BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, MYSORE-570023

CONSUMER COMPLAINT NO.73/2018

DATED ON THIS THE 1^st FEBRUARY 2023

Present:      1) Smt.A.K.Naveen Kumari

B.Sc., LL.M., - PRESIDENT  

                     2) Smt.Lalitha.M.K.,

M.A., B.A.L., LL.B., - MEMBER  

                        3) Sri Maruthi Vaddar,

                                                B.A., LLB (Special)  - MEMBER

Sri MARUTHI VADDAR,

MEMBER

1.         This complaint has been brought under Section 12 of the erstwhile C.P.Act, 1986 by the complainant A.Sunil Kumar, resident of Gokulam, Mysuru against the opposite party the Branch Manager, Reliance General Insurance Company Limited, Mysuru, alleging deficiency of service and unfair trade practice on the part of opposite party, directing the opposite party to renew the existing policy by collecting the premium amount with continuing accrued benefits and further to pay Rs.5,00,000/- towards harassments and mental agony along with cost and such other reliefs as this Hon’ble Commission deems fit in the interest of justice and equity.          
2. The brief facts of the complaint in a nutshell is as here under:-

It is alleged in the complaint that the complainant and his family members have obtained reliance health insurance policy plan standard from the opposite party since more than 10 years and have continuously renewed from 11.03.2015 to 10.03.2017, the policy No.1403742828000170 sum assured is Rs.6,00,000/- and cumulative bonus was accumulated to an extent of Rs.4,00,000/- as on 2017.The opposite party used to send the renewed intimation letter pertaining to the policy much in advance every year.But, this year the complainant has not received any such renewal intimation letter from the opposite party and the complainant has missed the date and could not get the policy renewed.Initially, the complainant’s children who were minor and on attaining the age of 21 separate policy was made in their individual names but opposite party failed to send intimation for renewal to the complainant except his children.

It is further alleged that on coming to know that the policy has been lapsed, immediately contacted the opposite party to pay premium and renew the policy, but the opposite party has not collected the same.In spite of sending E-mail, the opposite party has not renewed the policy but advised to purchase a new policy.Refusal to renew the policy along with accrued benefits under the said policy is totally unwarranted and the same is to defeat the enforcement of the policy.Hence, this complaint.

3. After registration of the complaint, notice was ordered to be issued to opposite party and in pursuance of the notice, the opposite party appeared through its counsel and has filed the detailed version contending that the complaint is not maintainable either in law or on facts and liable to be dismissed in limine.  Further, the opposite party admitted about the Health insurance policy taken by the complainant subject to specific terms and conditions as stipulated in the policy which govern the instant claim.  There is a duty caste upon the complainant to get his health insurance policy renewed before it expired and the complainant approached to renew his policy but once the policy is expired no renewal can be done from the date of its expiry and it was clearly informed to the complainant that it was not possible to renew the expired policy.

It is further contended that on the perusal of the complaint, it is seen that the complainant has stated that he has been continuously renewed the said policy for the last ten years, this clearly goes to show that the complainant is aware that the said insurance policy has to be renewed before it expires.It is also seen from the documents produced by him that there is a renewal letter dated 04.03.2017 and hence, it is a failure on the part of the complainant to renew the health insurance policy.Opposite party further contended that opposite party had not undertaken to send a renewal notice to the complainant and there is no duty caste on the Insurance Company and it is also not a condition precedent.The opposite party has even sent a renewal intimation letter but the complainant failed to renew his policy within time.Further, the complainant is not entitled to the accrued benefits and Rs.5,00,000/- towards harassment and mental agony along with costs.There is no deficiency of service on the part of the opposite party and hence, the complaint is liable to be dismissed.

4. The complainant has filed the affidavit towards his chief examination and the same was taken as P.W.1 and produced four documents.  On the other hand, opposite party has also filed its affidavit through its Claim Manager and the same was taken as R.W.1 and did not choose to mark any documents.    
5. Heard arguments of the learned counsel for the opposite party and the learned counsel for the opposite party has also filed written arguments.
6. Now the points that arise for our consideration are as here under:-  

1. Whether the complainant proves the alleged deficiency in service and unfair trade practice on the part of the opposite party and thereby he is entitled for the reliefs sought for?
2.  What order?

7.       Our findings on the aforesaid points are as follows:

      Point No.1 :- In the negative.

      Point No.2 :- As per the final order for the following

:: R E A S O N S ::

8.       Point No.1:- To prove his case, the complainant has filed his affidavit evidence and also some documents like policy copies and E-mail sent by the complainant to the opposite party.  The complainant has reiterated the averments of the complaint in his affidavit evidence.  After the evidence of the complainant, the opposite party has also filed its affidavit evidence but did not produce any documents.  The opposite party has reiterated the averments of its version in its affidavit evidence.  After the testimony of both parties only the learned counsel for opposite party has submitted his oral as well as written arguments.  But, the complainant failed to address arguments in spite of giving sufficient opportunity.  After perusing carefully the pleadings of both parties and the documents submitted by the complainant, it is noticed that there is no dispute between the parties regarding the issuance and taking of the health insurance policy. But, the only dispute is with regard to the renewal of the said policy.   As per the complainant, he obtained the health policy from the opposite party vide policy No.1403742828000170 sum assured Rs.6,00,000/- and he renewed the said policy for more than ten years by paying premium amount. 
9. It is further allegation of the complainant that opposite party used to send intimation letter pertaining to the renewal of the policy much in advance every year but in 2017, the complainant has missed the date and could not get the policy renewed due to the non-sending intimation letter by the opposite party.  Hence, his policy was lapsed and then the complainant contacted the opposite party to pay premium and renew the policy but the opposite party has not collected the same, but advised to purchase a new policy.  According to the opposite party, the opposite party had not undertaken to send a renewal notice to the complainant and it is also not a condition precedent to send the intimation notice for renewal of policy to the complainant.  The opposite party has even sent a renewal intimation letter but the complainant failed to renew his policy within time.  Hence, prayed to dismiss the complaint.
10. After going through the rival contention of both parties, it discloses that the complainant has renewed his health insurance policy from last ten years by paying premium amount to the opposite party. But, in the year 2017 since the opposite party has not sent the renewal intimation letter to the complainant, he missed the date and the policy was lapsed.  After the lapse of the policy, the complainant tried to renew the policy but the opposite party did not allow the same and directed to take new policy.  After perusing the policy copy, there is a note clause wherein it is clearly mentioned that “policy would be considered as a fresh policy if there would be break of seven or more days between the previous policy expiry date and current policy start date”.  As per this clause, the complainant has to renew his policy within 7 days. 
11. More over the complainant is a educated person and renewed the policy for more than ten years. So it is his bounden duty to renew the health insurance policy within due date. Without blaming the opposite party, the complainant has to keep his policy running. Both the complainant and the opposite party have entered into insurance contract and both are bounded by the terms and conditions of the policy.  When the opposite party not intimated the renewal date of the policy, it is the duty casted upon the complainant to renew the policy within time or to take a new policy as contended by the opposite party. If the said policy is other than health insurance policy, the matter would have been different. Hence, the rejection by the opposite party for the renewal of the policy is proper and justified. Hence, the complainant is not entitled to the relief as prayed in his complaint.  The complaint of the complainant is devoid of merits and it is sans merit and hence deserved to be dismissed. Hence, we answer this point in the negative.

12. Point No.2:- In view of answering point No.1 as above, we proceed to pass the following

:: ORDER ::

The complaint of the complainant is hereby dismissed with costs of Rs.1,000/-.

The complainant shall deposit the amount so awarded within one month from the date of this order, failing which the complainant shall pay interest at 6% p.a. till its payment.The amount so collected shall be payable to Consumer Welfare Fund.

Furnish the copy of order to both parties at free of cost.

(Dictated to the Stenographer transcribed, typed by her, corrected by us and then pronounced in open Commission on this the 1^ST FEBRUARY 2023)