DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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Manvinder Kaur wife of Sh.Rajanbir Singh, resident of House NO.31, Sector 69, SAS Nagar, Mohali

             …..Complainant

Versus

1]  Bharti AXA Life Insurance Company Limited, through its Managing Director having registered office Unit 601 & 602, 6^th Floor, Raheja Titanium, Off Western Express Highway, Gore Gaon, Mumbai 400063

2]  Bharti AXA Life Insurance Company Limited, S.C.O No.208-209, IInd Floor, Sector 34-A, Chandigarh through its Area Manager/Authorised Representative

   ….. Opposite Parties

BEFORE:  SH.RAJAN DEWAN             PRESIDENT

         SMT.PRITI MALHOTRA             MEMBER 

                    SH.B.M.SHARMA                      MEMBER

Argued by :- None for complainant

  Sh.Gaurav Bhardwaj, Adv. for OPs

PER PRITI MALHOTRA, MEMBER

         Briefly stated, the complainant was approached by one Kapil Malhotra, claimed to be IRDA Agent, told her that in case she invest Rs.50 lacs with various companies, then she would be eligible for sanctioning of licence for setting-up of Petrol Pump by the company.  It is averred that after the investments were made the complainant came to know that she had been allured by the persons who claimed to be connected with various companies for investment purposes.  Further averred that these persons also with motive to further extract more money from the complainant contacted her in the month of September, 2014 and told her to made available a sum of Rs.2.5 Lacs as the processing charges for the setting-up of the Petrol Pump which was promised at the time of investments as process was on the verge of completion. It is stated that one person namely Ajay Kumar took Rs.50,000/— from the complainant and thereafter, the other accomplice of Ajay Kumar kept on demanding for the remaining amount.  It is averred that the complainant smelt some foul play, thus informed the police; when these persons came to take the money, the police reached on the spot and apprehended them.  In this regard the police registered F.I.R. No.221 dated 21.10.2014 U/s 406, 420 IPC, Police Station Phase—I, SAS Nagar, Mohali (Ann.C-1) against them.  It is averred that the complainant after having indulged in various correspondences with the companies was refunded an amount of Rs.43 Lacs, as alleged in complaint, which was credited to the account of the complainant by the various companies, but the OPs did not pay any heed to the requests made by the complainant and did not bothered to go through the facts of the FIR which primarily established the offence committed by the brokers of various companies.  It is alleged that the OPs had not refunded the amount of Rs.5 lacs which got deposited by them against policies which were also part of transaction done by the said persons by alluring and mis-representing the facts.

         It is also averred that the complainant on receiving the policies, came to know that the same were not having one-time payment plans but every year there was an installment of Rs.2,49,999.81 to be paid to the OPs, but this fact was not intimated to the complainant at the time of filling of the proposal form on 13.5.2013 and 14.5.2013. It is pleaded that the complainant on number of occasions tried to bring to the knowledge of the OPs that the policies so issued have not been issued as per the information so provided to the complainant. It is also averred that till Nov., 2014, the OPs did not bother to even check their own records and only when the complainant kept on informing the OPs, the two excess policies came to be cancelled by them. It is also pleaded that the OPs have received the amount by mis-representing and by alluring the complainant in order to make wrongful gains by issuing policies without disclosing the correct figures and their terms & conditions, therefore, the OPs are liable to refund the amount so received from the complainant along with interest. Alleging the said act of OPs as gross deficiency in service and unfair trade practice, hence this complaint has been filed.  

2]       The OPs have filed joint reply and while admitting only the factual matrix of the case, stated that the policies No.5009928952 & 5009874446 in the name of policyholder i.e. complainant were issued in response to the proposal forms duly signed by the complainant (Ann.R-1 & R-2).  It has been stated that the other two policies bearing No.5009874453 & 5009903542 (Ann.R-3 & R-4) initially issued in favour of the complainant were cancelled due to dishonouring of premium cheques.  It is further stated that the complainant failed to return or withdraw the above said policies within the free look period of 15 days as provided in said policies in case she was not satisfied with features or terms & conditions thereof.  It is submitted that after a span of almost one and half year from the date of issuance of policy documents, the Company received complaints on 15.10.2014, 18.10.2014 & 3.11.2014 alleging mis-selling (spurious and hoax calls) and therefore seeking cancellation under the aforesaid policies. After investigating the complaint and verifying its record, the Company was unable to consider the request of the complainant and accordingly, the Company vide email dated 14.11.2014 (Ann.R-6) commutated its decision to the complainant.  It is submitted that OP Company received an email complaint on 7.12.2014 & 13.12.2014 from complainant for cancellation of Policies No.5009903542 and 5009874453 and the same was duly replied (Ann.R-7 & R-8).  It is also submitted that once again the OPs received email complaints dated 28.1.2015, 13.2.2015 & 11.3.2015 from complainant, which were duly replied on 19.3.2015 (Ann.R-9 & R-10).  It is asserted that the OP Company reiterates that the matter was duly investigated and it turned out that the allegations of mis-selling is bereft of merits. It is pleaded that the policies bearing No.5011126900 and 5011131595 were issued and were also cancelled in free-look period after receiving request from the complainant in August, 2013 and the proceeds towards cancellation were duly credited to the complainants account on 13.10.2013 (Ann.R-11). It is submitted that the OP Company is not privy to the communications and dealing of the complainant with alleged persons, who are neither the employees nor advisors of the OP Company.  So, the allegations are false, frivolous and are concocted one. It has also been submitted that the complainant has already approached the Ombudsman, Chandigarh with her complaint and it had already decided the matter on merits. It is asserted that currently the alleged policies are in lapse state and the complainant may get reinstated the policies to enjoy the benefit of the policies.  Denying all other allegations, the OPs have prayed for dismissal of the complaint.

3]       Rejoinder has also been filed by the complainant thereby reiterating the assertions as made in complaint and controverting that of OPs in their reply.

4]       Parties led evidence in support of their contentions.

5]       We have heard the ld.Counsel for the OPs and have also perused the entire record including written arguments of complainant.

6]       Admittedly, the OPs issued policies No.5009928952 & 5009874446 in the name of policyholder i.e. complainant (Ann.R-1 & R-2).  It is also an admitted fact that the request of the complainant for cancellation of above mentioned policies were declined by the OPs.

7]       Before going into the merit of the case, the preliminary objection of the Ops needs to be dealt with. The OPs have raised an objection that as the complainant had already raised this issue before the Insurance Ombudsman, Chandigarh, which has already decided the matter, therefore, neither she can approach this Commission/Forum nor this Commission/Forum has the jurisdiction to try this matter.  Since legally there is no bar to approach this Forum/Commission for redressal of her grievance, therefore, she has rightly approached this Forum/Commission and this Form/Commission has the full jurisdiction to try and adjudicate the matter in question.

         Reliance has been placed on the judgment of Hon’ble National Commission, New Delhi in case Kamleshwari Prasad Singh vs. National Insurance Co. Ltd., I(2005) CPJ 107 NC wherein it has held as under:-

“In view of the above discussion, it is held that the decision of the Ombudsman is not binding on the complainant and the decision of the Insurance Company to repudiate the claim is subject to adjudication by the Fora Constituted under the Consumer Protection Act.”

         Therefore, the objection of the OPs is rejected being untenable.

8]       After having meticulously gone through the evidence placed on record by the parties and giving a thoughtful consideration to the pleadings, supported with duly sworn affidavit of the parties, it transpires that the complainant having been misrepresented, opted for various insurance policies against false allurement of her getting sanctioned license for setting-up of Petrol Pump by the Company. The record also establishes that when the complainant lodged an F.I.R. against the misrepresentation committed by the agents of various insurance companies, those insurance companies, in order to save themselves from the legal consequences refunded the amount thereof, not only after the expiry of free look period of 15 days of the policies, rather after period of more than a year and duly credited the amounts thereof in the account of complainant. 

9]       There is no specific denial to the factum that the complainant was issued the disputed policies in question during that period only when the other policies were so issued by various insurance companies under the garb of getting her sanction of license for setting-up of Petrol Pump by the Company. The refund of premiums made by the other insurance companies to the complainant after having realized fraudulent act committed by their official/agents/representatives, corroborates & establishes the allegations made by the complainant about her being mislead and mis-represented while issuing the insurance policies.  The complainant has duly placed on record the statements showing refund of premiums by other insurance companies.

10]      It is gathered from the record that the complainant was issued the disputed policies in question during that period only when other insurance policies were so issued by other brokers of the companies. The record available is evident enough to establish that the complainant has been duped by the agents/representatives of the various insurance companies including the OP Company in question. By not refunding the premium amount of these policies, issued by OPs by mis-selling & mis-representation, as such the OPs have committed not only gross deficiency in service, but also resorted to unfair trade practice. Thus, the plea of the OPs qua the expiry of free look period provided in the policy, is bereft of any merit and not sustainable.  

11]      It is reiterated that thorough perusal of record without any reasonable doubt evident that the OPs acted unfairly throughout and it is only on the repeated requests made by the complainant that the OPs after having checked their record, cancelled the Policies bearing No. 5009874453 & 5009903542 issued earlier and that also in Nov., 2014 whereas the said policies were issued in May 16, 2013 & May 3, 2013 respectively.  The meticulous reading of the correspondences exchanged between the parties beyond any doubt reveals that the complainant has been made target of mis-selling of policies in the garb of fake allurement of sanctioning of license for establishing a Petrol Pump.  

12]      From the above discussion and findings, the deficiency in service & unfair trade practice on the part of Opposite Parties have been proved, which certainly has caused immense harassment & mental agony to the complainant.  Therefore, the complaint stands allowed against OPs with direction to refund an amount of Rs.5 lacs, being the premium amount of both policies in question, along with interest @9% p.a. from June, 2013 till the date of its actual payment. The OPs are also directed to pay an amount of Rs.25,000/- as compensation to the complainant for causing her harassment & mental agony, along with litigation cost of Rs.10,000/-.

         This order shall be complied with by the Opposite Parties jointly & severally within a period of 30 days from the date of receipt of its certified copy, failing which they shall be liable to pay additional compensatory cost of Rs.10000/- apart from above relief.

         The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

Announced

22^nd Feb., 2021                                                                       sd/-   

(RAJAN DEWAN)

PRESIDENT

Sd/-

 (PRITI MALHOTRA)

MEMBER

Sd/-

(B.M.SHARMA)

MEMBER