Haryana

Hisar

357/2009

Manoj Kumar - Complainant(s)

Versus

Aviva LIC - Opp.Party(s)

Ashish Goyal

22 Jan 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, HISAR.

                                                             Consumer Complaint no.357 of 2009

                                                              Date of Institution :          13.8.2009

                                                              Date of Decision   :           06.02.2015

 

Manoj Kumar  son of  Late Sh. Madan Lal, resident of H.No.78-S, Model Town, Hisar.

                                                          …Complainant

 

                                 Versus

 

1. Aviva Life Insurance Company Limited through its Branch Manager SCO 152 Red Square Market, Hisar.

 

2. Aviva Life Insurance Company through its CEO, Aviva Tower, Sector Road, opposite Course, DLF Phase V, Sector 43, Gurgaon.

 

3. Amit Rawle, Assistant Sales Manager, House No.1298, Shiv Nagar, Hisar.

 

4. Anju Gupta, Insurance advisor, House No.1425, Urban Estate-II Hisar.

                  

                                                     …Opposite parties

 

               Complaint under Section 12 of the Consumer Protection Act,1986.

 

 

Before:        SHRI VINOD JAIN, PRESIDENT

          SMT.RAJNI GOYAT,MEMBER.

Present:       Sh.Ashish Goyal, counsel for the  complainant.

                   Sh. Rajesh Arora, counsel for opposite parties No. 1 &2.

                   None for opposite party No.3.

                   Sh. Vikramjit Mittal, counsel for opposite party No.4.

 

ORDER

                    Complainant Manoj Kumar, on 5.6.2008, applied for Life Insurance policy vide proposal form No.NUP 11974831 for sum insured of Rs.7,50,000/-   against monthly payment of  Rs.2,000/-. For payment of first insurance premium, he gave cheque dated 5.6.2008 for Rs.2,000/- which was got enchased by the opposite parties on 28.6.2008. Opposite parties sent its acknowledgement dated 4.7.2008(Ex.C-16). The complainant then received letter dated 9.7.2008 (Ex.C-1) and letter dated 7.8.2008(Ex.C-2) sent by  opposite party No.2 requiring him to get himself medically examined in order to issue insurance policy to him. That immediately, after receiving these letters, he contacted Amit Rawle, Assistant Sales Manager i.e. opposite party No.3 and Anju Gupta Insurance advisor i.e. opposite party No.4,  to get himself medically examined but they showed reluctance.  The complainant thereafter received letter dated 20.8.2008(Ex.C-3), sent by  opposite party No.2 for rejection of his proposal for life Insurance policy,  for want of  his medical examination. The complainant, on 22.8.2008, sent  complaint (Ex.C-4) to opposite party No.2, regarding said mischief committed upon  him by opposite parties No.1, 3 & 4.  He received its reply dated 2.9.2008(Ex.C-5),  assuring him to get the matter investigated. On the  very next day dated 3.9.2008, opposite parties No. 3 & 4 came to him and handed him over, some other insurance policy (Ex.C-6),  which was neither purchased by him nor was proposed to be purchased nor had paid premium for it.  That the said insurance policy, was fraudulently got issued, by opposite parties No.1, 3 & 4 by forging his signatures and by cleverly getting transferred said amount of Rs.2,000/-  towards payment for this policy. That for it,  he got FIR No.156 dated  16.3.2009,  registered in Police Station, Civil lines, Hisar for offences punishable under Sections 420/467/468/471 of IPC and now said matter is pending adjudication  before Illaqa Magistrate . That the policy purchased by him was for sum insured  of  Rs.7,50,000/-, but in order to avoid their responsibility, to get the complainant medically examined, opposite parties No.1, 3 & 4,  got him issued said another fictitious  policy (Ex. C-6) of lower sum insured of  Rs.4,50,000/-.  That it was so done after forging his signature and mis appropriation  of  his said sum of Rs.2000/-. That when he visited Br. Manager of the opposite parties at Hisar on 8.9.2008,  firstly opposite party No.1, showed his reluctance  to entertain him and then insisted to sign a proforma which the complainant refused as it would have confession on  his part. The complainant also went before Insurance Ombudsman,  where the matter was fixed on  6.1.2009 but on that day he was admitted in the hospital, so sent a FAX message but, without hearing and in his absence, the matter was disposed off,  by Insurance Ombudsman with a direction to the insurance company to refund  Rs.2,000/- to the complainant. Averring all it,  as gross deficiency of service on the part of opposite parties; complainant has brought this complaint for a direction to the opposite parties, to pay him Rs.7,50,000/- i.e.  sum assured with up to date interest, besides damages for his harassment, mental agony etc. and litigation expenses.

2.       Opposite parties No.1 & 2 jointly and other two opposite parties individually have filed their written statements. They have contested the case of the complainant. They have denied the allegations of forgery, cheating etc. It is pleaded that complainant  did not get himself medically examined; that the policy was issued to him, which was asked in the proposal form; that the matter has already been decided by Insurance Ombudsman, Chandigarh and amount Rs.2,000/-, ordered by the  Insurance Ombudsman, has already been refunded to the complainant, so this complaint is not entertainable.

3.       Opposite parties No.3 has pleaded that he has already been terminated, from his service, as Assistant Sales Manager of the opposite parties, w.e.f. October,2008  and now he has nothing to do with opposite parties No.1 & 2. That the case of the complainant against him under FIR No.156 dated 16.3.2009 under sections 420/467/468/471 of  IPC in Police Station, Civil Line,  Hisar, is already pending adjudication, in the court Illaqa Magistrate.  That the complainant has already received Rs.2,000/- and so this complaint is not entertainable.

 4.      Opposite party No.4 has pleaded that her role was only limited to the extent of simply sending the proposal form of the complainant, to the company. Forgery and cheating, if any, would have been done by opposite party No.3, as she had no access to internal matter of the company therefore if somebody changed the papers, then she has no knowledge nor any concern with it. She has un-necessarily  been impleaded. It is also pleaded that complainant himself was having 15 days free look in period, not to accept the policy issued to him.

5.       In order to make out his case, the  complainant has placed on record  various documents from Ex.C-1 to Ex.C-18, including various letters of correspondence in between the complainant and the opposite parties, copy of order of Insurance Ombudsman , Chandigarh  dated 6.1.2009 , copy of FIR, copy of  police challan;  copies of his medical examination paper besides his own supporting affidavit CW1/A etc.

6.       Opposite parties have placed on record various documents including supporting affidavit; copy of FIR; copy of police challan; copy of Forensic science laboratory report etc.

 7.      We have gone through the record of the case carefully and have heard learned counsel for parties

8.       Opposite parties have led no co-gent or convincing  evidence to prove their aforesaid pleaded case in order to come out from the allegations of the complaint fully proved. Admittedly,  Insurance policy in question Ex.C-6, was issued to the complainant,  on the basis of premium amount which was given for obtaining  some other insurance policy for sum insured Rs.7,50,000/- which was already refunded.  It was on the basis of insurance proposal form No.NUP-11974831.  For want of medical examination, said proposal form was rejected vide letter of the Insurance Company dated 20.8.2008(Ex.C-3). It was only when the complainant made complaint against opposite parties No.1,3 & 4 then only opposite parties No.3 & 4, handed him over said fictitious  insurance policy Ex.C-6, which was for insured sum of Rs.4,50,000/- as for it, there was no requirement for his medical examination. For this insurance he never gave any amount nor even requested for adjusting his said amount for this new policy.  Therefore, it is very clear that in order to cover their own wrong, opposite parties No.1, 3 & 4 had  manipulated the things and got insurance policy (Ex.C-1) issued. There is nothing, as to how and  in what circumstances, said policy was issued to him, when he had not applied for it. In this regard, it is note worthy that police, after due investigations had submitted challan and prosecution matter is already pending adjudication before Illaqa Magistrate for offences  punishable under Sections 420/467/468/471of  IPC.   For all this, admittedly, insurance company has already terminated the service of opposite party No.3.   All this fully proves the pleaded case of the complainant.

9.       Although allegations of forgery and fraud, have been denied by the opposite parties, but fact remains that the insurance policy applied by the complainant, was got wrongfully rejected by the officials/agents of the insurance company and then wrongfully got issued another insurance policy, which was not applied by him.  It was for lower sum insured.  It is not only gross  deficiency of service on the part of the opposite parties, but is also quite unfair trade practice in their part.

  10.       Ld. Counsel for the opposite parties, have however contended that in view of order of Insurance Ombudsman, order  dated 6.1.2009(Ex.C-10) this complaint is not entertainable.  But we do not find any merit in this contention. That order was, on the back of the complaint.  It was within giving him an opportunity of being heard. Page No.35 of  Ex.C-15 is copy of FAX message dated 5.1.2009, which was sent to Insurance Ombudsman  by the complainant. It supports his contention that, he was admitted in the hospital and so on that date he was not in a position to attend hearing of 6.1.2009. Therefore said order of 6.1.2009 is not a bar for him  to file this complaint.

11.     In the facts and circumstances of the case in hand, complainant has not suffered any financial loss. He has only suffered harassment, mental agony etc. The insurance policy applied was not given to him, but was given which was unacceptable to him. Therefore this forum is to access damages for his harassment, mental agony etc.  Complainant is the consumer of  only of  opposite parties No.1 & 2 and  of opposite parties No.3 & 4, as they were only employees/ agents of opposite parties No. 1 & 2. Therefore, only opposite party No. 1 & 2 is answerable to the complainant.

12.     In the facts and circumstances of the case in hand, to our mind, a sum of Rs.25,000/- should be just and fair  amount, to duly compensate the complainant, for  aforesaid deficiency of service on the part of  opposite parties No. 1 &2.

13.     Resultantly, this complaint is hereby allowed, with a direction to  opposite parties No.1 & 2, to pay a sum of  Rs.25,000/- to the complainant with interest @ 9% per annum,  from the date of filing this complaint i.e. 12.8.2009  till payment. Complainant is also hereby awarded litigation expenses of Rs.1100/- against  opposite parties No.1 & 2.

Announced.                                                         

Dated:06.02.2015                                           President,

                                                                    District Consumer Disputes

                                                                   Redressal Forum, Hisar.

                                     

 

                                                                        Member/06.02.2015