C.C. No.261/2023

Mr. Tirtha Sarathi Mohapatra,

S/o. Kangali Charan Mohapatra,

At.- Deuligrameswar,

P.O./P.S./Dist.- Jagatsinghpur.                            ……………. Complainant

                                     (Versus)

1. The Branch Manager,

Star Health and Allied Insurance Co. Ltd.,

Branch Office- Cuttack,

Plot No.1677 (P)/1678 (P),

Holding No.608, 2^nd Floor,

Gajanan Complex (Dolamundai),

P.O.- Buxi Bazar,

Cuttack- 753001.

2. Corporate Office,

Star Health and Allied Insurance Co. Ltd.,

1, New Tank Street,

Valluvar Kottam High Road,

Nungambakkam,

Chennai- 600034,

Tamil Nadu.…..… Opposite parties

For Complainant………..Mr. R. Mohanty & Associates

For Opposite Parties………..Mr. S.P. Moharana & Associates

ORDER BY HON’BLE PRESIDENT- MR. P.K. PADHI:

                                                                                        JUDGMENT

            Complainant has filed this consumer complaint U/s.35 of C.P. Act, 2019 seeking following reliefs;

            “Direct the opposite parties to restore the seniority of the policy in the new policy vide No.11230254441700, and pay Rs.9,00,000/- towards loss sustained by complainant on lapse of the policy and also pay compensation Rs.1,00,000/- towards mental agony and Rs.30,000/- towards cost of litigation jointly and severally”.

            The brief fact of the case of complainant is that, on 26.8.2013 the complainant insured himself along with his family under a Family Health Optima Insurance Plan vide Policy No.11230195725409 with the opposite parties which is renewable in every year and the said insurance plan got renewed for the ninth year on 08.10.2022 on payment of Rs.22,382/-. The said insurance was renewed and was valid from 08.10.2022 to midnight of 07.10.2023 with quarterly premium payment frequently. The complainant received a mail in the first week of January, 2023 reminding him about the due date of payment 08.01.2023 and immediately after receiving the said mail, the complainant enquired about the grace period within which the installment due can be paid without affecting the policy, the opposite party No.1 replied as 120 days as grace period to pay the installment and assured the complain and that the coverage of policy will not be affecting during this 120 days grace period. In the 2^nd week of February, 2023 the complainant contact the opposite party No.1 for share the UPI code to which the installment dues can be made, but the opposite party No.1 after cross verification, informed the complainant about the non appearance of the policy on the portal for installment payment and regarding the lapse of policy. The complainant is a very sincere and caring person, even if after lapse of the said policy, the complainant insured his family with the opposite parties with another new policy bearing policy No.11230254441700. Due to wrong information given by the opposite parties the complainant lost his policy bearing No.11230195725409, lost his seniority and lost about Rs.9,00,000/-.

            Opposite parties have filed their written version stating as under;

            The complainant insured himself and his family members under the Health Optima Insurance Plan subject to the renewal every year as per the terms and conditions of the policy issued, but in the instant case, he failed to renew the same in time due to his own fault. The renewal from 08.10.2022 to 07.10.2023 midnight with quarterly premium of Rs.5,994/- but the failed to deposit the premium installment in time for which he is not entitled to get benefits available under the said scheme. The complainant well known that due to his own fault, he could not pay the installment dues for which policy was lapsed and for the safety of his own family he again insured before the opposite parties.

            The simple grievance of complainant is regarding to restore his seniority in the policy. It is not in dispute that the complainant has not paid premium or come after long lapse of time. Due to Covid-19 and mis communication there is few days delay in paying the premium. Since the default in paying during Covid-19 was unintentional and mis communication by opposite parties and there is no abnormal delaying in taking new policy. We therefore direct the opposite parties to restore the seniority of complainant from the beginning of his policy and since there is no ill intention (mensiria) of opposite parties we award no cost on opposite parties. With the aforesaid observation and direction the consumer complaint is disposed of. No cost.  

            Pronounced in the open Commission on this 8^th August,2024.