MAPUSA
The Consumer Disputes Redressal Forum, North Goa, directed National Insurance Co Ltd, Mapusa and Bank of Baroda, Guirim to jointly and severally pay Rs 1 lakh towards medical expenses and Rs 50,000 compensation towards mental tension and agony to a customer. The forum also directed them to pay Rs 20,000 towards cost of the litigation.
The complainant, Lolita Dias had secured a Baroda Health Policy in collaboration with National Insurance Co Ltd at an annual premium in June 2009. The bank paid three premiums from the complainant's account, but failed to pay the fourth despite there being sufficient funds in the account.
In August, 2012, the complainant fell sick and was admitted in a Povorim hospital where she was operated upon.
Since the insurance company failed to re-imburse an amount of Rs 1 lakh towards medical expenses, the complainant approached the consumer court.
The bank tried to wriggle out of the situation saying that there was no privity of contract between the complainant and the bank and it merely acted as an agent. The bank also said that the complainant had failed to instruct it to pay the fourth premium.
The insurance firm relying on terms and conditions of the contract said they were not duty bound to send notice or reminder to the complainant for premium payment.
The forum found that as per the conditions of the Baroda Health Policy it was clear that the bank had to remit premiums to the insurance company.
"It appears the employees of the bank were negligent in not discharging their duties. The complainant cannot be allowed to suffer on account of the fault of the bank. Moreover, it's a public sector bank. Banks act as custodian of public money and they are accountable. In this case, they have acted in an irresponsible and negligent manner," the forum said.
Taking the insurance company to task, the forum said the public sector insurance company should act in the interest of the community while securing insurance business and must be fair and reasonable in its dealings.
"Failing to intimate the consumer that the policy is due for renewal is unreasonable and against the interest of a consumer and against public policy besides being against the main purpose and objective of mediclaim insurance policy," the forum said, adding that it was the bounden duty of the insurance company to intimate consumers about renewal of policy and about the premium whenever it is due.
