Sri Shyamal Gupta, Member

Appeal Nos. FA/551/2014 and FA/596/2014 borne out of complaint case no. CC/327/2012 which has been allowed by the Ld. District Forum, Kolkata-II (Central) vide its order dated 18-03-2014.  The facts and circumstances of both these Appeals since been identical, the same are disposed of through this common order.

A complaint case was initiated by Sri Asit Hazari against ICICI Prudential Life Insurance Co. Ltd. and others alleging mis-selling of policies by the insurance agents.  On the other hand, both the Insurance Companies, i.e., ICICI Prudential Life Insurance Co. Ltd. (OP No. 2) and Birla Sun Life Insurance Co. Ltd. (OP No. 3) disputed such allegation of the Complainant contending inter alia that the disputed policies were issued following due norms and based on the applications of the Complainant.  The Insurance Companies also wondered as to why the Complainant did not raise the issue within the free-look period.

Parties were heard at length and documents on record gone through rigorously.

As it appears, the Complainant took one insurance policy from the OP No. 2 in the year 2007.  The said policy entailed payment of premium to the tune of Rs. 40,000/-. 

It is the case of the Complainant that he religiously issued requisite cheques through the OP No. 4 for timely payment of premiums.  However, the OP No. 4 did not deposit the same against the proper policy resulting which the same got lapsed.  On enquiry, he came to know that the same was used for issuing a new policy in the name of his daughter.  To aggravate the situation, the OP No. 2 foreclosed his policy and sent a cheque for an amount of Rs. 34,155.61 as surrendered value causing financial loss to the tune of Rs. 1,00,000/- to him. 

Although the above allegation has been fervidly denied by the OP No. 2, it is normal prudence that one would prefer to stay put with the existing policy rather than taking another policy at the cost of huge financial loss. Sheer timing of issuance of the disputed policy and identical premium amount, no doubt, does raise eyebrows.     

True, as pointed out by the Ld. Advocate for the OP No. 2, there is no dispute as regards the authenticity of the signature contained in the proposal form used for issuing the disputed policy in the name of the daughter of the Complainant.  In this regard, it is noteworthy that the Complainant is a semi-literate person, who has read only up to Class VII (although his education qualification has been mentioned as Graduate in the proposal form) and he earns his ends meet by selling milk.  Quite naturally, it was futile to expect him to understand what was written in the proposal form or the policy papers or the significance of signing a new proposal form.  It is not the first instance that such kind of allegations has been leveled against the agents of the OP No. 2.  The IRDA data draw a very grim picture in this respect.

It is also important to note here that the Complainant mentioned the policy no. (now foreclosed) on the reverse of the cheque being issued towards payment of premium. Certainly, one would not write a different policy no. on the back side of the cheque.

For all these reasons, we cannot accept the contention of the OP No. 2 that there was no wrongdoing in the matter of issuance of the disputed policy.  Although the concerned agent was arrayed in the case, she did not turn up to refute the allegation of the Complainant. In our considered opinion, therefore, the OP No. 2 cannot shrug off its responsibility to pay the decretal sum to the Complainant.   However, in the interests of natural justice, the OP No. 2 is exonerated from the liability of paying the penal interest amount @ Rs. 300/-.  Instead, we direct the OP No. 2 to pay simple interest on the decretal sum for the entire period of default.

The Ld. District Forum though held the OP No. 1 responsible for the misfortune of the Complainant, we cannot appreciate such decision for the simple reason that as a Regulatory body, the IRDA never canvas for any individual insurance company.  If someone resorts to any wrongdoing in the name of the IRDA, the wrongdoer must be held accountable for the same, not the Regulator.  We, therefore, deem it appropriate to exonerate the OP No. 1 from all liabilities.

In such premises, FA/551/2014 and FA/596/2014 stand allowed and allowed in part, respectively.