ORDER

07.02.2024

Sh. RAJESH, MEMBER.

1. Vide this order we will be deciding the admissibility of present complaint.
2. Present complaint has been filed by complaints seeking a direction to the opposite party to refund Premium of Rs.  30,901/- along with interest, cost and compensation.
3. It is stated that the complainant an insurance policy was booked on 24th May 2023 by mentioning all health problems i.e. Diabetes mellitus and insulin used by wife of complainant Mrs. Vandana Keswani such as Hypertension, Cholesterol, thyroid and same with complainant, but diabetes only with medicines.
4. It is stated that complainant when complainant received subject insurance policy, only diabetics and hypertension was mentioned therein.  But Insulin word was not used. Complainant objected and asked their agent to get it mentioned insulin.
5. It is stated that complainant also approached the OP to get the policy rectified but all in vain. Complainant wrote E mail to OP dated 10.11.2023 to cancel the policy and refund the premium but all in vain. Hence the present complaint.
6. We have heard the complainant in person and perused the record available before us.
7. To admit the present complaint, we have a form a prima facie opinion whether there is a Consumer Dispute in the present complaint within the meaning of the Consumer Protection Act 2019.
8. As per the averments made in the present complaint and record available before us the complainant submitted that on 24.05.2024 subject health insurance policy was booked with OP. However, complainant didn’t mention how much premium was paid for said insurance policy. On perusal of subject insurance policy it is transpired that subject insurance policy is a group Health Insurance Policy issued to the employees of Punjab National Bank office at Plot No. 4, Sector 10 Delhi 110075 for a period starting from 24.05.2023 to 23.05.2024 for a premium of Rs. 30,901/-. However, in the present complaint it not described whether the complainant paid this premium to OP. It is also not mentioned that how complainant has a right to reject the said group insurance policy purchased by Punjab National Bank for him and also how he is entitled refund of premium himself within free look period, if any.
9. In the present complaint the complainant has not mentioned the allegations of deficiency in service against the OP. Further no documents have been relied upon by the complainant to show deficiency in services against OP as defined under Consumer Protection Act, 2019. Present complaint lacks allegations of deficiency in services which may support his claim of refund of premium amount which as per subject insurance policy he has not paid. 
10. No grounds whatsoever or basis have been mentioned by the complainant for his entitlement for refund of premium paid by Punjab National Bank under the subject group insurance policy. It is important to note that the actual payer of premium for the subject group health insurance policy  i.e. Punjab National Bank has not been impleaded in the array of parties.  
11. In view of above discussions, we are of the considered opinion that since the complainant failed to show us that prima facie he has a right to claim refund of insurance premium in an insurance policy purchased by a third party in the present complaint therefore there is no consumer dispute and same is not maintainable in the eyes of law, hence. the present complaint is dismissed.
12. Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving the application from the parties in the registry.

Order be uploaded on www.confonet.nic.in. File be consigned to Record Room.

Announced in open Commission on 07.02.2024.

(SANJAY KUMAR)                            (RAJESH)

PRESIDENT                                        MEMBER