Order No. 12  dt.  05/09/2016

On 07/06/2014 the complainant’s father received a telephone call from an unknown lady, who introduced herself as the executive of the o.p. no. 1, allured the complainant’s father to make lump sum investment in an insurance scheme floated by o.p. 1 with PNB (o.p. 4). On 09/06/2014 o.p. 3 visited the complainant’s residence at Kolkata and met with the complainant’s father. O.p. 3 introduced himself as a staff of o.p. 4 and sub agent of o.p. 1. O.p. 3 clarified that there was a tie up between o.p. 1 and o.p. 4. As per available benefits of the scheme stated by o.p. – 3 the complainant’s father handed over a cheque to o.p. 3 amounting to Rs. 99,999/-. O.p. 3 assured the complainant that the premium would be paid as a single premium and that would be invested as fixed deposit for a tenure of 3 years and the complainant would get the return with compound interest @12% p.a. o.p. 3 took Voter ID Card, Pan Card of the complainant along with the photographs of his parents. O.p. 3 also assured the complainant’ father that his son, the present complainant would be the nominee. o.p. 3 did not obtain any signature from complainant’s father. On 30/07/2014 when complainant’s father went to his house at Bolpur, he found that one packet and one letter were delivered in his name by o.p. 1 containing the policy bond being no. 58410/012166204/kol dt. 16/06/2014. In the letter dt. 11/06/2014 o.p.  1 requested the complainant to comply with medical documents and other some documents. The complainant’s father became shocked to read the policy conditions which were totally opposite to the benefits assured by o.p. 3 on behalf of o.p.1. On 01/08/2014 the complainant’s father requested o.p. 1 to cancel the policy and demanded refund of Rs. 99,999/-. The policy bond was returned to o.p. 1 with that letter. The o.p. 1 by their letter dt. 05/08/2014 informed the complainant with assurance that 10 working days would be required to resolve the matter but o.p. 1 failed to do so. The complainant and his father continuously tried to contact the o.p. 3 but he was not traceable. After some time the complainant’s father received a money receipt bearing the logo of o.p. 4. The complainant lodged a complaint with Haridevpur P. S. stating the entire illegal acts of o.p. 1. O.p. – 1 did not refund any amount to the complainant. Hence the application praying for refund of Rs. 99,999/- along with interest, compensation and cost.

Neither of the o.p.s appeared before this Forum and so the matter was fixed ex parte as against all the o.p.s.

Decisions with reasons :

We have gone through the complaint petition, evidence and materials on record. It is evident from the record that one policy had been issued in the name of the complainant and the date of commencement of the policy was 11/06/2014. The premium amount was Rs. 99,999/- . The policy term was 18 years and the premium would be paid for 12 years @Rs. 99,999/ . The last premium due date was mentioned that 11/06/2025 whereas the policy expiry date was mentioned as 11/06/2032. It is astonishing that the policy commencement date was 11/06/2014 and on the same date a letter was issued by o.p. 1 to the complainant with a request to comply with certain documents and information within 15 days thereof. They had stated in that letter that ‘the proposal form is complete’. It was also stated in that letter that their authorized TPA would get in touch with the complainant for arranging an appointment with an approved medical practitioner as per complainant’s convenience. The complainant never sent any documents as per requirement sought by o.p. 1 nor o.p. 1 arranged any medical practitioner. No question of sending any document by the complainant did not arise since after receiving the policy documents and letter dt. 11/06/2014, the complainant sent a request for cancellation of the policy in question. O.p.1 sent the letter dt. 11/06/2014 asking for some medical and other required documents and surprisingly on the same date the policy was issued without receiving any documents from the complainant.. Due to unchallenged testimony we have nothing to disbelief the facts adduced by the complainant. So we are in the view that there is a missale of the o.p. 1 who issued the policy in question and as such there is deficiency in service on the part of o.p. 1. Therefore the complainant is entitled to get relief.

Hence ordered

That the case is allowed on ex parte against o.p. 1 and dismissed against o.p. 2, 3, 4 ex parte.

The o.p. 1 is directed to refund Rs. 99,999/-  (Rupees ninety nine thousand) only to the complainant along with compensation of Rs. 5,000/-  (Rupees five thousand) only for harassment and mental agony and litigation cost of Rs. 2,000/-  (Rupees two thousand) only within 30 days from the date of communication of this order, i.d. an interest @10% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.

Supply certified copy of this order to the parties free of cost.