Judgment:
Per Mr. P.N. Kashalkar,Honble Presiding Judicial Member
1) Being aggrieved by the judgment of dismissal passed by two members of the South Mumbai District Consumer Forum, in Consumer Complaint No.211/2005 dated 13/4/2007 whereby the learned members of the Forum below was pleased to dismiss the complaint but by dissenting order dated 7/6/2007, the learned President of the District Forum allowed the complaint and directed O.P./Insurance company to pay Rs.1,538/- with interest at the rate of 18% per annum to the complainant and also directed to pay Rs.2,000/- as compensation, the original complainants have filed this appeal challenging the dismissal of the complaint by the learned two Members of the Forum below.
2) Facts to the extent material may be stated as under
3) The complainants had taken Overseas Mediclaim Insurance Policy for the assured sum of US $5,00,000/- for the period 10/10/2003 to 8/12/2003. The total premium paid was Rs.5,497/-. The complainants further extended the policy by paying Rs.4,503/- and Rs.5,932/- by two cheques for the period 7/2/2004 to 4/3/2004 and 5/3/2004 to 3/4/2004. These cheques were encashed by the O.P./insurance company. Receipts were issued to the complainants. In these receipts, the insurance company mentioned on its own accord that they had received Rs.1,156/- and Rs.382/- as excess amount. It was sought to be refunded and insurance company procured advance receipt from the complainant to the effect that they have received Rs.1,156/- and Rs.382/- from the insurance company but cheques were not given to the complainant though receipts were obtained from them. Thereafter Insurance Company informed the complainants that they had rescheduled the policy in respect of excess amount received from them and refused to issue the cheque for the said amount. Hence, the complainant filed consumer complaint and claimed the refund of said amount totally Rs.1,538/- from the insurance company. They also claimed some amount towards cost and some amount towards compensation and mental agony.
4) In the written statement plea of the O.P./insurance company was that they had made calculation mistake while calculating first and second premium for the Overseas Mediclaim Insurance Policy issued to the complainant and because of computer mistake it was shown that the complainants had paid excess premium of Rs.1,156/- and Rs.382/- respectively. Because of mistakes, cheques were issued but when cheques were tendered for signature before competent authority he noticed the mistake and therefore the policy was rescheduled by mentioning endorsement clause and amount in excess was adjusted. Hence, the insurance company pleaded that complaint should be dismissed with cost.
5) On considering affidavits and documents placed on record, the learned President allowed the complaint but learned Members dismissed the complaint. Hence, this appeal filed by the original complainants.
6) We heard submissions of Mr.V.M.Bhardwaj, Adv. for the appellants and none appeared for the respondent.
7) We are finding that Mr.Bhardwaj rightly submitted that appellants had not sought readjustment of the policy towards excess period given by the complainant to cover the excess amount. The readjustment was done on its own by the insurance company. No request of this nature signed by the appellants is placed on record that they have made request to issue additional coverage for the excess amount recovered by the insurance company. This is what is mentioned by the appellants in the appeal memo in para âK and we are finding substance in this submission of the appellant. Admittedly, computer showed that complainant made extra payment of Rs.1,538/-. The cheques were prepared for the refund of excess amount but at the eleventh hour the cheques were withheld and not given to the complainants. When both the receipts showed that excess premium was paid by the complainants it should have been refunded without any murmur or any hitch by the insurance company/the respondent herein. They had no power to make readjustment and to give extended cover as they alleged. They were guilty of deficiency in service for which learned President of the District Forum rightly passed an award in his dissenting judgment. We agree with his finding. We dont agree with the finding recorded by the learned Members of the Forum below dismissing the complaint. Complaint was required to be allowed because insurance company had received excess amount for the policy purchased by the complainants. They had obtained receipts for the said two amounts from the appellants and still did not issue the cheques. This itself means a deficiency in service on the part of insurance company. Hence, we are inclined to allow the appeal. As such, we pass following order.
Order:
1) Appeal is allowed.
2) The judgment delivered by the learned Member Smt.Deeplaxmi Mhase and seconded by another Member Shri Sunil Rane is hereby quashed and set aside.
3) Complaint is allowed and as directed by the President of the Forum below we direct respondent to pay sum of Rs.1,538/- plus Rs.2,000/- as compensation for mental agony.
4) Parties are left to bear their own costs.
5) Copies of this order be sent to the parties free of cost.