D.O.F:04/05/2021
D.O.O:20/01/2023
IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, KASARAGOD
CC.No.90/2021
Dated this, the 20th Day of January 2023
PRESENT:
SRI.KRISHNAN.K : PRESIDENT
SRI.RADHAKRISHNAN NAIR.M : MEMBER
SMT.BEENA.K.G : MEMBER
P.Balakrishnan,
Meriland Studio,
Kanhangad,
Kasaragod : Complainant
And
- The Branch Manager,
Canara Bank II, Kanhangad
Kasaragod
(Adv.Sri.Mohan Prakash.K)
- Bajaj Alliance Insurance company : Opposite parties
2nd Floor, City Centre
Near Canara Bank Up Hill,
Malappuram
ORDER
SRI.RADHAKRISHNAN NAIR.M : MEMBER
The complaint is filed for compensation alleging service deficiency and unfair trade practice on the part of the opposite party.
The facts of this case in brief is that the complainant is having an account with Opposite Party No.1 Syndicate Bank, for last several years and having their Synd Arogya Mediclaim Policy for 8 years renewed periodically for which insurance amount was Rs.2,00,000/- and annual premium was Rs.5,500/-. In the meantime the amalgamation of the Syndicate Bank with Canara Bank took place and the complainant was informed that Synd Arogya Policy would be stopped and for continuity there will be an insurance policy as suggested by Canara Bank. The expiry date of the Synd Arogya Mediclaim Policy of the complainant was 04.05.2020 and by that time, due to corona lockdown, he was at his daughter’s house at Perinthalmanna. When the complainant approached the Syndicate Bank Perinthalmanna Branch for renewal of his Policy, he was told to take the policy of Bajaj Allianz company by remitting Rs.14,195/- as premium for availing continuity of the policy. The complainant was actually compelled to remit Rs.14,195/- with an apprehension that he may loss the insurance benefit unless he took that new policy by remitting that much amount. The individual Policy premium was only Rs.4,854/- but the Opposite Party No.1 and Bajaj Insurance Company was cheating the complainant. Due to that the complainant lost the chance of port to some other beneficial policy. Thereafter when the complainant approached the Opposite party No.1 to renew the policy again he was told to remit Rs.14,195/- as premium. But the complainant was informed by some insurance agents that only Rs.4,860/- was needed to be remitted and the opposite part No.1 was following unfair trade practice. Even though the complainant approached the opposite party No.1 to renew the policy by remitting Rs.4,860/- it was not allowed. The address of the complainant shown in the policy there was some errors and he had to approach the opposite party several times to get the address corrected. Also in the SB account pass book issued to the complainant the name and address of the complainant was not seen.
Another issue raised by the complainant is that the opposite party No.1 did not issue Kissan Credit Card and not sanctioned loan to him in spite of obtaining the possession certificates and Tax Receipts related to his three items of land situated in three villages. Now the opposite party No.1 say that the above documents are missing.
Due to acts and omissions of the opposite party the complainant, who is aged 65 years put to great hardships and mental agony. Hence this complaint is filed for a direction to the Opposite party to pay Rs.1,00,000/- towards compensation.
The notice send to the opposite party served and entered in appearance through their respective counsels, who filed written version. The notice send to the opposite partyNo.2 returned unserved stating that “left”. Hence the name of the opposite party No.2 called, absent and set exparte.
As per the version of the Opposite party No.1, the complaint is false frivolous and vexatious and not sustainable at law. The opposite party admit that the complainant is having an account with Opposite Party No.1, Syndicate Bank and a Synd Arogya Mediclaim Policy, which was renewed regularly. Subsequently, after amalgamation of the Syndicate Bank with Canara Bank the Synd Arogya Policy was converted to Group Mediclaim insurance of Canara Bank by paying premium amount of Rs.14,195/-. The above premium amount was remitted by the complainant as he himself had opted to have continuity of the benefits. The contrary allegations are not correct. The complainant has to pay the premium amount as per the policy condition of the insurance company. The contention that the opposite party defrauded the complainant is false and hence denied. The premium amount for a fresh policy is Rs.4,813/-and in the said fresh policy the complainant will not get the continuity benefit. The complainant has approached the opposite party for enquiring about the kissan Credit Card and handed over the KYC documents only to have his CIBIL search in the month of February 2021, along with possession certificate and basic tax receipts. The above documents are still with the opposite party and is ready to hand over the same to the complainant. But he did not approached thereafter, He has not submitted any application for KCC loan. If he applies for a loan it will be processed in accordance with the banking norms. There is no service deficiency on the part of the Opposite party No.1 and therefore the complaint is Iiable to be dismissed with costs.
The Complainant filed proof affidavit in lieu of chief examination and documents Ext. A1 to Ext. A5 and Ext.X1 series are marked.
The Ext.A1 is the Bank Pass book, Ext.A2 is the Synd Arogya Insurance policy, Ext A3are the Bajaj Allianz Mediclaim Insurance policy, Ext. A4 is the copy of letter dated 22.4.2021 issued by the complainant to the Opposite party No.1, Ext.A5 is the newspaper dated 29.07.2020, Ext.X1 series (3 in number) are the hospital records.
From the side of the Opposite parties the senior Manager of the Canara Bank filed proof affidavit in lieu of chief examination as DW.1 and marked a document. Ext.B1, which is a copy of the Bajaj Allianz Mediclaim policy Schedule.
Based on the pleadings and evidence of the rival parties in this case the following issues are framed for consideration.
1. Whether there is any service deficiency or unfair trade practice on the part of all or any of the opposite parties ?
2. If so, what is the relief ?
For convenience, both these issues are considered together.
Here the main case of the complainant is that he was having a Synd Arogya Mediclaim Policy for 8 years renewed periodically having annual premium was Rs.5,500/-.and due to the amalgamation of the Syndicate Bank with Canara Bank the Synd Arogya Mediclaim Policy was stopped and the complainant was compelled to take the policy of Bajaj Allianz company by remitting Rs.14,195/- as premium for availing continuity of the policy. The complainant was told that he may loss the continuity insurance benefit unless he took that new policy by remitting that much amount. The individual Policy premium was only Rs.4,854/- but the Opposite Party No.1 and Bajaj Insurance Company was cheating the complainant. Due to that the complainant lost the chance of port to some other beneficial policy. Thereafter when the complainant approached the Opposite party No.1 to renew the policy again he was told to remit Rs.14,195/- as premium.
The opposite party denies this contentions and states that above premium amount was remitted by the complainant as he himself had opted to have continuity of the benefits. The contrary allegations are not correct. The complainant has to pay the premium amount as per the policy condition of the insurance company. The contention that the opposite party defrauded the complainant is false and hence denied. The premium amount for a fresh policy is Rs.4,813/-and in the said fresh policy the complainant will not get the continuity benefit. The complainant admits that he wanted to have the continuity benefits of the earlier policy. The opposite party submits that for having the continuity of the earlier policy of Synd Arogya Mediclaim Policy, the insured has to remit Rs.14,195/- and take the Bajaj Allianz Mediclaim policy. The premium amount for a fresh policy is Rs.4,813/-and in the said fresh policy the complainant will not get the continuity benefit. The complainant remitted the amount fully knowing the facts. If the insured had any complaint regarding the policy he had the option to raise the same within 15 days. The complainant did not raise any such objection. Instead he raised the complaint regarding certain errors crept in the policy issued and got corrected. Thereafter complainant approached the opposite party to renew the new policy at the time of its expiry, by offering Rs.4,860/- which was not allowed. The complainant has to pay the premium amount of Rs.14,195/- as per the policy condition of the insurance company. Since that amount was not remitted, the policy was not got renewed.
Here the document Ext.A3 is a copy of the new policy issued to the complainant. The Ext.B1 is also a copy of the same Document. It has come in evidence that the new Mediclaim Insurance policy of the Bajaj Allianz company is the converted policy of the Synd Arogya Mediclaim Policy and the insured will get the continuity benefit of the earlier policy, Both the Ext.A3 and the Ext.B1 documents would show that the policy issued to the complainant is having continuity from his earlier policy No.1020012819P101491957 Expiry date:04 May 2020. The complainant has no case that the opposite party has not included such a provision in the newly issued policy.
The Ext A3 Policy provides for the disagreement or objection or changes with respect to information, declaration, Terms and condition, exclusions and contents of the policy within 15 days from the receipt of the policy. The complainant has no case that he had raised any such disagreement or objection or changes with respect to information, declaration, Terms and condition, exclusions and contents of the policy within 15 days or at any time and the same was not entertained by the opposite party. It is admitted by the complainant that he had raised issue of some errors in the address of the complainant occurred in the policy and the same was corrected.
The complainant did not renew the above policy by remitting the necessary premium amount in time. The document Ext.A4 is a copy of letter issued by the complainant to the opposite party demanding to renew his Bajaj Allianz Mediclaim Insurance policy by collecting Rs.4,860/-from his SB A/c No.221/1570. The opposite party argues that the unless the premium amount fixed for the policy is remitted, the policy will not be renewed by the insurance company. Since the complainant was not ready for that, his policy was not renewed thereafter.
The complainant submits that he had met with an accident by falling and undergone hospitalised treatment spending huge amount. He had produced documents Ext.X1 series, the entire treatment records including medical bills and argue that the opposite parties are liable to pay that amount. But unfortunately all these accident and hospitalisation are not with in the validity period of the insurance policy. The documents Ext.X1 series would show that the complainant was admitted in KIMS AL SHIFA hospital on 31-05-2021 and discharged on 03-06-2021, whereas the insurance policy Ext.A3 expired on 04-05-2021.
The complainant had the option to renew the existing policy or take a different policy of his choice by remitting a lesser amount. In the letter Ext.A4 he did not request for issuing a new policy available by collecting Rs.4,860/- or such small amount and therefore opposite parties cannot be blamed for not making arrangements for issuing such new policy. The complainant could have obtained a new insurance policy by remitting only Rs.4,860/- with the help of the insurance agents for getting coverage. But unfortunately that was not done.
In that situation it cannot be held that the opposite parties are liable to pay the hospital bill amount and compensation to the complainant.
Another issue raised by the complainant is that the opposite party No.1 did not issue Kissan Credit Card and not sanctioned to him in spite of obtaining the possession certificates and Tax Receipts related to his three items of land situated in three villages. Now the opposite party No.1 say that the above documents are missing.
The opposite party argues that the complainant has approached the opposite party for enquiring about the Kissan Credit Card and handed over the KYC documents only to have his CIBIL search in the month of February 2021, along with possession certificate and basic tax receipts. The above documents are still with the opposite party and is ready to hand over the same to the complainant. But he did not approached thereafter, He has not submitted any application for KCC loan. If he applies for a loan it will be processed in accordance with the banking norms.
The complainant had not produced any documents to show that he had filed any application for Kissan Credit Card or for KCC loan. No copy of such applications is produced and marked. Also during the cross examination he had admitted that he had not filed any application for such a loan.
Yet another complaint raised by the complainant is the address of him shown in the policy there was some errors and he had to approach the opposite party several times to get the address corrected. Also in the SB account pass book issued to the complainant the name and address of the complainant was not seen. But the complainant has not pleaded and proved that he had sustained any loss or damages due to such typographical errors or omissions.
Considering the facts and circumstances of this case this commission is of the view that there is no evidence for any service deficiency or unfair trade practice on the part of the Opposite parties.
In the result the complaint is dismissed with no costs
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exhibits
A1: Bank Passbook
A2: Synd Arogya Insurance Police
A3: Bajaj Allianz Mediclaim Insurance Policy
A4: Copy of the letter issued by the complainant
A5: News Paper dated 29.07.2020
B1: Copy of Bajaj Allianz Mediclaim policy schedule
X1 series are the hospital records (3 in number)
Witness Cross-examined
Pw1. Balakrishna.P
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
Assistant Registrar
Ps/
