Order-20.
Date-19/04/2016.
In this complaint Complainant Juthika Debnath by filing this complaint has submitted that ops are the insurance company and complainant is a bonafide consumer of the op within the meaning of C.P. Act, 1986 and op by appointing corporate agent used to convince public at large that they offered the best policy better than the other insurance sector.
Sometime in the month of March, 2013 the op nos. 1 & 3 tried to convince the complainant there was an attractive offer for this complainant and also stated that the policy in question was recently launched by the op Insurance Company, but complainant did not give any importance about the said call.But they (O.Ps.) tried to convince that policy in question as it is a ‘one term policy’ and here is not the end of the said O.Ps. they also stated that if complainant avoided the policy in question by paying of Rs.99,900/- in that event she will be eligible and can get much benefit and realized that it is the best policy i.e. ‘one term policy’.So, being convinced by the ops’, complainant thought that it was fit for her and complainant will have no headache for giving premium from time to time and as a result of which complainant as per assurance of the ops’ agent, ultimately took the policy being Policy No.876925140 and the plan name of the said policy was Money Back and date of commencement of the said policy was 12/03/2013 with a hope that she shall have to get benefit.
But on 20/04/2013 complainant suddenly received the questioned policy and unfortunate complainant is not so educated so with the help of one family member went through and came to know the content of the policy in question and after hearing, complainant was astonished and practically perturbed observing the fact that the policy in question is not at all one time policy and in the head of Polity Term it was detected that the policy terms of the said policy in question was for 10 years and regular premium shall have to be paid of Rs. 99,900/- per year for 6 years..
On perusal of the said policy, this innocent complainant was literally perplexed that there was discrepancy on the said policy from which it was evident that everything was intentional and on seeing the same complainant totally broke down mentally and physically and realized that ops totally misguided and cheated this complainant by mis-selling the product.
Thereafter complainant contacted ops and requested to refund hard earned money back on 24/04/2013 that is within free look period and O.Ps. assured that they shall refund after 15 days.
In reply ops practically stated nothing but to give assurance that they valued the complainant association and hope to resolve his complaint to the best of its satisfaction but in fact in reality ops did nothing.When all the efforts of the complainant went in vain inspite of several contracts to the official of ops, ops neglected to perform it and lastly sent a letter on 10/04/2015 and complainant received one letter from the op which was practically mysterious to complainant as contents of the letter was hazy and by way of letter ops refused the request of the complainant for cancellation of the policy and refund of the amount and practically due to mis-sell and misconduct and deceitful manner of trade, complainant has suffered much pain, agony, anxiety, unnecessary harassment and for not refunding of the same amount, complainant suffered huge loss for the misconduct, mis-sell in negligent and deficient manner of service, complainant prayed for deposit the amount by cancelling the said policy and also for compensation for harassment, anxiety etc.
On the other hand op nos. 1 & 2 by filing written statement submitted that there is no negligence and deficiency in service whatsoever on the part of the ops in dealing with the concerned policy when complainant neither raised any objection within the Free Look Period though he received the policy document nor complainant never reported any query at the time of getting Welcome call made by the op before or after issuance of the policy and now in order to harass the ops has filed a false and frivolous complaint.
It is specifically mentioned that complainant completely understood the terms and condition of the insurance product voluntarily applied for an Insurance Policy vide Proposal Form bearing no. 876925140 and complainant signed by paying of Rs.99,900/- on 12/03/2013 as premium agreed to pay for six years and the Coverage Term is also 10 years and complainant after understanding all the terms and conditions which was duly explained to him, signed the Proposal Form and thereafter he received the policy document but prayed for cancellation within the free look period and complainant took the policy after completely understanding the terms and condition of the same content of the proposal form which was also explained to the complainant in his vernacular language as can be seen on the proposal form and complainant took the policy being satisfied with the terms and condition of the policy.
Thereafter op issued a policy bearing no.876925140 having commencement date 12/03/2013 and sent the policy documents which complainant received.But thereafter op also made Welcome Call to complainant, however best reason known to the complainant that he did not attend the call and as per IRDA Rules, complainant had his scope to cancel the said product within 15 days of receipt of policy bond (Free Look Period).But complainant did not opt for which complainant is not entitled to any relief and complainant is estopped challenging the terms and conditions of the policy and not only that complainant filed two applications and purchased policy by sending it.
So, it is clear that complainant purchased it knowing fully well with the terms and conditions of the policy and thereafter he was satisfied knowing fully well of the benefit of the policy.In the above circumstances, this complaint should be dismissed.
O.P. No.-3 Agent Bank by submitting W.V. submitted that they only sold the same but there is no contract in between complainant and O.P. No.-3.
Decision with reasons
On an in depth study of the complaint and written version and also hearing the arguments as advanced by the Ld. Lawyers of both the parties, it is found that complainant prior to purchase of the policy never went to Branch Office of Kolkata of op and there was no talk in between the complainant and Branch Office sent at Kolkata.On the contrary from the complaint, it is found that the company O.P. Nos.-1 and 3 invariably allured the complainant by stating that it is single premium policy on payment of one premium.Complainant was not reported to pay further premium and policy shall continue and against that policy, complainant shall have to get such benefit and invariably considering the financial condition of the complainant, complainant relied upon the assurance as made by the O.Ps. and no doubt the agent of different private insurance companies’ are loitering at the doors of customers for purchasing the product of said insurance company like the op and all over West Bengal being allured lakhs of people in such a manner were allured to open policies in the name of different customers and by adopting such procedure the ops present agents allured the complainant and complainant as a villager failed to realise the fate of the policy and the terms and conditions of the policy and in such a manner this policy was sold by the agents and in fact claim of the op that op talked with the complainant about submission of application for purchasing the policy etc. which is completely false and fabricated.On the ground there is no phone or mobile of complainant and there is no mobile or phone number.Then how the op Branch Manager and their men talked with the complainant and it is found a false story of the op and this is the common defence in all cases as so many cases are filed in this Forum and all the cases have been allowed and ultimately they have refunded the amount.
In this particular case it is proved that at any point of time before the accepting the application for purchasing the policy, op or their men never talked with them and never collected any consent from the complainant to satisfy the op that complainant realized the contained terms and conditions of the policy and he is liable to pay premium etc.But in the defence the op has tried to say that they made call and talked with the complainant is completely false and fabricated.
Truth is that ops’ office is situated at Kolkata and they are continuing such sort of deceitful manner of trade staying in cool chamber but dishonest agents are spreaded all over India in the rural villages and they are collecting one premium and telling that one premium is sufficient and in such a manner the Insurance Company has been increasing their capital and that is their business and op knows very well that so called insured has purchased those product for their need but unable to pay such a huge amount at a time per year.
At the same time private insurance companies are very much reluctant to satisfy about the actual financial condition of the insured and insured shall be able to pay the yearly premium or not whether the insured has accepted to pay it.But it is only business tactics to collect one premium because they are well known that the insured cannot be paid further premium and that deposit is forfeited by the Insurance Company and their capital shall be increased and in this regard very world famous Nobel Laureate John Tielero seriously observed that insurance company in the field are deceiving the poorer section of people by their agent and corporate agent knowing fully well that the said insured has not accepted to pay further amount and in the present case ops have adopted that deceitful manner of trade by engaging dishonest cheat agent and they are loitering and collecting premium by alluring insured and in the present case no doubt their agent mis-sold this product that complainant shall get benefit of loan if one time policy by paying single premium, they purchased a policy, in that case they shall not get loan.
In the present case it is clear that complainant was deceived by the agent and it is no doubt a mis-sale because we have gathered that complainant is not an income tax payee and she has no such income to pay Rs.99,900/- per year.Probably many government officers having their monthly income of Rs. 50,000/- have their no capacity to purchase such a policy one after another and we are very much aware of the fact many high government officials have no such policy against payment of Rs.99,900/- per year and for other mis-sold policies.
Another factor is that op has failed to prove by producing any document or evidence that complainant’s income is so high that he has her capacity to pay Rs.99,900/- along with other payment of the policy per year as premium and it can be continued for 6 years.On the contrary after considering the materials it is found that complainant is not an income tax payee, she has no income to pay Rs.99,900/- per year for continuous 6 years and truth is that she is a very poor housewife and at her house complainant was allured by the ops’ men and they did everything, even the application form was also filled up by O.P. No.-3 and no doubt O.P. No.-3 who appointed as corporate agent of the op-1.But ops have not denied the allegation as made against its agent and about poor income of the complainant and about the mis-sale of the product, because ops are well aware of the fact that already the policy is lapsed.
So, they are not willing to pay the amount and refused.But fact remains that as and when complainant realized about the entire contents, they forthwith reported to the O.P. but the they somehow or otherwise misled her when complainant went to the ops, but ops did not bother to refund rather they tried to show that it was not mis-sold.But no doubt it is a mis-sale and another factor is that application form was not in Bengali language and it is in English form and it was filled by agent the dishonest and cheat agent of the op and collecting some material that O.P. No.-3 submitted the same and there is connivance in between the agent and op Insurance Company for which op is silent about O.P.-3’s activities and their misconduct and about the mis-sale.
Moreover after considering the materials, documents it is found that complainant is a poor housewife, somehow passed her days and somehow she collected some amount what she tried to invest for the purpose of future improvement and realizing that this is onetime payment of insurance and if complainant would be aware of the fact, if she purchases that policy she shall be burdened with huge yearly amount, in that case invariably she must not have to purchase it, not even any idiot shall proceed to purchase. Moreover, it is found that within free look period it was prayed for cancellation.
But truth is that complainant is made an idiot at the hand of the agent of the op for overall mis-sale, misconduct, misrepresentation of the agent of the op, complainant was deceived and in fact overall evaluation of the materials, we are convinced that complainant was allured by the ops’ agent and she mis-sold but he failed to realise the future of that policy as that was not disclosed.
In the light of the above observation and also considering the IRDA guideline we are convinced to hold that the policy is lapsed and as per IRDA guideline, it is the duty of the insurance company to refund the entire deposited amount if it lapsed after deducting 5 to 10 percent as service charge, but that has not been followed and it shall not be followed only for the purpose for grabbing the money as the policy is lapsed and by that way the dishonest insurance company have already procured a huge capital, but their purpose for selling insurance policy to the poorer section of people is completely fake trade.
In this context we want to say that 74 percent people in India out of 120 crores of people are not only poor but they are below poverty line and out of the balance people out of 120 crores of people, 25 percent people are very poor and complainant comes under the purview of that 26 percent people and her monthly income is within the range of Rs.10,000/-.Then how such a person can pay yearly premium of Rs.99,900/- with other payments.Op has tried to say that he verified the income of the complainant.But no such document is produced by the op, no such document was collected by the op to show that complainant has his good income to pay it but no such document is produced that the complainant has his huge amount deposited in savings or fixed deposit.
So, considering all the above fact, we are convinced that the present complainant is a poor housewife having her income of Rs. 10,000/- and that her income is yearly of Rs. 1,20,000/-. Even an idiot cannot believe that a person having her income yearly Rs. 1,20,000/- is able to pay Rs.99,900/- with other amount per year as premium.But no doubt complainant deposited Rs. 99,900/- that is hard earned money which was accumulated after long years’ collection and complainant thought that by depositing the same for one time against policy she shall have to get benefit and at the same time she was convinced that she shall get hefty money after 10 years but all are hoax of the agent.
Truth is that this op in so many cases was compelled to refund the same even after contesting up to State Commission and also National Commission and they have complied this order before this Forum.When they already got such order why they have not followed that principle as already laid down by the State Commission and National Commission.But it simply proves that they have no intention to pay, their only intention is to grab money and by grabbing money op has been increasing their capital.Grabbing of money by the op is their only trade for which in West Bengal their business is going to be closed and their products are not being sold and that is the position of the insurance company in West Bengal.
Similar fate is found in respect of other private insurance companies like Chholo Mondalam Life Insurance, Sun Life Insurance, Reliance Life Insurance and other private insurance companies only for their such sort of deceitful manner of trade for mis-selling the product to the poorer insured.
In the light of the above observation and considering the above materials, we are convinced to hold that there is sufficient ground to believe that the item/product was mis-sold by the cheat agent of the op and at ops’ instance, but op has failed to prove the financial condition of the complainant and also has failed to prove that before accepting the proposal though agent, they talked with the complainant or they received the consent form as per IRDA guideline, no such consent form is produced by the op that complainant submitted a consent for purchasing their product and op specifically then informed the complainant that they are accepting and for the above reasons, we are convinced that there is no such ground to disbelieve that the negligence and deficiency are on the part of the ops and by mis-sale of item or product to the complainant and by deceiving the complainant and taking chance of their simplicity and lack of knowledge ops managed to deceive the complainant and truth is that complainant has been deceived by the op for which complaint succeeds.
Hence, it is
ORDERED
That the complaint be and the same is allowed on contest with cost of Rs. 2,000/- against ops.
Ops are hereby directed to refund the entire deposited premium amount of Rs.99,900/- after deducting 5 percent as service charge and also shall have to pay a sum of Rs.4,000/- for harassing the complainant in such a manner and for mis-selling the articles/products and accordingly ops jointly and severally shall have to pay the entire decretal amount within one month from the date of this order, failing which for non compliance of Forum’s order, ops jointly and severally shall have to pay penal damages at the rate of Rs. 2,000/- per month till full satisfaction of the decree.
Even if it is found that ops are reluctant to comply this order, in that case, penal action shall be started u/s 25 read with Section 27 of C.P. Act, 1986 shall be started against the ops for which further penalty and fine shall be imposed upon ops.
