DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, RAYAGADA
C.C. Case No.40/ 2015.
P R E S E N T .
Sri Pradeep Kumar Dash, LL.B, President.
Sri Gadadhara Sahu, B.Sc., Member.
Khusmal Naik,S/o Budhia Naik,Residdnt of village Sankarada, P.O.Sankarada, Via:Tikiri,P.S.Tikiri, Dist. Rayagada.
…….Complainant
Vrs.
1. M/s Abira Insurance Services Limited, Corporate Agent of Max New York Life Insurance Co. Ltd.,(MNYL) Regd.Office,S.B.Mansion,16,R.N.Mukharjee Road,Kolkata-700001.
2. Manager,Max New York Life Insurance Co. Ltd.,12th Floor, DLF Square, Jacaranda Marg, DLF Phase II,Gurgaon,122002.Regd.Office: Max House,3rd Floor,1 Dr. Jha Marg Okhala, New Delhi-110020.
…..…..Opp.Parties
Counsel for the parties:
For the complainant: In Person
For the O.p 1: Sri A.K.Lenka & Associate Advocate, Rayagada.
For the O.P 2: Sri S.K.Nayak & Associate Advocate, Rayagada.
JUDGMENT
The case of the complainant is that the agent of the O.ps has convinced the complainant and given assurance that if the policy amount is continuously paid for the years their insurance will continue and for such investment they will get profit every year and believing their version the complainant has paid the premium for three years @ Rs.6740/- i.e. for the year 2006,2007 and 2008 in total the complainant has paid Rs.20,220/-. When the complainant contacted the O.ps they stated that the said policy is not getting any yield and as such the complainant will get less amount. The agent of the O.p 1 has explained that after three years the complainant can take back the amount , so he has asked for return of the amount but out of the said sum the O.p is not refunding the entire amount butt only a part amount below 30% of the total sum was paid. It was promised by the O.ps that there will be no financial loss for such investment and the proposal form was not explained to the complainant and with a false promise they have taken the said policy. Hence the complainant prayed that the O.ps may be directed to refund the balance amount of Rs.20,220/- with interest and award monetary compensation for the mental agony and cost of litigation and such other relief as the forum deem fit and proper. Hence, this complaint.
The O.Ps appeared through their learned counsel and filed written version. It is submitted by the O.p 1 that the complainant obtained an insurance policy coverage from Max New York Life Insurance through the facilitation of Golden Trust Financial Service. The Stepping stones insurance plan introduced by Max New York Life Insurance Policy was a traditional policy duly approved by IRDA and on the face of the policy it has been explicitly mentioned about the terms and conditions of the surrender benefit. The O.P 1 facilitate the insured to get insurance policy from O.P2 and the certificate of insurance coverage was a contractual liability on the part of the insurer O.P 2 with the complainant. Under no circumstances the O.P 1 could be made liable for the same as the O.P 1 is not allowed to settle any insurance claim under the law as the O.P 1 can not play the role of an insurer. The O.P1 had facilitated the insured to get insurance policy from O.p 2 and the subject certificate of insurance coverage was a contractual liability on the part of the insurer of O.P 2 and the complainant. Under no circumstances the O.P 1 could be made liable for the same as the O.P 1 is not allowed to settle any insurance claim under the law. Hence, prayed to struck down their name from the petition of the complainant.
It is submitted by the O.P 2 that the policy was issued to the complainant based on the information duly filled and signed by the complainant and the policy documents including policy schedule and terms and conditions were dispatched to the address of the complainant on time and the same was delivered to the complainant. The complainant duly signed the proposal form and availed a life insurance policy vide Policy No.286109525 after going through the terms and conditions of the policy where in it was clearly mentioned that if the policy will be surrendered before maturity date then how much would be the surrender value for which year. The complainant stopped depositing the premium and due to non payment of renewal premium within the revival grace period the policy went into reduced paid up mode as per the terms and conditions of the policy.
It is further submitted by O.P 2 that the complainant has admitted the declaration para of the proposal form that he fully understands the terms and conditions of the policy as explained to him and then he opted for the policy of the choice. After a period of three years he complained about mis-selling of the policy which never raised in the initial years or within the free look period. He was well informed about the surrender clause ;and he never complained about this before the year 2009. The complainant was intimated about the renewal of his policy time and again but he intentionally stopped the payment of the premiums to lapse the policy. The complainant has made misconceived and baseless allegations of unfair trade practice without any documentary evidence in support of the allegations made in the complaint. The O.p 2 has not committed any deficiency of service or any unfair trade practice and therefore there is no reason for the complainant to undergo any physical, financial and mental loss and agony attributable to this Opp.Party. The complainant is not entitled to any relief as claimed by him and this case is liable to be dismissed on merit against the Opp.Party with exemplary cost.
It is the cardinal principle of insurance law that the insurer is in the position of a trustee as it is managing the common fund for and on behalf of the community of policy holders. It has to ensure that nobody is allowed to take undue advantage of the arrangement. That means the management of the insurance business requires care to prevent entry(into group) of people whose risks are not of the same kind as well as paying claims on losses that are not accidental. The Management of life insurance companies are required to keep this aspect in mind and make all its decisions in ways that benefit the community. This applies also to its investments. That is why successful insurance companies would not be found investing in speculative ventures. The life insurance policy is a contract, in terms of the Indian Contract Act. A contract is an agreement between two or more parties to do, or not do, so as to create a legally binding relationship. Here in this case the complainant was asked to pay the premium amount by the agent explaining the benefits contained therein and the entire proposal form was written by the agent in his own hand writing and asked the proposer/complainant to sign on the dotted lines. The declaration form filled in this case also written by the agent and obtained the signature thereon. The agent’s responsibility is clearly explained in the IRDA instructions and also U/s 182 and 212 of the Contract Act. Here the agent has failed to discharge the duty as an agent and in order to get his income as commission has falsely represented the rural folks to divert their money. Hence the O.p has clearly violated the norms issued by the IRDA from time to time and as such the O.P is liable to pay the amount paid as premium to the complainant. In this case the surrender value far below their amount deposited with the O.p. The investment is made by the O.ps for the profit and not by the insurer. Hence the advise given by the agent and obtaining a form wherein the risk factor is transferred in favour of the insurer’s is definitely coming under the purview of unfair trade practice.
When a rural folk invest the money with the assurance of the agent in the insurance and when she came to know that the above investment is not yielding any profit even after years and as such the above investment brought by the agent and accepted by the O.P is not with any intention to give any economic protection but with an intention to grab the money of the rural folks. Hence the plea of the O.ps can not be accepted.
In view of the discussion above, it is found to be an unfair trade practice made by the agent and O.Ps. The O.Ps have introduced the agent to do the unfair deal with the rural folk as seen from the counter and as such the complainant is entitled to get refund of the entire amount deposited by the complainant in the said scheme so as to enable them to invest the same with their choice.
We have gone through the complaint petition and documents available in the record. This forum by relying upon a citation passed by National Commission, New Delhi in the New India Assurance Co. Ltd., Versus M/s Sukhadham India Pvt. Ltd.,2011(1) CPR 191 such as :- “ Insurance Company must settle claim without delay”. In the light of the above decision of law we allow the case.
Hence it is ordered.
ORDER
In the result the complaint petition is allowed on contest. We ordered the O.ps to refund the entire amount of Rs.20,220/- and after deducting the part payment made by the O.P to the complainant and pay interest @ Rs.9% per annum on the entire amount from the date of respective deposit till realization.. We are further ordered to pay Rs.1,000/- towards cost. All the payment must be made through the Forum only.
The O.Ps are directed to make the aforesaid payment within 30 days from the date of receipt of this order failing which the complainant is at liberty to take further proceeding U/s 25 and 27 of the C.P.Act.6 under the seal and signature of this forum.
Pronounced in open forum today on this 19th day of September,2016 under the seal and signature of this forum.
A copy of this order as per the statutory requirements , be forwarded to the parties free of charge.
Member President
Documents relied upon:
By the complainant:
- Copy of premium receipts.
- Copy of first premium paid receipt along with copy of policy bond.
- Copy of proposal form .
By the O.Ps. Nil
President
