Chandigarh

StateCommission

A/405/2014

Jagdish Chander Nagpal - Complainant(s)

Versus

ICICI Prudential Life Insurance Co. Ltd, - Opp.Party(s)

Appellant In Person

23 Feb 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

                                                                 

First Appeal No.	:	405 of 2014
Date of Institution	:	30.12.2014
Date of Decision	:	23.02.2015

 

Jagdish Chander Nagpal S/o Sh. Shankar Dass Nagpal, R/o H.No. 1001, Sector 27-B, Chandigarh.

……Appellant/Complainant.

Versus

(1)   ICICI Prudential Life Insurance Company Limited, ICICI Pru-Life Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai – 400025.

 

(2)   ICICI Prudential Life Insurance Company Limited, through its Zonal Manager, SCO No.134-135, Sector 8-C, Chandigarh.

 

(3)   ICICI Prudential Life Insurance Company Limited, through its Regional Manager, SCF 70, Phase IX, Mohali, District SAS Nagar.

 

(4)   Atul Vij, employee/agent ICICI Prudential Life Insurance Company Limited, r/o H.No. 1121, Pushpak Society, Sector 49, Chandigarh.

 

……Respondents/Opposite Parties.

 

Appeal under Section 15 of the Consumer Protection Act, 1986.

 

BEFORE:   JUSTICE SHAM SUNDER (RETD.), PRESIDENT.

                SH. DEV RAJ, MEMBER.

 

Argued by: Sh. Jagdish Chander Nagpal, appellant in person.  

Sh. Gaurav Bhardwaj, Advocate for respondent No.1 to 3.

Respondent No.4 exparte vide order dated 10.02.2015.

 

PER DEV RAJ, MEMBER.

              This appeal is directed against the order dated 26.11.2014 rendered by the District Consumer Disputes Redressal Forum-I, UT, Chandigarh (hereinafter to be called  as the District Forum only) vide which, it allowed the complaint of the complainant (now appellant) and directed the Opposite Parties (now respondents) in the following manner:-

“14.     Resultantly, in view of the foregoings and entirety of the case, we are of the opinion that the complaint must succeed. Therefore, the same is allowed.  The OPs are directed to refund Rs.6,00,000/- to the complainant.  They are also directed to pay Rs.15,000/- as compensation to the complainant for causing him mental agony and physical harassment, apart from paying litigation cost of Rs.7,000/-.

15.     This order be complied with by the Opposite Parties within a period of 30 days from the date of receipt of copy of this order, failing which they shall be liable to refund the above awarded amount along with interest @12% per annum from the date of filing this complaint i.e. 05.05.2014 till its actual payment, besides paying litigation cost, as aforesaid.”  

2.           The facts, in brief, are that complainant, being a senior citizen of about 87 years of age, was approached by Opposite Party No.4 in September 2006 with a proposal to purchase a Policy with annual premium of Rs.1 Lac and with a lock-in period of three years. It was stated that Opposite Party No.4 used to take the receipts of installments for depositing the premium with Opposite Parties No.1 to 3. It was further stated that after three years lock-in period, when the complainant asked for money, Opposite Party No.4 handed over a cheque of Rs.3,36,471.29, which was got encashed by the complainant on 5.09.2009.

3.           It was further stated that the complainant was happy with the services of Opposite Party No.4 and reposing good faith in him, Opposite Party No.4 induced the complainant to invest Rs.2 Lacs yearly on the same terms  as per the old Policy and the complainant was hopeful to get Rs.6 Lacs plus bonus after lock-in period of three years. It was further stated that in good faith, Opposite Party No.4 got signed from the complainant proposal form dated 30.08.2009 and another application Form No.LL33384804 (Annexure C-1). It was further stated that the complainant deposited three cheques of Rs.2 Lacs each dated 12.09.2009, 13.11.2010 and 26.09.2011 (Annexure C-2) on three successive dates for three successive years with Opposite Party No.4, on account of new Policy. It was further stated that the complainant never received any Policy Document or any proposal stage verification call from the Opposite Parties at any stage. It was further stated that on asking Opposite Party No.4 for the Policy Document,  he assured that the Policy was in force and he was responsible for everything and the complainant need not worry.

4.           It was further stated that since the complainant is very old and he could not be insured, so Opposite Party No.4 insisted the complainant to get the Policy for his grandson, which offer was acceded to by the complainant in good faith. It was further stated that after the expiry of three years, when the complainant requested Opposite Party No.4 for encashment of new Policy, Opposite Party No.4 started making excuses on one pretext or the other. It was further stated that on getting suspicious and, on enquires, the complainant came to know that he was deceived by Opposite Party No.4, who in fact got the money invested in a different plan instead of the previous Policy. It was further stated that since the forms were got filled up by Opposite Party No.4, therefore, the complainant was totally unaware of the terms and conditions of the Policy. It was further stated the complainant asked for copies of proposal forms, which were got signed by Opposite Party No.4, for comparison, through letters dated 8.08.2013 and 19.08.2013 and also sent reminder to issue copy of forms against Policy Nos.02661500 and 12534379, on 7.10.2013 to Mohali Office. It was further stated that since no response was forthcoming, the complainant filed a complaint, before the SSP Chandigarh, who forwarded the same to SHO Sh. Kirpal Singh for enquiry, who managed to procure few proposal forms (Annexure C-3). It was further stated that on going through the copies of proposal forms, the complainant understood the reason why the Opposite Parties were avoiding to give copies thereof, which could have weakened their case before the Ombudsman, Chandigarh. It was further stated that copy of application form No.33384804 duly signed by the complainant, typed/printed on one side and the other side left blank, was filed before the Insurance Ombudsman on 25.03.2013 and the one being filed alongwith the complaint was different.

5.         It was further stated that as per news printed in the Tribune dated 22.11.2012, 18.4.2013, 7.5.2013 and 17.1.2014, some persons/complainants were given relief/compensation by the Consumer Forum, Chandigarh (Annexures C-4 & C-5). It was further stated that on 25.03.2013, a complaint was filed by the complainant with Insurance Ombudsman, Chandigarh (Annexure C-7), which was decided without taking cognizance, however, as a matter of fact, the Polciy was not delivered to the complainant, which was further confirmed by Asstt. Secy.-cum-CPIO, while giving reply for the information demanded under Right to Information Act from the Ombudsman Office (Annexure C-8). It was further stated that the Insurance Ombudsman also did not consider letter dated 12.08.2013, where ICICI offered Rs.6 Lacs to the complainant in the shape of new Policy, which was refused by the complainant on the ground that he wanted cash only for his treatment. It was further stated that the complaint of the complainant was dismissed by the Insurance Ombudsman vide order dated 14.08.2013 (Annexure C-10).

6.           It was further stated that the complainant had realized that the Opposite Parties had issued Insurance Policy, which was to mature in the year 2019, due to their higher commission and more incentives from their Company, hence they played a big fraud with the complainant, who is an old person of 87 years of age. It was further stated that the document having plan name “Life Stage Assure Policy” having term of 10 years with maturity in 2019 was never got signed from the complainant but the same was typed in the office of the Opposite Parties at the back of the complainant. It was further stated that all this was done so that the complainant might not come to know all terms and conditions of the Policy and cancel the Policy within the free look period of 15 days.

7.           It was further stated that the aforesaid acts of the Opposite Parties, amounted to deficiency, in rendering service, as also indulgence into unfair trade practice. When the grievance of the complainant, was not redressed, left with no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter to be called as the Act only), was filed, directing the Opposite Parties, to refund Rs.6 Lacs alongwith interest @18% per annum; Rs.10 Lacs as compensation for mental agony and physical harassment and any other reliefs, which the District Forum deemed fit in the facts and circumstances of the case.

8.           Opposite Parties No.1 to 3 in their joint written statement, took up certain preliminary objections, to the effect that the complaint was not maintainable under Section 24A of the Act, as the subject Policy was issued in 2009 and the last premium was paid in 2011 and the complaint, having been filed after more than 5 years, was barred by time and that the District Forum was not having any jurisdiction to entertain the complaint as the complainant had levelled allegations of forgery, fraud, mis-selling, criminal conspiracy, misrepresentation, fabrication and cheating, in the complaint. On merits, while admitting the factual aspects of the matter, it was stated that on the basis of information and the declaration made in the proposal form, Opposite Parties No.1 to 3 issued “Life Stage Assure” Policy bearing No.12534379 to the complainant. It was further stated that the Policy was sent and was duly received by the complainant vide EL AWB No.365146121. It was further stated that at the time of taking the Policy, the complainant was well aware about the terms and conditions of the same. It was further stated that the complainant had himself opted for a premium payment term of 10 years with yearly frequency of payment. It was further stated that the complainant upon receipt of the Policy documents had the option to return the Policy under the provisions of free look as per the IRDA Regulations, 2002, within 15 days from the receipt of the Policy. It was further stated that, however, the complainant did not submit the request within the free look period of 15 days of receipt of the Policy Document and, thus, it was assumed that the complainant had accepted the terms and conditions of the Policy Document. It was further stated that the complainant did not approach the Opposite Parties with any discrepancies regarding premium payment, premium frequency and the Policy terms and conditions. It was further stated that the complainant filed a complaint with the Insurance Ombudsman, which was dismissed by the Ombudsman, stating that there was no deficiency in service (Annexure R-4). It was further stated that neither there was any deficiency, in rendering service, on the part of Opposite Parties No.1 to 3, nor they indulged into unfair trade practice. The remaining averments, were denied, being wrong.

9.           Opposite Party No.4, in his reply stated that the complainant accepted the said terms & conditions with open eyes and chose to pay the premium of 3 years as well. It was further stated that the complainant was even advised not to cancel the said Policy as it had 2 years more of minimum payment period still to expire. It was further stated that the complainant acted as per his own wishes and himself chose to cancel the Policy. It was further stated that an acknowledgment letter dated 30.8.2009 (Annexure R-4/1) was also signed by the complainant, wherein he himself stated that he understood all the terms and conditions of the Policy and that the said Policy had a lock-in-period of 5 years as far as payment of premiums was concerned, however to get the full value of the Policy, the lock-in-period was 10 years. It was further stated that the complainant was given the Policy of his choice, which he opted for in favour of his Grandson and only those documents were signed by the complainant which pertained to the Policy. A copy of the Insurance Proposal Form, which was duly signed by the complainant, was annexed at Annexure    R-4/2 and the same (proposal form) was duly delivered via courier on 03.10.2009 through ELBEE Express Airway, vide bill no.365146121. It was further stated that the complainant was also duly informed about his Policy details via SMS and it was extremely unbelievable that a customer would continue paying premium for 3 years without having any document ever sent to him, and without ever raising any complaint. It was further stated that neither there was any deficiency, in rendering service, on the part of Opposite Party No.4, nor he indulged into unfair trade practice. The remaining averments, were denied, being wrong.

10.         The complainant filed separate replications wherein, he reiterated all the averments, contained in the complaint and repudiated the same, contained in the written versions of the Opposite Parties. 

11.         The Parties led evidence, in support of their case.

12.         After hearing the Counsel for the parties, and, on going through the evidence, and record of the case, the District Forum, allowed the complaint, as stated in the opening para of the instant order. 

13.         Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant.

14.         We have heard the appellant in person, Counsel for Opposite Parties No.1 to 3, and, have gone through the evidence, and record of the case, carefully. 

15.         The appellant/complainant in person submitted that he being 88 years of age was made to run from pillar to post to get justice and he underwent lot of physical harassment and mental agony. He further submitted that relevant Annexures appended with the reply of the respondents/Opposite Parties were without his signatures and he was kept in the dark while issuing the Policy. He further submitted that the amount remained with the respondents/Opposite Parties since 2009, 2010 and 2011 for which he was entitled to interest/bonus but the District Forum awarded only a meagre amount of compensation in the sum of Rs.15,000/-.

16.         The Counsel for respondents No.1 to 3/Opposite Parties No.1 to 3 submitted that the Policy could be surrendered in terms of Clause 2.4 of the Policy but the appellant/complainant requested to cancel the same. He further submitted that Opposite Party No.4 in its written statement submitted that the appellant/complainant duly signed the documents. He further submitted that the complaint filed by the appellant/complainant, before the Insurance Ombudsman was dismissed. He further submitted that the appellant/complainant was not entitled to any further relief.

17.         The District Forum while allowing refund of Rs.6 Lacs, compensation of Rs.15,000/- and litigation cost of Rs.7,000/- to the appellant/complainant, did not allow any interest on the premium deposited during the years 2009 to 2011 despite following findings in Para 13 of its order:-

“13.   We feel that a person who is a social worker and that too of 86 years of age seeks help from the Police only when he becomes helpless. It is only non- cooperative attitude of the Opposite Parties which forced the Complainant to go to the police and then to the Insurance Ombudsman. It is pertinent to mention that Annexure R-4/2 where term of plan is mentioned as 10 years is not bearing the signatures of the Complainant. Further, it is noteworthy that page 34 of document Annexure R-1 where the term of the policy is written as 10 years under the Column 2(a) is again not bearing the signatures of the Complainant. Moreover, Annexure R-2 which is Benefit Illustration of ICICI Life Stage Assure is evidently generated on 9.2.2009, but the policy in dispute is dated 30.8.2009, again the same is not signed by the Complainant. We feel that only by going through document Annexure R-1 and R-2 the Complainant could come to know about the Policy term, but both these documents are not signed by him showing his innocence regarding the issue of the policy term. Therefore, non-supplying of the policy documents with terms & conditions and assuring that the policy terms of the present policy would be of the same i.e. of 3 years as that of the old policy taken earlier by the Complainant prove deficiency in service on the part of the Opposite Parties.”

18.         The appellant/complainant has pleaded that he was entitled to bonus/interest for the period the amount remained with the respondents/Opposite Parties. The core question, which arises for consideration, is, as to whether the appellant/complainant is entitled to interest/bonus and, if so, to which extent.

19.         No doubt, the Policy had lock-in period of 5 years. The contention of the appellant/complainant that he was told that the Policy had lock-in period of 3 years, and proposal form did not bear his signatures, has been accepted by the District Forum. In fact, the Policy issued was for a term of 10 years and lock-in period of 5 years. Since the appellant/complainant paid only three premiums, the question of accrual of any bonus did not arise. In the same manner, interest could also not be allowed from the date of payment of first premium in August, 2009, as second and third premiums were paid in the years 2010 and 2011. While the appellant/complainant has taken a specific plea in his complaint that the Policy and the terms and conditions were never received by him, Opposite Parties No.1 to 3 in Para 5 of the preliminary objections of their written statement stated that the Policy terms and conditions alongwith a forwarding letter stating the free look provision and a copy of proposal were sent to the appellant/complainant and the same were duly received by the complainant vide AWB No.365146121 but neither the Policy nor the acknowledgement has been produced in evidence. Policy document (Annexure R-3) attached with the written statement does not bear even the Policy No. and date of issue, and the same is also not addressed to the appellant/complainant. Thus, Annexure R-3, in no way, establishes that the Policy was sent to the appellant/complainant.

20.         In M/s Modern Insulators Ltd. Vs Oriental Insurance Co. Ltd., I (2000) CPJ 1 (SC), the principle of law, laid down, was to the effect, that it is the fundamental principle of Insurance law, that utmost good faith, must be observed by the contracting parties, and good faith forbids either party, from non-disclosure of the facts, which the parties knew. The insured has a duty to disclose all the facts, and similarly it was the duty of the Insurance Company, and its agents, to disclose all the material facts, in their knowledge, as obligation of good faith applies to both equally. It was, thus, the duty of respondents/Opposite Parties to disclose all the facts and circumstances, relating to the insurance cover, in respect whereof the Insurance Policy was taken by the appellant/complainant. It was also required of the respondents/Opposite Parties, to apprise the appellant/complainant of the benefits of insurance and the exclusion clauses, contained therein. It was, under these circumstances, the utmost duty of the respondents/Opposite Parties to supply the Insurance Policy and the terms and conditions thereof, to the appellant/complainant, so as to enable him (appellant/complainant) to go through the same and understand the clauses contained therein. In United India Insurance Co. Ltd. & Anr. Vs S.M.S. Tele Communications & Anr., III (2009) CPJ 246 (NC), it was observed that being aware of the existence of the Policy, is one thing, and being aware of the contents and meaning of the clauses of the Policy, is another. It was the bounden duty of the respondents/Opposite Parties to make the appellant/complainant aware of the terms and conditions. The respondents/Opposite Parties have failed to establish with cogent and convincing evidence if the terms and conditions were supplied to the appellant/complainant. There is, therefore, truth in the averment of the appellant/complainant that the Policy terms and conditions were never supplied to him by the respondents/Opposite Parties.

21.         As per averments of the appellant/complainant in Para 7 of his complaint to the Insurance Ombudsman, his expectation was that he would get approximately Rs.7 Lacs in September 2012 whereas surrender value came to be Rs.3,77,000/-. Since he (appellant/complainant) opted for the Policy under the bonafide belief that lock-in period shall be 3 years, in our considered opinion, it would be fair to allow him interest @9% per annum on the total premium amount of Rs.6 Lacs w.e.f. 26.09.2011, the date on which, he paid the third premium. Allowing 9% interest w.e.f. 26.09.2011 coupled with compensation of Rs.15,000/- already granted by the District Forum, in our considered opinion, shall meet the ends of justice. Thus, the order of the District Forum, has to be modified, to the extent indicated above.

22.         No other point, was urged, by the Counsel for the parties.

23.         For the reasons recorded above, the appeal is partly accepted, with no order as to costs. The order of the District Forum is modified, in the following manner:

1. The Opposite Parties are directed to refund Rs.6,00,000/-, as awarded by the District Forum, to the complainant alongwith interest @9% per annum from 26.09.2011 to the complainant, within a period of 30 days from the date of receipt of a certified copy of order.
2. The Opposite Parties are further directed to pay Rs.15,000/- as compensation for mental agony and physical harassment to the complainant, as awarded by the District Forum, within a period of 30 days from the date of receipt of a certified copy of the order.
3. The Opposite Parties are further directed to pay Rs.7,000/- as cost of litigation to the complainant, as awarded by the District Forum.
4. If the order is not complied with, within the stipulated period of 30 days, from the date of receipt of a certified copy thereof, the amount mentioned in Clauses (i) and (ii), above, shall be payable by the Opposite Parties alongwith interest @12% per annum, as awarded by the District Forum, from the date of filing the complaint i.e. 05.05.2014, till actual payment, besides payment of cost of litigation.

24.         Certified copies of this order, be sent to the parties, free of charge.

25.         The file be consigned to Record Room, after completion.

Pronounced.

February  23, 2015.

 

Sd/-

[JUSTICE SHAM SUNDER (RETD.)]

PRESIDENT

 

 

 

Sd/-

(DEV RAJ)

MEMBER

 

 

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