JUDGEMENT Complainant by filing this complaint has alleged that complainant being satisfied about Childrens’ Double Benefit Plan launched by the op Insurance Company purchased such term of policy subject to payment of Rs.15,000/- of only premium and accordingly paid a cheque vide No. 63709 dated 07.10.2011 to the op insurance company and said cheque was encashed by the op insurance company and complainant filed all material documents for issuing policy documents but no policy document was sent and subsequently on 10.09.2012 complainant received the Renewal Notice when the complainant again collected that he has sometime in the 2011 has taken this Childrens’ Double Benefit Plan for his son and till date he has not received either the policy papers nor any relevant documents pertaining to the said policy and from the renewal premium notice complainant came to know that his policy number was 14639753 and by that renewal premium notice complainant was directed to deposit Rs.15,000/- by 29.09.2012 and that premium shall be paid for the period from 29.09.2012 to 29.09.2013 and soon after receiving the said notice he immediately contacted with the op no.1 over mail and iterated that he has not received the policy papers in connection with the said policy against which the ops are claiming the renewal premium. Against that op regretted and apologized for the inconvenience cost to the complainant and further informed that as per their record the policy documents for the aforesaid policy was delivered to the mailing address of the complainant through Sri Chakra Transtech Courier on 10.10.2011 and it was received by one N. Pal and on receipt of the same intimation complainant was asked that there was no person of the family members who is Mr. Pal and no such Mr. Pal is in the address. So, question of receiving the payment of policy papers on behalf of complainant is absurd and impossible. Thereafter complainant has repeatedly enquired as to the present position and status of the said policy papers ops have failed to give any satisfactory answer to the same nor they are refunding the said premium amount that they have taken and practically the policy document was not yet received by the complainant and in fact the policy has already been lapsed. But op as per IRDA Regulation did not refund the said amount during it as a lapsed policy. So, it is a negligent and deficient manner of service on the part of the op. On the other hand op by filing written version submitted that policy was termed for 12 years with the annual premium of Rs. 15,000/- payable for 12 years i.e. the original policy documents were duly dispatched by the op to the complainant’s address through Sri Chakra Transtech Courier on 10.10.2011 and that was received by one N. Pal and that matter was reported to the complainant. But thereafter complainant was asked to file the Indemnity Bond and Affidavit etc but complainant did not comply with it. Though ops are always willing and ready to issue the policy document but for negative attitude of the complainant it could not be issued. So, the entire allegation of the complainant is false and for which the complaint should be dismissed. Decision with reasons Undisputed fact is that complainant purchased one HDFC Standard Life Childrens’ Double Benefit Plan policy on payment of premium of Rs.15,000/- by filing duly filled up form and application being No. 14639753. On 22.09.2012 i.e. long after one year from the date of opening of the said policy, complainant sent an email to the op for providing confirmation of dispatch of the policy document and complained that the policy document was not received by him. But op reported that the policy document was received by one N. Pal on behalf of the complainant as per report. So, complainant was asked to file Indemnity Bond and Affidavit duly notarized enabling them to reissue the original policy document. But complainant did not turn up and so no policy document was reissued. But fact remains complainant did not receive the said policy document and op has failed to prove by any cogent document that N. Pal was the member of the family or anyone of the family. Moreover op has failed to produce any such document to show that was dispatched and it was received by N. Pal but it is alleged that in the written version. But fact remains that it is admitted by the op that complainant did not receive it. So, op is ready to reissue it but some document is further recollected and to be executed by the complainant. But question is after lapse of one year how the complainant shall have to revive the policy and practically for such sort of activities on the part of the op, complainant has lost his all faith upon the present op/company about his service as service provider and as Insurance Company. In fact in this case complainant already paid to the op for refund of the said premium when policy document has not been issued and as per their version the policy has been lapsed and second premium has not been paid. When that is the fact then it is the duty of the op/insurance company to perform their social responsibility as per IRDA Regulations if any policy is lapsed, it is the bounded duty on the part of the insurance company to refund the entire premium amount when no benefit of the insurance policy is granted to the insured after deducting service charge in the year the premium was deposited. But most interesting factor is that all the private insurance companies have taken a bad path by not refunding the premium amount as deposited by the insured in respect of a lapsed policy and discontinued policy and they are practically grabbing that amount. But it is the mandatory regulations of IRDA that premium amount cannot be swallowed or eaten by the insurance company. But for this laches it is the duty of the insurance company to refund the said money after deduction service charge if service tax is not deducted of the said premium and it has not been deducted. But IRDA guidelines by which the present op is also guided and has not also been complied by it and that is the common practice of the present insurance company. Truth is that private insurance company has no capital except the premium collected by the private companies. So they are not willing to refund the premium and in all respect they are following the terms and conditions of IRDA and very recently for violation of the terms and conditions and regulation of IRDA, SBI Life Insurance imposed crores of rupees as penalty and the present complaint is an example of violation of the regulation of IRDA by the present op. Most interesting factor is that private insurance companies are spent huge money for litigation but they are not willing to bear little amount of premium of the insured when the said insurance coverage is already lapsed and then it is clear that private insurance companies are very much interested to contest case and to defeat the claim of the insured as claimant in different course. But they are willing to follow and disburse to implement the IRDA guidelines. Truth is that the present policy has already been lapsed when complainant failed to pay second premium. Truth is that the complainant has not yet received the original document. Op has also failed to prove by any cogent document by any original policy document which was duly served upon the complainant. So, we are convinced to hold that the policy as shown by the complainant lapsed and complainant is unwilling to continue the policy when the services of the op are no doubt unsatisfactory. In the above fact and circumstances, we are convinced to hold that as per IRDA regulation of the year 2010-12, op is legally bound to refund that Rs. 15,000/- after deducting service charge and if already service charge in respect of premium has been deducted in that case after deduction of the service charge, the balance amount of premium shall be returned to the complainant during the alleged policy as lapsed and when complainant is not willing to continue it. After considering the receipt of the op, it is clear that out of Rs.15,000/- as paid by the complainant as premium Rs.228/- had already been deducted as service tax and education cess so, no further deduction has not been deducted at the time of refund and refund Rs.14,722/- after deduction to the complainant and op as per mandatory regulation of IRDA 2010-12 is liable to refund that amount to the complainant without any fail and the defence of the op in this regard is found without any foundation and in fact the complainant did not get proper service from the op. It is to be mentioned in this regard that private insurance companies are in the field only for grabbing the premiums collecting the premiums but they have their no desire to refund the premium in respect of which the policy has been lapsed or cancelled. Because the premiums run the capital of those companies and they have no other business from any source and that capital is being invested by the private insurance companies and they are trying to run their business. But their financial capacity or profit is very poor in all respect and this is the position of the private insurance companies for which within coming one month the Aviva Life Insurance Company would be closed. They also adopted similar process and deceived so many customers in different manner. But the matter has already been taken by IRDA and for which refunding the premium concerned after deducting service charges and after completion of the same that the famous institution shall be closed. In the light of above observation we are convinced to hold that policy of the complainant had already been lapsed and rightful complainant has deposited one premium of Rs.15,000/- out of which op has deducted Rs.228/- as service charges. So, complainant is entitled to get back Rs. 14,772/- and also compensation of Rs.2,000/- from the op and op is bound to pay a sum as per Regulation of IRDA of the year 2010-12. But this Forum is not in a position for what reason the present Insurance Company is not following the rules and regulations of IRDA and violating the same. No doubt a ruling is referred by the op being No. 11 (2013) CPJ SC in connection with Appeal filed by Export Credit Guarantee Corporation of India Ltd. – Vs – Garg Sons International in Civil Appeal No. 1557 of 2004 with other which was decided on 17.01.2013. But on proper study of the said fact and circumstances of the judgement and after complying the present fact and circumstances, it is clear that the present judgement which has been referred by the Ld. Lawyer for the op is not applicable and practically being mis-conceived only to misguide the Forum and this is common expression of different Insurance Companies in most of the cases and no doubt some fora are being misguided and rejected the poor claim of the consumers. So, we have gathered the ruling as no connection in the present case. But it is unfortunate why the private insurance companies are spending huge money for litigation up to National Commission when by violating the IRDA rules because it is mandatory according to IRDA guideline are not a mere casual guide line because IRDA is appointed as per IRDA Act. Similarly Telephone Regulatory Commission or Electricity Regulatory Commission are also appointed as per Act and their guidelines and all the telephone authorities and electricity authorities are guided by this Act and no Court has any authority to declare authority’s decision or regulations as ultravirus. But IRDA guide lines and regulations in respect of refunding the premium after deducting service charge etc in case of lapse of policy and cancellation of policy is still pending upon all the insurance companies what prevented the op of the insurance company to follow that regulation. What prevented to refund the premium amount after deduction of service charges. In the eye of law any insurance company has no authority to swallow the money and audit the entire premium under any circumstances because it is the money of the insured not of the company and insurance company has not given any benefit against one premium, then the premium must be returned to the insured during the entire policy as cancelled or lapsed. When in this case complainant is not willing to continue it and he prayed for refund of the same it was the best judgement of the op insurance company to refund the premium after deduction of service charge and truth is that certain service and deduction has already been deducted, so balance amount must be returned at once and retention of the same and defend the case without any material is nothing but an act of deficiency and negligent of service and no doubt it is also an act of adopting unfair trade practice to deceive the insured who is willing to get back his premium. In the whole India all the private insurance companies are blood sucker of the insured who deceived their and no social responsibility and having their no intention to give proper relief to the consumer. They have entered in the business field only to collect the same and to enjoy profit at the cost of the insured and this such sort of practice is no doubt unfair trade practice and in the present of the op is well proved, lakhs of rupees can be spent by the private insurance companies for litigation, but pretty amount of Rs. 14,772/- cannot be paid. It indicates that they are banyans in all the field and such sort of practice should be controlled and in fact in future the C.P. Act should be amended so that such sort of dishonest practice may be controlled under the head of any commission like C.P. Commission etc and in India the present situation of the private insurance companies are unexplainable. All over India the private insurance companies and private banks are squeezing money as blood sucker from the insured or the customer and they are imposing different type of penalties etc violating the guidelines, rules and regulations of IRDA or the RBI or in other authorities. So, we find there must be a control to check against such malpractice as adopted in this case. Whatever it may be complainant is entitled to get relief. Thus 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 op. Op is hereby directed to refund Rs.14,772/- out of Rs.15,000/- as paid by the complainant as premium when already service charge and Education Cess has been deducted from that amount by the op and for harassing and for adopting unfair trade practice op shall have to pay a compensation of Rs.5,000/- to the complainant and accordingly op shall have to pay Rs.24,772/- to the complainant within one month from the date of this order positively failing which for violation of the Forum’s order and for denial the order of Forum they shall be imposed penal interest @ Rs. 200/- per day till full satisfaction of the decree. For adopting unfair trade practice and for violating the regulation of the IRDA of the year 2010-12, ops are imposed of penalty of Rs.10,000/- and it is imposed to check the future activities of the HDFC Life Insurance in their insurance field and to give them a chance to discharge their social responsibility as per guide line and regulation of IRDA. Ops are hereby directed to comply the order very strictly within the stipulated period failing which they shall have to pay further penalty and fine u/s 27 of C.P. Act 1986.
| [HON'ABLE MR. Ashok Kumar Chanda] MEMBER[HON'ABLE MR. Bipin Muhopadhyay] PRESIDENT[HON'ABLE MRS. Sangita Paul] MEMBER | |