Sri Ranjan Ray, Ld. Member

FINAL ORDER/ JUDGEMENT

This complaint U/S 11 and 12 of C.P. Act, 1986 was initially filed against the Opposite Party (O.P.)- 1) Bharati Axa Life Insurance Company Limited, Rajani Bhawan, Hill Cart Road, Siliguri, Dist.- Darjeeling, Pin Code- 734001, 2) Bharati Axa Life Insurance Company Limited, Unit No. 601 & 602, 6^th Floor, Raheja Titanium, Off Western Express Highway, Goregaon (E), Mumbai- 400063, 3) National Insurance Company Ltd., Regd. Office Middleton Street, Kolkata- 71 who contested the case by filing their Written Version (W.V.).

                             The case of the complainant as per his complaint is as follows-

The complainant argued in her plaint that on 23.08.2012 the Bharati Axa Branch office conducted an art competition where her son namely Avishek Das participated and out of 1000 participants her son secured his place among first 19 winners. The complainant added that when they went to collect the winner’s certificate an agent named Sarwan Roy told them her son won the art competition with a scholarship of Rs. 1, 00, 000/- (Rupees One Lac.) only and its premium would be paid by the company and after that he made a wrong claim regarding their “Life Aajeevan Sampatti Policy” and the span of its premium was 15 years which would be paid by the company for 03 or 05 years and from 6^th year. The complainant also added that it was also said them that from the 6^th year they would receive Rs. 60, 000/- (Rupees Sixty Thousand) only to Rs. 70, 000/- (Rupees Seventy Thousand) only and in addition to this after every 10 years there would be an annual increment of Rs. 10, 000/- (Rupees Ten Thousand) only.

The complainant also argued that based on such assurance she handed over a cheque of Rs. 49, 999/- (Rupees Forty Nine Thousand Nine Hundred and Ninety Nine) only to the O.P. No.1on which the O.P. No.1 issued an acknowledgement receipt on 13.09.2012. The complainant also added in her plaint that on 24.03.2016 they got information from the customer care executive that they had to continue the said policy for 15 years but the complainant was unable to pay such huge amount for 15 years as her husband was a store keeper. The complainant also argued that her family had some financial barriers related to continue the study expenses of their children and her father-in-law was too a cancer patient. The complainant also argued that the agent of the O.P. kept them in the dark regarding this policy and forced them to buy a health policy saying that it would be amended an education policy for their daughter and son on which they would be entitled to get the privilege on education expenses at the time of Class IX and X and also secure with a job. The complainant also argued that the O.P.s intentionally harassed them which was a deficiency in service and she was not satisfied to the service of the O.P. and when the complainant asked to withdraw their policy and also to get back their hard earn money the O.P. showed several rules and regulations of the company and denied to refund their money.               

The prayers of complainant are as follows :

1. To pass an order directing the O.P.s to hand over the entire policy amount of Rs. 2, 86, 820/- (Rupees Two Lac. Eighty Six Thousand Eight Hundred and Twenty) only to them.
2. To pass an order directing the O.P.s to pay Rs. 5, 00, 000/- (Rupees Five Lac.) only for harassment, mental agony, expenses of correspondence during these days from the date of claim till today.

                             List of Documents filed by the complainant:

1. Photocopy of the certificate of appreciation, dated 1^st September, 2012.

(01 page, marked as Annexure A-01)

2. Photocopies of Certificate of National Insuran ce Company Ltd. for Insurance for Standard Fire & Special Perils being Certificate No. 07/13/000912814. (02 copies, marked as Annexure 02 and 03)
3. Photocopy of cheque of Rs. 49, 253/- being cheque no. 059114, dated 15.03.2015 and account no, 20018604437. (01 page, marked as Annexure 04)
4. Photocopy of cheque of Rs. 50, 000/- being cheque no. 059110, dated 13.09.2013 and account no, 20018604437. (01 page, marked as page no.  05)
5. Photocopy of Acknowledgement of Rs. 49, 999/- being Proposal No. 7303810, dated 13.09.2012. (01 page, marked as Annexure 06)
6. Photocopy of Acknowledgement of Rs. 18, 000/- being Proposal No. 6654088, dated 12.07.2013. (01 page, marked as page no.   07)
7. Photocopy of letter of Bharati Axa Life Insurance Company Ltd. (02 copies, marked as page no.   08 and 09)
8. Photocopy of Deposit Receipt of Rs. 49, 253, dated 16.03.2015. (01 page, marked as page no. 10)
9. Photocopy of Acknowledgement of Rs. 11, 946/-, dated 16. 07.2013. (01 page, marked as page no. 11)
10. Photocopy of letter of Bharati Axa Life Insurance Company Ltd. (01 copy, marked as page no. 12)
11. Photocopy of Insurance Premium Collection Acknowledgement of Rs. 11, 800/-, dated 03.02.2016. (01 copy, marked as page no. 13)
12. Photocopy of letter of Max Bupa Health Insurance, dated 24.07.2014. (01 copy, marked as page no. 14)

          On behalf of the Opposite Party (O.P.)- 1) Bharati Axa Life Insurance Company Limited, Rajani Bhawan, Hill Cart Road, Siliguri, Dist.- Darjeeling, Pin Code- 734001 and O.P. 2) Bharati Axa Life Insurance Company Limited, Unit No. 601 & 602, 6^th Floor, Raheja Titanium, Off Western Express Highway, Goregaon (E), Mumbai- 400063 who contested the case by filing W.V. and as per their W.V. the case is as follows.   

The O.P. No. 1 and 2 denied all allegations made by the complainant in their W.V. and argued that the art competition was taken up as a C.S.R. activity and was not associated with any sale of policy at all any offer for payment of premium was made to the complainant by the O.P. for any policy for his son coming 19^th in the art competition. The O.P. No.1 and 2 added in their W.V. that the policy about that the complainant was complaining did not exist in the product offer of them and as per standard protocol all policy details with illustration was available in the website to be checked and verified. The O.P. No.1 and 2 also added that the complainant was not served the policy bond because of that it was impossible for them to make any substantial statement. The O.P. No.1 and 2 also argued that the complainant paid the premium for three years which proved that she was well aware of the terms and conditions of the policy and when the complainant was dissatisfied with the policy terms she could easily cancelled the policy within its Free Look period.

The O.P. No.1 and 2 also argued in their W.V. that since the complainant faced some financial problem for which she was not willing to continue the said policy and if the said policy had attained any maturity value the same could be encashed by the complainant as per policy terms and conditions however, the entire premium never be returned as the insured had already enjoyed the insurance cover over a period of time.      

  The O.P. No.3 denied all the allegations made by the complainant against them and argued in his W.V. that the present case was bad for mis-joinder of unnecessary party and the O.P. No.3 was an unnecessary party in this case and all the statements in this complaint was not related to the O.P. No.3. The O.P. No.3 also argued that the cause of action never arose against the O.P. No.3 at any point of time and no specific averment, assertion and/ or allegation arose against them and therefore, the O.P. No.3 prayed for dismissal of the present complaint which was filed by the complainant against them.    

Having heard, the Ld. Advocate of both the side and on perusal of the Complaint, Written Version and documents filed by the parties the following points are taken to be decided by this Commission.

Points for consideration

1) Whether the complainant is a consumer?

2) Whether the case is maintainable under the CP act 2019?

3) Whether this Commission has its jurisdiction to decide this case? 

4) Whether there is any deficiency in service in the part of the O.P. as alleged by the complainant?

5) Is the complainant is entitled to get any award and relief as prayed for? If so, what extent?

Decision with reasons:-

All the points are taken up together for consideration and decision.

Seen and perused the complaint petition and Written Version filed by the parties which are supported by the affidavit, documents filed by the parties. We are also heard arguments of both the parties in full length.

The complainant resides in Siligui of Darjeeling district O.P. No.1 is also carrying his business in Hill Cart Road, Siliguri of Darjeeling. Thus, the Commission has no doubt that the complainant is a very much consumer as per the Consume Protection Act, 1986 and Consumer Protection Act- 2019 and also there is no doubt that this Commission has its territorial jurisdiction to decide this case.

At the time of argument Ld. Advocate of the Complainant submits that the Complainant has been able to prove its case against the O.P not only through his Written Deposition but also by producing documents.

In this instant case, as per evidence the complainant made a policy from O.P. No.1 and 2 and also in connection to the said policy she made payments in the following manners- Rs. 49, 253/- being cheque no. 059114, dated 15.03.2015, Rs. 50, 000/- being cheque no. 059110, dated 13.09.2013, Rs. 49, 999/- being Proposal No. 7303810, dated 13.09.2012, Acknowledgement of Rs. 18, 000/- being Proposal No. 6654088, dated 12.07.2013, Deposit Receipt of Rs. 49, 253, dated 16.03.2015, Acknowledgement of Rs. 11, 946/-, dated 16. 07.2013 and Acknowledgement of Rs. 11, 800/-, dated 03.02.2016. Thus, this Commission has no doubt to hold that as per the Consume Protection Act, 1986 and Consumer Protection Act- 2019 the complainant is a very much consumer and there is no doubt that this Commission has its jurisdiction to decide this case.

From the evidence of the complainant, it is clear that 23.08.2012 the Bharati Axa Branch office conducted an art competition where her son namely Avishek Das participated and secured his place among first 19 winners. It is also clear from the documents filed by the complainant that she made a policy from O.P. No.1 and 2 and also in connection to the said policy she made those said payments. In her plaint the complainant also stated that the she was unable to pay such huge premium amount of the said policy for 15 years because her family had some financial barriers related to continue the study expenses of their children and her father-in-law was too a cancer patient and her husband was a store keeper.

In their W.V., the Opposite Party No.1 and 2 told that the policy about that the complainant was complaining did not exist in the product offer of them and as per standard protocol all policy details with illustration was available in the website to be checked and verified. The O.P. No.1 and 2 also added that the complainant was not served the policy bond because of that it was impossible for them to make any substantial statement. The O.P. No.1 and 2 also stated that the complainant paid the premium for three years which proved that she was well aware of the terms and conditions of the policy and when the complainant was dissatisfied with the policy terms she could easily cancelled the policy within its Free Look period. The O.P. No.1 and 2 also stated in their W.V. that since the complainant faced some financial problem for which she was not willing to continue the said policy and if the said policy had attained any maturity value the same could be encashed by the complainant as per policy terms and conditions however, the entire premium never be returned as the insured had already enjoyed the insurance cover over a period of time. In support of them the O.P. No.1 and 2 referred some judgments, e.g.- (i) Ravneet Singh Bagga v. KLM Royal Dutch Airlines [(2000) 1 SCC 66], (ii) Life Insurance Corporation of India vs. Siba Prasad Dash, reported as IV (2008) CPJ 156 (NC), (iii) Appex Court in United India Insurance Co. Limited Vs Harchand Rai Chand Rai Chandan Lal I(2003) CPJ 393 & Vikram Greentech (I) Ltd. & Anr. Vs New India Assurance Co. Ltd. II (2009) CPJ 34 etc.

From the evidence and documents filed by the parties it is very much clear that the Bharati Axa Branch (O.P. No.1 and 2) office conducted an art competition where her son namely Avishek Das participated and secured his place amongst first 19 winners. It is also clear from the documents filed by the complainant that she made a policy from O.P. No.1 and 2 and also in connection to the said policy she made those said payments to the O.P. No.1 and 2 and after that she was unable to pay such huge premium amount of the said policy for 15 years because her family had some financial barriers related to continue the study expenses of their children and her husband was a store keeper and her father-in-law was too a cancer patient. It is also clear that the O.P. No.1 and 2 accepted the fact that the complainant made a policy from them and based on the evidence it is also clear that the complainant made those said payments in connection to her said policy and the O.P. No.1 and 2 issued acknowledgement receipts against her said payments.

The complainant did not file her policy paper with the documents she filed and so, it is not possible for this Commission to assess what type of problem occurred with the complainant regarding the policy. However, this Commission does not have its jurisdiction to evaluate the terms and conditions of policy.

In this instant case, this Commission did not find any shortfall of O.P. No.3 and even in her entire complaint the complainant also did not raise any deficiency in the part of O.P. No.3. The complainant filed a photocopy of Certificate of O.P. No.3, namely Insurance for Standard Fire & Special Perils being Certificate No. 07/13/000912814 which is not relevant and the complainant failed to prove the role and involvement of O.P. No.3 in this case.  

  So, as per the above discussion it is very much clear that complainant that she made a policy from O.P. No.1 and 2 and also in connection to the said policy she made those said payments. The O.P. No.1 and 2 also admitted this fact. Hence, the complainant is entitled to get the admissible refund as per the terms and conditions of the policy from the O.P. No.1 and 2.

Hence, it is,

O R D E R E D

That the Consumer Case No. 05/2017 be and same is disposed off.

The Opposite Party 1 and 2- Bharati Axa Life Insurance Company Limited is directed to refund the admissible amount as per the terms and conditions of the policy to the complainant. No cost was awarded as because there is no deficiency in service from the part of the O.P. No.1 and 2.

Let a copy of this judgment be given to the parties directly or through their representative Ld. Advocate for compliance free of cost.