Order-13.

Date-26/08/2015.

Complainant Dr. Pratap Chandra Mandal by filing this complaint has submitted thatcomplainant was approached by the agent of the op Company to make three life insurance policies being Nos. 0310419347, 0314823883 and 0315672615 and op’s agent assured the complainant that after lapse of 3 years, complainant shall have to get benefit and relying upon the statement of the op’s agent, complainant purchased it and continued it for 3 years and after that stopped payment and agent assured him that after maturity complainant is liable to receive Rs. 7,76,000/- from the Company which includes the interest also and it was further informed by the op’s agent that out of that amount of Rs. 1,00,000/- shall be deposited to the Company as Security Deposit and op’s agent visited the complainant various times and as per their guidance on good faith issued cheques being No. 30060 of Rs. 15,000/- dated 18.12.2013, 30067 of Rs. 10,000/- dated 30.01.2014, 30073 of Rs. 45,000/- dated 24.05.2014 and 30075 of Rs. 30,000/- dated 21.07.2014 and after receipt of the said amount, agent never turned up again and being frustrated complainant enquired about the delay in the payment the company sent a chequewithout date through its agent who came and took the signature of the complainant at its back and said that it was for verification of his signature.

          After such day the agent never turned up and company was also unwilling to assist the complainant.  Thereafter complainant went to their office to enquire when he faced ill behavior and complainant was asked to fill up the surrender form through which he will receive only Rs. 1,20,000/-

          Subsequently complainant practically felt so much insulted he filled up the form and submitted the same to the op.  But he found only Rs. 98,632/- was deposited in his bank account and the op only returned an amount of Rs. 98,000/- through ECS regarding the 3 policies so taken by the complainant on 28.12.2013 whereas the complainant was liable to receive Rs. 7,76,000/- with interest and to get back the Security amount of Rs. 1,00,000/-.  But being deceived by the op, complainant has prayed for proper relief for adopting such unfair trade practice by the op and for their negligence and deficient manner of service and also prayed for refund of Rs. 1,20,000/- along with interest 18 percent p.a. from 28.12.2013 till date of actual payment and refund of Rs. 1,00,000/-.

          On the other hand op by filing written statement submitted that the complainant did not involve an issue of deficiency of service by BALIC (op) and the allegation of the complainant is against the agent of op and op Insurance Company never assured the complainant in such a manner as alleged by the complainant and for the act of the agent of the op Insurance Company is responsible for that. 

Policy was issued which is based on the duly filled and signed proposal form which is just and legal and all transactions between the insurance company and the insured are based on the terms and conditions of the policy contract, so it is binding upon both the parties.

Further it is submitted that Cheque Nos. 30060, 30067, 30073 and 30075 were never deposited by the op or the complainant and claim of the complainant is fictitious for the act of the agent of op, cannot be responsible and in fact the complainant surrendered the same.

Accordingly surrender value of 3 policies of Rs. 98,632/- was duly paid and it was communicated with the insured vide letter dated 05.11.2014.  Further it is submitted that at any point of time, op never assured the complainant that he will get such amount as stated by the complainant.  In the result op prays for dismissal of this case.

Decision with reasons

On proper consideration the complaint and written version and also considering the document as filed by the complainant, it is clear that complainant opened 3 life insurance policies invariably being allured by the agent and the policies would be matured after 3 years and complainant shall have to get special benefit and no doubt it is fact that most of the doctors and busy officers during their busy hours allowed the agents and sometimes to oblige the agent opened such sort of Insurance Policies.  But it is impossible for such practicing doctor to see all the conditions and generally rely upon the agents.

Anyhow from many corner, it is ventilated that agent works for the consumer, but all over world it is admitted fact that agent acts on behalf of the Company because agent is appointed by the Insurance Company.  So, agent must have to inform to the purchaser the details of the product particularly in respect of the policy.  Admitted position is that against agent, allegation is made by the complainant and no doubt an agent is appointed by the op.  But now op is trying to shift all the liabilities upon the agent stating that they are honest but have not denied the agent’s status and appointment by the op and also allegations.

But truth is that if the agents appointment are cancelled by all the Insurance Companies and Insurance Company run their business, in that case it would be found that all private insurance companies shall be closed after 2 or 3 months.  Truth is that at present all the private insurance companies are marketing their product through agents who are doing everything without giving any scope to the purchaser to know about the fate of the policy.

But in the present case no doubt complainant as doctor relied upon the assurance of the agent of the op and opened it and continued it for 3 years.  But subsequently he has suffered huge loss, whatever it may be op has stated that they never received any money against cheque Nos. 30060, 30067, 30073 and 30075 and complainant has failed to prove that was deposited.

But fact remains that complainant continued the policy for 3 years and thereafter it was not continued because the agent stated that it is for 3 years.  But actually after consulting the policy, it is found that the said policy was not for 3 years.  So, complainant submitted that all the policies when op assessed the surrendered amount and released Rs. 98,000/- and odd.  But complainant’s version is that he was assured that he shall get Rs.1,20,000/-.  Anyhow op has not proved by any document that same were never encahsed and in respect of that Rs. 1,00,000/-, there is doubt about the conduct of the op and considering that fact, we are directing the complainant to show that those cheques are already encahsed by the op BALIC and if it is proved by the complainant that it was encashed by the BALIC, in that case op shall have to refund of Rs. 1,00,000/- no doubt and regarding the surrendered value, we have gathered that as per IRDA guideline of the year 2014 if any policy is found lapsed after 3 years, in that case out of total deposited premium amount 5 percent to 10 percent shall be deducted as service tax and balance amount shall be returned to the insurer and that is the position of law and in most of the cases, this was followed by the other Insurance companies.

In the present case it is proved that for 3 years, complainant deposited premium amount but same are not returned by deducting 5 to 10 percent service charge but more than that has been deducted.  Op as per IRDA guideline of the year 2014 shall have to refund total deposited premium amount of 3 years against 3 policies only after deducting 10 percent out of that and shall have to pay the balance amount of the total deposited premiums against 3 policies and it is the mandatory provision and that has not been followed by the op Insurance Company.

No doubt this complainant has been deceived by their agent and anyhow there are so many findings by different Foraabout agent act on behalf of the complainant.  But truth is that as per law agent is appointed by the company not by the insured and agent acts on behalf of the company, then any over act of the agent shall be treated as overact of the company, but that view is not followed by the consumer dispute.  But we have failed to understand why the legal position has not been followed but otherwise interpreted is not known to this Forum because for agent’s act, no commission is paid by the insured but by the insurer and agent is selling the product of the company.  Then an agent’s overact shall be treated as overact of the op that is General Principle of Law and considering the allegation of the complainant, we find that it is the common practice of the agent in almost all the cases and being busy professional man like the present doctor are being deceived through the agent by the company and their persons and in this case the complainant has been deceived no doubt by the insurance company through their agent.

Considering all the above materials facts, we are convinced that complainant intended to purchase a policy for only 3 years term only,so Complainant deposited the said amount, but it was subsequently found by him that it was for 10 years or 15 years.  But complainant had no intention to purchase such a policy for long term and he was assured by the agent that he shall have to get it after 3 years.  But anyhow when after 3 years, he found that he must have to continue the policy for another 10 to 15 years finding no other alternative, complainant submitted surrender application and against that complainant got only Rs. 98,000/- and odd and as per guideline of the IRDA of the year 2014, op shall have to refund against the said 3 policies, the entire deposited amount after deducting 10 percent from it and it must be complied by the op within one month from the date of this order.

About payment of Rs. 1,00,000/- through cheques, complainant shall have to submit the encashment by the op by producing such Bank A/C to the op and if it is found that op has encahsed it, in that case, op shall have to refund that Rs. 1,00,000/- also.  But considering the entire fact materials and the position of the complainant, the conduct of the agent of the op and for not giving proper relief by the op as per IRDA guideline, op shall have to pay litigation cost because waste of time of doctor is proved.

In the result, complaint succeeds.

Hence, it is

ORDERED

That the complaint be and the same is allowed on contest against the op with cost of Rs. 5,000/-.

Op is hereby directed to refund the entire deposited premium amount for 3 years against 3 policies after deducting 10 percent out of the total amount to the complainant within one month from the date of this order.

Complainant shall have to submit the statement of Bank A/C showing encashment of that Rs. 1,00,000/- by the op and if from the Bank Statement it is found that it was encashed by the op, in that case op shall have to refund of Rs. 1,00,000/- also within one month from the date of submitting Bank Statement by the complainant in support of the encashment of Rs. 1,00,000/- by the op Insurance Company.

Op is hereby directed to comply the order within one month from the date of this order, failing which for non-compliance of the Forum’s order, op shall have to pay penal damages  at the rate of Rs. 100/- per day till full satisfaction of the decree and if it is collected, it shall be deposited to this Forum.

Even if it is found that ops are reluctant to comply the order, in that case, op shall be prosecuted u/s 25/27 of C.P. Act 1986 for which further penalty and fine shall be imposed upon the op.