DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

C.C. No. 335/2019

QUORUM:

Judgment By: Shri S.S. Malhotra (President)

JUDGMENT

By this judgment the Commission would dispose off the present complaint filed by the Complainant against OP alleging deficiency by the OP in not renewing his previous existing policy.

1. Brief facts as stated by the complainant in the complaint are that complainant was an employee of Mother Dairy and got retired in 2012. OP1 is one of the leading public sector insurance company of India and OP2 is branch of public sector commercial bank having its head office in Mumbai. In the year 2012 complainant received a phone call from the office of Mother Dairy Pvt. Ltd. i.e. his previous employer, informing him that Bank of India is offering One BOI National Swastha Beema Policy in tie up with the OP1, only for Bank of India account holders whereafter complainant visited the OP2 and got certain informations and then opened a bank account with OP2 and as per the promises and rosy picture shown by the employees of OP1 and OP2, the complainant purchased one policy i.e. Policy No.361701/48/13/8500000360 for the period of 17.04.2013 to 16.04.2014  and paid a premium of Rs.4734/- and continue to renew the same upto the year 2018-19 without any break although with some marginal increase in the premium. The OP2 was asked many times to provide the copy of arrangement made in between OP1 and OP2 but no such arrangement letter was provided however in the year 2018 the complainant requested again for supply of such letters but the same was not given however in the month of March 2019 when complainant visited the OP2 for renewal of said policy he was shocked and surprised to hear that OP1 has discontinued BOI National Swastha Beema Policy w.e.f. 03.10.2018 and was also told that no fresh policy will be issued for the first time customers and as far as existing customers are concerned, they have an option to renew the policy for one more year only but the premium thereof was quite exhorbitant and accordingly, the complainant felt utterly cheated and deceived but having no other alternative, bought a fresh policy which was valid from 17.04.2019 to 16.04.2020 and paid an exhorbitant premium of Rs.36899/- i.e. Rs.31928/- in excess than that of the policy for the previous year, only for the reason that OP1 has closed/discontinued the policy without any information to the complainant and even in violation of IRDA rules which according to the complainant was unfair trade practice and malafide and accordingly he has filed the present complaint case inter alia with the prayer to direct the OP1 to issue a mediclaim policy having similar feature of BOI National Swastha Beema Policy at a similar premium which was being charged for the year 2019 and also direct the OPs jointly and severally to refund Rs.31928/- as charged in excess and to pay compensation of Rs.200000/- along with litigation charges.
2. The OPs were served and both the OPs have filed their separate written statement.    
3. OP1 has inter alia stated that complaint case is not maintainable on various grounds inter alia that complainant has not come to the Commission with clean hands, he has concealed material facts from the purview of this Commission, OP1 has no liability towards the complainant in reference to the renewal of the policy, there was no deficiency on the part of OP1 in closing/discontinuing his policy as insurance company cannot run its function smoothly by regularly incurring heavy losses and since this policy was running into losses w.r.t. the public funds, it was found appropriate for the authorities to discontinue the present policy and every steps were duly taken as per IRDAI guidelines. It is further submitted that IRDAI is an independent regulatory body and rules and regulations framed by IRDAI are to be followed by every insurance company.  It is further submitted that OP1 had issued a circular dated 25.09.2018 with the title ‘withdrawal of BOI National Swastha Beema Policy’ and ‘Baroda Health Policies’ wherein the process of withdrawal of the co-branded products was illustrated effectively and it was respectfully submitted that according to the circular any new policy whose renewal is post 01.01.2019 shall not be renewed and policy holder would be required to choose any of the alternative product of OP1 and further the complainant has deliberately concealed the material facts that BOI National Swastha Beema Policy provides a specific clause that in the event of tie up with the banks being discontinued or not renewed then current policy held by the insured may be allowed to continue till expiry of that particular year and thereafter can be switched over to other policy with continuity benefits and since the policy was not to be renewed complainant was offered another policy at the rates as decided by the company and therefore there is no illegality either in discontinuing the BOI National Swastha Beema Policy or offering the new policy which the complainant even opted for.
4. As far as merits are concerned it is submitted that facts which are relating to OP2 are not required to be replied but as far as the facts pertaining to OP1 are concerned, the each and every fact w.r.t. not renewing the policy of the complainant or compelling him to buy the policy are denied word by word. It is denied that complainant felt cheated /deceived by the OP or was left with no alternative except to buy another policy at the higher rates as alleged and it is submitted that complainant could have opted for any other policy or could have switched to another policy of the OP1 as per procedure and even had an option to migrate any of the insurance policy after, considering the terms and conditions of that particular policy/plan and it is submitted that complaint of the complainant be dismissed.   
5. OP2 has also filed its reply taking preliminary objection that this Commission does not have any jurisdiction to entertain the present complaint w.r.t. any dispute qua the policy, and the instant complaint filed by the complainant is only to harass the answering OP and to extract unjust money /monetary benefit from OP2 there is no deficiency in service on the part of OP2 rather he has been made a party unnecessarily without claiming any relief from him. Complainant has not come to the Commission with clean hands, the same is based on false and frivolous facts as OP2 had no relation with the complainant or with the policy and has opened the bank account of the complainant as per law without any deficiency on its part, therefore complaint of the complainant is liable to be dismissed against OP2.
6. As far as merits are concerned the facts which are pertaining to OP1 are denied for want of knowledge and it is reiterated that there is no cause of action against OP2 and case of the complainant against OP2 be dismissed.
7. Complainant has filed Rejoinder to the written statement of both the OPs and also has filed his own evidence by way of affidavit whereas OP1 has filed evidence by way of affidavit of Ms. Deepti Matta, the authorized signatory of OP1 and OP2 has filed evidence by way of affidavit of Ms. Anju Kerai AR of OP2.
8. Complainant has filed written arguments.
9. The Commission has heard the arguments and perused the record.
10. The grievance of the complainant in nutshell is that the policy which was started by OP1 in collaboration with OP2 i.e. the policy which was being issued to the Bank Account holders of OP2 at a lower premium, which was purchased by the complainant from the OP2, after becoming member/account holder of OP1 and continued to pay the premium which was about Rs.4734/- in the beginning and it was almost same except some additional amount, upto the year 2019 however OP1 abruptly discontinued this policy in violation of terms and conditions of the IRDAI which amounts to deficiency in service towards the consumer/ policy holder and therefore complainant was compelled to pay Rs.31,928/- more for the policy purchased in the previous years, which is unfair trade practice for complainant who is a senior citizen and retiree from Mother Dairy in the year 2012.
11. The main contention of the counsel for OP1 on the other hand is that the policy although was started by the OP1 in collaboration of OP2 thereby granting certain benefits to the bank account holders of OP2 for a premium but since this policy was a source of recurring losses, the company decided to discontinue the policy by a circular dated 25.09.2018 thereby giving an opportunity to the existing policy holder to shift to either of the two polices of OP with benefit of continuity which accrued in the previous years to the policy holder with further directions that no other policy would be issued under this plan after 01.01.2019 and discontinuation of policy were prerogative of the company which is done in terms of the rules and regulations of IRDAI and it was only after the approval of IRDAI was received, the policy was discontinued by giving appropriate advertisement and issuing required circulars and therefore discontinuation of a policy cannot be termed as a deficiency in service by the OP1 or in any case any unfair trade practice.
12. The contention of counsel for OP2 is that the complainant has not shown any grievance against the OP2 right from the beginning and it only acted for opening a bank account of the complainant which he opened as per law and on account of that opening of account, the complainant was entitled to have the policy i.e. BOI National Swastha Beema Policy which he obtained and even continued for about six years and if the OP1 had discontinued its policy no deficiency can be attributed to OP2. 
13. From all these facts as discussed herein above the Commission is of the considered opinion that if OP1 has decided to discontinue a particular policy then it is the sole prerogative of OP1 however subject to the rules and regulations /guidelines issued by IRDAI from time to time.  The contention of complainant that OP1 has failed to comply with the terms and conditions / directions of IRDAI while discontinuing is, of no consequences as IRDAI does not have any objection w.r.t. approval for discontinuing the policy i.e. BOI National Swastha Beema Policy. The insurance otherwise is an agreement in between the insured and the insurance company and both the party agree to certain terms and conditions for taking a policy and no one can be compelled to continue the policy. In other words the complainant cannot say the OP1 has to continue the policy for all the time to come, nor OP1 can compel the complainant to buy this particular policy from OP1 only for all the time to come. Either party has an independent right and they can continue or discontinue their policy.  As far as the terms and conditions of their agreement pertaining to the insurance policy and if one party intends to discontinue the policy the complainant cannot claim that there is deficiency in service on account of discontinuation of the policy. Therefore, the arguments of counsel for complainant on this aspect is not supported with any case/law nor has any merit whereas contention of counsel for OP1 and OP2 is well found the policy has been legally discontinued, by OP1 after having a necessary approval from the IRDAI and if the policy has been discontinued it cannot be termed as a deficiency in service on the part of OP1 or in any case an unfair trade practice. Accordingly, the complainant has not been able to prove any deficiency on the part of OP1 and as such complaint case of the complainant is dismissed.             

Copy of the order be supplied / sent to the parties free of cost as per rules.

File be consigned to Record Room. 

Announced on 05.11.2024.