Bihar

Muzaffarpur

CC/21/2013

Baleshwar Ojha - Complainant(s)

Versus

Managing Director, Tata AIA Life Insurance Company Ltd., & Others - Opp.Party(s)

Shri Yeshpal Shanker And Shivendra Kumar

29 Sep 2015

ORDER

District Consumer Forum, Muzaffarpur

Complain Case No. - 21/2013.

 Baleshwar Ojha, S/o of Late –Devdhari Ojha, Residence of village and post – Khabra, P.S- Sadar  District- Muzaffarpur……………….Complainant

V/S

1. Managing Director Tata AIA  life insurance company limited Delphi- B.Wing,  second floor Orchard avenue Hiranandni business  park, pawai Mumbai-  400076.

 

2. Zonal operation head East zone TATA, AIA life insurance company limited 5^th  floor Chowringhee court -55 Chowringhee road Calcutta- 700071.

 

3. The Branch Manager TATA AIA life insurance company limited. Second floor om  Shanti complex Jila school road Muzaffarpur.

 

4. Miss Payal Chaudhari, Dauther of Shri- Narayan Chaudhari, North Bankesh chowk Chandbara…………………………………………… Opposite Party.

Date of order- 17-03-2015

                                                                                                  Present.

1. Shri Govind Prasad Singh

                                                                                           President,

       Consumer Forum Muzaffarpur

2.  Smt. Archana Singh- Member

        Consumer Forum Muzaffarpur

 

Advocate for complainant –Shri                                                   

Advocate for Opposite Party-Shri

 

Order

 

                     The complainant has filed this case on 07-02-2013 for claim of Rs. 1,5,0000/- ( One lakh five thousand only).  Including the premium with held by the company Rs. 50,000/- (Fifty thousand only),   for physical and mental harassment Rs. 25,000/- (Twenty Five thousand only), for financial loss Rs.20,000/- (Twenty thousand only) and cost of litigation Rs. 10,000/- (Ten Thousand only).

            The ground of claim appears from complaint petition as well as schedule written brief  of complaint  that complainant  has purchase an insurance policy from the opposite party through its agent O.P.No. – 4 under the allurement and accordingly he had paid cheque of Rs. 50,000/- on 20.11.2009 bearing no. – 902413 which was acknowledged by him that the cheque was incashed by the company. After laps of sometime when he had not received any policy document he contacted the opposite party No. -4 who gave uncertain reply, then the complainant wrote a letter dated 10-02-2010 and 16-07-2010 to the opposite party no. -2. After hectic search he found some torn pages of policy document from O.P.No.-4 from which he came to know that his policy number is U125669533 accordingly  he persuaded the matter by writing a letter  to the company on 04-01-2012 for delivery of duplicate policy paper, as such the local Muzaffarpur Branch,  delivered duplicate policy document on 02-03-2012. After going through the policy paper he found that his signature has been forged on several pages accordingly he contacted to the local branch, office showing the anomaly in policy document and requested  for cancellation of policy but they showed their inability and direct him to contact the higher office accordingly he written a letter dated 17-03-2012 to the o.p. no.-2 Zonal operation head East Zone, Calcutta which was not replied to him. He again and again written to authority concerned but not replied. He has further alleged that original document was delivered directly to the agent. When no reply was received  by him from the opposite party he has send the legal notice on 06-05-2012. Which was replied belatedly on 31-07-2012 and the company has denied to cancel the policies after that he wrote to insurance ombudsman Calcutta on 09-10-2012 and 16-11-2012 with request to direct the company to refund his premium amount along with interest but no action was taken and nothing is pending  before them. As such in the aforesaid circumstance it clearly shows that the company is liable for deficiency of service since the complainant has invested the money believing good services but the company knowingly kept mum and need not replied resulting in lapse of time the company did not bauther to enquiry  into forgery as alleged by any expert or at their own level  as such the complainant has suffered total loss of Rs. 1,5,0000/- (One lakh five thousand only) and accordingly he claimed the compensation amount with interest. The said fact has been supported by affidavit dated 07-02-2013.

            In this case opposite party no- 1,2 and 3 have appeared and filed their written statement  on 27-06-2013 denying all the facts and alleged that the complainant case is against the norms, terms, conditions of the company as well as policy taken by the complainant and has alleged that the company has never misleaded  allured the complainant to purchase his policy but the complainant himself had voluntarily filled up the proposal form singed it, offered  a model  premium  of Rs. 50,000/- only to be paid annual towards the premium under the such policy “TATA AIG LIFE INVEST ASSURE GOLD” after with fall understanding of all terms conditions which was duly explained to him, he has provided the relevant document for issuance of policy such as copy of Pan card, copy of election I.D., copy of authority letter by which he authorizes Mr. Ajay Kumar  to receive his policy document by his authority letter dated 02-03-2012 as well as copy of driving license of said Ajay Kumar which have been attached   with the written statement the company has never allured him as such the complainant  is bound to go through the terms conditions and now stopped to challenge against the terms and conditions. The opposite party has issued the policy bearing no.U-125669533 with the commencing dated 26-11-2009 thereafter the policy document along with the schedule and the standard terms and conditions there too and the welcome letter was sent to the policy holder, it was duly delivered to the address of the complainant. He has further submitted that it is clearly mention that if the policy document is not delivered or receive by the life  assure in 45 days from the date of application form, the life assured (policy holder) to contract the company, however the complainant has never contacted the opposite party in the past after expiry of 45 days,  for the first time he has approached on 02-02-2012 to the opposite party for issuance of duplicate policy document and insisted the opposite party with an indemnity bond on the stamp paper of Rs. 200/- and limited a charge of Rs. 250/- for issuance of duplicate policy document accordingly the duplicate policy document was handed over to the complainant on 03-03-2012. The opposite party has further alleged that on one hand the complainant has not paid due premium under the said policy despite of reminder notices sent to him and now he is leveling allegations, on false and fabricated with concocted ground  to take advantage of his wrong. After that on 04-04-2012 the complainant approach the opposite party with false, forged and concocted ground requested to cancel the said policy. The complainant was duly informed that since the request for cancellation of policy is beyond the free look period and that too after the lapse of more than 2 years, hence request cannot be processed there is no any negligence on the part of opposite party in dealing with the policy or with the policy holder. It has been further submitted that as the contact  of insurance is contact of Uberime fide  and was provided their services with covering the risk of life of the policy holder complainant from the date of commencement of the policy and as such the complainant  is estopped from challenging the contents  at such belated stage. The complainant has not came with clean hand and has misrepresent this forum by twisting the facts which is nothing but abuse of process of law. Opposite party has further submitted  that since  the premium amount due for 25-11-2010 has not been received by the opposite part. The opposite party by his letter dated 25-02-2013 the intimated the complainant about auto surrender as per the policy terms and conditions the terms was provided “after payment of at least 3 years regular premium” the policy will be maintained in  force and the policy charges and any other cost will be pay as due by deduction on units at unit price from the total fund value of the policy under the conditions, the total fund value is in commencing  to cover the policy charges and cost payable, surrender value, false  below amount equivalent to one annual regular premium or two years from the due date  of first on paid regular premium,  unless receipt of written request to continue estopped to the other conditions laying for the policy, as such the case of the complainant is false, malicious, incorrect, malafide and is an attempt to take undue advantage and the complainant has no valid cause of action to file the case, which is based on mere  surmises and conjecture which cannot be invoked by law.   

            The opposite party has further submitted that as per protection of policy holder interest regulations 2002, police terms and conditions specially provides for free look period up to 15 days, during which period the policy holder is entitled to review the policy terms and conditions and request for his cancellation if dissatisfied with the terms and conditions policy. This term and condition was duly incorporated  by the opposite party in the terms and conditions  of extant plan taken by the complainant  if any for forgery appears before him it should not be adjudicated  by  this forum but it can be adjudicated  by competent court and competent jurisdiction that civil court the opposite party has attached the copy of proposal form as annexure-1 with the written statement he has further annexed the copy of cover sheet and policy information as annexure-2. In the November,2010 policy was due for renewal premium due date 25-11-2010 and the same was intimated to the complainant vide premium payment notice dated 26-10-2010 but despite the notice the complainant has failed to pay the premium hence the opposite party has issued lapse notice on 26-12-2010 stating therein, in case the complainant wish to reinstate policy he is required to remit (a) all the outstanding premium plus interest as applicable and(b) beyond 180 days after premium dues date kindly also provide with a duly filled health certificate in the format as satisfied by TATA-AIG the copy of letters or annexed as annexure no.-3. It is him to note that since the complainant has failed to make the subsequent premium even after reminder premium notice therefore the policy was lapsed  on 26-12-2010 but for the first time on 02-02-2012. The complainant has approached to the opposite party as mentioned about. In view aforesaid fact the opposite party has issued a cheque bearing no. 994749 dated 06-02-2013 for Rs. 5616 towards the surrender value being full and final settlement of all claims and it was informed that the opposite party will stand discharge of all its further liabilities. On the aforesaid facts the opposite party has prayed to dismiss the case with cost.

            The complainant has filed Xerox copy of several letters which are dated 10-02-2010 regarding the now receipt of policy paper reminder dated 16-07-2010 as annexure- 1and 2, including its courier receipt annexure –B dated 13-03-2012 regarding cancellation  of police annexure © legal notice dated 06-05-12 annexure (D) reply of legal notice send by the opposite party dated 31-07-2012 annexure- (D-1) dated 31-08-2012 for cancellation of police annexure-(D-2) application send to the office of the insurance ombudsman with its courier receipt annexure (D-3) dated 10-11-2012. Send by Dr. Karuna Ojha  to the ombudsman Calcutta with request to take suitable action so that send  may get the premium amount deposited in her policies within 3 weeks (it is not relevant for this case) the further Xerox copy of letter dated 14-02-2013 for closer of his complaint dated 31-08-2012 regarding his policy indorse to the secretary ombudsman Xerox copy of letter dated 07-02-2012 issued by the opposite party, duplicate policy information page and duplicate papers of policy including the application form. The complainant has also filed rejoinder against the written statement filed by the opposite party no. 1,2 and 3 mentioning therein that the company has committed deficient in service  as it has acted in violation of provisions of law because the policy document was sent directly to the agent who gave term policy to the complainant after long time and too by intervention of police nothing new has been alleged in his rejoinder.

            The complainant has filed copy on letter with copy of cheque for Rs. 5616.10/- that he has not accepted and he has returned the cheque to the company.

            The opposite party has submitted the affidavit as his evidence by his legal manager Mr. Rahul  Dhanautia in support of his case.

            Her both the parties perused the record