West Bengal

Birbhum

CC/167/2015

Nitya Gopal Banerjee - Complainant(s)

Versus

Manager, HDFC Standard Life INS Co Ltd - Opp.Party(s)

Sanjit Kr Acharya

16 Apr 2018

ORDER

Shri Biswa Nath Konar, President.

            The case of the complainant Nitya Gopal Banerjee, in brief, is that the insurance Advisor of the O.P/Insurance Co. met with him and requested him to get a policy with assurance that only single premium would have to be paid one time for a policy and after six years double of the amount will be paid as maturity amount and life insurance will be covered during that period. On believing that he agreed to get policy and paid Rs. 90,000/- by cheque.

            It is further case of the complainant that proposal form is not filled up by him and he put only signature for one policy and other signature there are manufactured by O.P and he has no knowledge about contains of the proposal form.

            It is the further case of the complainant that he got insurance policies being No. 17003634 premium of Rs. 40000/- dated 01.08.14 and policy No. 16580802 premium of Rs. 50000/- dated 17.01.14. But he never proposed for such policy for more than one year policies and O.P/Insurance Co. is in connivance with said Advisor procuring false signature made two long term polices with numerous premium instead of single premium.

            It is the further case of the complainant that he lodged complaint before O.P Insurance Co. and requested them to convert the said policies into a single premium policy or to refund back money with 18% interest per annum. But in vain, which amounts to deficiency in service and illegal trade practice.

            Hence this case for directing the O.Ps to convert the policies in question into single premium policy or refund back deposited amount of Rs. 90000/- with 18% interest per annum.

            The O.P HDFC Standard Life Ins. Co. Ltd. has contested the case by filing written version denying all material allegations of the complaint contending inter alia, that the case is not maintainable and the complainant has not cause of action to bring this case.

            It is the specific case of the O.Ps that the policy documents when dispatched to the customer is accompanied by a letter wherein “option to return” clause is stated which gives the policy holder the option to return the policy stating the reason thereof, wherein the stipulated time from the receipt of the policy document in case the consumer is not agreeable to any of the provision stated in the policy and same has been duly received by the complainant. Moreover, it is the sole responsibility of the complainant to bring to knowledge of the Co. any discrepancy in the policy conditions and that too within the specified time from the date of the receipt of the policy documents. Thus inaction on the part of the complainant/customer to withdraw the policy within stipulated period disentailed him to cancel the policies and to claim refund of the same.

            It is the further case of the O.Ps that there was no deficiency in service or illegal trade practice on their behalf and the case is liable to be dismissed with cost.

 Point for determination.

1.  Whether the complainant is a consumer under Sec. 2(1)(d)(ii) of the C.P. Act.?
2. Whether this Forum has jurisdiction to try this case?
3. Whether there is any deficiency in service on the part of the O.Ps?
4. Whether the complainant is entitled to get any other relief or reliefs as prayed for?

DECISION WITH REASONS

During the trial the complainant Nitya Gopal Banerjee has been examined as PW1 and also filed some documents. He was also cross examined by the O.Ps.

The O.Ps have not adduced any oral evidence but submitted some documents.

Heard argument both sides.

Point No.1:: Evidently the complainant had purchased  policies from the O.Ps bearing No. 17003634 premium of Rs. 40000/- dated 01.08.14 and policy No. 16580802 premium of Rs. 50000/- dated 17.01.14.

So, the complainant is a consumer U/s 2(1)(d)(ii) of the C.P. Act.

Point No.2:: O.Ps No. 2 has Branch Office within jurisdiction of this Forum.

The total valuation of the case is Rs. 95000/- which is far less than maximum limit of the pecuniary jurisdiction of the Forum i.e. Rs. 20,00,000/-.

So, this Forum has pecuniary and territorial jurisdiction to try this case.

Point No. 3 and 4:: Both points are taken up together for convenience of discussion as they are related to each other.

The complainant in his complaint and evidence stated that he got insurance policies being No. 17003634 having premium of Rs. 40000/- dated 01.08.14 and policy No. 16580802 having premium of Rs. 50000/- dated 17.01.14.

Copy of the policy certificate show that the complainant paid Rs. 51015/- to the O.P/Insurance Co. in respect of policy No. 16580802 and Rs. 38801/- in respect of policy No. 17003634.

The complainant in his evidence on affidavit stated that he never proposed for such policy for more than one year policies and O.P/Insurance Co. is in connivance with said Advisor procuring false signature made two long term polices with numerous premium instead of single premium and he lodged complaint before O.P Insurance Co. and requested them to convert the said policies into a single premium policy or to refund back money with 18% interest per annum. But in vain, which amounts to deficiency in service and illegal trade practice.

He was cross examined by the O.P/Insurance Co. but nothing come out from his such cross examination. The O.P/Insurance Co. also has not filed in evidence on affidavit against the evidence of the complainant/PW1 Nitya Gopal Banerjee.

In view of the ruling reported in VI 2006CPJ 2013(NC) where the O.P failed to adduced evidence by way of affidavit or cross examined the deponent, the allegation of the complainant remain uncontroverted and in absence of any counter affidavit case of the complainant stands prove.

We find that it is the main contention of the O.P/Insurance Co. that as the complainant has not availed of opportunity to option of “free look” in due time, inspite of due service of policy document with a letter wherein option to return clause has been enumerated and, as such, he is not entitled to cancel the policies or to claim refund of the same.

In his reply Ld. Advocate/Agent of the complainant submitted that irrespective of non-avilability of option of “free look” the complainant is entitled to get surrender value of the policy as per Rule 7 of IRDA Regulations subject to deduction of discontinuation charge.

In support of his contention he cited a ruling in VI (2013)CPJ 128(UT Chandigarh), where the complainant purchased capital builder 15 years unit link policy expecting good return and paid three regular installments. He did not take option of free look. The O.P Insurance Co. refunded the amount after deducting more than 50% of the amount deposited by the complainant. The Dist. Forum dismissed the complaint of the complainant.

But Hon’ble State Commission on Appeal pleased to hold that complainant is entitled to get surrender value as per Rule 7 of IRDA Regulations with compensation on account of mental agony and mental harassment.

In view of Regulation No. 7 obligation of an insurer upon discontinuation of a policy, where the policy is discontinued during first policy year maximum charge for policy having annualized premium about Rs. 25000/- lower of 6% (AP or VP) subjected to maximum of Rs. 6000/-.

In the present case annual premium of Rs. 40000/- and Rs. 50000/- for two policies and the same were discontinue at first year, so in view of the Regulation 7 deduction will be Rs. 6000/- as maximum for each policy.

In view of the facts and circumstance of the case, evidence on record and relying upon the rulings cited above we think the complainant is entitled to get back Rs. 90,000/- minus Rs. 6,000/- each for two policies = Rs. 78,000/- with 8% interest from the date of purchase.

Withholding of such amount by the O.P No.1 Insurance Co. amounts to deficiency in service and the complainant is entitled to get Rs. 5,000/- as compensation.

Accordingly the present case is allowed in part.

Proper fees have been paid.

Hence,

O R D E R E D

that C.F case No. 167/2015 be and the same is allowed in part on contest against the O.Ps with cost of Rs. 2,000/- payable by both the O.Ps.

            The O.Ps are directed jointly and severally to pay Rs. 78000/- (Rs. 90000/- - Rs. 12000/-= Rs. 78000/-) with 8% interest from the date of purchase. Both the O.Ps are directed to pay Rs. 5000/- as compensation.

            All such payment be made to the complainant by the O.Ps within one month from the date of this order failing which the complainant shall be at liberty to execute the order as per law and procedure.

 Copy of this order be supplied to the parties each free of cost.