DIST. CONSUMER DISPUTES REDRESAL FORUM
NORTH 24 Pgs., BARASAT.
C. C. CASE NO. 106/2015
Date of Filing: Date of Admission Date of Disposal:
05.02.2015 12.02.2015 23.09.2015
PETITIONER = Vs. = O.Ps.
Sri Pradip Kumar Chowdhury 1. M/s. Aegon Religare Life Insurance
S/o. Late Prakash Chandra Chowdhury Company Limited
2nd floor of 19/28, building no-3, 3rd floor, Unit No-1,
Kshudiram Bose Sarani, Nesco IT Park, Western Express
near Shibkali Mandir, Highway, Goregoan (East),
Mall Road, Kolkata-700080. Mumbai-400063.
2. Mr. Manish Madan
Head Customer Service
M/s. Aegon Religare Life Insurance
Company Limited
building no-3, 3rd floor, Unit No-1,
Nesco IT Park, Western Express
Highway, Goregoan (East),
Mumbai-400063.
3. The Area Manager
M/s. Aegon Religare Life Insurance
Company Limited
5th floor of Andromeda Building
DD-30, Sector-I, Salt Lake City
P.S.-Bidhannagar (North),
Kolkata-700064.
4. Ms. Moumita Mondal
Relationship Manager
M/s. Aegon Religare Life Insurance
Company Limited
306A, P.K. Guha Road, 3rd Floor of
Tribeni Apartment, Airport-1
No Gate, Opp. To Milansangha Club
P.S.-Dum Dum, Kolkata-700028.
J U D G E M E N T
Facts of the case, in short, is that the complainant is being a senior citizen wanted to be an insured by making onetime payment to the OP No-1 through OP No-4, the Relationship Manager and the Agent of Aegon Religare Life Insurance Company Limited. Since the complainant had obtained an insurance policy with ICICI Prudential Life Insurance Company Limited through the present OP No-4 who earlier was engaged in the ICICI Prudential Life Insurance Company Limited as an agent. Due to nonpayment of dues premium such policy was lapsed but whatever deposit was lying with the ICICI Prudential Life Insurance Company Limited that was realized for investment in the Aegon Religare Life Insurance Company Limited for an one time premium paid policy and the said amount of Rs 25, 000/- was being deposited to the OP No-1 through the present OP No-4. For such system, after expiry of three years the complainant shall be eligible to obtain the amount of Rs 50, 000/- from the OP No-1 in the name of Mr. Pradip Kumar Chowdhury.
Complainant stated that name of the insured is Mrs. Papia Das, the daughter of the complainant, Mr. Pradip Chowdhury, instead of in the name of Mr. Pardip Chowdhury though the proposal for making insured duly filled in by the complainant Mr. Pradip Kumar Chowdhury only and in such replacement there was no information to the complainant from the OP No-1. Not only that when the complainant received the LIC policy in which the name of the insured is Mrs. Papia Das has been inserted like ghost related matter and the name of Mr. Pardip Kumar Chowdhury has been deleted by their will mode of payment was done through cheque no-316606 dated 16.08.2012 of United Bank of India, Central Hospital Branch, Assansol-713340 in the name of the complainant and it is impliedly deemed as the policy should be in the name of the complainant.
Complainant further stated that there was another wrong instituted in writing the spelling of the daughter’s name of the complainant which was wrongly written as Mrs. Papia Das instead of Mrs. Papia Das. Complainant was very much surprised that the name, which the complainant has never uttered to record in the LIC Policy issued by the OP. insertion of the name of the daughter was recorded only due to on-insertion of the name of the complainant by their own will.
Complainant also stated there was forged signature of the daughter of the complainant depicted in the LIC Policy which is most vital crime in the eye of law. Till now the forged signature of the daughter of the complainant from the OP No-1, the Aegon Religare Life Insurance Compamy Limited. There was another wrong
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instituted by the OP that is instead of one time premium paid option LIC policy, the OP is willingly allowed the premium to be paid consecutively period of 10 years and the complainant has to pay the premium every year, consecutive period of 10 years due to their willing mistake done by the OP and as such the complainant immediately contacted to the OP for necessary correction but the OP has failed to do so and this unjustified service has been served by the OP No-1 to the complainant and for such willing mistake of the OP, complainant has been suffered much mental agony and monetary insufficiency and ultimately a huge loss shall has to be borne by the complainant. When the copy of the written version submitted by the OP and the complainant received the same on 20.07.2015 at the time of appearing before the Ld. Forum the complainant was further surprised that the complainant has no son at all but a name has suddenly been depicted as Mr. Akshit Shah as a son and this name is recorded in the policy as insured being no-0776261 dated 16.08.2012 for Aegon Religare assure Plan for Annual Premium of Rs 25, 000/-.
Complainant stated that the Aegon Religare Life Insurance Co. Ltd is such Insurance Company where all the false, fabricated, willful insertion of any name and signature and manufactured documents are used to keep/arrange which is finally done for the purpose of fraud to the concerned insured person like this complainant. for making top of the above policy the OP falsely assured the complainant to deposit a further payment of Rs 5, 000/- otherwise the policy holder shall not get top up facility as one time policy holder and accordingly the complainant has made payment of the amount of Rs 5, 000/- by an A/c payee cheque No-765768 dated 16.08.2013 drawn on State Bank of India, Dum Dum Cantonment Branch and the OP duly issued a money receipt no-90006550071 dated 16.08.2013 in the name of the complainant. The said amount of Rs 5, 000/- has duly been debited from the bank account of the complainant on 19.08.2013 but most unfortunately the OP No-1 issued a cheque being no-76298 dated 22.08.2013 drawn on HDFC Bank for an amount of Rs 5, 000/- in the name of the complainant for which the complainant was unable to understand the issue of such cheque there for and as such the complainant instantly contacted to the OP No-4 and in reply to the complainant she expressed that the OP No-1 wrongly issued the said cheque amount of Rs 5, 000/- and in such situation she (OP No-4) needs to refund the said amount immediately to the OP No-1 otherwise the complainant may lose the top up opportunity from the OP No-1 and also the policy shall be lapsed on the ground of nonpayment of further premium of the said policy and also showed a vague reason that the OP generally not accepted of such a small amount of Rs 5, 000/- by cheque and instead, a sum of Rs 5, 000/- has to be paid in cash to the OP No-1 immediately and thereby the complainant
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will not lose the top up opportunity. Believe such vague reason, the complainant without having any other alternative, have duly been paid sum of Rs 5, 000/- in cash to the OP No-4 and the OP No-4 duly issued the money receipt no-9000460068 dated 16.09.2013 and thereafter in the year 2014 the complainant further contacted to the OP No-1 record in the particular policy issued by the OP No-1 in favour of the complainant not astonished to see the remaining available balance in the said policy shown as zero and the complainant requested their Mumbai office verbally to give their Kolkata address but the OP No-1 has ignored to keep the complainant requests and as such through internet complainant found out the Kolkata address of the OP No-1 and simultaneously first time issued a letter to the OP No-3 on 03.11.2014 and in reply to such letter on 05.11.2014 the OP No-3 informed the complainant that in the year 2012 the only amount of Rs 25,000/- was deposited by the complainant and there was no entry for the amount of Rs 5, 000/- which the OP No-4 collected from the complainant for deposition of the same to the OP No-1. On 15.11.2014 complainant issued a letter to the OP No-1 for enquiring about the issue of cash money receipt no-9000460068 dated 16.09.2013 of Rs 5, 000/- in cash by the OP No-4 and in reply to that the OP No-1 communicated through telephone on 18.11.2014 and by a letter dated 19.11.2014 to the complainant stating that the money receipt has to be submitted to the OP immediately.
Complainant further stated that on 20.11.2014 complainant issued one letter to the OP No-1 for releasing the top up return payment of Rs 5, 000/- in cash dated 16.09.2013, 22.08.2013 drawn on HDFC Bank in favour of the complainant against the Top Up payment made by the complainant vide receipt no-9000460068 dated 16.09.2013 issued by the OP. in reply to that the OP No-1 wrote a letter dated 04.12.2014 intimating the complainant that no such amount of Rs 5, 000/- has yet been deposited in cash by the OP No-4 and therefore advised the complainant approach the OP No-4 directly.
Complainant stated that on 10.12.2014 issued a letter to the OP requesting to intimate the address of the OP No-4 since the OP No-4 has never given her residential address and in reply to the above, a letter was sent on 23.12.2014 by the OP No-1 wherein he has disclosed the entire residential address of the OP No-4 there for.
Complainant also stated that from the very beginning the OP No-1 was reluctantly and cleverly avoiding the complainant that there is no such residential address of the OP No-4 recorded in their system/register at all. Being a consumer of the OPs, the complainant was harassed in different way by the OPs and not
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only that the OP No-4 being an agent committed foul play, committed forged signature and also committed gross deficiency in service with the help of OP No-1 for proving service to the complainant as a service providers.
Complainant further stated that being an honest senior citizen, the complainant is a consumer and the OPs are the service providers has been suffered physical and mental harassment and also sustained monetary loss only due to the OPs and last at all, the OPs misappropriated the whole consideration money of the complainant and top up amount of Rs 5, 000/- as a result of which the complainant being a consumer, grossly harassed by different way by the OPs for which the OPs are liable to pay compensation amount of Rs 1, 00, 000/- towards physical and mental harassment of the complainant and cost of litigation of Rs 20, 000/- to the complainant. Hence the complaint.
OPs have contested the case by filing written version.
OP No-1 to 3 stated that the complaint is barred by section3 of the Consumer Protection Act, 1986 which provides that the act is in addition to and not in derogation of any other law in force. The dispute raised by the complainant is squarely confined to the statuary period of free look period available under the insurance regulatory and Development Authority Regulations, 2002 with the policy holders for applying for cancellation of the policy and exit from the terms and conditions of the policy in entirety bringing both the parties to the same conditions and status as it existed before the submission of the proposal form. The statutory period of 15 days creates a virtual lien of the complainant on his premium which has to be refunded by the OP if the claim for refund is made within 15 days from the receipt of the policy documents. There is no deficiency in service within the meaning of the Consumer Protection Act, 1986.
OP No-1 and 3 also stated that the complaint is barred by section 3 of the Consumer Protection Act, 1986 as amended up to date in as much as the present case involves recording of elaborate evidence both oral and documentary and as such the matter deserves to be relegated to the Civil Court of competent jurisdiction. Without prejudice, it is further submitted that this is not the appropriate Forum for redressal of allegations tainted with criminality and only the criminal courts of competent jurisdiction can entertained the same. Reliance is placed on section 3 of the Consumer Protection Act, 1986.
OP No-1 and 3 further stated that also made a call to the complainant at pre insurance stage to reconfirm the details and terms and conditions of the plan mentioned in the proposal form. During the call, the complainant had also confirmed to the answering OP that he had signed the proposal form and benefit
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illustration. Further, in the said call, the complainant also confirmed that the concerned ARLI representative has not promised any discount, bonus, gift and any other benefit not covered under the terms and conditions of the policy. After receiving the consent of the complainant, the aforesaid policy was issued to the complainant.
OP No-1 and 3 stated that as formulated and mandated by insurance Regulatory Development Authority (IRDA) regulations, each policy holder is apprised about the option of free look period of 15 days through a Welcome letter sent along with the policy contract documents. Under the free look option, if the policy holder finds any discrepancy in the policy terms and condition sent to him, he may exercise the free look period option by informing the ARLIC’s concerned department in writing. In such cases, if the policy holder is not satisfied he can place a request for change in plan or cancellation of policy.
OP No-1 and 3 also stated that at the time of entering into a contract of insurance with the answering OP, the complainant was duly apprised of the key features of the ST & C in detail and the life assured after having understood the same, in complete cognizance of the ST&C of the policy, had entered into the contract with the answering OP. these documents clearly mentioned the terms of the policy, tenure of the policy, the various charges and Standard Terms and Conditions of the policy.
Point for Decision:-
Whether the complainant is entitled to get any relief as prayed for?
Decision with Reasons
Admittedly the complainant has submitted an application the insured the life of his son Mr. Akshit Shah, bearing no-A0776261 dated 16.08.2012 proposing for Aegon Religare Assured Plan, for annual initial premium of Rs 25, 000/- . The policy term was for 10 years and the premium praying term was for 5 years. From annexure-2 of OPs it will be seen the said policy was admittedly issued on 18.08.2012 to the complainant and the complainant received the same on 21.08.2012 which will be seen from annexure-3. According to the OPs, complainant was fully award as regards the risks and consequences of the policy and the terms and conditions of the policy. According to the OPs, complainant was given free look period of 15 days through a Welcome lettering to examine the terms and conditions of the policy. But complainant did not inform anything within this period. The statutory obligation is that the insurer shall informed by the letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy documents to review the terms and conditions of the policy
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and where the insured disagrees to any of those terms and conditions, he has the option to return the policy stating the reasons for his objection, when he shall be entitled to a refund of the premium paid, subject only to a deduction of a proportionate risk premium for the period on covered and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges. Ld. Lawyer for the OPs relied on the judgment passed in R.P. No-555 of 2011 (Life Insurance Company Limited Vs K.S. Eshwarappa) passed by Hon’ble National Commission.
Admittedly complainant is a senior citizen and considering the complaint and documents, OPs affidavit in chief and documents we are of the view that there is a deficiency of service on the part of the OPs and OPs will refund amount of Rs 60, 000/- against the payment made by the complainant Rs 25, 000/- and Rs 5, 000/- and also the litigation cost.
Hence
Ordered,
that the complaint be and the same is allowed on contest against the O.Ps in part.
O.Ps are directed to pay Rs 60, 000/- to the complainants along with interest of Rs 12% per annum from the date of filing of the case till final payment within one month from the date of this order.
The O.Ps are further directed to pay Rs. 5,000/- litigation cost to the complainant within one month from the date of this order, failing which OPs shall have to pay sum of Rs 100/- per day from the date of this order till its realization, as punitive damages, which shall be deposited by the OPs in this State Consumer Welfare Fund.
Let copies of the order be supplied to the parties free of cost when applied for.
Member President
Dictated & Corrected by me.
