Date of Filing: 29/01/2015 Date of Final Order: 21/07/2015
The brief facts of the case as can be gathered from the case record is that the complainant, Rupak Chakraborty purchased a policy being No.16118247, Client id. 61702335 from the O.P. No.1, HDFC Life on 13/06/2013 for the period of eleven years. The yearly premium of the said policy of Rs.16,103/- and its final premium due date 13/06/2023. The said policy of the complainant was introduced through the mediation of agent RDB Insurance Broking Service Pvt. Ltd., Kolkata bearing Code No.00516829 and License No.366.
It is the case of the complainant that according to the terms and conditions laid down in the deed, the 2nd premium was to be paid on or before 30/06/2014 since a time of additional 15 days. Accordingly a demand draft of Rs.15,300/- was collected from the complainant by the aforesaid broker on 18/06/2014 through their courier and the same was encashed in Kolkata on 27/06/2014. The draft money was withdrawn by the company at drawee branch code No.10391.
It is the further case of the complainant that a mobile call was received from the company registered agent office at Kolkata instructing that the policy holder had to pay Rs.15,300/- less Rs. 803/- because some bonus benefits and relief was/were given by the company to the policy holder for the year under dispute. Hence the policy holder purchased a draft of Rs.15,300/- from the S.B.I Branch of Dinhata. The policy holder simply believed the broker because the deed itself advises the policy holder to talk to the certified financial consultant (Insurance agent) who has advised him while taking this policy.
From 31/07/2014 the complainant has been receiving SMS at intervals that the policy has been running on lapsation because of the non-payment of the premium for the year 2014. The last SMS was received on 25/11/2014 at 01.02 p.m. Being surprised at and confused with so many messages at regular intervals the complainant finally wrote registered letter to the Manager/Officer-in-charge HDFCS Life, Kolkata complaining against the broker for the non-payment of the draft and leaking the secret of my deed to other broker which were tantalizing the comp1ainant to purchase another policy under the insurance company Exide India Insurance Company ltd. After receiving the said registered letter of the complainant the company's Grievance Cell informed him that their customer relation representative Mr. Swapnil Kadam was looking into the complaint and they would reply to the complainant with a resolution within 14 days.
After that the company's Grievance Cell broke their promise as they sent no letter to the complainant within the stipulated 14 days. On waiting for some days and being vexed the complainant wrote again to the Grievance Cell of the Mumbai Office of the company on 30/10/2014. Then the company's Grievance Cell wrote to the complainant on 07/11/2014 and informed the complainant that he would hear from the company within 14 days though they broke their promise and wrote nothing to the complainant within the stipulated 14 days. On 27/10/2014 the complainant sent an e-mail to the Grievance Cell of the company and received an e-mail answer from the company's Grievance Cell stating therein that the company has kept their decision unchanged meaning that the policy was dead because of the non-payment of the premium under dispute. They also advised the complainant to submit a demand draft clearance certificate for their further investigation.
Surprisingly, though the company received the premium in time, by deliberate mistake, it was sending SMS's to the customer that the policy had been lapsed and it is still lapsed as of this day on the record of the company. It is clear from that if the complainant had died by this time the company would have deprived his family of its due payment for their mistake. This type of negligence is a fault that cannot be connived at. The company may argue that money less than the assured premium was sent and hence the policy was not renewed. But such argument does not hold ground since they did not write any letter to the complainant about this. Moreover as stated of this complaint the complainant was advised by the agent and broker in sending Rs.15.300/- in place of the assured sum Rs.16.103/-. The company has provided the complainant with a deliberately faulty address of the broker/agent. So letter written to them had been returned since the peon could not find it out and accordingly the said letter had been sent back to the complainant.
Though the company received the aforesaid money in time for two successive years beginning with 13/06/2013 and ending on 30/06/2014, the company has so far not provided with any receipt and hence the complainant has lost opportunity to take income tax benefit because of such fault of the company.
The complainant sent a letter to the Ombudsman West Bengal, Bihar, Jharkhand and UT of Andaman & Nikobor Islands, Sikkim on 11/10/2014 which was received on 21/10/2014 requesting the Honorable office to pursue the case. Then the office wrote on 21/10/2014 to the complainant but unfortunately the letter reached to the complainant on 22/12/2014. Due to the inordinate delay in the delivery of the letter by the postal department the complainant has now lost the opportunity to comply with the order contained in the Ombudsman office letter since they have closed the files. Due to such activities and negligence on the part of the O.Ps the complainant has suffered a lot from mental agony, pain and huge monetary loss and unnecessary harassment.
Hence, the complainant filed the instant Case No. CC/6/2015 with enclosed relevant documents together with I.P.Os. of Rs.200/- before this Forum for redress of the dispute and prayed for direction to the O.Ps to pay (1) Rs. 1,27,827/- for total damage since this is the sum assured in the policy and with this orders from this honorable court asking the insurance company to revive the policy immediately, besides other relief(s) as the Forum deem fit, as per law & equity.
The O.P. No.1, Branch Manager/Customer Relation Officer, HDFC Life, Cooch Behar and the O.P. No.2, HDFC Life through their Branch Office HDFCSLIC, Kolkata has contested the case by filing their written version denying all material allegation of the complaint contending inter-alia that the complainant has no cause of action to being this case and the case is not tenable in law. The main allegation of the O.P. No.1 & 2 is that the complainant is clearly stated in his complaint that the said DD in respect of the due premium amount was collected by broker not the company. So it is clear that the O.P company did not have any role in DD collection. Secondly if renewal premium was deposited with the company a renewal premium receipt would have been provided to the complainant. Thirdly as stated by the complainant himself that the premium amount was Rs.16,103/- not Rs.15,300/- as such the premium differs from the actual amount of the due premium. Here, the OPs. submits that the DD may be for any other policy or wrongly made in the name of the O.P company and the present complaint is for some ulterior motive.
Furthermore, it is categorically stated that no employee of the OPs directly or indirectly took delivery of the alleged policy premium. As per the complainant himself, the alleged Bank DD was sourced to the complainant through insurance broker who are the representatives of the Insured i.e. the complainant but not of the O.Ps company as alleged by the complainant.
It is the case of the O.Ps that the policies or premiums when sourced by broker in such cases broker is a representative of the insured not the insurer. The O.P company craves leave to file the relevant broker regulations when necessary.
It is the further case of the O.Ps that this O.Ps did not receive any renewal premium against the said policy so lapsed notification of the policy was sent to the complainant time and again.
On 13/10/2014 the first correspondence was received which was replied stating requirement of DD certificate with number for investigation of his complaint. Here, it is submitted that the requested Draft Clearance Certificate was to be collected from the Bank which issued the alleged DD and so there is no need of any specification on that as asked by the complainant. The O.P. No.1 & 2 also stated in their W/V that as per records no renewal premium was deposited against the policy No.16118247. So, lapsed notification was sent to the complainant. Further when The O.Ps wanted to investigate the complaint, the complainant did not co-operated and failed to provide any DD details to the O.P company as requested. Moreover, it appears from the complaint petition that whatever grievances are brought by the complainant there are no involvement of the O.P. insurance party but of the broker who is not made a party to this complaint petition. It is clear that the policy premiums once settled cannot be altered by anyone whether he is a broker or the insurance company.
The O.Ps have provided ample opportunity to the complainant to reconsider his complaint on the basis of the O.Ps present submissions but all went in vain as the complainant failed to assist or listen to them. Hence, there is no question of deficiency in service and/or suffering of physical and mental agony as alleged in the instant case of the complainant. Thereby, harassing the O.Ps company. Thus the allegations made by the complainant are false and fabricated.
Ultimately, the O.P. No.1 & 2 prayed for dismissal of the case with costs.
In the light of the contention of the complainant, the following points necessarily came up for consideration.
POINTS FOR CONSIDERATION
- Is the Complainant is a Consumer as per Section 2(1)(d)(ii) of the C.P. Act, 1986?
- Has this Forum jurisdiction to entertain the instant complaint?
- Have the O.Ps any deficiency in service as alleged by the Complainant and are they liable in any way?
- Whether the Complainant is entitled to get relief/reliefs as prayed for?
DECISION WITH REASONS
We have gone through the record very carefully, peruse the entire documents in the record also heard the argument advanced by the parties at a length.
Point No.1.
Evidently the Complainant purchased a policy being No.16118247 from the O.P. No.1, HDFC Life on 13/06/2013 on payment of yearly premium Rs.16,103/- for the period of 13/06/2013 to 13/06/2023. So the complainant is consumer under the O.Ps U/S 2(1)(d)(ii) of the C.P. Act, 1986.
Point No.2.
Office of the O.P. No.1 is situated within Cooch Behar town within jurisdiction of the Forum and total valuation of the present case is Rs.1,27,827/- which is far less than maximum pecuniary limit of this Forum i.e. Rs.20,00,000/-.
So, this Forum has territorial and pecuniary jurisdiction to try this case.
Point No.3 & 4.
It is the case of the Complainant, Rupak Chakraborty that he purchased a policy being No.16118247, Client id. 61702335 from the O.P. No.1, HDFC Life on 13/06/2013 for the period of eleven years. The yearly premium of the said policy of Rs.16,103/- and its final premium due date 13/06/2023. The said policy of the complainant was introduced through the mediation of agent RDB Insurance Broking Service Pvt. Ltd., Kolkata bearing Code No.00516829 and License No.366.
Original insurance policy kit reveals that the complainant obtained HDFC Life, Sampoorn Samriddhi. Insurance plan having maturity value Rs.1,27,827/- with annual premium of Rs.16,103/- and money receipt shows that he has paid Rs.16,100/- as first premium of Rs.16,103/- with Tax to the O.Ps on 14/06/2013.
It is the further case of the complainant that according to the terms and conditions laid down in the deed, the 2nd premium was to be paid on or before 30/06/2014 since a time of additional 15 days. Accordingly a demand draft of Rs.15,300/- was collected from the complainant by the aforesaid broker on 18/06/2014 through their courier and the same was encashed in Kolkata on 27/06/2014. The draft money was withdrawn by the company at drawee branch code No.10391.
It is the next case of the complainant that a mobile call was received from the company registered agent office at Kolkata instructing that the policy holder had to pay Rs.15,300/- less Rs. 803/- because some bonus benefits and relief was/were given by the company to the policy holder for the year under dispute. Hence the policy holder purchased a draft of Rs.15,300/- from the S.B.I Branch of Dinhata. The policy holder simply believed the broker because the deed itself advises the policy holder to talk to the certified financial consultant (Insurance agent) who has advised him while taking this policy.
So, it is clear that though yearly premium of the said policy was Rs.16,103/- but he deposited Rs.15,300/- as premium on 18/06/2014.
But it appears from Clause-4(vi) of the terms & condition of the policy in question that the Annualized Premium Level cannot be decreased or increased at any point of time except due to a chance in premium paying frequency and only to that extend. Clause-4(i) also provides that subsequent premiums are due in full on the dates (i.e. due date).
We further find from the ruling reported in II (2014)620 N.C cited by Ld. Adv./Agent of the O.P that insurance contract is species of commercial transaction and while deciding dispute between insured and insurer, terms and conditions have to be construed strictly.
In the present case it is the specific case of the complainant that he received a mobile call from the Agent of the O.P instructing him to pay Rs.15,300/- less Rs.803/- because some bonus benefit and relief were given for that year by the O.P company.
But the complainant has nothing to show that any such instruction was given to him by the Agent of the company.
It is the case of the complainant that a D/D of Rs.15,300/- was collected by the broker of the company on 18/06/2014 through the courier and the same was encashed in Kolkata on 27/06/2014. The complainant has filed original Pay-in-slip of D.D and copy of Remittance enquiry of the said D.D.
But the Ld. Adv./Agent of the O.P submitted the Agent/Broker has no authority to collect any such premium and he drew our attention to Insurance Regulatory and Development Authority Act, 1999.
In view of the said Act 2(f) intermediary or insurance intermediary includes insurance brokers, reinsurance brokers, insurance consultants, surveyors and loss assessors. Words and expression used and not defined in this Act but defined in the Insurance Act, 1938 or Life Insurance Corporation Act, 1956.
Insurance Agent – means an insurance agent licensed u/s 42 who receives or agrees to receive payment by way of commission or other remuneration in consideration of his soliciting or procuring insurance business including business relating to the continuance, renewal or revival of policies of insurance. Intermediary or insurance intermediary – includes insurance brokers, reinsurance brokers, insurance consultants.
Surveyors and loss assessors or any other person representing or assisting an insurer in one or more of the following :
(i) Soliciting, negotiating, procuring or effectuating an insurance contract or a renewal of an insurance contract,
(ii) Disseminating information relating to coverage or rates,
(iii) Forwarding an insurance application,
(iv) Servicing and delivering an insurance policy or contract,
(v) Inspecting a risk,
(vi) Setting a rate,
(vii) Investigating or assessing a claim or loss,
(viii) Transacting a matter after the effectuation of a contract, or
(ix) Representing or assisting an insurance or other person in any other manner in the transaction of insurance with respect to a subject of insurance resident, located or to be performed in India,
(x) Servicing a policy or contract; includes insurance brokers, reinsurance brokers, insurance consultants, surveyors and loss assessors.
Section 42 of the Insurance Act, 1938 provides Licensing of insurance agents which runs thus - The Authority or an officer authorized by it in this behalf shall, in the manner determined by the regulations made by it and on payment of the fee determined by the regulations, which shall not be more than two hundred and fifty rupees, issue to any person making an application in the manner determined by the regulations, a license to act as an insurance agent for the purpose of soliciting or procuring insurance business.
We find that no where the Agent has been authorized to receive money from the insured.
The Complainant submitted schedule III of Insurance Regulatory and Development Authority (Insurance Brokers) Regulations, 2002. According to rule 2(4) of the said Regulation.
Every insurance broker shall obtain written mandate from the client to represent the client to the insurer and communicate the grant of a cover to the client after effecting insurance. But the said regulations also does not authorize the Agent to collect premium from the insured.
Regarding payment of premium in question by D.D it is the case of the O.Ps that they did not receive any renewal premium against the said policy. So, lapsed notification was sent to him time and again.
It is the further case of the O.Ps that they wanted to investigate the complaint but the complainant did not co-operate and failed to provide any D.D details.
But it appears from the copy of the letter dated 06/09/2014 sent by the Complainant to O/C, Grievance Redressal Cell, Mumbai, letter dated 10/10/2014 sent by the Complainant to O/C, Manager, R.D.B Insurance Broking Service Ltd., Kolkata, letter dated 05/01/2015 sent by the Complainant to the office of the Insurance Ombudsman, Kolkata, letter dated 30/10/2014 sent by the complainant to the Chief Grievance Redressal Officer, Mumbai that he time and again agitate his grievance before the said Authorities.
It is the specific case of the O.Ps that inspite of demand of D.D clearance certificate by e-mail dated 02/12/2014 the Complainant did not submit the same rather he has filed the present case, which is prematured one.
Considering over all matter into consideration, we find that though the policy premium once settled cannot be altered by anyone but the Complainant has paid Rs.15,300/- instead of Rs.16,103/- through the Agent of the O.P, insurance company and it also appears that the said Agent has no authority to collect the said premium but the facts remained that the said Agent collected the said premium from the Complainant.
We further find that from the submission of the O.Ps that by sending e-mail dated 02/12/2014 the Complainant was asked to submit D.D clearance certificate but he without filing the same takes shelter of the Forum and the case is prematured one.
We find substance in the submission of the O.Ps.
Ultimately, we do not find any deficiency in service on the part of the O.Ps and the case is liable to be dismissed.
However, the O.Ps are to be directed to consider the grievance of the Complainant and the Complainant is also directed to co-operate the O.Ps to decide the matter in dispute.
Accordingly, both the points are decided against the Complainant.
Thus, the case fails.
ORDER
Hence, it is ordered that,
The present Case No. CC/6/2015 be and the same is dismissed on contest without any costs. The O.Ps are to be directed to consider the grievance of the Complainant and the Complainant is also directed to co-operate the O.Ps to decide the matter in dispute.
Let plain copy of this Final Order be supplied, free of cost, to the concerned parties/Ld. Advocate by hand/be sent under Registered Post with A/D forthwith for information and necessary action, as per Rules.
Dictated and corrected by me.
President President
District Consumer Disputes District Consumer Disputes
Redressal Forum, Cooch Behar Redressal Forum, Cooch Behar
Member Member
District Consumer Disputes District Consumer Disputes
Redressal Forum, Cooch Behar Redressal Forum, Cooch Behar
