Haryana

Karnal

CC/487/2019

Parveen Kumar Sharma - Complainant(s)

Versus

Birla Sun Life Insurance Company Limited - Opp.Party(s)

R.K. Verma

27 Aug 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                       

                                                Old complaint no.149 of 2017

                                                New complaint no.487/2019

                                                Date of instt. 1.5.2017/1.8.2019

                                                Date of Decision 27.08.2019

 

Parveen Kumar Sharma aged about 57 years son of Shri Triloki Nath Sharma resident of House no.309/9, Vakilpura, Sadar Bazar, Karnal through its GPA Holder Shri Surinder Nath Sharma son of Shri Purshotam Dutt resident of House no.858, Sector-7, Panchkula.

                                                                                                                                                                        …….Complainant

                                        Versus

 

1.Birla Sun Life Insurance Company Ltd., One Indiabulls Centre, Tower-1, 16^th floor, Jupiter Mill Compound 841, Senepati Bapat Mart, Elphintone Road, Mumbai-400013 through its Managing Director/CEO.

 

2. Birla Sun Life Insurance Company Ltd., SCO no.138, 2^nd floor, Main Market, Sector-13, Karnal through its Branch Manager.

 

…..Opposite Parties.

 

           Complaint u/s 12 of the Consumer Protection Act. 

         

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary……Member

 

 Present   Shri R.K. Verma Advocate for complainant.

                  Shri Lalit Chopra Advocate for OPs.

                  

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that the complainant is a blind person as well as paralyzed from the left side of the body and is unable to do any work since December 2014, therefore, the present complaint is filed through his GPA. The complainant purchased the policy of the OPs and invested Rs.8,00,000/- with the OP company and amount was paid through RTGS. The complainant borrowed the amount from his relatives. After sometime, complainant came to know of the fraud and mis-selling with him when he received the five policies inspite of one time investment in one policy bearing nos.005298524, 005299873, 005300079, 005299871 & 005339878. The said policies shows the amount of Rs.1,60,000/- each investment in the name of complainant and insured his daughters namely Varinda Sharma, Priyanka Sharma and Madhvi Sharma for the period of 15 years and maturity date is shown in the policies is 30.12.2031 wherein installment to be shown in the policies is Rs.1,62,438/- annually per policy. Thus, the authorized agent/brokers of the OP playing a fraud upon the complainant and cheated with him for snatching the money of Rs.8,00,000/- in the name of OP company with the false assurance of returning the double amount within one year of the invested money alongwith other benefit also. These policies issued by the OP without the willingness and consent of the complainant. It is a clear case of forgery, because the complainant is a blind and signatures of his daughters are fabricated and forged. Hence the policies become vide abinitio and OPs’ company cannot force the complainant to carry on the policies. It is further alleged that the annual income of the complainant has wrongly shown as Rs.17 lacs per annum and moreover, the complainant wrongly shown as owner of the firm named as Sharma Construction Company whereas the annual income of the complainant is Rs.1,58,246/- in the year 2010-2011, Rs.1,59,116/- in the year 2011-2012 and Rs.1,77,270/- in the year 2012-13. Thus, the proposal of the company has not filled with the consent of the complainant. It is also alleged that the OP company cannot issue insurance policies more than the income of the person and committed serious irregularities.  In the year 2012 complainant approached the OP no.2 for cancellation of his policies issued by the OP and to refund the entire amount of Rs.8 lacs alongwith interest but OPs have not bothered the request of the complainant. Thereafter, complainant gave the many representations and applications for cancellation of the policies but all in vain. The authorized representative of the company also appeared before the office of the Insurance Ombudsman, Chandigarh and promised to issue the new single premium policy instead of the five old policies on 9.9.2013 but later on OPs have not issued the single policy. Due to this act and conduct of OPs complainant has paralyzed in the month of December, 2014. Thereafter, complainant had made many complaints to the OPs for cancellation of the policies and requested for refund of the policies amount but OPs did not do so. Then complainant filed a complaint in the office of Insurance Ombudsman, Chandigarh where the OPs promised to issue the single term policy by clubbing all the policies as full and final settlement during hearing before the above authority on 9.9.2013 but OPs do not comply with their promise and complainant filed a complaint before competent authority of the OP company on 30.1.2015 for cancellation and refund the invest amount but to no effect. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed written version raising preliminary objection with regard to maintainable; cause of action; concealment of true and material facts: present complaint is made out on the allegations of fraud, cheating and misrepresentation, hence the complicated question of law and facts are involved, which cannot be decided in summary jurisdiction. On merits, it is pleaded that the complainant had submitted to the OPs, five proposal/applications for purchase of five different insurance policies for three daughters. In the insurance policies complainant was the proposer and his daughters were life assured. Before acceptance of the proposal by the OPs the contents of all the proposals/applications, illustrations and the addendum forms were read and explained to the proposer/LA. After understanding all the terms and conditions, the proposals forms were signed by the proposer as well as the life assured to that effect. It is further pleaded that the complainant paid the premium amount of Rs.1,60,000/- in each of the policy by way of different cheques drawn on PNB Karnal. The premium amount was paid in all the policies form his bank account maintained in PNB Karnal from which it is quite evident that he was fully aware the fact that the premium was payable annually and it was not a one time premium payment policy. It is further pleaded that the policy documents were delivered to the complainant provided him a period of 15 days within which he/she could returned the policies to the OPs by stating the reason thereof. The act and conduct of complainant is not returning/surrendering the policies within the given time signified his acceptance of the terms and conditions mentioned in the policy documents. It is further pleaded that all the five policies have already been terminated because of the non-payment of the subsequent premiums and the life assured/complainant has already taken all the benefits of the policies for the period for which they had paid the premium. It is further pleaded that a similar complaint was filed by the complainant before Insurance Ombudsman Chandigarh which was decided vide order dated 9.9.2013/17.09.2015 whereby complaint was to be closed with the observation that all the policies will be clubbed and converted into a single policy subject to fulfillment of under writing condition without a freelook option. Thereafter, OPs asked the complainant to submit the documents i.e. original policy documents, consent form for change in plan, fresh application form, sales illustration duly signed by the policy holder, valid address and photo ID proof attested by self and branch head and copy of communication. But the complainant has failed to fulfill the requirements, hence the OPs could not convert the five policies into one policy. Hence there is no deficiency in service on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence his affidavit Ex.C1 and documents Ex.C2 to Ex.C24 and closed the evidence on 21.11.2017.

4.             On the other hand, OPs tendered into evidence affidavit of Aakriti Manocha Ex.OP1/A and documents Ex.OP1 to Ex.OP10 and closed his evidence on 3.7.2017.

5.             It is pertinent to mention here that the present complaint had been dismissed by this Forum on 15.11.2018. The complainant challenged the order passed by this Forum before the Hon’ble State Consumer Disputes Redressal Commission, Haryana, Panchkula by way of filing the appeal. The Hon’ble State Commission, vide its order dated 08.04.2019 accepted the appeal of the complainant and set aside the order dated 15.11.2018 passed by this Forum and case has been remitted to this District Forum to decide its on merits.

6.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

7.             The case of the complainant, in brief, is that between the months of December, 2011 and January, 2012 agent/broker or manager of OPs company induced the complainant for one time investment with the OPs company and they also forced the complainant to purchase the policy with the assurance that complainant will get the double amount on one time investment after one year alongwith benefit of bonus etc. also. The complainant purchased the policies and invest Rs.8,00,000/- with the OPs company. After sometime, complainant came to know about the fraud and mis-selling has happened with him when he received five policies despite of one-time investment in one policy. The OPs played a fraud upon the complainant and cheated with him or snatching the money of Rs.8,00,000/- with the false assurance of returning double amount.

8.             Further, OPs company had taken the money from the complainant by committing the conspiracy with their so called agent/broker and issued five policies illegally in the name of the complainant. It is clear case of forgery, because the complainant is a blind and signatures of his daughters are fabricated and forced. The annual income of the complainant has been wrongly shown as Rs.17,00,000/-by the OPs in the policies. In the year 2012 the complainant approached the OP no.2 and request to refund the entire amount of Rs.8,00,000/-alongwith interest but the OPs have not bothered the genuine request of the complainant.

9.             Further, the complainant had filed a complaint in the office of Insurance Ombudsman, Chandigarh where the OPs promised to issue the single term policy by clubbing all the policies as full and final settlement, but the OPs did not comply with their promise. The complaint again filed a complaint before the competent authority of the OPs company on 30.01.2015 for cancellation and refund the invest amount and demanded the relevant documents from the competent authority of the OPs company under RTI Act 2005 but no documents has been supplied by the competent authority of the OPs company. The learned counsel for the complainant relied upon the judgments of Hon’ble Apex Court in case Chandan Singh Versus National Insurance Co. Ltd. & Anr. 2015(2) Civil Court Cases 248; Nand Kishore Versus State of Punjab (1995) 6 Supreme Court Cases 614; N.Balakrishnan Versus M.Krishnamurthy (1998) 7 Supreme Court Cases 123 and Delhi Development Authority Versus Rajinder Kumar R.S.A. no.233 of 2013 date of decision 7.5.2015 of Hon’ble High Court of Delhi at New Delhi.

10.            On the other hand, the case of the OPs is that the complainant submitted five proposals for the purchase of “BSLI VISION PLAN-GSB-PAY 15” through Endeavour insurance booking Pvt. Ltd. All the policies were received by the complainant/life assured in year 2012. Complainant/LA also signed the declaration form after understanding the terms and conditions thereof. The premium amount was paid in all policies from his bank account maintained in PNB, Karnal. Since the option has not been exercised by complainant/LA within the stipulated period of 15 days, therefore, now complainant cannot be allowed to wriggle out the terms and conditions of the policy and there is no deficiency in service on the part of the OPs. The

11.            Further, the policies have already been lapse due to non-payment of premium for the subsequent year within the stipulated period. The policies were purchased by the complainant in the year 2012 and the present complaint is filed in the year 2017, which is hopelessly time barred. The complainant is no stretch of imagination can ask for the refund for the premium after lapse of the policy and after enjoying the insurance cover. That in the entire complaint, complainant have levelled allegations of mis-sale, cheating and fraud against the insurance agent/broker, but said agent/broker was not impleaded as an OPs in present complaint, despite of the facts that Broking Company was a necessary party in the present complaint. The OPs relied upon the authorities Grasim Industries Ltd. Versus Aggarwal Steel (2010)1 SCC 83; Shgrikant Murlidhar Apte Versus Life Insurance Corporation of India in Revision petition no.634 of 2012 decided on 2.5.2013 of Hon’ble National Commission and Gurinder Kaur Versus HDFC Standard Life Insurance Co. Ltd. & Anr. in Revision Petition no.5563 of 2014 decided on 23.02.2015 of Hon’ble National Commission.

12.            Admittedly, the complainant have purchased five policies from the OPs and paid Rs.8,00,000/- in this regard. Out of four policies had been purchased in the year of 2011 and one policy was purchased in the year 2012. All the five policies were issued to the complainant in the year of 2012 as admitted by the complainant. The complainant/LA signed the declarations in each of the proposal forms from which it is quite evident that he/she signed the proposal form only –after understanding the terms and conditions thereof. The signatures were signed in English spirit. Moreover, the payments were made through cheques/RTGS.

13.            In Grasim Industries’ case (supra) the Hon’ble Supreme Court has held that “in our opinion when a person signs a document, there is a presumption, unless there is a proof of force or fraud, that he has read the documents properly and understood it and only then he had affixed his signatures thereon, otherwise no signature on a document can aver be accepted.”

14.            It is admitted by the complainant that he has received all the policies in the year 2012. As per the terms and conditions of the policies, the complainant could have returned the policies to the OPs within free look period of 15 days on receipt of the policies documents, by stating the reason thereof. The complainant failed to return the policies within free look period. Since, the said option has not been exercised by the complainant/LA within the stipulated period of 15 days. Meaning, thereby, complainant has accepted the terms and conditions mentioned in the said policy.

15.            In Shrikant Murlidhar’s case (supra) the Hon’ble National Commission has held that “in our view, in the circumstances, LIC cannot be blamed for issuing 11 policies with monthly or yearly premium mentioned therein because once 15 days ‘cooling off’ period is over, the policy documents become binding on both the parties and contents therein are also blinding on both of them.”  In Gurinder Kaur’s case (supra) the Hon’ble National Commission has held that “Be that as it may, the fact remains that the Petitioner having failed to exercise her option within the stipulated free look period of 15 days, it cannot be held that there was any deficiency in service on the part of the Insurance Company in declining to accede to the prayer for foreclosure of the policy. Thus, we do not find any material irregularity or illegality in the impugned order, warranting our interference in exercise of Revisional Jurisdiction. The Revision Petition is dismissed accordingly.”

16.            The policies in question had already been terminated because of non-payment of subsequent premiums and the life assured/complainant has already taken all the benefits of the policies for the period for which they had paid premium. Once the complainant had utilized the policies for which he had given premium, he has no right to claim the refund.

17.            The out of five policies, four policies were issued by the OPs on 31.12.2011 and were received by the complainant/LA on 11.01.2012 whereas fifth policy was issued on 31.01.2012 and was received by the complainant February, 2012. The cause of action, if any, occurred to the complainant to file the complaint was within two years either when he received the policies documents or at the most when the policies were lapsed due to non-payment of subsequent premium. The present complaint has been filed by the complainant in May, 2017 after expiry of five years of purchasing the policies. The learned counsel for the complainant argued that complainant is a 100% blind person so he could not understand/read the term and condition the policies. The counsel for the complainant relied upon the disability certificate Ex.C12. The complainant specifically mentioned in para no.2 of his complaint that he is a blind person as well as paralyzed from the left side of the body since December, 2014 but policies in questions were purchased by the complainant in the year 2011. Meaning, thereby, at that time complainant was not blind person or paralyzed.

18.            Before filing the present complaint, a similar complaint was filed by the complainant before Insurance Ombudsman Chandigarh which was decided by the Insurance Ombudsman Chandigarh on 17.09.2015, whereby complaint was closed by the Insurance Ombudsman with the observation that all the policies will be clubbed and converted into a single policy subject to fulfillment of under writing condition without a free look option. The OPs asked the complainant to submit the documents but complainant failed to deposit the same with the OPs. So, the OPs could not convert the five policies into the one policy. When the complainant has failed to submit the documents as required by the OPs to convert the five policies in one policy, failed to exercise the option within stipulated free look period of 15 days and also failed to file the present complaint within limitation prescribed under the Consumer Protection Act and thus there is no deficiency in service on the part of the OPs. 

19.            In view of above discussion, we do not find any merits in the complaint and the same is hereby dismissed. No order as to costs. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:27.08.2019

                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

        (Vineet Kaushik)     (Dr. Rekha Chaudhary)

            Member                 Member