Decided on April 08,2008

Branch Manager New India Assurance, Respondents


K.SAMPATH, J. - (1.) The complainant in O.P.No.291/2003 on the file of the District Consumer Disputes Redressal Forum, Chennai (South) is the appellant herein. His case was as follows :- (a) He took a mediclaim policy from the opposite party for a period of one year from 10/10/2000 to 09/10/2001 by paying Rs.5,080/- for himself and his family members numbering about five. He paid a sum of Rs.5,080/- and had the policy renewed from 10/10/2001 to 09/10/2002. The whole process was routed through an agent Mr.K.P.Haridoss and his Development Officer one Mr.Ramanujam. The complainant preferred a mediclaim on the above said policy for his son and routed the same through the said agent. On 18/10/2002, the complainant approached the opposite party to ascertain the mediclaim and for further renewal of the policy. He sent a letter dt.24/10/2002 with a request to the opposite party to condone the delay and to renew the policy and also offering to issue a cheque for the said amount. The renewal was denied by the opposite party. The opposite party ought to have sent advance information to the complainant regarding the renewal of the policy which the opposite party did not do. On 04/12/2002 the opposite party sent a letter enclosing the proposal form with calculation sheet regarding the payment of the above policy. The delay in sending that letter had not been explained anywhere. It was very much clear that the opposite party had decided to renew the policy by delaying the process which showed negligence and deficiency in service on the part of the opposite party. The complainant could not therefore avail the benefits of the policy when his wife was treated in Shri Ramachandra Hospital and he had to spend Rs.15,000/-. In these circumstances, he filed the complaint seeking payment of Rs.15,000/- together with a sum of Rs.1,00,000/- towards mental agony, etc.,
(2.) The opposite party filed a version stating inter-alia as follows: - As per policy condition 5.9, the policy was renewable by mutual consent and in any event, the opposite party was not bound to give notice that the policy was due for renewal. As per condition 5.2 of the policy, the premium should be paid in advance before commencement of the risk and this clause in the policy was only in accordance with the statutory requirements under Section 64 V B of the Insurance Act and no insurer shall assume any risk prior to the receipt of the premium. The policy in question was not statutory but purely contractual and parties are bound by the terms and conditions thereof. The complainant ought to have been fully aware and was bound by the terms and conditions including the terms relating to renewal and the payment of premium in advance. The same not having been done by the complainant, the policy had lapsed. For renewal, the complainant ought to have approached the opposite party. This the complainant had not done. Policy had expired on 09/10/2002. More than 15 days after the expiry of the policy the complainant had sent a letter only on 24/10/2002 to the opposite party. There was no mention in the said letter regarding the request for renewal earlier either directly with the opposite party or through the agent or development officer. There was no question of condoning the delay as Section 64 V B of the Insurance Act prohibited assumption of risk prior to receipt of premium. Though the opposite party should not be compelled to issue the policy, the complainant's request by offering the insurance from the date of receipt of premium was accepted. The complaint was liable to be dismissed.
(3.) Before the District Forum, the complainant marked Exs.A1 to A10 while no document was marked on the side of the opposite party.;

Click here to view full judgement.
Copyright © Regent Computronics Pvt.Ltd.