SRI.K. VIJAYAKUMARAN, PRESIDENT. This Complaint is for seeking compensation costs. Etc. The averments in the complaint can be briefly summarized as follows: The complainant had joined in a Health Insurance Policy namely Hospitalization and Domiciliary Hospitalization Benefit Policy promoted by the New India Assurance Company Ltd. through its Ottapalam Branch during the year 2002. His wife Leelamma and Son Mr. Sebastian Clifford have also had coverage. The policy promised for the reimbursement of the sum upto Rs.2,00,000/- incurred by the insured beneficiaries. The policy was a continuing one and the insured given the option to renew the same is subsequent years. The scheme of the policy prescribe that the maximum age at which a person can join the policy is 60 years after which one cannot join the scheme and if he joined the scheme on or before the completion of 60 years, he can renew the policy for a further period of 4 yeas consecutively in case of no break in renewing the policy. The Insurance company has offered privileges like free health check up to Rs.50,000/- at the end of 4th year of the policy and the risk of certain diseases which were excluded during the 1st year of the policy will also get covered during the subsequent years. If there is any breakage the complainant will not be in a position to subscribe the policy again The complainant had drawn a cheque dated 23.5.2005 from out of the account maintained by him with the opp.party in favour of the New India Assurance Co. Ltd. for Rs.5,441/- for the renewal of the premium for the Insurance Policy for the 3rd year and has entrusted the same with the office of the Insurance Company at Ottapalam. The cheque was received by the opp.party for collection at a time when the complainant’s account with the opp.party was having sufficient balance to honour the cheque.. But the opp.party has dishonoured the cheque on the ground that funds are insufficient in the complainant’s account. The dishonour of the cheque for the above reason is caused due to the negligence of the opp.party which amounts to deficiency in service. The policy also could not be renewed and stood cancelled and the complainant thereby deprived of the benefits of free medical checkup up to Rs.50,000/- and insurance coverage and other benefits. Due to the negligence of the opp.party the complainant and his family members are deprived of the benefits of the policy and thereby the very purpose for which the policy was taken is also defeated. The complainant and other beneficiaries are burdened with the expenses due to the risk of disease apart from depriving them of the free medical checkup facility and other ancillary benefits. The dishonour of the cheque caused much financial loss and mental agony for which the opp.party is liable to compensate the complainant. Hence the complaint The opp.party filed a version contending, interalia that the complaint is not maintainable either in law or on facts. The complainant has no cause of action against the opp.party. The complainant is an SB account holder of this opp.party with account No.2031000002031 The complainant has infact issued a cheque towards his insurance premium amount in favour of New Indua Insurance Company Ltd. for Rs.5441/-. The above cheque was presented for collection by the payee through State Bank of Travancore, Ottapalam Branch. The payee sent the cheque directly to this opp.party for clearance. As per the accepted banking procedure any out station cheques for clearance shall be routed through the clearing bank of the concerned area. State Bank of Travancore, Kollam Main Branch is the clearing bank in Kollam Town area and the payee ought to have sent cheque for clearance through the said clearing bank Since the same was not presented through the clearing bank this opp.party did not honour the instrument and return the same to the State Bank of Travancore Ottappalam Branch for presenting it through the proper clearing bank. But inadvertently this opp.party failed to endorse the reason for not honouring the cheque and returned the same to the payee bank without stating any reason in the cheque return memo attached with instrument. This opp.party specifically entered the reason for return of the cheque un paid in the register kept with the bank in its ordinary course of business. Unfortunately due to the volume ness nature of work this opp.party failed to make proper endorsement stating the reason for return of the instrument unpaid in the return memorandum attached with the instrument. This opp.party reasonably believe that some one who was in possession of the instrument has conveniently made an X mark corresponding to Funds in sufficient among the unpaid reasons printed in the cheque return memorandum. In the above memorandum the date or return of the instrument and the signature of the drawee are conspicuously absent. It leads to the presumption that the opp.party never made any entry or endorsement in the cheque returned memorandum while the same has been dispatched The exact reason for return of the instrument unpaid has been properly entered in the register kept with the bank. The complainant in fact cunningly make use of the opportunity by marking insufficiency of funds as the reason for the return of the instrument. The allegation that the complainant has sustained pecuniary loss due to the non renewal of his mediclaim insurance policy is absolutely false and hence denied. There is no legal impediment in getting his policy renewed after complying the necessary formalities with insurer though the policy was cancelled. The claim made in the complaint that the complainant was eligible to undergo medical checkup upto Rs. 50,000/- from the fourth year onwards, as per the medi claim policy is false and hence denied.. The complainant has not suffered any loss towards any kind of medical treatment or hospitalization expenses during the policy coverage period of the cancelled policy. There is no deficiency in service on the part of the opp.party. Hence the opp.party prays to dismiss the complaint. Points that would arise for consideration are: 1. Whether there is any deficiency in service on the part of the opp.party 2. Reliefs and costs.. For the complainant PW.1 is examined. Ext. P1 to P10 are marked. For the opp.party DW.1 is examined.. Ext. D1 toD3 are marked. POINTS; The receipt of the cheque dated 23.5.2005 issued by the complainant in favour of New India Assurance Company for Rs.5441/- towards renewal premium for insurance by the opp.party and the dishonour of the same are not disputed. It is also not in serious dispute that the complainant is an account holder of the opp.party and that at the time of receipt of the above cheque, the complainant had a credit balance of Rs.28569.69 in his account. Ext.P2 statement of account in relation to the complainant’s account with opp.party also shows that as on 25.6.05 , the date of receipt of the cheque by the opp.party for collection there was a credit balance of Rs.28569.69. The specific contention of the complainant is that despite the fact that he had sufficient balance in his account to honour the cheque the opp.party returned the same on the ground of insufficient funds in the account is deficiency in service on the part of the opp.party. It is further contended that due to the dishonour of the cheque he has suffered other losses when his Insurance policy was cancelled for non payment of renewal premium due to the dishonour of cheque due to the negligence of the opp.parties. According to the opp.party the cheque was returned dishonoured not for insufficient funds but because the cheque was not presented through the notified clearing bank in the locali9ty. It is argued that the SBT Ottappallam branch instead of sending the cheque for clearance through State Bank of Travancore main branch, Kollam has send the same directly to the opp.party which is a clear violation of the accepted banking proceeding . However no such procedure was produced. It is the further contention that the cheque return memo was issued without making any endorsement such as ground for objection, date, signature of the drawee etc. an inadvertent mistake and that the ‘X’ mark in the dishonour memo is made by some one else. That argument cannot be accepted. The return of the cheque without making any endorsement in the dishonour memo itself is deficiency in service. Even assuming thatg there is an endorsement in their records that the cheque was returned with the endorsement “present for clearing through SBT, Kollam branch” it is not sufficient to infer that it is due to an inadvertent mistake because as argued by the complainant those records being in their possession they can make any entry at their will. In this context the evidence of DW.1 is material In cross examination at page 3 DW.1 has stated as follows: Qgk sv]\ dxd\,rk ir\rk amb\bjulH sv]\ return register hkA memo ujhkA simultaneous Lluj}lujgj]kAentry igkr\rfk. In further cross examination DW.1 has stated that “Bank H dxd\,R igkr\rfk verify svu\ulR clerical staff KA officers KA Kn\mk. Return svu\ukr\rfjrk akRek officers verify svu\ukA. It cannot be believed by any stretch of imagination that the clerical staff as well as officers committed mistake inadvertently. Whether or not it is an inadvertent mistake the return of a cheque for insufficiency of funds when there was sufficient Funds in that account to honour that cheque naturally will cause mental agony and harassment and humiliation to the account holder and the opp.party bank cannot absolve themselves of their liability saying that it is an inadvertent mistake . In our view it is a clear case of deficiency in service The case of the complainant is that due to the dishonour of his cheque negligently by the opp.parties his insurance policy which was being renewed regularly was cancelled by the insurer and many benefits accrued to him had the policy been renewed in tune were lost. According to him the cumulative bonus, reimbursement of cost of medical checkup once at the block of every 4 year were lost. The policy conditions says that if there are no claim reported during the block and the insurance continues without break the insured is entitled to get cumulative bonus and reimbursement of expenses for medical check up and the opp.party failed to establish that the complaints made any claim during the block of 4 years. Under clause 7 of Ext.P8 policy the sum insured under the policy shall be progressively increased by 5% in respect of each claim free year of insurance if the premium is paid without any break . It is argued that since due to the negligent act of opp.party the policy was cancelled the complainant sustained loss of cumulative bonus referred to in Ext.P8. According to the complainant at the end of the 4th year if the policy was not cancelled he would have been entitled to get Rs.30,000/- . As pointed out earlier there is no material to show that the complainant made any claim during this period . Therefore had the policy been not cancelled the complainant would have received Rs.30,000/- at the end of the 4th year of the block period. Another contention is that as per clause 8 of Ext.P8 policy the complainant would be entitled for reimbursement of cost of medical check up once at the block of every four underwriting years provided there are no claims reported during the block and there is no break. Under the above clause it is 1% of the amount of the average sum insured during the block of four underwriting years which comes to Rs.8000/- . The complainant would contend that he is entitled to get Rs.8000/- on that account. There is no doubt that had the policy been not cancelled the complainant would have received the same. The learned counsel for the complainant would argue that due to the dishonour of the cheque his reputation was adversely affected causing severe mental agony to him for which he may be availed compensation. We find that there is force in that contention. For all that has been discussed above we hold that there is deficiency in service on the part of the opp.party. Point found accordingly. In the result the complaint is allowed in part directing the opp.party to pay the complainant a sum of Rs.38,000/- towards cumulative bonus and cost of health check up and Rs.10,000/- towards compensation and with interest @ 9% per annum from the date of complaint till realization and costs Rs.2000/-. The order is to be complied with within one month from the date of this order. Dated this the 20th day of November, 2009 . I N D E X List of witnesses for the complainant PW.1. - Cliford Fernandez List of documents for the complainant P1. – Insurance policy P2. – Statement of account from1.4.05 to 19.8.2005 P3. – Memo [cheque return] P4. – Copy of letter dated 20.7.05 P5. – Copy of Adv. Notice P6. – Acknowledgement card P7. – Reply notice dated 27.10.2005 P8. – Policy condition P9. – Insurance Policy 2002-03 P10. – Insurance policy 2003-04 List of witnesses for the opp.party DW.1. – Nebu Thomas List of documents for the opp.party D1. – Reply notice P2. – Under certificate of postal receipt D3. – True copy of cheque return register extract |