This fact has been suppressed by the O.P.No.2 and simply stated that there is no any relation with insurance business, when a proposal is given to the insurance company it is the duty of intermediary to see the difficulties of a consumer. In the instant case the complainant has not filed any documents any evidence against O.P. No.2 but made a party. For non-disclosure of factual aspect the O.P. No.2 is deficient in service.

The complainant failed to file any documentary evidence relating to her illness and treatment details.

From the supra discussion deficiency in service of the O.Ps established and accordingly it is ordered:

ORDER.

The complaint is allowed on contest against the Opp.Parties. The O.P.No.1 is directed to refund Rs.2600/- with 9% interest P.A w.e.f. 20.10.2015 to the complainant within one month of this order. The O.Ps are jointly and severally liable to pay compensation of Rs. 20,000/- and litigation expenses of Rs.5000/- to the complainant. In case of non-payment within one month the entire amount will cover 12 % interest P.A till realisation.

Order pronounced in the open court on 1^st May of 2023.

Supply free copies to the parties.