This case has been filed U/s.12 of the Consumer Protection Act, 1986 by the complainant, In short, the complainant states that he purchased a medi claim policy from O.P. no. 3 for himself and his family members @ of Rs. 3,50,000/- each out of which he paid Rs. 12,410/-as premium for the year 2017-2018, but on 06/11/2018 he applied before O.P. No. 3 for switching over the said policy and to increase the sum assured to Rs. 5 lac of each member of his family including himself and for this he sent a Bank Draft amount to Rs. 14,904/- to O.P. No. 3.
It is also stated by the complainant that on 08/11/2018, the Administrative Officer of the O.P. no. 3, Mr. Somnath Banik sent a letter to the complainant mentioning that the bima policy Sampoorna Surakha Bima Policy has been temporary withdrawn from their office and again on 14/02/2019 O.P. No. 3 issued new Sampoorna Suruksha Bima Policy to the complainant and his family members and for which the O.P. no. 3 received premium Rs. 17,058/-
Thereafter the complainant sent a Legal Notice through his Ld. Advocate on 15/04/2019 which was duly received by the O.P. no.3 but O.P. no. 3, did not respond or settled the grievances of the complainant. So the conduct of the opposite parties have caused tremendous mental tension to the complainant and he has been passing through mental agony and his legitimate prayer has been rejected with vague plea by the O.P. no. 3.
Accordingly complainant filed the complaint petition praying for proper replies against the opposite parties as mentioned in the prayers of petition of complainant.
The opposite party No.1,2 and 3 have contested the case by filing written version denying all the material allegations as made against them. This opposite parties submit that the complainant has no cause of action against them and the claim is totally misconceived and has no cause of action at all arose for filing the instant case and the claim is liable to be dismissed with costs.
The complainant filed evidence on affidavit which is nothing but a replica of complaint petition and supports the averments of the complainant in the complaint petition and denial of the written version of the opposite parties.
Ops by a petition dated 28/02/2020 have prayed for their w/v may be treated as evidence in chief on their behalf and this Commission directed to keep the said petition and record.
From the discussion herein above, we find the following issues/points for consideration.
Issues/points for consideration
- Whether the complainant is the consumer of the opposite parties or not?
- Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
- Whether there is any deficiency of service on the part of the opposite parties?
- Whether the complainant is entitled to get relief/reliefs or not?
DECISIONS WITH REASONS
All the points are taken together for easiness of the discussion of this case.
In the light of the discussion hereinabove and from the materials on record, it transpires that the complainant is a Consumer as provided by the spirit of Section 2 (1) (d) (ii) of the Consumer Protection Act, 1986, the complainant here in is a consumer of the opposite party.
Both the complainant and the opposite parties are resident having their office addresses within the district of Hooghly. For mental agony and other expenses which are within Rs. 2,00,000/- limit of this Forum. So, this Forum has territorial/pecuniary jurisdiction to entertain and try the case.
Complainant and Op National Insurance Company filed written notes of argument. The evidence on affidavit and written notes of argument of both sides are taken into consideration for passing final order.
On a close scrutiny of the materials on record it appears that complainant in his complaint as well as affidavit in chief has categorically stated that he obtained a hospitalization and domiciliary hospitalization benefit policy, family mediclaim policy from the opposite party no. 3 to cover the risk for himself and his family. That on 06/11/2018 complainant applied before OP 3 for switching the policy being no.; 153600/48/17/8500007012 under the scheme of “Sampoorna Suraksha Bima” Policy and to increase the sum insured to Rs. 5 lac of each member of his family and fixed all relevant papers and a bank draft of Rs. 14,904/- for acceptance of the op. 3, butMr. Somnath Banik Administrative Officer of Op 3 by a letter dated 08/11/2018 intimated complainant that due to technical reason and to render prompt and hassle free service to complainant issuance of new ´Sampoorna Suraksha Bima Policy” has been temporarily withdrawn from the office of National Insurance Company. Accordingly complainant became surprised and categorically stated that contents of said letter of said Somnath Banik is far away from the truth as he on behalf of op 3 suppressed the material facts. That apart in support of his contentions complainant has relied upon one photocopy of policy premium details of one Avijit Mondal & his family members Customer ID 9514917606 and Policy no. 1536005918110002125 and total premium received Rs. 17,058/-.Complainant further stated that Sampoorna Surakha Bima is a complete personal Life Insurance Plan designed to cover virtually every personal protection need of individual property, health, cover against accident, security against professional error or negligence. Complainant also state that thus, this rule flows directly from the doctrine of equality embodied in Article 14 of the Constitution of India. Complainant also stated that op 3 illegally ignored in switching of the policy of complainant to Sampoorna Suraksha Bima policy. Complainant added that op 3 cannot deny from issuing Sampoorna Suraksha Bima policy in favour of complainant.
On the other hand, op 1 to 3 by a petition dated 28/02/2020 made a prayer for treating their W/V as their affidavit in chief.Going through the W/V of op 1 ,2 and 3 this Forum is of the view that ops tried to by-pass the main allegation of complainant. In a very criptic manner they have drafted their W/V which clearly indicates the op 1 to 3 literally have no ground / reason to deny and dispute the prayer of complainant. By furnishing BNA on behalf of National Insurance Company said op try to highlight some reason, but to the mind of this Forum which appears to be baseless and bias. Ops cannot discriminate their choice and preference upon the customer which is totally illegal and contrary to law. Article 14 of the Constitution of India clearly speaks about equality before the law but, here ops have done unequal work for their own interest which should be condemned.
Thus, in view of the above discussions and considering the facts and circumstances of the case we are of the view that complainant has succeeded to prove this case.
Hence,
it is
ordered
that the complaint case being no. C.C. 74/2019 be and the same is allowed on contest against op no.1 ,2 and 3 with costs.
Op no. 3 is hereby categorically directed to allow the prayer dated 06/11/2019 of the complainant made before op no.3 and switch over the policy of complainant being no. 153600/48/17/8500007012 to “Sampoorna Surakha Bima Policy” with retrospective effect within 45 days from this date of order.
Op 1, 2 and 3 are further directed to pay complainant Rs. 20,000/- towards litigation cost.
Let a plain copy of this order be supplied free of cost to the parties/their ld. Advocate/Agent on record by hand under proper acknowledgement/send by ordinary post for information and necessary action.
