Hon’ble Mr. Subhas Ch. Guin, Member.
This is a complaint petition U/S 35 of Consumer Protection Act 2019. The fact of the petition in a nutshell is that the Complainant Md. Soleman Mia, a resident of Natun Pally, ward no.-8, P.S. Kotwali, P.O. & Dist.- Coochbehar, purchased one policy from Nippon Life Insurance having policy no. 54138353 and plan name Reliance Nippon Life fixed Money Back Policy. The said policy was purchased from office of the Branch Manager, Reliance Nippon LIfe Insurance Company Ltd, RRN Road, P.S.-Kotwali, P.O & Dist- Coochbehar(O.P) with date of commencement 11.07.2022 on payment of 1st premium Rs. 20799.92. The O.P assured the Complainant at the time of purchasing the same that the said policy had medical facilities. That on 22-09-22 the Complainant's only son shahrukh Hossain was ill and got admitted to a Nursing Home in Dum Dum Road, Kolkata from 22-09-22 to 25-09-22 and a bill of Rs 15200/- was charged for the same. Thereafter the Complainant submitted all relevant documents to one employee of the O.P. Company Mr. Ali for reimbursement. Mr. Ali informed the Complainant that the said amount for bill would be disbursed through NEFT to the Complainant's A/C but the Complainant did not receive the amount of the said bill till today. The complainant had been to O.P's office on various occasions and enquired about reimbursement of the said bill but all his attempts were in vain. Ultimately the O.P informed the Complainant that if he paid the 2nd premium of the said policy then he would get Rs 32000/- as bonus. So, as per information of the O.P. the Complainant paid the 2nd premium in the month of October 2022 but to his utter surprise he did not get the bonus prize till date. Being frustrated with the O.P’s conduct, the Complainant decided not to continue said policy. In the mean time the complainant came to know that the 2nd premium paid by the Complainant was not deposited by the then Branch Manager Mr.Ankit Jaiswal. Thus, the complainant had been deceived by the then Branch Manager Mr. Ankit Jaiswal as the money receipt issued by the O.P for paying the premium of the said policy was fake and false. After this shocking news the Complainant approached the O.P to discontinue the said insurance policy and requested the O.P to refund the entire amount i.e. Rs. 39600/. On 26-02-23 the then Branch Manager Mr. Ankit Jaiswal handed over a cheque having No.- 409471 amounting to Rs 39600/- to the Complainant after several request but that cheque bounced. Again on 18.04.2023 the Complainant sent an e-mail to the Branch Manager Reliance Nippon Life Insurance, Sevok Road, Siliguri with a request to refund Rs. 39600/- against the said policy but to no avail. Thereafter, the Compainant filed two written Complaint to the Branch Manager, Mr. Ankit Jaiswal on 31-05-23 and 02-06-23 to discontinue the said policy and to refund the premium amounting to Rs. 39600/- but till today he was yet to receive any reply from him. Ultimately, the Complainant filed a written complain to the Asstt. Director, Consumer Affair and Fair Business Practices, Coocbehar on 12.06.2023 for refund of Rs. 39600/- which he paid to the O.P as premium for the said policy but this attempt also failed.
That being a senior citizen, the Complainant was in hardship due to the non-coperative and negligence attitude of the O.P. Mr. Ankit Jaiswal was acting Branch Manager at the time of alleged incident so as per the rule of vicarious liability the O.P was liable for his negligence act while he was holding the chair of Branch Manager. Now at this juncture, the Complainant was facing an irreparable loss and injury from the O.P’s end for non-payment of Rs. 3966/-. That by such willful act of omission and commission by not paying the Complainant his hard earning money the O.P had caused deficiency in service to the Complainant which promoted him to file this case before this commission for having proper and effective justice. The cause of action of the present case arose on 11.07.2022 when the Complainant and his wife purchased the insurance policy and on 22.09.2022 when the Complainant paid a bill of RS. 15200/- to a nursing home in Dum Dum Kolkata for his son’s treatment and on when the Complainant submitted all documents for reimbursement to Mr. Ali in October 2022 and on when the Complainant filed two written complaint to the O.P and still continued.
That due to such activity of the O.P, the Complainant suffered from acute mental pain, agony, pecuniary loss and unnecessary harassment. The O.P also adopted their deficiency in service for not paying the Complainant his hard earned money which he paid to the nursing home. As a last resort the Complainant filed this case before the commission for redressal of his grievances. He prayed to the commission for direction to the O.P to pay Rs. 200000/- as compensation for harassment, 500000/- for deficiency in service, Rs. 500000/- as Compensation for mental pain, agony and unnecessary harassment, Rs. 10000/- as compensation for unfair trade practice and Rs. 15000/- towards cost of proceeding.
The Complainant, Mr. Soleman Miah purchased one policy named Reliance Nippon Life Fixed Money Back from the O.P on 11.7.2022 being persuaded by one employee of the O.P named Asgar Ali and then Branch Manager, Mr. Ankit Jaiswal having policy no. 54138353 (Anex-A). The Complainant paid the 1st premium Rs. 20799.72 to the O.P and at the time of taking the said policy, the O.P assured the Complainant that the said policy had medical facilities. That on 22.09.2022 the Complainant only son Shahrukh Hossan fell ill for which he was admitted to a Nursing Home in Dum Dum Road, Kolkata from 22.09.2022 to 25.09.2022 and the Complainant paid the nursing home charge Rs. 15200/-( Anex-B1,B2,B3). On the basis of verbal assurance of the O.P’s Branch Manager the Complainant submitted all relevant documents to Mr. Ali for reimbursement of the said bill Rs. 15200/- and Mr. Ali told the Complainant that the claim amount would be disbursed through NEFT to the Complainant’s account. But the O.P did not disburse the said bill till today. The Complainant had been to the O.P’s office on several occasions and inquired about the above said bill but all his attempts were in vain. Being frustrated with the O.P he filed this case before this commission.
The Complainant filed the original policy documents of the said policy. On perusal of the policy documents it is clear that there is feature named Reliance Nippon Lie Critical illness rider which provides a lumpsum benefit which is payable if the life assured survives for a period of 30 days following diagnosis of any one of the covered 25 critical illness with fulfillment of covered critical illness definition subject to the Rider benefit being force. But in the said policy the life assured was Mrs. Zinnat Jahan, wife of the Complainant. His son who was treated was not included in the said policy. So, the claim of medical bill was not reimbursed by the O.P. Therefore, the commission finds no deficiency in service nor was any unfair trade practice on the part of the O.P. As such the Complainant is not entitled to get any relief what soever.
In the result, the complaint case fails.
Hence, it is
Ordered
That the complaint Case No. CC/66/2023 be and same is dismissed ex-parte against O.P.
D.A. to note in the trial Register.
Let a plain copy of this Order be supplied to the concerned party by hand/by Registered Post with A/D forthwith, free of cost, for information & necessary action as per rule.
The copy of the Final Order is also available in the official website: www.confonet.nic.in.
