This is an application u/s.12 of the C.P. Act, 1986.

          As per version of the complainant, it is specific case of the complainant that he paid Rs.40,000/- by cheque and obtained ICICI Prudential Life Insurance Policy bearing No.059C0024 dated 20-02-2007 for a period of 15 years with the portion to withdraw the same after three years.

          The specific case of the complaint is that he paid the initial premium of Rs.40,000/- in the year 2007 through its agent OP4 who deposited the cheque not against the proper policy of the complainant as a result of which the policy was not renewed and it was foreclosed without any consent of the complainant.  Fact remains, after several reminders, it is learnt from their agent did not deposit the cheque in favour of the policy of the complainant.  On the contrary, it is reported that they utilized the cheque to issue a new policy in the name of the daughter of the complainant and deposited the said cheque against that policy of the daughter of the complainant.  Though the complainant never approached the agent, the OP2/ICICI Prudential nor their office to close his policy but by foreclosing the policy, they issued a cheque of Rs.34,155=61 caused financial loss of Rs.1 lakh.  Subsequently, after making complain to the IRDA/OP1, two agents of OPs 5 and 6 asked the complainant to pay Rs.25,000/- in additional as one time premium for one year and thus after one month of the delivery of the policy bond, the OP3 assured to make good the loss and accordingly the complainant paid Rs.25,000/- and also he was cheated by the OPs with their ulterior motive by adopting unfair trade practices and thereby he suffered financial loss.  Hence, this case.

          On the contrary the OP3 by filing written version submitted that the complainant’s petition is not maintainable in the eye of law and the subject matter of dispute raised by the complaint in the entire case has no cause of action and in view of the fact the present complaint is barred by limitation under the provision of C.P. Act, 1986.

          It is stated by the OP3 that along with OPs 4,5 and 6 who sold the policy are the only necessary parties as they sold the policy and gave details to the complainant and the agent mentioned in the complaint is solely responsible for the same.  Fact remains that the complainant with best known reasons has not pleaded that he had voluntarily applied for the insurance policy after fully knowing well about the terms and conditions of the policy.

          Fact remains in the proposal form the complainant gave all relevant details and information in the prescribed form for an assured sum amounting to Rs.3,91,100/- for which a premium amounting to Rs.25,000/- was proposed to be paid on annual basis for a term of 18 years.  The said policy was also duly delivered at the address of the complainant on 31-102-2012.  In the said policy contract, it was clearly explained that if the policy holder is not satisfied with the terms of the policy or otherwise he or she can approach them within the free look period, however, the complainant failed to approach within the freelook period as granted by the terms and conditions of the policy. It is also stated that after receipt of the policy documents on 31-12-2012, the complainant failed to provide the required documents as asked for, the best reason known to him and thus failed to fulfil the requirements before them and now have filed this false and frivolous complaint.

Decision with Reasons

Admittedly, the complainant invested and paid Rs.40,000/- as per annual premium basic vide cheque No.179936 dated 17-08-2007 to ICICI Prudential Life Insurance Policy OP No.2 bearing No.09505960024 for 15 years.  The main contention of the complainant is that though he paid 3(three) years payment/premium through his agent/OP4 who did not deposited the same before the OP2/ICICI Prudential Insurance Company instead a policy was issued in the name of his daughter with the ulterior motive and by adopting unfair trade practice for which he suffered financial loss.  Subsequently, after making complain to IRDA, two agents of OP3/Birla Sunlife Insurance Company i.e. OP No.5 and 6 visited the complainant and suggested that if he pays Rs.25,000/- in addition as one time premium for one year, then after one month of the delivery of the policy bond, the OP3 Birla Sunlife Insurance will make good the loss and accordingly he again deposited Rs.25,000/- by cheque and was also cheated by them.  It is alleged by the complainant that since he cannot read, write and understand the contents of any documents written in English though he somehow been able to sign the name in English and taking that advantage the OPs have cheated him and in this respect complaint was made before the IRDA/OP1 but to no effect.  In its support, the complainant referred a circular No.RBI/2011-12/470/BNBSCCPD No.266/03/12 dated revised on 20-11-2011 and last revised and circulated on 26-03-2012 practice code for NBFC wherein it is specially mentioned that all the terms and conditions should be printed in the vernacular language unless the prospective policy holders be made aware of the terms and conditions, but in the instant case, the said order of the RBI was not followed by the OPs.  Thus the complainant made an allegation for deficiency and for adopting unfair trade practice by the OPs in this respect and issued legal notice dated 30-05-2012 stating his grievances before the OPs.

          On the other hand, it was argued on behalf of the OPs that as per complainants request for cancellation of the policy within freelook period which was acceded by the OP3/Birla Sunlife Insurance Co.  In its submission after completely understanding the terms and condition of “BSLI Vision Plan” had voluntarily applied for the insurance policy vide proposal Form bearing no.44829297 dated 23-12-2011.  In the proposal form, the complainant gave all relevant details and information in the prescribed form for an insured sum amounting to Rs.3,91,100/- for which a premium amounting to Rs.25,000/- was proposed to be paid an annual basis for a term of 18 years and the said policy was duly delivered to the complainant’s address on 31-12-2012.  But the complainant failed to approach within the freelook period as granted by the terms and condition of the policy the complainant also encashed on 29-09-2011 regarding foreclosure issued by the OP2/ICICI Prudential Life Insurance Co.  Further it is also stated by the OP2 that the OP/Company had received a duly filled and signed application form bearing No.LL38040224 towards which policy bearing No.14078425 was issued on June, 23, 2010 on payment of cheque bearing no.643329 dated 18^th June, 2010 from the side of the complainant the name of his daughter but the premium of the said policy have not been paid since June, 23, 2011 due to which the policy has acquired a lapsed status and the said two policy Nos.004069935 and 004386607 have ceased to be in force w.e.f. June, 21, 2011 and September 30, 2011 respectively and to revive the same the complainant to submit certificate of insurability along with outstanding premium due.

          On meticulous study of the complaint including the written version of the OP and particularly status of the complainant and his knowledge we are confirmed that the fellow complainant is half literate because he read uup to Class VII then it is impossible for any person with standard of education VII to read and know the thousands terms and conditions of the policy and practically in this case complainant has alleged that the agent assured him that he will look after the matter and he must have to deposit three premiums and after that it shall be matured and it is the fact rather it is the truth that in general every investor rely upon the agent’s version and sweet behaviour in the garb of deceiving the customers procures signs in the application form and fact remains in the present case entire body of the proposal form were written by the agent and it is impossible for that complainant to fill the application because meaning of the terms and condition of the application form cannot be realized by the present complainant having standard knowledge of Class-VII.  Fact remains it is the practice of the insurance agent to collect signatures in the forms that means the signature are made by the so called insured not knowing fully well the terms and condition and future effect of the policy but relying upon the assurance of the agent so, we are convinced that there was no scope on the part of the complainant to continue such a policy for 15 years to deposit Rs.40,000/- per year.  Truth is that on three occasions he paid Rs.40,000/-, on two occasion it was paid on third occasion same was received from the complainant by the agent having no option to take fresh policy again in the name of his daughter and complainant never applied for opening a new policy against her daughter’s name not even an idiot can accept such a path when it is impossible for any person to continue a policy after two years he shall have to open another policy for same amount.  The whole theorization as presented by the OP as claimed that both the forms are signed by the complainant then complainant is bound by that.  For the sake of the argument if it is accepted that his agent was honest in that case agent ought to have been produced by the OP insurance company to substantiate that agent did not fill up the blanks of the entire form.  Fact remains not a single private insurance company shall be able to run the insurance business in India without the help of the so called cheater agents as the collector of the capital of private insurance company and they are cheating the public at large and in West Bengal in the hands of so called cheater agents the general public are being deceived but IRDA is here and there but their authority are blind till now.  Truth is that the application form must be in Bengali form what this is the guidelines of IRDA but no private insurance company has adopted it and in this case this complainant has no knowledge of English may be he has his capacity to sign for that reason it cannot be presumed that this insured has his English knowledge.  Truth is that having master degree also many has no English knowledge then how the person having Class-VII standard education has his English knowledge to interpret the meaning of the clause of the policy then how we can come to a conclusion only on the plea of the OP that complainant submitted his application by putting his signature so it is his willful act and further plea that within freelook period complainant did not file any application.  We feel that the word freelook period is an idiotic expression but it shall be the duty of the insurance company after receipt of any application presented by the agent to verify on spot after contacting with the so called insured whether he has realized it or he actually paid the amount for opening the new policy or whether he has another policy or whether the said policy is being continued etc. but nothing has been done in this case but sitting in the glassroom the private insurance company is collecting the investment through the cheater agents and that cheater agents are the capital of the entire insurance business of the private insurance companies but it must be proved before this Forum by the OP to justify that there was no fault on the part of the agent.

          Applying our judicial conscience and also considering the entire fiction we are confirmed that a half educated complainant is cheated by the agent who filed the application form giving no chance to the complainant to realize what would be the future effect of the policy.  Fact remains insurance company is silent about agent and his overact but fact remains it is the duty of the insurance Company to prove that the agent did nothing wrong but truth is that agent received the money in three occasions then there is no other alter native but to hold that agent always kept the complainant in darkness by assuring the complainant by their sweet tongue having poison in their mind and ultimately cheated the complainant.  No reasonable and prudent man shall have to believe that one intended insured shall have to open one after another policy and shall have to lose his money as it shall be automatically forfeited.  No possible clause has been shown by the OP because they are depending upon the cheater agents who are their capital but they are not thinking about the loss of the insured who are investing their hard money for relief.  IRDA is here and there but they are also sitting in the glassroom of the private insurance companies and they are also hired which is evident in the practical sense if it is the conduct of the IRDA then we feel it should be abolished when interest of the insured is not safe under that authority.  Fact remains no evidence is produced by the OP by producing the agent to prove that the agent was honest and he discharged his duty by placing the entire fact as printed in proposal Form in English to the complainant.  Complainant realized it then OP Bank shall have to produce such evident that complainant signed in the application after realizing the terms and conditions and filling the same and then he opened the new policies again and again.  There must be a certificate or declaration of the insured that terms and condition he has realized but nothing is there.  So, conduct of the OP is no doubt an unfair trade practice and if that unfair trade practice is not continued by the private insurance companies in that case all the private insurance companies shall be closed and it is observed by this Forum after considering the total income of the private insurance company and their delay payment and after mathematical calculation it would be evident actually insurance company has been running on the fund invested daily but they have no capital.  This is the situation of all the insurance company in India barring LICI because LICI has some merchant insured of Indian Airlines or Ship or voyage etc. but if any air crash is held or any ship is found drowned in that case the fate of the insurance company shall be like a drowned ship or crash air flight.  Reason is that the private insurance companies are cheating daily in the market but in the field IRDA is absent though many guidelines are given time to time but they are nowhere.  Practically IRDA is working as bosom friend of the private insurance company which is proved from the IRDA’s action in the present case whatever it may be we have realized the sequences of depositing Rs.40,000/- continuously for three years but OP has tried to convince that he did not pay third premium for first policy but he opened another policy.  Can a prudent man believe that agent went to the insured to collect Rs.40,000/- for new policy but did not collect another Rs.40,000/- for continuing the policy.  This overact simplifies the theft of money by the agent and for which the insurance company has not produced that cheater before this Forum.  If cheater would be produced the Forum shall get chance to enquire about the matter but even then in his absence we have gone through filled up form as produced by the OP wherefrom we gathered that agent by practicing fraud filled the same.  Then invariably the insurance company is responsible for any overact of his office agent.  Another factor is that one advisory’s signature is evident and his name is some Verma and in the complaint there is allegation against another agent of ICICI Prudential Life Insurance, Ms. Ishita Roy but they are not produced.  So, considering all the above fact and also the ruling reported in 2013 (1) CPR 199 NC we are convinced that present insurance company is responsible for the act of his agent and also it is proved that proposal forms were not filled up by the complainant but it was filled up by the agent of the OP when it is proved that the complainant is a half educated person and another fact is that he paid the money or the premium for three years to the agent but agent has failed to convince why previous policy was discontinued but intended to purchase another policy in his daughter’s name.  So, we are convinced that IRDA decided the dispute as womb of the private insurance policy not as justice deliverer to the insured.  So, we are not relying upon such a proactive order of the IRDA bujt fact remains mal practice and unfair trade practice are being  practiced by the agent who procured signature of the complainant and filled up such separate second insurance policy only to grab the entire money of the poor complainant by the OP through their so called cheater agent so we are convinced that the complainant has been deceived, cheated by the OP and Insurance Policies was opened at the behest of the agents but knowledge of the insured is zero as he relied upon such a cheater agent ultimately he has been cheated by the OP and in this field the present OP and private insurance companies have spread their cheater agents which is proved from OP’s practical conduct but for adopting unfair trade practice by the OPs a consumer must not be cheated by the Forum.  Consumer Forum is here and there to give justice to the consumer who has been actually cheated but sometimes it is found we are not devoting to realize the dispute and not particularly entering into the issues and not particularly considering the legal aspect for which many claims are being refused by the Forum.

          If the present practical case is properly studied by any forum invariably such a very painful picture could be searched out and if no proper relief is given to such insured then such an OP who has adopted unfair trade practice shall have to continue unfair means of practice so it is the duty of the Forum to keep watch about any overact of any insurance or bank or whatever it may be.    Approach of the Forum must be dedicated approach.  Fact remains cases are pending for long period, executions are not being disposed of years together but none is here and there to look after the same.  Another factor is that this case was filed in the year 2012 and it is now 2014.  Is there any explanation on the part of this Forum for what ground the case is being continued.  If the Forum are not always vigilant, speedy, introspection in that case entire spirit of the C.P. Act shall be frustrated and to some extent the damage is already caused.  So, protection must be taken to recover from such damage to place the image of the forum to the consumers so that Forum must not lose their credibility but we are trying hard always to be vigilant.  In the light of above observation we are confirmed that in the particular case the OP and their agent adopted unfair trade practice and cheated the consumer the present insured through their agent and that agent is in the glassroom and complainant a poor fellow is loitering in the Forum for justice whatever it may be unfair trade practice has been adopted by the OPs for which the OP shall be imposed such penalty and at the same time the complainant is entitled to get back the entire amount of premiums as deposited against two policies though we have already come to a conclusion that two policies were procured by the distinguished cheater agent but anyhow the insurance company may deduct 5% of the total amount as service charge and the amount which has been paid shall be deducted form the total amount but complainant shall have to get back Rs.1,20,000/- after deduction of 5% by the OPs Insurance Company and if any amount has already been paid by the OP to the complainant in that case same shall be deducted from the awarded amount and for harassment of the complainant by the OPs OPs shall have to pay some compensation and for adopting unfair trade practice punitive damages shall be imposed against such insurance company who has cheated the complainant engaging their agent.

          In the result, the case succeeds.

Hence,

Ordered

That the case be and the same is allowed on contest against the OPs No.1,2 and 4.

OP1 is directed to pay cost of Rs.10,000/- (Rupees Ten thousand only) to the complainant. 

OP2 is hereby directed to refund Rs.1,20,000/-(Rupees One lakh twenty thousand only) as deposited as premium against two policies after deduction of 5% as service charge and any amount already paid by the OP to the complainant and shall have to pay the balance amount within one month from the date of this order to the complainant.  OP2 is also hereby directed to pay a compensation of Rs.5,000/-(Rupees Five thousand only) to the complainant for negligent and deficient manner of service and also for adopting unfair trade practice through their agent OP4.

To control the unfair trade practice as adopted by the OP2 and to check such unmerchantable business done on the part of the OP2 a sum of Rs.10,000/- is imposed as punitive damages which shall be deposited to this Forum by the OP2.

OP2 is hereby directed to comply the order as per spirit of this order failing which penal action shall be taken against OP2 for which OP shall be responsible and even after that penal interest @Rs.300/- shall be assessed till full satisfaction of the decree and further penal measure shall be taken.