DIST. CONSUMER  DISPUTES  REDRESAL  COMMISSION

NORTH 24 Pgs., BARASAT.

C.C. No. 16/2023

Date of Filing                        Date of Admission                Date of Disposal

 20.01.2023                                      09.02.2023                             23.11.2023

P R E S E N T                :- Sri. Daman Prosad Biswas……….President.

                                       :- Sri.  Abhijit Basu…………………. Member.

JUDGMENT/FINAL ORDER

          The Complainant filed an application U/s 35 of the Consumer Protection Act, 2019 (as amended up to date).

          The brief facts of the case is that Complainant purchased one exide life saral bachat scheme for Rs. 2,00,000/- bearing policy no. 04460933 in the name of her grandson and address of the life assured Abhiraj Chakrabarty, Uttarayan Apartment, 37 Bachaspati Para, Dakshineswar, Kolkata – 700076 with an yearly premium of Rs. 20,900/- for 15 years.

          The Complainant alleged that the agent of the said exide life saral bachat scheme convinced the Complainant for the cover of risk will start after one year and depositing money for the purchase of life saral bachat commission would be paid to the Complainant @ Rs. 20% at par with the commission. The Complainant also alleged that when she received the policy bond it revealed from that the risk period would start after two years from the time of purchase of said policy. The Complainant alleged that the agent of the O.Ps misrepresented the Complainant. The agent of the O.P No. 1 verbally assured to the Complainant that the risk period would start after one year but after the payment the premium of Rs. 20,900/- to O.P. The Complainant came to notice after receiving policy paper that the risk would start after two years. The Complainant objected before agent of O.P No. 1, the agent stated that it was a printing mistake and it would be rectified by the companies head office, but correction was done. Even 20% Commission amount was not received by the Complainant.

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The Complainant alleged that the O.P falsely stated that her Post Office Account was closed.

The Complainant argued that the Opposite parties has vicarious liability as the agent was working on behalf of the O.P. No. 1. So, the Opposite Parties are liable for each and every work of the agent of the O.P No. 1.

The Complainant alleged that the agent misrepresented the Complainant as such she agreed to assign the said policy on 30/09/2021. The Complainant purchased one exide life saral bachat scheme on good faith as per said representation of the agent of O.Ps. After receiving the policy bond by the Complainant the Complainant observed that the risk period will start from the date of risk after two years but at the time of purchase the policy the agent categorically mentioned that the period of risk would start after one year. The Complainant immediately informed the matter to the agent to give him light on the facts. The agent of the O.P No. 1 orally assured that the period of coverage was a printing mistake and would be rectified in due course of time from head office. But no response or alteration was made by the Opposite Parties. After submitting complane before company the authority of the company informed to the Complainant that the Complainant received the training on product features and benefits as such he is very much aware of the terms and conditions of the product. The advocate for Complainant submits that Complainant never received any such training from O.P9s). The Opposite Parties did not produce such evidence that the Complainant received the training of produce i.e. policy. The Complainant also alleged that she never visited the exide life insurance office which is situated at Netaji Bhavan and she never appeared in the insurance examination at any time and allegations raised against her by the O.P are totally false and baseless.

It is also stated by the Complainant that O.P No. 1 issued receipt for receiving money. The agent falsely represented to the Complainant and the agent of the O.Ps falsely misleading the facts regarding the service of the Opposite Parties. The Complainant prays that:-

1. To pay the full amount of Rs. 20,900/- by the O.P No. 1.
2. To award compensation up to the extent of Rs. 1,00,000/- (one lac) by all the O.P’s.
3. To Pass any order/orders which the Commission deems fit and proper.

The O.Ps did not contest the case by filing W/V and did not appear at the time of argument.

Regarding the said matter the Complainant filed an application before the Hon’ble Insurance Ombudsmen. The insurance ombudsmen passed an order dated 30/12/2022 that “taking into account the facts and circumstances of the case the submission made by the Complainant and the insurer at the hearing and relevant documents the contention of miss-selling by the Complainant does not seem to be justified. The insurer is directed to take necessary action and pay the commission due to the agent. Hence the Complainant is hereby dismissed without any relief to the Complainant if the decision is not acceptable to the Complainant, he is at liberty to approach any other forum/court as per the law of the land against respondent insurer.”                                                         Contd. To Page No. 3 . . . ./

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Compelling circumstances the Complainant filed the said case before this Commission. Hence, the case do run ex-parte against O.Ps. The Complainant sent notices to the Opposite Parties through this Commission but the Opposite Parties did not appear before this Commission. The case is within the territorial and pecuniary jurisdiction of this Commission.

Issue framed for the purpose of decision

1. Whether the case is maintainable or not?
2. Whether the complainant is entitled to get relief or reliefs or not?

DOCUMENTS

          Complainant filed the photocopy of following documents:-

1. Aadhar Card of Nandita Acharjee
2. Letter of M.D. and C.E.O (Annexure – 1), Exide Life Insurance Company Ltd. (Annexure – 2) dated 01/10/2021
3. Award of Insurance Ombudsmen (Annexure – 3)
4. Application for appeal against the resolution adopted by the H.D.F.C Life dated 21/10/2022 (Annexure – 5)
5. Exide Life Saral Bachat – terms and conditions (Annexure – 1)
6. BNA filed by Complainant.

Reason with Decision

 Considering the facts and circumstances of the case as well as nature and character, all the points are interlinked with each other and as such all the points are taken up together for consideration for the sake of brevity and convenience.

We have perused the complaint and supporting documents filed by the Complainant. As the Opposite Parties did not appear before this Commission and did not file any W/V after service of notice hence the case heard ex-parte.

The Complainant alleged that Complainant purchased an exide life saral bachat scheme on 30/09/2021 for Rs. 2,00,000/- for the life assured in the name of  her grandson named Abhiraj Chakrabarty, Uttarayan Apartment, 37 Bachaspati Para, Dakshineswar, Kolkata – 700076 with an yearly premium of Rs. 20,900/-. The Complainant paid the said premium and the authority of Opposite Parties issued the receipt. The agent of the said insurance company represented to the Complainant that the risk coverage would start after expiry of one year from the date of purchase of policy but after receiving the policy bond the Complainant observed that the risk coverage will begin after two years. The said facts informed the agent by the Complainant. The agent of the Opposite Parties assured to the Complainant that it is a printing mistake and it would be rectified in due course of time from head office but no rectification was made.

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Thereafter, the Complainant was aggrieved and wanted to return the deposited amount and file letter before the Opposite Parties and they did not agreed to pay the same as such the Complainant filed a complaint before the Hon’ble Insurance Ombudsmen but the said Hon’ble Ombudsmen passed an order that “taking into account the facts and circumstances of the case the submission made by the Complainant and the insurer at the hearing and relevant documents the contention of miss-selling by the Complainant does not seem to be justified. The insurer is directed to take necessary action and pay the commission due to the agent. Hence the Complainant is hereby dismissed without any relief to the Complainant if the decision is not acceptable to the Complainant, he is at liberty to approach any other forum/court as per the law of the land against respondent insurer.”

In the instant case the agent of the O.P No. 1 falsely represented to the Complainant and mislead the Complainant which would be treated as deficiency of service. The agent of O.P No. 1 misrepresented to the Complainant that the risk coverage of life assured person will start after one year from the date of purchase of said life saral bachat scheme which would be treated as misrepresentation and false information placed by the agent of the O.Ps.

As per Consumer Protection Act, 2019 the Complainant paid the money for avail service so he is a consumer as per section 2 (7) (ii) of C.P. Act and the agent of the O.P No. 1 misrepresented to the Complainant which would be treated as deficiency of servic3e by O.Ps. The O.Ps issued policy schedule being policy no. 04460933 dated 30/09/2021 and issued First Premium receipt dated 01/10/2023 being Receipt No. 04525466.

On considering the terms and conditions of exide life saral bachat as produced by the Complainant it revealed that in section 45 (1) “no policy of the life insurance shall be called in question on any ground whatsoever after expiry of three years from

1. The date of issuance of policy or
2. The date of commencement of risk or
3. The date of revival of policy or
4. The date of rider to the policy whichever is later.

As per section 45 (2) on the ground of fraud, a policy of life insurance may be called in question within three years from

1. The date of issuance of policy or
2. The date of commencement of risk or
3. The date of revival of policy or
4. The date of rider to the policy whichever is later.

For this the issuer should communicate in writing to the insured or legal representative or nominee or assignees of insured as applicable mentioning the ground and materials on which such decision is based. And in section 45 (6) life insurance policy can be called in question within three years on the ground that any statement of or suppression of a fact material to expectancy of the life of the insured was incorrectly made in the proposal or other documents basis which policy was issued and revived or rider issued. For this the issuer should communicate in writing to the insured all legal representative or nominee or assignees insured as applicable mentioning the ground on materials on which decision to repudiate the policy of life insurance is based.”                                

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From the letter issued by the M.D and C.E.O Exide Life Insurance Company Limited dated 01.10.2021 that “you have a period of 15 days from the date of the policy document to review the terms and conditions of the policy and in case of disagreement with the said terms and condition, an option to return the policy to the company for cancellation can be exercised stating the person for objection… . . . . . . . .’’.

The Complainant on good faith believe the assurance of the agent of the O.P that the correction would be made from the head office of Exide Life Insurance that the risk period would start after one year from the date of purchase of the policy. Though no correction was made. Hence, the Complainant filed application before said Hon’ble ombudsmen and thereafter filed Complainant before this Commission.

After considering the submitted documents by the Complainant and as discussed above we are in opinion that the Opposite Party No. 1 was vicarious liability as the agent of the O.P. No. 1 did the said misrepresentation to the Complainant. Vicarious liability means liability which falls on some person as a result of action of some other person e.g. that of matter for the actions of his servant. In the instant case Opposite Party appointed an agent for making policies to the public. Therefore, at the time of purchasing the said policy the agent represented to the O.P No. 1 and the agent misrepresented to the Complainant that the life risk would cover the assured person after one year from the date of policy commencement or date of inception of policy. Thereafter, as per policy schedule paper issued by the managing director and CEO Exide Life Insurance Co. Ltd. it revealed that the life risk would cover the assured person after two years from the policy commencement or date of inception of policy. The said two representation is totally different which would be treated as unfair trade practice, misrepresentation by the agent of O.P No. 1 and deficiency in service on the part of the Opposite Parties.

The Complainant paid first premium along with GST total Rs. 20,900/- for the benefit and/or life insurance of said Abhiraj Chakrabarty which will be treated as a consumer as the life assured said person is beneficiary as per section 2 (7) (ii) of Consumer Protection Act, 2019.

The Complainant applied for cancellation the policy and refund the amount paid by him before the insurance ombudsmen as the agent of the O.P No. 1 misrepresented to the Complainant which would be treated as unfair trade practice and deficiency in service but in vain. Complainant is not satisfied by the order passed by the said insurance ombudsmen.

Hence, the Complainant filed this case before this Commission. The Opposite Parties did not controvert the allegations of the Complainant by filing any evidence or written version. We find that the Complainant proves the case and is entitled to get relief. We are in opinion that complainant is a consumer and O.P(s) are service provider but the agent of the O.P misrepresented to the Complainant which would be treated as deficiency in service as per C.P. Act 2014.

Having discussion above, it is clear before us that Complainant is entitled to get some relief.

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Hence ,

It is ordered,

That the case being no. C.C./16/2023 be and the same is allowed ex-parte against the Opposite Parties.

          The Opposite Party No. 1 is directed to refund Rs. 20,900/- to the Complainant with 9% interest from the date of investment till recovery within three months from the date of issue of this final order.

Failing which the Complainant is at liberty to file execution case as per law.

Let a plain copy of this order be given to the parties free of cost as per CPR, 2005.

Dictated and Corrected by me

Member

                                                                                                Member

I concur

President