The Complainant has filed this complaint against both the O.P’s under Section 35 of the Consumer Protection Act 2019 and praying for following Order / Relief :-
- To admit the complaint,
ii) To direct the O.P’s to pay/return a sum of Rs. 51,000/- (Rupees Fifty One Thousand Only) to the Complainant with interest @ 12% p.a.
iii)To direct the O.P’s. to pay the Complainant compensation of Rs.3,50,000/- (Rupees Three Lakhs Fifty Thousand Only) for unfair trade practice with the Complainant and for the financial loss sustained and the mental agony, suffering caused to the Complainant on account of such unfair trade practice and serious negligence on the part of the O.P’s. to render service to the Complainant.
iv)To direct the O.P’s. to pay to the Complainant as compensation to the tune of Rs. 40,000/- (Rupees Forty Thousand Only) as cost of the legal proceedings including expenses in correspondence and travelling in respect of realization of the said amount.
v)To direct the O.P’s to pay the Complainant a compensation to the tune of Rs. 60,000/- (Rupees Sixty Thousand Only) towards professional loss and harassment. The total claim amount is of Rs. 501,000/- (Rupees Five Lakhs One Thousand Only).
The case of the Complainant in brief is that, the Complainant is a consumer as well as policy holder of the O.P. No. 1 Company and the Complainant purchased one policy by paying a sum of Rs. 51,000/- (Rupees Fifty One Thousand Only) and issued one Cheque Bearing No. 998852 Drawn on United Bank of India on 14.11.2017/The Complainant received Computer Generated Statement from the O.P. No. 1 on 15.01.2018/ the agent of the Company told that all the required documents will be submitted to the Complainant’s registered address which was mentioned in the documents namely Aadhar Card, Voter Card, Pan Card of the Complainant. The Complainant waited for about one year to receive the original Policy Bond by the O.P’s., after that on 07.01.2019 the Complainant without getting any other way made a written application to the Branch Manager, Siliguri Branch of Aditya Birla Sun Life Insurance Company Limited @ Birla Sun Life Insurance Company Limited and the O.P. was requested to make reply within seven (7) days by Registered Post / but the O.P. made no reply to the Complainant. It is also case of the Complainant that he met with the O.P. for collecting Policy Bond but the O.P. told him that the original Policy Bond had already been issued but the Complainant did not receive any original Policy Bond / on 06.03.2019 the Complainant again sent another written application to the O.P. No. 1 asking for making reply in respect of application dated 07.01.2019/ subsequently on 01.04.2019 the Complainant sent Legal Notice through Ld. Advocate which was receipt by the O.P. No. 1 on 02.04.2019 / the O.P. No. 1 replied on 25.04.2019 by stating that the original Policy Document was dispatched on 13.12.2017 to the Complainant on its registered address which was duly received by the Complainant on 18.12.2017. It is also case of the Complainant that on 27.03.2019 the O.P. sent the Photo Copy of the Policy Document along with the letter of Aditya Birla Sun Life Insurance Company Limited in the letter pad to the Complainant through courier which was received by the Complainant on 05.04.2019 / in the Photo Copy of Policy Document which was sent by the OP No-1 the Mobile Number & E-mail I.D. of the Complainant was wrongly mentioned and in the letter of Aditya Birla Sun Life Insurance Company Limited in the letter pad stated that on 03.11.2017 the O.P. delivered the original Policy Document through Blue Dart
Airway Bill No.- 34586625415 , the Complainant received the Photo Copy of Policy Document and letter from the O.P’s. on 05.04.2019 / on 12.04.2019 the Complainant send a written application to the O.P. No. 1 to avail the “Free-look” benefit of the aforesaid policy as per part-D of the Photo Copy of the Policy document it was clearly stated that “ Within 15 days of the receipt of the policy document in case the policy holder is not satisfied with the terms and conditions of the policy, the company will refund the premium”/ On 08.04.2019 the Complainant had contacted to call center (toll-free) which call was registered and the Complainant gather information that the original Policy Document was delivered to Sukamal Sarkar who was not known to the Complainant / The Complainant again sent one application to the Branch Manager, Siliguri Branch of Aditya Birla Sun Life Insurance Company Limited to approach the Insurance Ombudsman for redressal on 21.10.2019/ on 14.01.2020 the Complainant sent an application to the Grievance Redressal Department of Aditya Birla Sun Life Insurance Company Limited for redressal of grievances but of no result. The Further case of the Complainant is that, the Complainant has paid the proper court fees and he is entitled to get the relief as prayed for.
In support of the Complaint the Complainant has filed some documents which are given bellow :-
- Photocopy of the bank statement of United Bank of India of Complainant,
- Photocopy of Computer generated statement of Aditya Birla Sun Life Insurance Company Limited,
- Photocopy of written application by Complainant on 07-01-2019,
- Photocopy of written application by complainant on 06.03.2019,
- Photocopy of Legal Notice through Advocate on 01.04.2019,
- Photocopy of tracking report of the RW965046981IN from SILIGURI HO on 02-04-2019,
- Photocopy of reply of legal notice from Aditya Birla Sun Life Insurance Company Limited on 25-04-2019,
- Photocopy of “Overnite Express Limited” vide Airway Bill No.- 5256765463 received on 05-04-2019,
- Photocopy of letter of Aditya Birla Sun Life Insurance Company Limited,
- Photocopy of policy document of Aditya Birla Sun Life Insurance Company Limited,
- Photocopy of written application by Complainant on 12-04-2019,
- Photocopy of the application of the Insurance Ombudsman on 21-10-2019,
- Photocopy of the application to the Grievance Redressal Department on 14-01-2020,
- Photocopy of the tracking report the RW961605773IN was delivered 23-01-2020 to the addressee from KASARVADAVALI SO,
- Photocopy of the Order before the Hon’ble State Consumer Dispute Redressal Commission, Circuit Bench, at Siluguri, dated 03-12-2020,
- Photocopy of the Order before the Ld. District Consumer Dispute Redressal Forum, Siliguri, dated 20-09-2019,
- Photocopy of Aadhaar Card Being No. 5520 1542 4963 of the Complainant.
On receiving notice the O.P. No. 1 & 2 appears before this Commission through Vokalatnama, filed Written Version on behalf of them. By filing Written Version both the O.P. has stated that the Complainant has filed this case against them without having any locus-standi to file the same. They have categorically denied the entire allegation of the Complainant leveled against them. Both the O.P. have stated that only to harass them the Complainant has filed this case knowing fully well aware that the Complainant has no cause of action to file this case and he is not entitled to get the relief as prayed for.
Both the O.P’s have also stated that the Complainant was required to approach them within the free-look period of 15 (Fifteen) days in case of any grievance, but the said opportunity was not availed by the Complainant despite receipt of the Policy Document on 18.12.2017, the Complainant was required to pay the premium amount annually for a period of 10 (Ten) years but the Complainant only paid one premium till 16.11.2018 and not thereafter and thereby the policy was lapsed / they have also stated that the Complainant had an option to revive the policy by paying all the due premium within two years from the date of first unpaid premium, the Complainant has failed revive the policy within the revival period and therefore, the policy was terminated and as the Complainant has only paid one yearly premium as such he is not entitled to get the surrender value as the policy acquires surrender value if three annual premium are paid. In the Written Version both the O.P’s. have also stated that the Compliant of the Complainant is entirely vague, false, vexatious, frivolous and requires to be dismissed as the Complainant has approached this Commission not with clean hands and for the first time the Complainant approached the O.P’s. through its letter dated 07.01.2019 with grievance of not receiving original Policy Bond but the O.P’s. had replied in view of letter of the Complainant at the Registered E-mail I.D. where the Complainant was requested to visit at the nearest Aditya Birla Sun Life Insurance Branch to submit the requirements for the issuance of duplicate Policy Documents and on request of the Complainant a duplicate Policy Bond was sent to the Complainant but the free-look period was available from the date on which the original policy was delivered and not from the date of delivery of the duplicate policy. By filing the Written Version the O.P. No. 1 & 2 praying for dismissal of this case.
‘ Having heard the Ld. Advocate of both the parties and on perusal of the Written Complaint, Written Version, documents filed by the parties the following points are to be decided by this commission .
Points for consideration
- Whether the complainant is a consumer?
- Whether the case is maintainable in its present form and prayer under the provisions of the Consumer Protection Act 2019?
- Whether there was any cause of action to file this case by the Complainant?
- Whether there was any deficiency in service on the part of the O.P’s. as alleged by the complainant?
- Is the Complainant has been able to prove its case and entitled to get any relief as prayed for as per the prayer of the Complaint?
Decision with Reasons
All the points are taken up together for discussion to avoid unnecessary repetition and for the sake of convenience and brevity of the case.
Ld. Advocate of the Complainant to prove its case has filed written deposition in Chief of the complainant in the form of an Affidavit. In the written deposition the complainant has categorically stated and corroborated the contents of the complaint. In the written deposition the complainant has specifically stated that, there was clear deficiency in service by the O.P’s and they deliberately did not obey their duty towards the complainant.
The complainant has also filed their brief notes of argument. In the brief notes of argument the complainant has stated that, the complainant has been able to prove its case against the O.P.’s. He also argued that, not only through written deposition but also by filling documents the complainant has been able to prove the fact that the complainant was a consumer who by paying a sum of Rs.51,000/- purchased one policy from the O.P. No.1. The complainant has also stated in the Brief Notes of Argument that the Agent of the P.W.- 1 told the complainant that the documents will be submitted to the registered address but the Original Policy Bond / Policy document was not received by the complainant from the O.P. within one year and then finding no other option the Complainant sent Written Notice on 07.01.2019 to the O.P. No. 1 asking to provide Original Policy Bond/ Policy Document and to make reply within 7 days but the O.P. No. 1 made no reply. Complainant also argued that the OP. in his deposition para No. 6 has narrated that they gave reply in respect of the Letter dated 07.01.2019 by sending the same to the Complainant through E-mail I/ D and at his registered address but the O.P. did not produce any print out / documents before the Commission to that effect . It is also
the argument of the Complainant that, on 06.03.2019 the Complainant again sent another written letter to the O.P. No. 1 and on 01.04.2019 legal notice was sent to the O.P. on behalf of the Complainant and receiving the said notice the O.P. No. 1 replied on 25.04.2019 disclosing that original policy document was dispatched to the Complainant to his Registered Address and stated that original policy document was dispatched on 13.12.2017 to the Complainant to its registered address which was received by the Complainant on 18.12.2017 . But the O.P. did not produce any document before this Commission for proving the fact that the original policy documents was duly received by the Complainant himself.
It is further argument of the Complainant that, the O.P. sent Photocopy of the Policy Document to the Complainant through Courier Service and the same was received by the Complainant on 05.04.2019 but the Complainant found that in the Photocopy of the Policy Document Mobile Number and E-mail of the Complainant was wrongly mentioned.
It is also the argument of the Complainant that, the Complainant on receiving the Photocopy of Policy Document on 05.04.2019 he sent a Written Application to the O.P. No. 1 on 12.04.2019 to avail the Free-look benefit of the said policy because as per part D of the Photocopy of the Policy Document it was clearly stated that, “ Written 15 days of the receipt of the Policy Document in case the Policyholder is not satisfied with the terms and conditions of the Policy, the Company will refund the premium”. Further argument of the Complainant is that, the Complainant on 08.04.2019 contacted to call center Toll Free Number which was registered and the Complainant gathered information that Original Policy Document was delivered to one Sukamal Sarkar who is not known the Complainant and it was within the Knowledge of the O.P’s. that the Original Policy Document was delivered to another person namely to Sukamal Sarkar instead of the Complainant. Ld. Advocate of the Complainant submits that the Complainant has been able to prove the case against both the O.P’s. that from the very beginning the O.P’s started deficiency of service towards the Complainant.
At the time of argument Ld. Advocate of the O.P’s submit that the Complainant has failed to prove its case against them and by suppressing the true fact the Complainant has filed this case on some false allegation to extort compensation amount from both the O.P. Ld. Advocate of the O.P. argued that, the original Policy Document was dispatched to the registered mailing address of the Complainant on 13.12.2017 through Blue Dart airway Bill No. 34586625415 and was delivered to the Complainant on 18.12.2017 but the Complainant had to approach the O.P. within Free-look period making any grievance . It is also argument of both the O.P’s. that the Complainant for the first time approached the O.P. through its letter dt. 07.01.2019 with grievance of not receiving the Original Policy Bond and the O.P’s. replied to the Complainant’s letter dt. 07.01.2019 at his registered E-mail I.D. wherein the Complainant was requested to visit at the nearest Aditya Birla Sun Life Insurance Branch to submit the undertaking form filled and signed by the policy owner, I.D. proof of self and branch attested and address proof self and branch attested for issuance of duplicate policy document. It
is also argument of the O.P. that Complainant was required to pay the premium annually for a period of 10 years but the Complainant only paid one premium till 16.11.2018 and that’s why policy was lapsed / the Complainant had an option to revive the policy by paying all the due premium within two years from the date of first unpaid premium but the Complainant failed the revive the policy within the revival period of 16.11.2020 therefore policy was terminated.
Ld. Advocate of the O.P’s. also argued that , there was no deficiency of service or negligence from the part of the opposite parties and the Complainant has not established any willful fault, imperfection, shortcoming or inadequacy in the service of the O.P’s. Ld. Advocate of the O.P’s. at the end of argument submits that the Complainant has failed to prove its case and thereby not entitled to get any relief as prayed for.
Having heard, the Ld. Advocate of both the sides and on perusal of the Complainant, Written Version, Evidence of the parties, Reply to the Questionnaires of the parties, Brief Notes of Argument and from the documents filed by the parties it is admitted fact that the Complainant purchased one Insurance Policy from the O.P. No. 1 by making payment of Rs. 51,000/- (Rupees Fifty One Thousand Only) as premium. It is also admitted fact that, the O.P. No. 1 issued computer generated money receipt on 15.01.2018 (Annexure-B). It is also admitted fact by both the side that, on 07.01.2019 the Complainant sent a written letter to the O.P. No. 1 requesting to provide Original Policy Bond /Document and also requested to make reply within 7 days at registered address.
It is also fact that the Complainant again sent another written letter to the O.P. No.1 on 06.03.2019. It is also not denied by the O.P’s that the Complainant did not sent Legal Notice on 01.04.2019 through Advocate Biswajit Biswas. On the other hand on receiving the Legal Notice the O.P. No. 1 gave reply dated 25.04.2019 to the Complainant by stating that, they have already dispatched the Original Policy Document on 13.12.2017 to the Complainant and the same was received by the Complainant on 18.12.2017 at the registered address.
The O.P. No. 1 & 2 in their Written Version, Evidence and in the Brief Notes of Argument has stated that, they have dispatched the Original Policy Document and the same was received by the Complainant. But the O.P. No. 1 & 2 did not produce any document before this Commission to substantiate the fact that the original Policy Document was duly received by the Complainant himself.
Moreover, on 27.03.2019 the Opposite Parties sent a Photocopy of Policy Document along with the Letter of the O.P. No. 1. The Complainant has annexed the Photocopy of the Policy Document (Annexure-J) along with the Complainant. The Complainant received the said Photocopy of Document on 05.04.2019. In Part-D of the Photocopy of the Policy Document it is clearly stated that within 15 days of the receipt of the policy document if the policy holder is not satisfied with the terms & conditions of the policy the policy holder may avail Free Look benefit and the Company will refund the premium.
From the Annexure-J (Photocopy of Policy Document) & From the Annexure-K (Written Application of the Complainant dated 12.04.2019) it reveals that the O.P. sent the Photocopy of Policy Document which was received by the Complainant on 05.04.2019 and on 12.04.2019 the Complainant sent letter to the O.P. No. 1 to avail the Free-Look Benefit of the said policy which was within 7 days out of 15 days.
It is needless to mentioned hare that since after few days of purchase of the policy the Complainant was compelled to write letter one after another to the O.P’s. asking for supply of original Policy Document. But the O.P’s. paid no heed to that and reject as well as refused to settle the same. The Opposite Parties have failed to substantiate the fact that they dispatched the Original Policy Document to the Policy Holder (Complainant) to his registered address.
Moreover, the Photocopy of Policy Document which was received by the Complainant it reveals that, the Mobile Number & E-mail I. D. of the Complainant was wrongly mentioned though the address was rightly mentioned. Such wrongly mention of Mobile Number as well as E-mail I.D. of the Complainant by the O.P. on the Photocopy of Policy Document are nothing but the deficiency of service on the part of the O.P’s.
The Complainant when registered a Complaint through call-center Toll Free No. 1800-270-7000 he gathered information that the Original Policy Document was delivered to one Sukamal Sarkar instead of the Complainant. But the O.P. No. 1 & 2 have stated nothing against the said delivery of a vital document to a wrong person and this act / conduct of the O.P. was nothing but a gross negligent act on their part. From the above discussion it is proved that, the O.P’s. have failed to justify as to why they did not allow the Complainant to avail Free-Look benefit.
Considering all, we are of the view that the Complainant has been able to prove its case against both the O.P’s. and the Complainant is entitled to get the relief.
The decisions referred by the O.P’s. are not applicable to the facts and circumstances of this case.
Hence it is therefore,
O R D E R E D
That the instant Consumer Case being in No. C.C. 23/ 2020 be and the same is allowed on contest but in part. Both the O.P’s. are directed to pay a sum of Rs. 51,000/- (Rupees Fifty One Thousand Only) to the Complainant with interest @ 9 % per annum from the date of deposit of the same to the O.P’s till the making of payment . Both the O.P’s. are also directed to pay a sum of Rs. 30,000/- (Rupees Thirty Thousand Only) to the Complainant for unfair Trade Practice with the Complainant as well as deficiency in service. Both the O.P’s. are also directed to pay a sum of Rs. 10,000/- (Rupees Ten Thousand Only) to the Complainant as cost of the legal proceedings.
Both the O.P’s. are also directed to pay Rs. 10,000/- (Rupees Ten Thousand Only) only to the Consumer Legal Aid Account.
Let a copy of this order be given to parties free of cost.
