Shri Swapan Kumar Mahanty, President.

This is an application u/s.12 of the C.P. Act, 1986.

Briefly stated the facts relevant for the disposal of the Complaint are that being instigated by the O.P.-2, complainant purchased a policy being No. 501-5217069 from O.P.-1 Bharti Axa Life Insurance Company Limited by paying a sum of Rs. 42.000/-. It is the further case of the complainant that his signature appearing in the policy form is forged and the assurance of return of 1  percent sum assured in each month has not been written in the policy document. The complainant on receipt of policy document approached the O.P.-2 about mis-selling of policy in question fraudulently but the O.P.-2did not pay any heed to the protest of the complainant. The Complainant approached the authority of O.P.-1 but in vain. According to the complainant, the O.Ps. have intentionally and fraudulently mis-sold the policy which amount to unfair trade practice and deficiency in service. Thus, he raised a Consumer dispute seeking refund of Rs. 42,000/- paid for purchasing the said policy. The complainant also claimed damages of Rs. 5 lakhs for mental agony and harassment beside litigation expenses.

            The O.P.-2 in their Written Version denied the allegations of the complainant. The Specific case of the O.P.-2 is that after obtaining duly filled up and signed proposal form together with cheque from the complainant the answering O.P. forwarded the same to the O.P.-1 / Insurance Company and thereafter further steps were taken by the O.P.-1 regarding issuance of policy and sending the original policy document to the complainant. The answering O.P. has no authority regarding processing, issuance, or sending original policy document. The complainant is not entitled to the claim as alleged in the Complaint. The answering O.P. has prayed for dismissal of the complaint with costs.

The O.P.-1 has neither appeared in this case nor filed any written version and did not contest the case. The case has proceeded ex-parte against O.P.-1.

            In the light of the pleadings do the parties the following points necessarily came up for determination.

Points for determination

1) Have the O.Ps. deficient in rendering services to the complainant?

2) Have the O.Ps. indulged in unfair trade practice?

3) Is the complainant entitled to get relief as prayed for?

DECISION WITH REASONS

Points No. 1 to 3.

            All the points are taken up together for the brevity of discussion and convenience.

To prove their case both parties have adduced evidence on affidavit. They have also filed questionnaire and replies vis-a-vis relevant documents in support of their respective cases. 

            We have examined the entire material on record and given a thoughtful consideration to the arguments advanced before us.

            It remains undisputed that the complainant had taken a policy being No. 501-5217069 with O.P.-1 through O.P.-2 by paying a sum of Rs. 42,000/- . The complainant alleged that O.P.-2 for their illegal benefit misrepresented him with an assurance to pay 1  percent of the sum assured every month but on receiving the policy document the assurance of return of 1  percent of the sum assured has not written in the policy document. Complainant approached the authority of O.Ps. about the misrepresentation but in vain. Photo copies of letter dated 24.01.2017and 06.03.2017 addressed to the O.Ps. prove the approach of the complainant regarding intentional and fraudulent mis-sold the policy in question which amounts to unfair trade practice and  deficiency in service.

            It is also true that the O.P.-2 is a authorized broker of O.P.-1 to the extent of promote and log into the various policies offered by the O.P.-1. O.P.-2 is not involved in any monetary transaction, as the complainant directly disbursed payments to the O.P.-1/Insurance Company. The O.P.-2 only forwarded the proposal form to the O.P.-1 for processing and the role of the O.P.-2 cease at this point of time. The plea of the complainant that his signature appearing in the policy document is forged but the complainant never filed any application for comparison of his signature with the signature appearing in the policy document with the assistance of Hand Writing Expert. In absence of any opinion of the Hand writing Expert, we are not inclined to believe the version of the complainant.

            Nobody can dispute that the Insurance agents take the signature of the insured on a dotted line, most of the terms and conditions of insurance policy contain various provisions and exclusion clauses which could not be understood easily even by the experts in the field on occasions ambiguous, the terms and conditions which are meant for understanding by the insured are mostly in a small print which would require strenuous reading by the insured, if at all he is vigilant, insurance companies have not simplified their proposal form or the form of insurance policies for reasons best known to them, insurance companies are not keen to publish the insurance proposal forms or the policies in the regional languages which could be understood by the insured or a layman, and exclusion clauses are never highlighted or explained by the agent or Development Officer to the insured.

            The O.P.-1 Bharti Axa Life Insurance Company Limited did not turn up to contest the case nor controvert the version of the complainant as adduced in his evidence on affidavit. The evidence of the complainant remains unchallenged and uncontroverted against O.P.-1/Insurer. In absence of any contrary and controverting materials on record coupled with the documents on records, we think that complainant has been able to establish his case against the O.P.-1. We are constrained to hold that the O.P.-1 has exhibited a gesture of unfair trade practice as well as deficiency of service. Thus, all the points under determination answered in affirmative.

Hence,

Ordered

            That the Complaint case be and the same is dismissed on contest against the O.P.-2 without any cost and is allowed in part ex-parte against O.P.-1 with litigation cost of Rs. 5,000/- (Rupees Five Thousand) only.

            O.P.-1 is directed to refund Rs. 42,000/- (Rupees Forty Two Thousand) only to the complainant being premium amount along with litigation cost within one month from the date of this order.

            O.P.-1 is also directed to pay Rs. 5,000/- (Rupees Five Thousand) only to the Complainant as compensation within the stipulated period.

            O.P.-1 is further directed to deposit Rs. 5,000/- (Rupees Five Thousand) only to this Forum as punitive damage for practicing unfair trade within the stipulated period.

            Liberty be given to the complainant to put the order into execution, if the O.P.-1 transgress to comply the order.