Justice Sunita Yadav, J.

1. The opposite party no.1-Bank of India/appellant has filed this appeal against the order dated 20.09.2016 passed by the District Consumer Disputes Redressal Commission, Khandwa (for short 'District Commission') in C.C.No.216/2015 whereby the complaint filed by the complainant/respondent no.1 has been allowed.

2. In short, the facts of the case are that the complainant is account holder of opposite party no.1-bank and the opposite party no.2-insurance company is an authorized agent of the opposite party no.1-bank to issue National Health Insurance Policy. The complainant/respondent no.1 is account holder of the opposite party no.1/appellant-bank and from the year 2008-09 after getting the requisite form filled had obtained Health Insurance Policy till 2013-14 which was valid till 26.06.2014. It is alleged by the complainant that she had deposited Rs.3,500/- in her account and thus there was balance of Rs.4,226/- and the new policy was to be commenced from 27.06.2014. It is alleged that since new policy commencing from 27.06.2014 was not revived, the complainant had approached the appellant-bank on 12.08.2014 and came to know that since there was not sufficient balance in her account, the said policy could not be renewed. It is further submitted by the complainant that she had fallen ill in May-2015 and undergone surgery at Indore Hospital and had incurred Rs.1,56,613/- towards medical and other expenses and since the policy was not renewed, the complainant was deprived of health insurance benefits. The complainant therefore alleging deficiency in service on part of the opposite parties approached the District Commission seeking relief.

3. The opposite party no.1-bank in its reply before the District Commission resisted the complaint stating that there was no standing instructions of the complainant to the bank to remit the premium to the insurance company after deducting the same from her account. For the first time on 09.06.2015 the complainant had given in writing to the bank to deduct the amount from her account and remit the same to the opposite party no.2-insurance company. There was no mandate of automatic deduction of premium. There has been no deficiency in service on part of the opposite party no.1-bank and therefore the complaint against it be dismissed. Bank Of India vs Smt. Anita on 23 December, 2025

4. The opposite party no.2-insurance company in its reply before the District Commission submitted that the complainant/respondent no.1 failed to pay any premium for renewal of insurance policy for the period 27.06.2014 to 26.06.2015 and therefore the policy could not be renewed. The responsibility to get the policy renewed is of the complainant. Since the policy could not be issued for want of premium and therefore there has been no deficiency in service on part of the opposite party no.2-insurance company. After two months of lapse of policy on 26.08.2014 an application was made for renewal of policy. The insurance company is not liable to pay the claim of medical expenses of Rs.1,56,813/- as the policy was in lapsed condition. There has been no deficiency in service on part of the insurance company. It was thus prayed that the complaint be dismissed.

5. The District Commission allowed the complaint and directed the opposite party no.1-bank to pay medical expenses of Rs.1,56,813/- to the complainant after getting opinion on medical papers from the opposite party no.2- insurance company under National Swasthya Bima Policy within a period of 30 days failing which 12% interest shall be payable on the aforesaid amount. The opposite party no.1-bank is further directed to pay compensation of Rs.5,000/- within 30 days for not remitting the premium to the insurance company despite having sufficient balance in the account of the complainant failing which interest @12% p.a. shall be payable on the aforesaid amount. Costs of Rs.1,000/- is also awarded.

6. Learned counsel for the opposite party no.1/appellant-Bank of India argued that the impugned order passed by the District Commission is perverse and against the settled principles of law. It is further argued that the District Commission while passing the impugned order overlooked the fact that the complainant has failed to prove that there was any mandate in respect to automatic deduction of premium by the appellant-bank, therefore, the appellant-bank was not under any obligation to deduct the premium from the complainant's bank account for remitting the same to the insurance company. It is further argued that the statement of complainant's account indicates that opening balance amount on 25.06.2014 was only Rs.726/- which was insufficient for payment of premium. It is further argued that learned District Commission ignored the evidence adduced by the appellant and ignored the facts and circumstances of the case and passed the impugned order which is liable to be set-aside. He placed reliance on a decision of Hon'ble National Commission in Alok Jain Vs Bajaj Allianz General Insurance Co. Ltd. & Others CDJ 2017 (Cons) Case No.488 and a decision of this Commission in First Appeal No.1585/2019 (Bank of India Vs Yogesh Dongre & Ors) decided on 31.05.2024 and other similar matters in support of his contentions.

7. Complainant/respondent no.1 has filed written arguments wherein it is submitted that the District Commission after appreciating the evidence available on record has rightly passed the impugned order holding the opposite party no.1/appellant-bank liable for non-payment of premium to the insurance company as despite sufficient balance in the complainant's account, the bank failed to deduct the premium and to remit the same to the insurance company. It is therefore prayed that the appeal be dismissed.

8. Learned counsel for the opposite party no.2/respondent no.2-insurance company argued that the District Commission after considering the facts and circumstances of the case and evidentiary material available on record has rightly passed the impugned order. At the time of claim since the Bank of India vs Smt. Anita on 23 December, 2025 policy was not in existence and had already in lapsed condition and could not be renewed for want of premium therefore, the insurance company cannot be held liable to pay compensation to the complainant.

9. Heard and perused the record.

10. On perusal of record, it is apparent that the complainant has pleaded that it was obligation/duty of the bank to deduct the premium and to remit the same to the insurance company, however, the complainant has failed to file any documentary evidence to prove that she had given any standing instructions to bank to deduct the premium from her bank account and remit the same to the insurance company towards renewal of insurance policy. Therefore, it is not proved that the appellant bank was under any obligation to deduct the premium from the complainant's account and remit the same to the insurance company automatically without instructions from the complainant. Under these circumstances, the bank cannot be held liable for deficiency in service on its part. Similarly, when no premium was received by the insurance company, the insurance company could not renewed the policy.

11. In view of the aforesaid discussion, in considered view of this Commission learned District Commission has erred in allowing the complaint and therefore the impugned order cannot be sustained. Accordingly, the impugned order is hereby set-aside. Consequently, the complaint filed by the complainant is dismissed.

12. Accordingly, this appeal is allowed. No order as to costs.