Adv. For the Complainant: -    Sri Prakash Mishra

Adv. For O.P. No. 1 &  2           :-   Mr. D. Bagarty and Others

Date  of filing of the Case  :- 04.07.2022

Date of Order :-    30.10.2022

JUDGMENT

Fact of the case in nutshell :-

1. The  complainant on  dated 19.07.2017 on the instigation of the Branch Manager Reliance life Insurance Co Ltd. Balangir who is the Op No.1 in this case . taken a policy vide No.53009157 which names as Reliance  Nipon Life insurance . where the system of which is to pay an installment premium of Rs.20,552/- in every year up to fifteen years fell on the un due influence of  OP No. 1 that the complainant have to pay a sum of Rs.21,500/- at the time of opening of the policy and subsequently the complainant have to pay a sum of Rs.10,000/- in every year up to five years and committed if the complainant take a policy from the Op No.1 the Op No.1 will provide a gift pack of free living of two days accommodation in a luxurious hotel  where ever you choosed within India with family , to get the belief of the complainant the Op No 1 had given some printed advertisement of their scheme which is not related to reliance Insurance Co. Ltd. which was fraudulent  one. No policy bond was sent to the complainant through Registered post which ultimately taken by the complainant in person. The complainant had deposited the premium installment for two years and due to bad economical condition stop payment for the third year. Then notice was issued to the complainant by the OPs and subsequently in fourth year i.e. in year 2019 the complainant arranged money and  had been  to the office  of OP No.1 to deposit two years installment i.e. Rs.41.105/- at a time . But the Op fraudulently taking the innocent nature of the complainant taken Signature of the complainant on some papers and close the previous policy and started a new policy bearing policy No. 53949522 vide client  ID No. 37873536 bearing the commencement dated 26/06/2021. Out of Rs.41.105/- the Op No.1 returned Rs.11,105/- to the complainant and stated only Rs.30,000/-is required for your policy renewal Believing the version of OP No.1 the complainant returned home with the impression that his previous policy is updated. But after some days the complainant received a cheque of Rs.8,053/- dt.23/07/2021 from the reliance company. The complainant failed to know which money was it and enquire the matter to OP No.2 where OP No.2 stated that your previous policy is closed on default and this is the balance amount of your policy. The complainant after that came to know that he was cheated by OP No.1  by his false commitment and mis-sell of the insurance policy. Hence this case.

2. To  substantiate his case the complainant relies on the following documents.

1. Xerox copy of Aadhar card of the complainant.
2. Xerox copy of the Receipt of the policy bond.
3. Xerox copy of the cheque.

3. Heard the complainant and perused the material on record having gone through the complainant it’s accompanied documents Prima facie it seemed to be a genuine case hence admitted and notice to the OPS were served and in response they appeared through their councel and filed their version.

4. In rival contention the Ops averred that the case is not maintainable . The complainant take both the policy after due understanding the policy structure and denied all allegation made by the complainant and prayed for the dismissed  of the complaint case.

      ( 5) To counter the allegation the Ops relies on the following documents.

1. One CD with Annexure 16 to 75 which includes the proposal form , the postal tracking report the policy bond and the premium receipt of both the policy etc.

6. Heard the complainant and perused the material on record with submission and vehement denials of the learned advocate for the O.P. with arguments.

7. After going through the allegation in the complaint as well as written version filed by the Ops the following issues emerged for settlement.

1. Whether the complaint is maintainable?
2. Whether the complainant prove his case?
3. Whether any remedies deserves by the complainant?

Issue No.1

       Service is defined in Sec 2 Sub sec.42 of C.P. act 2019 as follows.

                      “ Service “ means services of any description which is made available to potential users and includes but not limited to the provisions of facilities in connection with banking financing Insurance , transport , processing , supply of electrical or other energy , telcom, boarding or lodging or both , housing construction , entertainment ,  amusement or the purveying of news or other information , but does not include the rendering of any service free of charge or under a contract of personal service.

         Sec 2 sub sec 7 of C.P. Act.2019 defines consumer means any person buys  any goods for a consideration which has been paid or promised or party paid and partly promised or under any system of deferred  payment and includes any user of such goods other than the person who buys . such goods for consideration paid or promised or partly paid or partly promised or under any system of deferred payment when such use is made with the approval of such person but  does not include a person who obtains such goods for resale or for any commercial purpose and sub sec 21 of sec 2 of C.P. Act 2019 define goods. “goods” means every kind of movable property includes food as define in clause (J) of sub –sec(1) of sec 3 of FSS Act 2006. As such the complainant is a consumer and the case is maintainable . issue No.1 answered accordingly.

Issue No.2.

       To prove his case the complainant did not filed the money receipt neither of the former policy nor the policy later which is vital for adjudication of the case. From the document filed by the OP . it is ascertained that which  reflected on the  Annexure  No.24 the first premium paid by the complainant on dt.19^th July 2017 and the next renewal date was 19 July 2018 where it is also reflected that the policy term was 15 years and premium payment term was 10 years, Consist of Rs.21,604,00/- as premium amount in every succeeding years. After the first date of payment on 19^th July 2017 the complainant did not paid any installments up to 19^th July 2021 and according to the term and condition of the Insurance company the policy was lapsed for non payment of premium within the grace period.

          In this case for non payment of policy money within the grace period the  policy became lapse after 19^th July 2018. According to the agreement the lapse policy can be revived within two years from the date of first unpaid premium the revival is subject to the board approved under taking policy which is clearly reflected  in the policy bond in 5.7 Para of the policy bond.

         According to the policy bond “Lapse ” means a condition where in the due premium have not been paid in full is required under the plan there by rendering this policy unenforceable no benefit will be paid when the policy is in lapse status. “ Revival of Policy” means the restoration of the policy which was discontinued due to the non payment of premium. The complainant stated in this complaint petition that he is doing a private Job and the policy bond not sent to him by Registry post which taken by  the complainant in person but the postal tracking report filed by the Op shows that the policy bond booked on dt.28/07/2017 and delivered to the complainant on dt. 31/07/2017 at Ramchandrapur B.O as per the postal address given by the complainant. From the proposal form it is clear that the complainant is a state government employee know as G.R.S in  MGNREGS panchyati Raj Department Govt. of Odisha. The complainant is an educated person who have the English knowledge have the capacity to read. Write and understand it . The complainant form an imaginary story to gain the mercy of this commission and acting like an illiterate person. If the complainant did not believe the Insurance company why should again purchase same type of money back policy again for a longer term.

         In the case of Prema and others Vrs. Life Insurance Corporation of India Ltd. Iv(2006) CPJ 239 (NC) in which the Hon’ble NCDRC has observed the following in Para 8 of the Judgment.

8. In sofar as the filing of the proposal forms in concerned Manju Nath was a lineman in K.E.B. at Davangere As such the state commission was justified in taking the view that it was reasonable to believe that he would have the minimum knowledge of these matters. Consequently it could not be believed that he had simply put his signature on different proposal forms without understanding the contents of the relevant items.

Hon’ble S.C in the case of Canara bank and Others. V. Debasis Das and ors. Reported in AIR 2003 SC 1561 where it held that.“A person seeks equity must comes with cleam hands. He who comes to the court with false claims cannot plead equity nor the court would be Justified to exercise equity Jurisdiction in his favour . A person who seeks equity must act in a fair and equitable manner.

                            It is the principle of law that the burden of proving the deficiency in service is upon the person who alleges it. The Hon’ble supreme court in Ranveet singh   Baggq Vrs. KLM Royal Dutch Airline & A no(200) I SCC 66 held that , “The burden of proving deficiency of service in upon the person who alleges it in Para 60 the Judgment laid down as under. The deficiency in service cannot be alleged without attributing fault, imperfection. & hort coming or inadequacy in the quality nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service the burden of proving the deficiency in service is upon the person alleges it.

             The case in hand after the survival period was over the policy became lapse and turn to fore closer in 19^th July 2021 and according to the terms and  conditions of the policy the insurer sent a cheque of Rs.8,053,26/- known as fore closer amount after the termination of the policy , after knowing all the facts the complainant again buy another money back policy from the Insurance company for another long term of 15 years.

The complainant has on facts been found to have not established any willful fault, imperfection short comings or in adequacy in service of the OP.

Issue No.2     answered accordingly.

Issue No.3

         From the above facts and circum stances discussed in  issue No.2 the complainant is entitled for the fore closer amount Rs.8,053,26/- and Rs.27,6000/- for the closing amount of the 2^nd policy after deducting 8% for official charges total amounts toRs.35,653,26/- and other expenses as the commission computed.

        In view of the aforesaid discussion the complaint petition is allowed with following direction as per the prayer of the complainant.

ORDER

The Ops are directed to pay a sum of Rs.35,653,26/-@ 7% interest per annum from the date of filing of the case till the date of order and Rs.1000/- towards litigation expenses. Within one month from the date of order, failing which the entire amount should be paid by the OPS @ 9% interest per annum from the date of filing till realization.

No award as to cost.

         PRONOUNCED IN THE OPEN COMMISSION TODAY I.E DATED  30^th   DAY OF October’2023