Karnataka

Kolar

CC/114/2023

Sri.Chetan Chowdappa M.A - Complainant(s)

Versus

Max Life Insurance Co Ltd - Opp.Party(s)

Sri.Chetan Chowdappa M.A

30 Aug 2024

ORDER

 

BEFORE THE KOLAR DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, OLD D.C. OFFICE PREMISES, KOLAR – 563 101.

 

Dated:30^th DAY OF AUGUST 2024

 

Present:-  1) Sri. Y.S. Thammanna. B.Sc., LL.B…..PRESIDENT

                 2) Sri. Raju. K.S., B.Sc., LL.M., PGDCLP…MEMBER

CONSUMER COMPLAINT NO:114/2023

 

COMPLAINANT/S  :-       Sri. Chetan Chowdappa M.A.

                                                   S/o. Late Ajjappa,

                                                   Aged about 38 years,

     R/o at 5^th Cross,

    Gowripet,

     Kolar Town,

    Kolar.

 

                                     (Rep. by Smt. Bhuvana K.S.. Advocate)

 

-V/s-

 

OPPOSITE PARTIES    :-   1)  Max Life Insurance Co.Ltd.,

    Office address: 11^th Floor,

    DLF square, Jacaranda Marg,

    DLF City Phase II,

    Gurugram(Haryana)-122002.

 

                                                    2)  Max Life Insurance Co.Ltd.,

    Registered Office Address:#419,

    Bhai Mohan Singh Nagar,

    Railmajra, Tehsil Balachaur,

    Nawanshahr District,

    Punjab-144533.

 

                                                    3)  Max Life Insurance Co.Ltd.,

    Office Address:#70&71/1,

    4^th Floor, Vimal Chambers,

    MG Road, Bangalore-560001.

( Rep. by Sri. B.Kumar. M.A.. Advocate for OP.No.1 to 3)

 

                                              

Date of Filing of Complaint	26/07/2023
Date of Issue Notice	31/07/2023
Date of Order	30/08/2024
Duration of Proceedings	01 Year 01 Month 04 Days

 

 

 

 

Judgment by

Sri. Raju. K.S. Member

 

1. The complainant filed this complaint U/s 35 of the CP Act 2019 seeking for a direction to refund the insurance policy amount of Rs. 2,10,906/- by canceling the policy availed and for the relief of compensation of             Rs. 25,00,000/- from the Ops.

 

2. Due to inducement of one Ravi kiran and Manjunath claims to be  agent/representatives of the  ops Kolar branch has availed Max Life Smart Wealth  Insurance Policy bearing No. 348810672 on 10.01.2022 by paying Rs. 2,04,500/- to the OP.No.3 who is branch of OP.No.1 & 2.  At the time of availing the Insurance policy the representatives of the OP.No.3 has misguided about the policy details and made forced to buy Insurance policy by the complainant.  In the policy the sum assured at the time of death of the insured is Rs. 22,00,000/- and sum assured on maturity is Rs. 16,82,793.44/-.  Further the policy term is 38 years and the complainant has to pay annual premium of                  Rs. 2,00,000/- up to 8 years.  Further the policy included Max Life critical illness and the disability rider for               Rs. 5,00,000/- assured amount.  For the critical illness policy the complainant has to pay Rs. 1,905.70/- annual premium.

 

3. Unsatisfied with the benefits of the policy after availing by the complainant, the complainant immediately informed to the agent/representative of the OP Ravi Kiran towards Non-continuation of the policy and asked the OP officials to clarify the doubts about the policy.  The complainant has made this intimation by whatsapp number of OP representative as well as through E-mail.  Inspite of request made by the complainant towards his non-continuation of policy within Free-Look period, the OPs has failed to satisfy with the conditions of the policy suitable to the complainant.  Instead of that, OPs has dodged the issue without fruitful solution.  The complainant has made number of communications to the OPs representatives through E-mail as well as whatsapp chats.  The OPs have failed to explain the details of the Insurance Policy availed by the complainant and also failed to satisfy the benefits and conditions of the policy to the complainant.  Further the Ops misused the ECS given by the complainant and illegally transferred Rs. 55,729.54/- from the complainant account on 05.05.2023 without knowledge of complainant.  This illegal debit of Rs. 55,729.54/- by changing the mode of payment behind back of the complainant. 

 

4. Further the complainant has issued legal notice dated:13.04.2023 towards non-continuation of the Insurance Policy availed.  Inspite of receiving the legal notice the Ops failed to solve the issue till today and liable to the complainant under deficiency of service.   Till today the Ops neither cancelled the policy nor refund amount of               Rs. 2,10,906/-.  Hence this complaint for refund of money as prayed for.

 

5. After serving of notice by this Commission the OP.No.1 to 3 appeared through their counsel and filed their version by resisting the claim of the complainant.  Further the Ops took specific contention that, the complainant has availed Insurance service i.e Insurance Policy through their company agents “Ravi Kiran” and “Sikhandhara Pasha”.  The above said agents are necessary parties to the proceedings and this complaint is to be dismissed for non-joinder of necessary parties.  Further the Ops coated the citation of Hon’ble National Commission in Revision Petition No.634/2012 Srikanth Murlidhar Apte Vs Life Insurance  Corporation of India dated: 02.05.2013 in which the Hon’ble Apex Commission has held that, “the insurance agent is a facilitator between the insurance company and the prospective policy holder, he is an agent of consumer as well as Insurance company.  He is not exclusive agent of Insurance Company.  Moreover, he cannot bind the Insurance Company if he gives quotations of any policy at lesser monthly or yearly premium than prescribed by the under writing Insurance Company”.

 

6. Further, the OP took specific contention that, the proposer/complainant has duly submitted his documents after getting full knowledge about the premium, mode, period of policy, sum assured on maturity, policy terms and conditions etc.  Being an advocate the complainant has got knowledge about the policy and submitted proposal form to the Ops by giving assent to obtain the subject policy.  Further the complainant has to review the above subject policy within Free-look period and premium factor within the said period.  Failed to review the subject policy within Free-Look period the complainant cannot entitled any relief as sought for.

 

7. Further the subject policy availed by the complainant is lapsed due to non-payment of further premium and the complainant is not entitle any benefits under the said policy.  The Ops has not made any deficiency of service as alleged by the complainant and the complainant not entitle any relief from this Commission and prayed to dismiss the complaint with cost.

 

 

 

8. In support of claim of the complainant, complainant has filed affidavit in lieu of chief examination with documents.  OP.No.1 to 3 representatives one Aman Agarwal has filed affidavit in lieu of Chief Examination along with documents.

 

9.  Both complainant and OP.No.1 to 3 has submitted their respective arguments.  The points that would be arised for our consideration are as follows:-

 

1. Whether the complainant has proved the deficiency of service by the Ops?
2. Whether the complainant is entitle for the relief as sought for?
3. What order?

Our findings on the aforesaid points are as follows:-

1. Point No.1 :-     Affirmative.
2. Point No.2 :-     Partly Affirmative.
3. Point No.3 :-     As per the final order.

 

     REASONS

 

10. POINT NO. 1 :-   Before going to discuss on merits in this complaint , the complainant has filed an application for impleading the proposed OP.No.4 to 7.  This Commission has dismissed impleading the OP.No.4 & 5 vide its order dated: 27.10.2023.  Further the impleading of proposed OP.No.6 has dismissed vide its order date:28.05.2024.  With regard to proposed OP.No.7 the notice has been served through whatsapp messages as filed by the complainant through memo dated: 18.04.2024.  No further steps has been taken towards proposed OP.No.7 and he placed exparte.  Thereafter this complaint against OP.No.7 has dismissed on 29.08.2024 as per request of complainant’s memo dated: 29.08.2024.
11. In this complaint there is no dispute with regard to the availing of Insurance Policy by the complainant from the OP.NO.1 to 3 under name “Max Life Smart Wealth Income Plan (UIN-104N120V01) under policy No.348810672 dated: 10.01.2022 by paying Rs. 2,04,500/-.  The sum assured under this policy is Rs. 22,00,000/- in the event of death, and the sum assured on maturity is                             Rs. 16,82,793.44/-.  The premium term is 8 years and policy term is 38 years.  Further the complainant agreed to pay             Rs. 2,00,000/- annual premium for 8 years.  Further the above said policy is assured under Max Life critical illness and disability rider for Rs. 5,00,000/- with annualized premium of Rs. 1,615/-.

 

12. The complainant main allegation is that, due to inducement and wrong statistics given with regard to benefits under the policy given by the agents of OP.No.1 to 3 he had been forced to purchase the subject policy.   After got the policy with detailed terms and conditions complainant realized wrong suggestions had been made by the agents/officials of the OP.No.1 to 3.  Immediately on 11.01.2022 the complainant communicated his dissatisfaction with the policy benefits and mode of payment, premium and such other things through whatsapp communications to the OP.No.1 to 3 authorized persons.   He expressed his willingness towards non-continuation of the subject policy unless clear the doubts by the OP.No.1 to 3.  The OP.No.1 to 3 agents/representatives dodged the quires of the complainant by sending recorded statements.  When the representatives of OP.No.1 to 3 are failed to satisfy the complainant quires than the complainant has sent his willingness towards non-continuation of the subject policy through E-mail dated: 09.01.2023, 10.01.2023, 20.01.2023, to the service help desk, Nodal Officer, Manager Services of the OP.No.1 to 3.  In addition to that, the complainant has made number of communication through E-mail and whatsapp chats to the OP.No.1 to 3 for cancellation of subject policy and seeking for refund of the money of                Rs. 2,10,906/-paid.

 

13.  On the other hand, the OP.No1 to 3 has took specific contentions in their version that, if the complainant having any doubts with regard to the policy terms and conditions he having Free-Look Period of 15 days.  If the complainant approached within 15 days certainly the OP.No.l to 3 has clarify the conditions and terms of the subject policy.  Further if the complainant having dissatisfaction with the conditions of the policy he having right to non-continuation by cancelling the subject policy within Free-Look period.

 

14.  Further the OP.No.1 to 3 has specifically stated in their version that, the communication made to the agents of the OP.No.1 to 3 is not valid in view of the Hon’ble NCDRC Order in Revision Petition No. 634/2012 in Srikanth Murlidar Apte Vs Life Insurance Corporation of India dated: 02.05.2013.  In this citation the Hon’ble Apex Commission has held that, the insurance agent is a facilitator between the insurance company and prospective policy holder.  Further the OP has specified that, the agent of Insurance Company simultaneously agent of consumer and he is not exclusive agent of Insurance Company.  Further the Insurance Company is not responsible for any wrong quotation for lesser premium and higher benefits.

 

 

 

15. The contention of the Insurance Company with regard to the communication made to the agent is not authorized and cannot be considerable is not at all acceptable.  In this specific complaint, the complainant has made whatsapp conversation to the one Mr. Ravi Kiran Agent Adviser/principle officer specified person, and expressed his unsatisfaction with the subject policy conditions and his willingness towards not to continue with the subject policy and made request to cancel. Instead to cancelling or modify the subject policy the ops has continued with the policy and even without consent of the complainant modify the mode of payment and got  illegal credit of Rs. 55,729.54 on  05.05.2023 without knowledge of complainant.   The above said Ravi kiran name is specifically mentioned in the page no.13 of policy copy with declaration. In the above said declaration the said Ravi kiran  categorically declared that he satisfactorily explained the terms and conditions of the subject policy and obtained assent from the complainant and his designation mentioned as Principal officer with specific code as 834054.

 

16. The OP.NO.1 to 3 contentions that, the complainant has made communication to the Agent and not with the OPS towards non-continuation of the policy within Free-look period. This contention of the OP.No.1 to 3 is not at all sustainable.  That the complainant has made communication to the ops authorized person immediately on 11.01.2022 i.e., the very next date of obtaining the policy details and within Free-look period. Thereafter, the complainant has made number of communications with        E-mail and whatsapp chats. The above said Ravi Kiran having bounded duty to communicate the complainant wish immediately to the Ops.  The said Ravi Kiran being the responsible person having responsibility to satisfy the customers on behalf of OP.No.1 to 3 after availing the subject policy.  The above said Ravi Kiran having designation of authorized person as mentioned in the subject policy copy and he having bounded and duty to give service after availing the policy by the complainant.  For any misrepresentation of Ravi Kiran or other staffs of OP.No.1 to 3, the OP.No.1 to 3 are held responsible since they have direct nexus with them. Instead of effectively solving the issue the op no.1 to 3 have dodged the issue and prolonged to till today.  As per policy documents the above said Ravi Kiran is not only agent but authorized person of OP.No.1 to 3.  The OP.No.1 to 3 simply washing their hands by directing liability towards the agent Ravi Kiran or Axis Bank.  Since the said Ravi Kiran is the authorized person and any communication made by the complainant towards cancellation of the subject policy is authorized one.  In the above circumstances the OP.No.1 to 3 having liability towards refund of the subject policy amount received. 

 

17. OP.No.1 to 3 did not initiated any action towards communication made by the complainant with regard to termination of the policy and refund of amount paid.  Even number of E-mail and whatsapp conversations are made between complainant and OP.No.1 to 3.  The OP.No.1 to 3 did not find out fruitful solution towards this issue.  Even after receiving the E-mail and whatsapp chats the OP.No.1 to 3 have illegally deducted Rs. 55,729.54 on 05.05.2023 from complainant account without any intimation by misusing ECS facility by modifying premium amount themselves.  When complainant protested this action then the OP.No.1 to 3 refunded the above said Rs. 55,729.54 to the complainant.  This attitude of the OP.No.1 to 3 amounts to unfair trade practice under section 2(47) of C.P.Act 2019.  Thereby OP.No.1 to 3 are liable to the complainant.  The citations mentioned in the version did not helpful to the Ops and the said facts in citations are different from the present complaint.  Hence as discussed above OP.No.1 to 3 are liable to the complainant under deficiency of service and unfair trade practice.  Hence we fastened the liability of the OP.No.1 to 3 to the complainant towards refund of Rs. 2,04,500/- premium amount paid by the complainant and we answered Point No. 1 in Affirmative.

 

18. POINT NO.(2):-  In this complaint, the complainant seeks for refund of Rs. 2,10,906/- policy amount paid to the OP.No.1 to 3.  The complainant has paid Rs. 2,04,500/- premium amount to the Ops at the time of availing the subject policy.  The OP.No.1 to 3 has to pay       Rs. 2,04,500/- premium amount paid by the complainant with interest @ 9% P.a from the date of payment i.e. 10.01.2022 to till realization.  So for the relief sought by the complainant towards compensation is very high and abnormal.  In our view the complainant is entitle                 Rs. 10,000/- compensation for inconvenience and mental agony suffered.  In addition to that complainant is also entitle Rs. 5,000/- litigation cost.  Hence we answered Point No.2 Partly Affirmative.

 

19. POINT NO. (3):-   As discussed supra, for the foregoing reasons we proceed to pass the following:

ORDER

The complaint is hereby allowed in part. 

The OP.No.1 to 3 are hereby directed to pay jointly and severally Rs. 2,04,500/- to the complainant within 30 days of this order, with 9% interest P.a from 10.01.2022 to till realization.

 

The OP.No.1 to 3 are hereby directed to pay jointly and severally Rs. 10,000/- compensation for inconvenience and mental agony with Rs. 5,000/- litigation cost.  If the OP.No.1 to 3 has failed to comply the order within 30 days from the date of this order the above said Rs. 15,000/- carries interest @ 9% P.a to till realization.

In view of the above order if any Interlocutory Applications  pending are disposed off.

Supply free copy of this order to both the parties.

(Dictated to the Stenographer, typed by him, the transcript corrected, revised and then pronounced in the open Commission on 30^th day of August, 2024)

 

    ( Raju. K.S)                                                 (Y.S. Thammanna.)

        MEMBER                                                            PRESIDENT

 

:-ANNEXURE:-

 

List of documents filed by the complaint side:-

01	Copy of Policy-Max Life Smart Wealth Income Plan of its No.348810672.
02	Copy of Proposal form- Max Life Smart Wealth Income Plan of its No.348810672.
03	Copy of Illustration- Max Life Smart Wealth Income Plan of its No.348810672.
04	Copy of the mail to the Mac Life Insurance & its Employees.
05	Copy of the illegally change of premium payment of mode frequency.
06	Copy of the illegal debit of an amount of Rs. 55,729.54/-.
07	Copy of the legal notice issued to the respondents.
08	Copy of the Postal receipt.

 

List of documents filed by the Opposite Parties side:-

01	Policy copy with terms and conditions.

 

 

 

    ( Raju. K.S)                                                 (Y.S. Thammanna.)

        MEMBER                                                            PRESIDENT