Complainant by filing this complaint has submitted thatrelying upon the representative assurance and promises made by the complainant invested a sum of Rs. 37,500/- to purchase one policy and issued a cheque bearing No. 679387 dated 20.04.2005 drawn on HDFC Bank and said cheque was honoured from the account of complainant and accordingly a policy being No. 000420476 was issued in favour of the complainant and at the time of said version for opening that policy, the agent of the op asked the complainant to sign some papers and accordingly as per agent of the ops, signed without knowing the details of the investment plan, terms, etc. and subsequently the said agent collected the two cheques of Rs. 12,329.95 paisa on 12.05.2005 and 04.10.2005 stating that it is required for that subsequent premium and that fellow used to collect money from the complainant towards monthly premium.
On the other hand op also deducted the premium directly prior to the account of the complainant as per debit mandate. Ultimately complainant contacted with another agent namely Reshma Khan, being her agency code No. 191691 who represented herself as ops’ agent to whom complainant narrated the total incident and after hearing the same, the said agent advised the complainant to pay a sum of Rs. 25,000/- for adjustment of the same with new policy and she took away original policy certificate being No. 000420476 from the complainant for further process to adjust the premium amount. However, complainant was issued another policy being No. 001542413. But first policy certificate was kept in the custody of that lady that has not been returned.
Subsequently this matter was disclosed to another agent and that agent also confessed that matter and she assured that shall be settled by her and a new proposal under Bachat Money Back Plan shall be opened for a terms of 20 years and assured that his entire problem was solved. Accordingly complainant again as per her advice paid another amount of Rs. 25,000/- drawn on Federal Bank. But subsequently another policy being No. 005552907 for yearly premium of Rs. 30,285.26 paisa under BSLI Vision Pla GSB.
Considering of the above conduct of the ops’ agent, complainant was completely astonished and thereafter reported the matter to the op but they did not pay any heed and also did not give any relief and further submitted that the policy being No. 001542413 has been terminated on 02.08.2010 as same has not been revived and other two policies being Nos. 000420476 and No. 005460495 are already lapsed due to non-receipt of renewal premium and op suggested the complainant to revive the said two policies but complainant then realized that he did not depute the agent of the op so wrote a letter to the op requesting him to refund the policy amount. But no redressal was made by the op and ultimately complainant was compelled to file this complaint for redressal directing the op to refund the amount which was received by the op so far along with interest and for harassment.
On the other hand op nos. 1, 2 & 3 the Insurance Company by filing written statement submitted that the premium was directly being paid through ECS inspite of which the policy had lapsed is baseless as the complainant had availed the facility of ECS only for policy bearing No. 000420476 and the said policy commenced on 19.05.2005 with an initial premium of Rs. 36,990/-. Thereafter the op received a total amount of Rs. 1,84,949.25 paisa against the said policy till 19.03.2006. So the policy later got terminated due to deficiency from the complainant’s end to make due payments.
It is admitted by the op that three policies being Nos. 0001542413, 0005460495 and 0005552907 only the initial premiums were paid during the commencement of policy and thereafter the said policies got lapsed due to non-receipt of renewal premiums. Therefore, the policy contract for policy No. 001542413 with the op now stands null and void and it is stated that complainant is trying to make frivolous statements to mislead the Ld. Forum and gain sympathy.
It is further submitted that the agent of the insurance company gave clarification of the policy whenever it is asked for by the insured or the proposer and it is also a practice that in case of doubt the insurer discussed the terms and condition of the policy with the company officials directly who always gave a detail and clear picture of the policy.
It is specifically mentioned that complainant enjoyed the policy Nos. 000420476 was issued on 19.05.2005, annual premium was Rs. 1,47,960/-, 2) Policy No. 001542413 was issued on 02.05.2008 and annual premium of Rs. 1,00,000/-, 3) Policy No. 005460495 was issued on 20.03.2012, annual premium of Rs. 25,755/- and 4) Poliy No. 005552907 was issued on 18.05.2012, annual premium of Rs. 30,286/-.
Those policies 1) Policy No. 000420476 was delivered on 25.05.2005, 2) Policy No. 001542413 was delivered on 10.05.2008 and 3) Policy No. 005460495 was delivered on 29.03.2012 to the complainant and therefore further submitted that those payments in respect of the complainant invested knowing fully well of the terms and conditions of the policy for which the present complainant is not entitled to get any benefit and fact remains that complainant cannot get back any advance as same has already been forfeited.
Decision with reasons
On over all consideration the agreement as advanced by the Ld. Lawyers of both the parties and also considering the fact of this case and the complaint, it is clear that a poor man cannot purchase such a policy having his liability to pay more than Rs. 3,50,000/- per year as premium and it is fact that complainant is a poor fellow of the village and is a peasant by profession. Truth is that as and when complainant collected the hard earned money by selling paddy etc., the agent of the op allured them and collected the money stating that he shall have to get more fund and manage to secure his signature in the application form and an idiot peasant relyied upon the agent on the ground that invariably after paying such premium, he shall have to get huge amount. But that is the common practice of the private insurance company in India.
Practically they are grabbing money of the poorer section of the people particularly from the rural people and it is their business and the matter has been specifically pointed out in so many cases by this Forum about the conduct of the private insurance company and their activities and in the present case, it is proved that the poor people has been deceived by the op and the complainant poor peasant have no capacity to pay such an amount without realizing the context of the proposal form and the future fate of the insured in respect of his liability of payment for years together.
Fact remains if any policy is lapsed due to non-payment of further premium, same are called a dead policy. If any insured does not revive same in that case after lapse of one yearthe premium amount shall be returned to the insured when his life is not insured and there is no question of forfeiting of the entire amount by the Insurance Company. At best insurance company may claim some service charge as per guidelines of IRDA of the year 2010 – 2012. It must be kept in our mind that Insurance Act is a social legislation and the Act was not promulgated to give the insured to grab money from the poor insured.
Another factor is that in the application form practically signature is of the poor peasant. But the entire form is filled up by the agent and most interesting factor is that in the said column it is found that he is an employee of a transporter. But his total yearly income is not noted that means the Insurance Company Authority before accepting the proposal form did not verify what is the financial capacity of this poor complainant. Ops are trying to convince that they always discussed with the insured before accepting the proposal form but that is false. This Forum can say without any hesitation that if this cheat agent are sacked by the Insurance Company and the present Insurance Company cannot continue their business directly with the customers in that case the Sunlife Insurance Company shall have to close their door from India. In fact all the private Insurance Companies are running their business with the help of cheat agent, consultant etc. who are loitering in the rural field because after globalization all the private Insurance Companies have realized that 74 percent of the people of India are residing in rural area and during harvesting season, the poorer section of people get some fund for investment in the bank or etc. for getting interest and for future protection and said funds are being squeezed by so called agent from rural Bengal and rural people.
Practically by deceiving if any agent uses to say the complainant that he shall get money after three years of deposit and it shall be continued for 20 years by payment of such installment, in that case op shall not get any chance to collect the same. If all those matters would be disclosed before the complainant in that case even an idiot peasant shall not have to sign in any paper of the agent of the op. Practically for lack of awareness of the consumer in rural field exploitation of the rural consumer is rampant and that is being made by three industries, one is insurance industry, another is mobile industry and other is banking industry and that this the present problem in Indian rural market. But fact remains from the hands of the cheater to save those rural people from the hands of so called cheat insurance companies no proactive machines is not there. But anyhow this matter has been already detected long years back by renowned Nobel Laureto Jean Tirelo (who received Nobel Price in this year) as per said Nobel Laureto the banking industries, insurance industries must be controlled by the Government with tough hands otherwise consumers shall be exploited by those industries and that is equally a fact in Indian market.
We are no doubt aware of the fact that those business of the private insurance companies in West Bengal and practically for using mobile by different people even by the rural villager they are getting phone call from different persons and they are attending them and alluring them, giving a hoax that they will get huge benefit and thereafter those agents like this present agent managed to deceive the customer like the complainant and in the present case that happened.
Most interesting factor is that everyone is talking about IRDA, but we are telling with confidence what sort of steps has been taken by the IRDA so far. Practically IRDA has become a stone chair of the Government who have nothing to do. They are not attending the consumers. They are not saving the poorer section of people from exploitation but in India Forum can save the poorer section of the people if the Forum can properly implement to spirit of the act. Law is here and there but it is not rigid but flexible one. C.P. was enacted to defend the consumer but in the present case it is proved that consumer has been exploited by the ops. It is settled principal of law if the policy is lapsed then and there the deposited amount shall be returned after deducting 5 or 10 percent as service charge. But premium amount cannot be the capital of the insurance company that is the principle of law and fact remains if any policy is found lapsed, it is deadand then the life of the insured is not covered. Then invariably that amount shall be returned and it is the legal bounden duty of the insurance company to refund after deducting 5 percent as the service charge and considering the above principle of law and the materials we are convinced to hold that invariably by refusing to refundto the complainant the net amount after such deduction is no doubt negligent manner of service.
On overall evaluation of the complaint and written version, particularly the argument of the Ld. Lawyer of the op, we have gathered that op’s insurance company tried to convince that it is their money. But life of the complainant is not insured, his policy is dead. Then it can safely be said that the insurance business is Kabuliwala business, which is one kind of trade, exploitation of the poorer people and how long the insurance company shall continue such business in India. Why they shall have not showed their social and moral responsibility as traders? No doubt the Foraare very reluctant for which thousands of cases of exploitation by the insurance company are being made and many poorer section of people are unable to attend the Forum for which they are being deprived.
But in the present case somehow or otherwise the complainant appeared and we have realized that the present situation of the insured in the society in West Bengal and in India in the hands of the Insurance Company.
In the light of the above observation we are convinced to hold that ops are bound to refund the entire amount which has been received against the policies stands in the name of the complainant after deducting 5 percent as service charge out of the total amount deposited premium against this policy and that must be made by the op without any further delay and by refusing to refund the same, ops are no doubt adopted a deceitful manner of act.
Accordingly the complaint succeeds.
Hence, it is
ORDERED
That the complaint be and the same is allowed on contest with cost of Rs. 5,000/- against the ops.
Ops are jointly and severally shall have to pay the entire received premium amount in respect of all the policies as mentioned in the body of the judgement to the complainant within one month from the date of this order after deducting 5 percent as service charge and it must be made within the stipulated period of one month failing which for non-compliance of the Forum’s order, ops jointly and severally shall have to pay penal interest at the rate Rs. 200/- per day till full satisfaction of this decree. If penal interest is collected, it shall be deposited to this Forum’s account.
Ops are directed to comply the order very strictly otherwise penal action u/s 27 of C.P. Act 1986 started against them for which they shall have to pay further penalty and fine.
