O R D E R.

By Smt.  Beena. M, Member :-

          This is a complaint preferred   under Section 35 of the Consume Protection Act 2019.

2. Brief facts of the case are as follows:-  The  Complainant  joined in the Munich Appolo Health policy, which is issued only for the  customers of the Canara Bank,  in the year 2017 and deposited the premium amount in  Complainant’s Savings Account before the month of November and also remitted the premium before November till 2020.  In 2020 November the Complainant deposited Rs.12,000/- in his account and  he thought that it would be auto debited as usual towards premium.  However, as per the message received by the Complainant on  20^th  April 2021, it is understood that Rs.1,785/- has been debited from the Complainant's account for using locker facility and the balance is only Rs.16,899/- and the health insurance premium has not been paid.  The Complainant was neither called by the bank nor informed in writing about non-payment of policy premium.  Being a senior citizen above 70 years of age and not being a member of any other health care scheme in old age, the lapse of the policy is a heavy loss to the Complainant.   In the month of April 2021, as per the messages received from the bank, the Complainant was informed that a service charge of Rs. 1,785/- has been charged for the locker facility and that there is a balance of Rs.16,899/- in the savings bank account. At that time only, the Complainant realized that the premium amount was not auto debited to the account of the insurance Company.    When the Complainant went directly to the bank and inquired, he was told that the insurance company had changed, but no clear notification was received.  Therefore, the Complaint has been filed seeking that the Opposite Parties should maintain the insurance cover that was lost or to pay a compensation of Rs.4.5 lakhs.

3. The Opposite Parties entered appearance and filed version.  The Opposite Party No.1 admitted that the Complainant is having bank account with them and  the Complainant was remitting the insurance policy premium to the Second Opposite Party through the account of the Complainant with the  bank till October 2019.  The renewal policy amount had to be remitted on or before 31/10/2020, but the Complainant had not remitted premium amount within the stipulated date and time. The Complainant was regularly paying the insurance premium through the account.  But the Complainant had not maintained sufficient balance on 30-11-2020 to renew the policy.   Hence the Opposite Party is not liable.  The payment to the 2^nd Opposite Party is an auto debit payment from the account of the Complainant and no service charge or payment is charged by the bank towards this transaction and there is no deficiency of service from their part.   Second Opposite Party also filed version. The averment in the version is that the Complainant has remitted Rs.12,000/- as premium in November is false and so  the policy was expired on 11-11-2020. Hence the company is not liable for non renewal of the policy.  The Complainant neither contacted nor requested the Opposite Party for renewal.  Hence there is no deficiency in service from the part of Second Opposite Party.       

4. On perusal of Complaint, Version and documents, Commission raised the following points for consideration:-

   1. Whether there is any deficiency in service from the part of Opposite

      Parties?

  2. Whether the Complainant is entitled to get any relieves as prayed for?

5. Point No. 1 and 2 :-  For the sake of convenience and brevity both the

points are considered together.

          6. Complainant was examined as PW1 and Ext. A1 marked. 

         7. There is no dispute to the fact that Complainant is an account holder of the First Opposite Party.  It is also not in dispute that the Complainant was a policy holder of the Second Opposite Party and premium was used to be deducted from the Complainant’s savings account.  Due to the non-payment of installment of premium within time, the policy was lapsed. A grace period of one month could be allowed for annual payment. Here the grace period to renew the policy was up to 12/01/2021.  During that period the Complainant has paid the premium for the renewal of the policy. The Second Opposite Party did not inform the Complainant directly, in writing or through text message that the policy of the Complainant was lapsed or the policy was not renewed due to insufficiency of funds in the account. Anyway, it is seen that the Complainant has not failed to renew the policy intentionally. This was happened due to a failure in communication between the complainant and the Second Opposite Party.  As the first   insurance company was not the insurer at the time of due date for remittance of the last installment of premium in question, as it was changed, the Second Opposite party had the obligation to inform the Complainant about the change of insurance company.   It is seen that there has been a lapse in communication regarding the change of the insurance Company on the part of the Second  Opposite Party. Moreover, there was sufficient amount for renewal of the policy in the account during the grace period and therefore, the Second Opposite party is liable to renew the policy. So, Commission is of the view that the cancellation of the policy is only due to the fault of the Second Opposite Party.  Therefore, the Second Opposite Party is liable to renew the policy by debiting the money for renewal of the policy from the account of the Complainant directly or collecting it from the Complainant by serving notice to the Complainant.

 Hence the complaint is partly allowed  and we direct the 2^nd Opposite Party to reinstate the policy bearing No. 0137101010563 of the Complainant without charging any interest, fine or imposing any other penalty or to give Rs.4,00,000/- (Rupees Four Lakh  only)  as compensation.  

           The above order shall comply within one month from the date of this order, failing which the same shall carry interest at the rate of 8% per annum from the date of this order.

          Dictated to the Confidential Assistant, transcribed by him and corrected by me and pronounced in the Open Commission on this the 22^nd  day of  March 2023.

          Date of filing: 12.07.2021.

                                                                             PRESIDENT:  Sd/-

                                                                             MEMBER     :  Sd/- 

                                                                            MEMBER   :  Sd/-

APPENDIX.

Witness for the Complainant:

PW1.          Dr. Thomas. P                Complainant.       

Witness for the Opposite Parties:

Nil.   

Exhibits for the Complainant:

A1.    Copy of Statement of Account.

Exhibits for the Opposite Parties:

B1.    Copy of Statement of Account .        dt:14.02.2023               

                                                                                    PRESIDENT :   Sd/-

MEMBER     :   Sd/-

MEMBER     :   Sd/-