Delhi

East Delhi

CC/862/2014

RANJIT SINGH - Complainant(s)

Versus

AEGON LIFE INS. - Opp.Party(s)

03 Aug 2017

ORDER

               DISTRICT CONSUMER DISPUTE REDRESSAL FORUM EAST Govt of NCT Delhi

              CONVENIENT SHOPPING CENTRE, 1^st FLOOR, SAINI ENCLAVE, DELHI 110092  

 

                                                                                                   Consumer complaint no.        862/2014

                                                                                                   Date of Institution                16/09/2014

                                                                                                   Order reserved on                 03/08/2017                                                                                                   

                                                                                                   Date of Order                          04/08/2017

                                                                                      

In matter of

Mr. Ranjeet /Ranjit Singh Kappor, adult   

R/o 211, Avtar Enclave,   

Paschim Vihar, New Delhi 110063……….…….…………………………..…………….Complainant

                                                                   

                                                                                

                                                                                           Vs

 

The Manager

Aegon Religare Life Insurance Ltd.Co. 

Plot no.- 12, 2^nd Floor, V3S East Centre

Laxmi Nagar, Delhi 92.……………………………………………………………………………Opponent

  

 

Quorum                                 Sh Sukhdev  Singh        President

                                                 Dr P N Tiwari                 Member

                                                 

Order by Dr P N Tiwari, Member

Brief Facts of the case

Complainant aged 81 years was convinced by the agent of OP to take a single premium life insurance policy explaining various age related benefits and assured that no further premium would be required to pay. So, complainant paid a sum of 2 lakh through cheque on 01/09/2011 and put his signatures on various papers given by the agent. Thereafter complainant received two policies (Ex CW1/1 & Ex CW1/ 2) for two policy proposal forms filled by the complainant (Ex CW1/3 and 4) having serial no. 0134820 and 0134823 instead of one policy. The policies issued from 05/09/2011 and 12/09/2011 in the name of Jasraj Singh for 16 years duration and had to pay the premium of Rs one lakh every year up to 10 years. The policies “AEGON Religare Money Back Plus Plan”(in short Policy).

 

 

Seeing details terms and conditions of these two policies, he immediately lodged complaint with the Manager of OP stating fraud and cheating had been done to him as he was assured for one policy having single premium in his name.

Even after repeated calling and visit to the office of OP, no satisfactory reply was given to him, so, he gave written representation to the Branch Manager of OP on 02/03/2012 (Ex CW1/4) when he was called to pay some more amount as a part of premium of Rs 28,000/-and Rs 25,000/- and was assured by OP for refund of a sum of Rs 3 Lakh as a premium amount instead of Rs 2,53,000/- which he paid. Thus complainant paid additional amount through cheque drawn on SBI and Corporation Bank on the same day. It had been stated to OP that his financial condition for paying future premium was not good to pay up to 10 years at this advanced age.

 

Even after completing all the requirements for refund, he visited number of times for his refund as assured by OP, but did not get refund or satisfactory reply till filing this complaint. Thus, he filed this complaint and claimed refund of assured amount a sum of Rs 3 Lakh with 18% and compensation Rs One lakh for physical harassment with litigation charges Rs 25,000/-.

 

OP submitted their written statement and denied all the facts and allegations in the complaint. It was stated that the complaint be dismissed at the initial stage as it was barred by the limitation of two years under Sec. 24A of the Consumer Protection Act. It was also stated that complainant did not opt the benefit of “Free Look Period” provided by the OP as per IRDA guidelines and wanted refund after the lapse of free look period, so as per the conditions of the policies, he would not get the refund, but could continue as per the policy schedule and could avail all the benefits. OP also took the excuse to refund the premium on the basis of filling entire policy proposal form and put his signatures on “Declaration Form”. Hence, complainant had understood all the benefits and future liability of the said two policies. So OP prayed for dismissal of complaint.

  

Complainant failed to file his rejoinder though ample opportunity was given to file his rejoinder with evidence, but he could not file the same, so OP was directed to file their evidence.

 

OP through Mr Jitin Parekh, authorized representative, submitted evidence through affidavit and deposed on oath that facts and content of their written statement were correct and true.

The premium was not refunded as per the conditions of the policies. So, non refund of premium amount (paid by complainant) was on—

1. Complaint was barred by two years limitation,
2. Lapse of ‘Free look period’, and
3. Complainant had put his signatures on ‘declaration’ after proper reading policy conditions.

During the course of proceedings, complainant filed an application for recalling the orders of this Forum (dated 06/11/2015) (Ex CW1/6A & B), which was later rejected by the Forum on dated 04/12/2015 as Forum do not had power to recall its own order. Thereafter, complainant filed his Revision Petition before Hon. State Commission vide RP no. 39/2016. Honble State Commission justified the order of this Forum, but in the interest of justice, allowed RP 39/2016 filed by the appellant / complainant through daily order dated 04/11/2016 and directed complainant to file his rejoinder with evidence on 09/02/2017 before the Forum subject to cost Rs 2000/-(Ex CW1/7).

Complainant filed his rejoinder with evidence on affidavit where he affirmed on oath that all the contents of his complaint were true and correct and rejoinder and evidence could not file due to his ill health. He further stated that he had put his signatures on ‘some blank’ insurance papers brought by the agent of OP and all those papers were filled by the agent and nothing was explained to him about the type of policy was offered with related benefits. More so being in advanced age (80+years), he could not understand all the contents of policies, but reaffirmed that he had told for one single premium policy having multiple benefits at this age.

After getting assured for various benefits stated by the agent, he had put his signatures on the papers, but did not fill the policy proposal form nor signed the declaration.     

 

Heard arguments from both party’s Ld. Counsels and after perusal of file, order was served.

After analyzing all the facts and evidences of both the parties, we have also observed some issues in this complaint before taking merits. These were as –

1-whether the said two policies were actually desired by the complainant at the age of 80+years?

2-was there any relevance of facts in issues in complaint pertaining to policy documents?

3-whether any relief is to be granted to the complainant?  

 

1-Whether said two policies were actually desired by the complainant at the age of 80 + years?

As per the contents of complaint, it was clear that complainant was convinced by he agent of OP for various age related benefits and policy had one time premium whose premium was one lakh, but two cheques of one lakh each were issued on the same date by complainant which means two policies were taken. Both the policies were in the name of minor grandson. Also he paid two premium of Rs 25,000/- and Rs 28,000/- to OP which were cashed. So it is clear that complainant had taken two policies from OP.  

Complainant was proposer of his grandson, but OP did not explain whether the life expectancy of complainant/proposer would be over 10 years as per conditions of the policy and would continue to pay the premium amount or who would be paying in case of proposer’s death. Here it is evident that OP was entrusted in taking consideration from the complainant so under unfair trade practice by OP is established as OP did not perform services legally and kept consideration for their benefit.

 

2- Was there any relevance of facts in issues in complaint pertaining to policy documents ?-    

We have seen minutely the contents of the case where it had been specifically stated that complainant had not asked for two policies and he had signed on ‘some’ insurance papers.  After seeing the policy proposal form (a vital document for issuing policy), it has been observed that lot of discrepancies were present and “Declaration” column was neither filled nor signed by the complainant. OP had taken defence in non refund of premium amount on this issue.

OP had submitted wrong submission before this Forum. It itself amounts to OP’s concealment of material facts and grave deficiency in their services. Blank declaration column proves that no contract between complainant and OP and no privity of contract. It was a ab-initio contract.

It was also noted that OP had mentioned wrong name as “Ram Jeet Singh” instead of Ranjit Singh Kapoor. All policy documents had been written as Ram Jeet Singh when complainant’s ID and bank details were with OP. OP had also asked to submit signatures and name verification from bank where complainant had his bank account. The bank had also verified his name and signatures and stated that the correct name was ‘Ranjit Singh Kapoor’. When premium amount cheque was cleared and amount was received by OP meaning thereby the name and signatures were correct, but asking for name and signature re-verification from complainant itself amounts to deficiency in services of OP.  

It was also observed that complainant had specifically denied for giving beneficiary name as Jasraj Singh in his policy proposal form. His income was also wrongly mentioned in the policy proposal form.   

3-whether any relief is to be granted to the complainant ? 

We have seen the points on which refund was denied by OP as—

a)-Complaint barred by limitation –OP had taken two years limitation date as cause of action arisen from the lapse of Free look period ie after 14/09/2011 and protest was lodged by complainant on 02/03/2012. We have seen Ex. CW1/4, where it had been stated that OP had called to deposit additional premium amount of Rs 25,000/- and Rs 28,000/-, but complainant had refused to pay any additional amount, but after assurance from OP that a sum of Rs 3 lakh would be refunded instead of Rs 2,53,000/-as total amount paid by the complainant. On this assurance, complainant paid the amount through cheques which were received by OP. A written request was lodged for cancellation of his both the policies to OP.  

When OP failed to refund the assured amount to complainant then actual cause of action arise, but his complaint was filed in the month of Sept 2014 and was admitted too thus delay if any was condoned by the Forum. So there was no issue of dismissing the complaint after it had been admitted. This fact may not be known to OP.

b)-The second point of non refund of premium amount by OP as Lapse of “Free Look Period”—as per complaint, the said agent did not explain any relevant point to the complainant who was of the age of 80+ years where all sensory and motor functions of the body and mind gets weakened. So, agent had not explained every relevant point before taking policy proposal form when complainant was at much advanced age. After looking the policy proposal form, it looks that agent was in hurry to take the premium amount and policy papers. More so the Free Look Period duration was neither explained to complainant nor it was printed in bold or big letters so a complainant of above 80 years age could read. Thus this point does not hold any weight in reference to Section 6(2) of IRDA  Regulations.

3-OP had taken third point as “Declaration” in the policy proposal form was signed by complainant, hence under the contract, no refund could be made.  It is very important to see that policy proposal form is a vital insurance document for policy seeker and insurer. Here in this case, as per the contents of complaint, complainant had not signed declaration and it was evident from Ex. CW1/3. So, when no signatures were put, no contract between the parties.          

OP had asked to pay the premium amount Rs 25,000/- and Rs 28,000/- which was paid through cheques by complainant. It is to be seen that when yearly premium of both the policies were Rs 99,999/-each then how premium amount of Rs 25,000/- and Rs 28,000/- was asked to pay by OP. Also it was assured by the Branch Manager of OP to refund sum of Rs 3 lakh as full and final amount, but despite of repeated visit by complainant to OP, he did not get any amount. This being so, unfair trade practice is established besides deficiency in services of OP.  

 

We have also seen all the citations as submitted by OP. These are as –

1. M/s Reliance Life Insurance Co. Ltd vs K S Eshwarappa in RP 555/2011 NC.  The facts were not similar to this case as complainant here was over 80+ years and complainant had denied taking any such policy which would last for 16 years and he had to pay for ten more days. So he himself requested to cancel the policies.  The law laid down in this citation is not applicable.  
2. Dr Aditya Prasad Roy vs TATA AIG Co. & others in RP 4351/2014 –NC. Under this case, it was a TATA AIG life Invest Assure Flexi Plan Policy for ten years. There was quarterly based premium plan and complainant had paid a sum of Rs 1,75,000/-and asked for refund as it was a unit linked policy, so OP had refunded Rs 43,771/- after deducting the value of units at that time. Here in this case, this policy was not a unit linked, so it was not related here.
3. Mohan Lal Bansal vs ICICI Prudential Life Insu. Co. Ltd. In RP 2870/2012 - NC. It was laid down by Honble NCDRC that when entire premium amount was paid in the policy tenure, OP had to refund the amount as per terms and conditions. Here in this case, no entire amount was paid by the complainant, hence this citation too was not applicable.  
4. ICICI Prudential Life Insu. Co. Ltd. vs Prof. Ravinder Sripad Kullarni, FA A/634/2011- SDCRC Maharastra &
5. Ashok Kumar vs M/s Kotak Mahendra Life Insurance Pvt Ltd. FA 79/2011-SCRDC –Chandigarh. In both first appeals from Honble State Commissions, complaints were dismissed. But here the facts were different so these citations of OP were not applicable.  

OP had also submitted their written arguments which were on record. It was noticed that OP had taken another defence of ITR copy on record to prove that complainant was capable to pay future premiums as well though there was no evidence ever submitted by OP or any facts raised by complainant about his ITR issue. In absence of such ‘new issue’, it is presumed that OP intentionally did all the tactics not to refund the premium amount or total assured amount a sum of Rs 3 lakh.   

Taking merits of case, facts and evidences on record, we are of the opinion that this complaint has merit so we pass the following order as under—

a)-OP shall refund a sum of Rs 3 lakh (as promised) with 9% interest from the date of filing of this complaint to the complainant within 30 days.  

b)-We also award compensation of Rs 25,000/- for physical and mental harassment to the complainant along with Rs 5,000/- as litigation charges.   

c)-If order is not complied in the time essence, entire awarded amount shall carry the same interest till realized.  

The order copy be sent to the parties as per act and file be consigned to the record room

 

(Dr) P N Tiwari  Member                                                   Shri  Sukhdev Singh  President