BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 199 of 2017
Date of Institution : 03.08.2017
Date of Decision : 17.1.2019
Simran Jangra, aged 18 years, daughter of Shri Lalit Kumar son of Shri Ram Singh Jangra, resident of Gali Khaiwali, Hissaria Bazar, Sirsa, District Sirsa.
……Complainant.
Versus.
- ICICI Lombard General Insurance Company Ltd., The Statement, 4th Floor, Plot No.149, Industrial Area, Phase-1, Next to Hometel Hotel, Chandigarh- 160002, through its Manager.
- ICICI Lombard Healthcare, Office No.78, 5th Floor, Metro Police Mall, Opp. Vidyut Sadan, Near Sun City, Delhi Road, Hisar, through its Manager.
- ICICI Lombard General Insurance Company Ltd., ICICI Lombard House, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi, Mumbai- 400025, through its Authorised Signatory.
- Sachin Goyal son of Sh. Nand Kishore, resident of Gali Bawriwali, Noharia Bazar, Sirsa, (Agent, ICICI Lombard General Insurance Co. Ltd.,).
..…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SHRI R.L. AHUJA……………….. PRESIDENT SHRI ISSAM SINGH SAGWAL ……MEMBER.
Present: Sh. Anil Bansal, Advocate for complainant.
Sh. H.S. Raghav, Advocate for opposite parties no.1 to 3.
Complaint against opposite party no.4 already got dismissed as withdrawn.
ORDER
2. In brief, the case of complainant is that opposite party no.4 few years ago came into contact with the complainant’s father Shri Lalit Kumar and his family members and very shortly, the op no.4 with his sweet and respectful behavior towards the family members of complainant won their hearts and as a gratitude towards op no.4, he was given the status of a family member by the father of the complainant. The op no.4 being an insurance agent got purchased several insurance policies for the complainant and his family members from Life Insurance Corporation of India as well as other insurance companies. The complainant and his other family members always gave due regard and respect to the wisdom and decision of op no.4 in the matter of purchasing such insurance policies. The complainant’s father and other family members purchased such insurance policies through op no.4 in crore of rupees and paid lacs of rupees as insurance premium. It is further averred that complainant’s father desired to purchase some health policies for the complainant and his family members and for that the complainant’s father made a contact with op no.4 and asked for purchasing some health policy. The op no.4 advised the complainant’s father for purchasing the health policy of ICICI Lombard General Insurance company Limited (ops no.1 to 3) and accordingly, as per advice of op no.4, the complainant’s father purchased policy No.41281/HSM/99804705/00/000 from ops no.1 to 3 for sum assured of Rs.10 lacs and paid Rs.21,265/- as insurance premium. This policy was effective w.e.f. 24.2.2015 to 23.2.2017. The op no.4 got two more such health policies from ops no.1 to 3 bearing No.41281/HSM/100508393/00/000 for Rs.10 lacs for the period w.e.f. 17.3.2015 to 16.3.2017 and paid a sum of Rs.21,265/- as insurance premium and policy No.41281/HSM/114966925/00/000 for Rs.10 lacs for the period w.e.f. 31.3.2016 to 30.3.2018 and paid Rs.21,670/- unnecessarily by breach of trust. All three policies mentioned above were purchased through op no.4 by complainant and the amount of premium of all three policies was paid and entrusted to op no.4 in cash. It is further averred that however from some other insurance agent, the complainant came to know of the fact that only one health policy was required to be purchased and that the insurance company indemnifies the proposer/ insurer of such health policy only against one policy and that the insurance company never pays the claim against other such health policies. The complainant on coming to know of such was highly shocked and surprised, because the op no.4 had got two subsequent health policies for complainant from ops no. 1 to 3 in connivance with each others. The complainant further came to know of the fact that in normal course, the insurance companies do not issue more than one such health policies and that it is the duty of the insurance company to be vigilant in issuing such policies. It is further averred that in July, 2016, the complainant on coming to know of facts lodged a protest with op no.4 and also made a complaint and claim with op no.3 for cancellation of two subsequent policies in writing vide letter dated 4.10.2016 followed by reminders dated 7.11.2016 and 24.12.2016 sent through registered post and also requested to refund of insurance premiums, but of no use. It is further averred that it has come to the knowledge of complainant from toll free no. 1800 2666 of ops no.1 to 3 that both subsequent policies of complainant stood already cancelled by them and refund of amount of policy No.41281/HSM/114966925/ 00/ 000 for the period w.e.f. 31.3.2016 to 30.3.2018 has been remitted to op no.4 and amount of refund of another policy shall be sent shortly. The payment/ refund of premium of one policy to op no.4 instead of complainant is totally wrong and illegal, when the insurance company had taken cancelled cheque from complainant for refund of two premiums. Neither op no.4 nor insurance company have paid the amount of two premiums to the complainant till date despite repeated requests. That the op no.4 not only played mischief and cheated the complainant and her family members in connivance with ops no.1 to 3 but also shattered their deep faith and trust in op no.4. The complainant is also planning to launch appropriate criminal proceedings against op no.4. That in this manner, the ops have been indulged in unfair trade practice and have committed gross deficiency in service towards the complainant due to which complainant and her family members suffered unnecessary harassment, mental tension and as such the complainant is entitled to a compensation of Rs.4,00,000/- from the ops. The complainant is legally as well as factually entitled to refund of Rs.21,265/- and Rs.21,670/- in respect of above said two policies alongwith interest thereon at the rate of Rs.18% per annum from the date of deposit till realization of the same from ops. It is further averred that after knowledge of misdeed done by ops, the complainant approached and requested the ops on many occasions to admit her claim but to no effect. Hence, this complaint.
2. On notice, opposite parties appeared. Opposite parties no.1 to 3 filed written statement taking certain preliminary objections. It is submitted that in fact the insurance company has nothing to do with the relation in between the customer and the insurance agent and that the question of purchasing the numbers of policy depends on the sweet will of the consumer and same is happened in this case. It is further submitted that as per request of complainant they have cancelled the two insurance policies and as per policy schedule the premium amount was returned to the same account from which it was disbursed. It is further submitted that as per colorful story of complainant, it is clear that if the complainant has any grievance it is up to op no.4 and complainant wrongly impleaded the answering op. It is further submitted that complainant never approached to the answering ops. It is relevant to mention here that before filing the present complaint, the complainant approached before the Secretary office of the Ombudsman, Chandigarh and said complaint was withdrawn. Remaining contents of complaint have also been denied and prayer for dismissal of complaint made.
3. Opposite party no.4 filed written statement taking certain preliminary objections regarding maintainability; locus standi; cause of action; no deficiency in service; jurisdiction and estoppal etc. It is submitted that op no.4 came into contact with father of complainant and other family members and that op no.4 being insurance agent got purchased several insurance policies for complainant and her other family members. The answering op is an insurance agent and as business corollary, the answering op has to make contact with several persons and to apprise them about different insurance scheme and thereby to get business. It is further submitted that answering op being a professional insurance agent made such contact with the father of complainant and her family members well within the business ethics. The answering op being a local resident and a professional insurance agent treats his all customers with due respect and regard and enjoys high respect and reputation in the town. It is further submitted that answering op had got purchased above said insurance policies as per wish, desire and direction of the father of complainant. The father of complainant had told the answering op that he wants to purchase two such policies for the purpose of getting benefit under Income Tax Act and that one policy will be shown by him in individual account and the other will be shown by him in HUF. Thus, as per direction of father of complainant, the answering op had got purchased the above two policies. However, the answering op made payment of amount of premium of above policy through his bank by way of bank transaction. As regards the third insurance policy bearing No.41281/HSM/114966925/00/000, it is submitted that the answering op had to make payment of insurance premium for some other customer through his bank account, but due to some inadvertence and accidental slip, this policy got purchased in the name of complainant. It is wrong to say that complainant made payment of insurance premium of above three policies to the answering op, rather the answering op had obtained the amount of premium of two policies from the father of complainant. Now on account of some misunderstanding between the father of complainant and answering op, the relations between the family of complainant and answering op have become strained and thus, complainant while taking the disadvantage of the above inadvertent mistake on the part of answering op has filed this complaint in order to extract money from answering op. It is further submitted that answering op on coming to know of above mistake on his part got cancelled the third policy No.41281/HSM/ 114966925/00/000 through complainant and the amount of insurance premium paid by answering op for this insurance policy was refunded to answering op by op no.1, as the amount of insurance premium was paid from out of the bank account of answering op. It is further submitted that answering op on coming to know of the above mistake on his part i.e. making payment for one more insurance policy detailed above from out of his bank account, he apprised these facts to the father of complainant and then the answering op got cancelled this extra policies through complainant and got refund of the amount of premium. The answering op had received amount of premium from father of complainant only for two insurance policies and not for third policy, so there was no occasion for the answering op to refund any amount to the father of complainant or to the complainant. Remaining contents of complaint have also been denied and prayer for dismissal of complaint has been made.
4. The parties then led their respective evidence by way of affidavits and documents. The complainant produced her affidavit Ex.CW1/A and copies of documents Ex.C1 to Ex.C10. OP no.4 produced his affidavit Ex.R1. Ops no.1 to 3 produced affidavit of Sh. Apurva Sharma Ex.R2 and copies of documents Ex.R3 to Ex.R14.
5. It is pertinent to mention here that on 20.12.2018 learned counsel for complainant got the complaint dismissed as withdrawn against opposite party no.4. 6. We have heard learned counsel for complainant as well as learned counsel for opposite parties no.1 to 3 and have perused the case file carefully.
7. The complainant in order to prove her case has furnished her affidavit Ex.CW1/A and has furnished documents i.e. policies documents Ex.C1 to Ex.C3, copies of letters Ex.C4 to Ex.C6, copy of writing of Sachin Goel Ex.C7, copy of application moved against op no.4 Ex.C8, copies of postal receipts Ex.C9 and Ex.C10. On the other hand, ops no.1 to 3 produced affidavit of Sh. Apurva Sharma Ex.R2, copies of policies documents Ex.R3 to Ex.R13 and copy of letter Ex.R14.
8. It is undisputed fact between the parties that father of complainant got three insurance policies from opposite parties no.1 to 3 out of which last two policies were cancelled by ops no.1 to 3 on the request of complainant/ father of complainant. As per contention of complainant, complainant has not received premium of two cancelled policies though during pendency of complaint, complainant has received refund of premium of Rs.21,670/- from opposite party no.4 Sachin Goyal and learned counsel for complainant had also suffered his separate statement and complaint was got dismissed as withdrawn against op no.4 vide his statement dated 20.12.2018.
9. Now the claim of complainant is only qua refund of premium of Rs.21,265/- of second policy. Though, ops have taken the plea that both last policies were cancelled by them and refund was given to the complainant but however, the ops have not placed on record any such evidence from which it could be presumed that refund of both policies have been handed over to the complainant. The perusal of copy of letter dated 16.3.2017 Ex.R14 reveals that refund of Rs.21,670/- was given and the refund of Rs.21,265/- was not given to complainant. So, it is proved fact that refund of premium of Rs.21,265/- of second policy No.41281/HSM/100508393/00/000 was not given though it was legal obligation of the ops no.1 to 3 to pay the same which clearly amounts to deficiency in service on the part of ops no.1 to 3.
10. In view of the above, we allow the present complaint qua opposite parties no.1 to 3 and direct the ops no.1 to 3 to make refund of premium of Rs.21,265/- alongwith interest @6% per annum from the date of cancellation of policy in question (bearing No.41281/HSM/100508393/00/000) till actual realization to the complainant. We also direct the ops no.1 to 3 to further pay a sum of Rs.3000/- compensation and Rs.2000/- as litigation expenses to the complainant. The ops no.1 to 3 are liable to comply with this order within a period of 30 days from the date of receipt of copy of this order. A copy of this order be supplied to the parties free of costs. File be consigned to the record room after due compliance.
Announced in open Forum. President,
Dated:17.1.2019. Member District Consumer Disputes
Redressal Forum, Sirsa.
