BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KAITHAL.
Complaint Case No.19 of 2019.
Date of institution: 23.01.2019.
Date of decision:14.02.2020.
Bhupinder Kumar son of Sh. Daryai Lal, resident of Mahadev Colony, Sirta Road, Kaithal, District Kaithal.
…Complainant.
Versus
- Bank of Baroda, through its Branch Manager, R.K.Plaza, Park Road, Kaithal.
- National Insurance Company Ltd., through its Branch Manager, Pehowa Chowk, Kaithal.
….Respondents.
Before: Sh. D.N.Arora, President.
Sh. Rajbir Singh, Member.
Smt. Suman Rana, Member.
Present: Sh. Anurag Gupta, Advocate, for the complainant.
Sh. Dinesh Singh, Advocate for the OP.No.1.
Sh. C.S.Gupta, Adv. for the Op No.2.
ORDER
D.N.ARORA, PRESIDENT
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that the complainant has been maintaining his bank account No.0920100001463 under the Baroda Jeevan Suraksha Scheme with the Op No.1 since the year 2007. It is alleged that the Op No.1 represented the complainant that it has got an arrangement with the Op No.2 and according to which, its every customer under the scheme known as “BARODA HEALTH POLICY” can avail medical insurance and the premium of which shall be automatically deducted from the amount standing in the name of its customer. Thereafter, the Op No.2 issued annual policy bearing No.420503/48/8500009113 dt. 16.02.2015 in favour of the complainant for an amount of Rs.5,00,000/- and premium of Rs.7079/- was duly deducted by the Op No.1 from the bank account of complainant. Similarly, the policy No.420503/48/15/8500000085 dt. 16.02.2016 was issued for the next year and its premium amounting to Rs.7214/- was automatically deducted by the Op No.1 from the bank account of complainant. The Op No.2 again issued policy No.420503/48/16/85000000105 dt. 13.02.2017 for the next year valid from 16.02.2017 to 15.02.2018 and its premium of Rs.7246/- was automatically deducted by the Op No.1 from the bank account of complainant. It is further alleged that prior to expiry of the said policy period, the complainant visited the office of Op No.1 for getting his medi-claim policy for the next year i.e. covering risk 15.02.2018 to 14.02.2019, the officials of Op No.1 told the complainant that there is some delay on the part of Op No.2 in issuance of policy. Unfortunately, the complainant fell ill on 04.05.2018 and due to which the complainant was suffering from acute pain in chest, left upper limb and left shoulder for which the complainant was admitted in emergency in Columbia Asia Hospital, Patiala and he was discharged on 05.05.2018 where he incurred Rs.13,887/- on his treatment. However, the complainant could not get any relief in his pain and therefore, he was again admitted in emergency in BS Heart Care and Multi Specialty Hospital at Kurukshetra on 05.05.2018 and the aforesaid hospital charged a sum of Rs.15,600/- from the complainant for his treatment. The complainant approached the office of Op No.2 and requested them for reimbursement of his total amount of Rs.29,487/- but the Op No.2 flatly refused to pay the said amount to the complainant. So, it is a clear cut case of deficiency in service on the part of Ops and prayed for acceptance of complaint. Hence, this complaint.
2. Upon notice, the OPs appeared before this Forum and contested the complaint by filing their replies separately. Op No.1 filed the reply raising preliminary objections with regard to locus-standi; maintainability; cause of action; that the complainant has concealed the true and material facts from this Forum. The true facts are that the complainant is having bank account No.09820100001463 with the Op No.1. The Op No.1 launched a medical health policy scheme known as Baroda Health Policy and tie-up with the Op No.2 in the month of February, 2015. The complainant availed the said medical policy and got insured himself in the amount of Rs.5,00,000/- with the Op No.1 under the policy ‘Baroda Health Policy’. As per direction of complainant, the premium amount of Rs.7079/- was transferred in the account of Op No.2 on 16.02.2015 and the Op No.2 issued medical policy from 16.02.2015 to 16.02.2016 covering the complainant and his family members; that in the month of February, 2016 the complainant again contacted the officials of Ops No.1 & 2 and got renewed the above-said policy from the year 2016-17 and premium amount of Rs.7214/- was transferred in the account of Op No.2 on the request of complainant on 11.02.2016; that in the month of February, 2017 the complainant again contacted the officials of Ops No.1 & 2 and got renewed the above-said medical policy from the year 2017-18 and premium amount of Rs.7246/- was transferred in the account of Op No.2 on the request of complainant on 09.02.2017; that in the month of February, 2018 the Op No.1-bank gave intimation to the complainant for renewal of said medical policy from 15.02.2018 to 14.02.2019 but the complainant did not take any interest for renewal of his medical policy of the year 2018-19 and did not give his consent for automatically deduct the premium amount from his account to the Op No.1; that there is no deficiency in service on the part of Ops. On merits, the objections raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.
3. Op No.2 filed the reply raising preliminary objections that there is no deficiency in service on the part of answering Op on any count because neither any premium was received for the policy for the period w.e.f. 15.02.2018 nor such policy was ever issued in favour of complainant. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
4. The complainant tendered into evidence affidavit Ex.CW1/A and documents Annexure-C1 to Annexure-C15 and thereafter, closed the evidence. The complainant tendered in rebuttal evidence Annexure-C16 and thereafter, closed the evidence.
5. On the other hand, the Op No.1 tendered into evidence affidavit Ex.RW1/A and document Annexure-R1, Op No.2 tendered into evidence affidavit Ex.RW2/A and thereafter, closed the evidence. The Op No.1 tendered in additional evidence Annexure-R2 to Annexure-R4 and thereafter, closed the additional evidence.
6. We have heard the learned Counsel for both the parties and perused the record carefully.
7. It is an admitted fact that the complainant is having bank account No.09820100001463 with the Op No.1 and the Op No.1 launched a medical health policy scheme known as Baroda Health Policy and tie-up with the Op No.2 in the month of February, 2015. It is also admitted that the complainant availed the said medical policy and got insured himself in the amount of Rs.5,00,000/- with the Op No.1 under the policy ‘Baroda Health Policy’. The main grievance of the complainant is that as per the medical policy, the premium is to be deducted from the amount standing in the name of complainant. The Op No.1 is agent of Op No.2 and they are deducting the premium amount automatically from the account of complainant. Perusal of the statement of account Annexure-C4, it is clear that the bank has deducted the amount of Rs.7079/- on 16.02.2015 for the insurance period 2015-16 and next year, the amount of Rs.7214/- was also deducted from the account of complainant on 11.02.2016 for the period 2016-17. Similarly, the insurance amount of Rs.7246/- was deducted from the account of complainant on 09.02.2017 for the insurance period 2017-18. The dispute between the complainant and Op No.1-bank is according to Op No.1-bank that it is not an automatically deduction from the account of complainant. They are deducting the amount on the instructions of complainant and dispute between the parties is according to complainant, the bank has not deducted the policy amount for the period 15.02.2018 to 14.02.2019. Ld. Counsel for the Op No.1 contended that the complainant has not instructed the bank and accordingly, they have not send the amount to the insurance company. Ld. Counsel for the Op No.1-bank has filed the application for additional evidence and the same was allowed and they have placed on record copy of the vouchers Annexure-R2 to Annexure-R4 dt. 08.02.2017, 11.02.2016 and 13.02.2015 respectively. From the above-said vouchers, it is clear that the amount was paid to the insurance company subject to confirmation on the phone from the complainant. We are of the view that the vouchers are filled-up by the bank itself. We are of the further view that the bank is deducting the amount automatically from the account of complainant but they have not sent the amount for the period 15.02.2018 to 14.02.2019 to the insurance company. In the rebuttal, the complainant has produced the copy of order passed by Banking Ombudsman Annexure-C16, wherein it is clearly mentioned that the complainant has authorized the bank to debit the premium from his account and accordingly, they have deducted the premium for the period 2015-16, 2016-17 and 2017-18 but they have not deducted the amount for the period 15.02.2018 to 14.02.2019. Perusal of statement of account, it is clear that there was a sufficient amount in the account of complainant in the year 2018. The Op No.1-bank could easily deduct the amount and send to the insurance company. It is negligence on the part of Op No.1-bank because they are duty bound to give the facility which was availed earlier by the complainant and due to stoppage and negligence on the part of bank, the insurance company has declined the medical bills of complainant due to non-receiving the premium amount and there is no medical policy issued in favour of complainant. Hence, we find that there is no fault on the party of Op No.2 rather there is deficiency in service on the part of Op No.1. The complainant has placed on record the copy of bill dt. 05.05.2018 Annexure-C7 vide which he incurred Rs.12,476/- on his treatment in Columbia Asia Hospital, Patiala and as per bill dt. 06.05.2018 Annexure-C10, he incurred Rs.15,600/- on his further treatment in B.S. Heart Care 7 Multi Speciality Hospital Pvt. Ltd., Kurukshetra and so, the complainant has spent the total amount of Rs.28,076/- and the same is not denied by the Op No.1, therefore, he is entitled for the amount of Rs.28,076/- alongwith interest.
8. Thus, as a sequel of above discussion, we allow the complaint against the Op No.1-bank and direct the Op No.1-bank to pay Rs.28,076/- to the complainant alongwith interest @ 9% p.a. from the date of filing of present complaint till its realization. The Op No.1 is also directed to pay Rs.5,000/- as lump sum compensation on account of harassment, mental agony including the litigation charges. Let the order be complied with within 30 days from the date of preparation of copy of this order. A copy of said order be supplied to the parties free of costs. File be consigned to record-room after due compliance.
Announced in open court:
Dt.:14.02.2020.
(D.N.Arora)
President.
(Suman Rana), (Rajbir Singh)
Member Member.
