Haryana

Karnal

CC/238/2015

Atam Parkash Madan S/o Vir Bhan Madan - Complainant(s)

Versus

M/s Bharti AXA Life Insurance Company Ltd - Opp.Party(s)

Deepak Bhandari

15 Sep 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                           Complaint No.238 of 2015

                                                           Date of instt. 05.10.2015

                                                           Date of decision: 15.9.2017

 

1. Dr. Atam Parkash Madan son of Shri Vir Bhan Madan;

2. Mrs. Ved Kumari w/o Dr. Atam Parkash Madan.

    Both residents of 5-A, Session Marg, Karnal.

                                                                                                                     …….Complainants.     

                                        Versus

 

Bharti Axa Life Insurance Company Ltd. (through it’s Karnal Branch office) SCO 82-83, 1^st -2^nd floors, Mughal Canal, Karnal-132001.

                                         

                                                                     …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act.            

 

Before   Sh. Jagmal Singh……. President.

              Sh. Anil Sharma……….Member.

               

 

 Present  Shri Deepak Bhandari Advocate for complainants.

                Shri Vikash Chauhan Advocate for opposite party.

 

ORDER:                    

                        (Jagmal Singh President)

 

               

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 alleging therein that the complainants are retired person and Senior Citizen of the age of 73 years and 66 years respectively. It is further alleged that the complainants are in old age with suffering from severe multifarious ailment. It is further alleged that the complainants were entrapped by a Gang of Fraudsters/Cheats and got booked policies worth Rs.14 lacs within 15-20-30 days. The complainant further stated that they were entrapped to buy polices of nine insurance companies and five polices were of the opposite party. The detail of the same is as under:-

501-1346706/28.9.2013    Atam Parkash Madan/Vibhu Madan     1,50,000/-

501-1346375/30.9.2013              Ved Kumari/ Palak Madan                   1,50,000/-

501-1393948/23.10.2013            Atam Parkash Madan/Nidhi Bhandari   2,00,000/-

501-1473070/19.11.2013     Atam Parkash Madan/Vibhu Madan                99,000/

501-1473088/19.11.2013    Ved Kumari/ Palak Madan                      99,000/-

The complainant further alleged that on getting suspicious, the complainants had acted for recovery of Rs.5 lacs and the complainants had filed a complaint with Superintendent of Police  Karnal on which First Information Report no.476 dated 18.6.2014 was registered and the case was solved and the accused was arrested and now facing trial before the Court of Learned Chief Judicial Magistrate, Karnal. The complainant further stated that except the opposite party the money has been refunded by the eight insurance companies. It is further alleged that the complainants had made various complaints against the opposite party and ultimately filed a complaint before Insurance Ombudsman Chandigarh, who passed an order dated 19.12.2014 and copy of the same has been attached with the complaint as Ex.C23.

        In pursuance of the order of Ombudsman the opposite party cancelled the abovementioned five policies of the complainants and issued two new policies no.501-3188478 (of Atam Parkash complainant) and policy no.5013188569 (of Ved Kumari) dated 15.5.2015 and 18.5.2015 respectively. It is further alleged in the complaint by the complainant that the company had even ignored the orders of Insurance Regulatory Development Authority ( hereinafter mentioned as IRDA) to refund their money and now the opposite party had ignored to implement the order of the Ombudsman in its letter and spirit and in this way the opposite party is deficient in providing services to the complainant. The complainants prayed for directing the opposite party to issue fresh policy bonds from 8.7.2013 with a back period of five years with a lock-in-period of five years or in the alternative, opposite party be directed to pay the FDRs interest at the concrete.

2.             Notice of the complaint was given to opposite parties, who appeared and filed reply to the complaint raising preliminary objections that the complaint is false, frivolous and vexatious; the order of the Ombudsman implemented, therefore, complaint is bad for mis-joinder and non-joinder of parties and this Forum has no jurisdiction.

                On merits, the allegations traced in the complaint are denied and prayed for dismissal of the complaint. It has been submitted that the information provided by the complainants at the proposal stage, the company had issued the policies nos. 5011346706, 5011346375, 5011393948, 5011473070 and 5011473088 to the complainant. But after a span of more than 4 months from the date of issuance of policy, the opposite party company received a complaint dated 21.2.2014 alleging misselling and therefore seeking cancellation under the aforesaid policy. After investigation, the opposite party was unable to consider the request of the complainants as there was no misselling involved and that the complainants approached outside freelook period of the aforesaid policies. Furthermore, policy documents including policy terms and conditions were duly dispatched and received by the complainants. Thereafter, complainants approached the Ombudsman, Chandigarh and filed a complaint alleging mis-selling of policies. Ombudsman duly adjudicated the matter and had given directions to the opposite party to cancel the abovementioned five policies and adjust the premium in a new single premium policy with a lock in period of 5 years subject to underwriting and fulfillment of requirements. The said orders of Ombudsman have already been complied and new single premium policies bearing no.5013188478 and 5013188569 were sent to the complainants and the same were duly received by them on 25^th May, 2015. Once the order has been complied with there was no question of the same issue being raised in different Fora. It has been submitted that even if the complainants have any grievance with regard to the policy they could directly approach the Ombudsman but they could not approached this Forum which had no jurisdiction to entertain the complaint. It has further been pleaded that after received the new policies the complainant had raised a new concern stating that the new policy issuance date was from May, 2015 and it was not backdated in line with his old policies. The opposite party had also got the clarification from Ombudsman that issuance of the new policy was from current date it would not be backdated. Hence there was no deficiency in service on the part of the opposite party and complainants are not entitled to any relief. The other allegations made in the complaint have also been denied.

3.             Complainant tendered to evidence his affidavit Ex.C1 and document Ex.C2 to C100.

4.             On the other hand, opposite party, affidavit of Sachin Kalra Ex.RW1/A and documents Ex.R1 to Ex.R4.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             From the pleadings and evidence of the case, it is clear that the complainants are retired persons/senior citizen of the age of 73 years and 60 years respectively. According to the complainants, they were entrapped by a gang of cheats posing themselves as the officers of IRDA for purchasing the insurance policies from various companies. The complainants were entrapped to buy polices from nine Insurance Companies including the opposite party. According to the complainant on the intervention of IRDA and Ombudsman of the Companies, the eight Companies refunded the money charged in lieu of insurance policies. According to the complainants the opposite party i.e. Bharti Axa Insurance Company ignore the advice of IRDA and has not return the amount invested in five policies mentioned above with the opposite party.

7.             The complainants filed complaint against the opposite party to various authorities, but the opposite party did not give any relief to the complainants. The complainants then filed the complaint with the Insurance Ombudsman Chandigarh, vide complaint no.CHD-I-008-1415-0870. The Ombudsman pass the award dated 19.12.2014, the copy of the same is Ex.C19. Para no.6 and 7 of the award are relates to the relief grated which runs as under:-

        “6.After going through the written submissions and verbal pleadings, I am of a view that it is a case of gross mis-selling and violation of rules. In fact, insurance is a subject matter of solicitation and it appears that the representatives of the Company are selling insurance in a fraudulent manner promising high return without looking into insurance needs, premium paying capacity and age of proposer/life assured. Keeping in view this factual position, on award is passed with a direction to the insurance company to cancel the mentioned policies bearing numbers 5011346706, 5011346375, 5011393948, 5011473070 and 5011473088 since inception and adjust the premium in a new single premium policy with a lock in period of 5 years subject to underwriting and fulfillment of requirements.

        7.The award shall be implemented in letter and spirit within 30 days of a receipt of the order and a compliance report shall be sent to this office for information and record.”

                The opposite party was bound to implement this award in letter and spirit, but the opposite party has not implemented the same in its letters and speed. According to this award the direction were issued to the opposite party to cancel above mentioned policies i.e. since inception and adjust the premium in a new single premium policy with a lock-in period of 5 years subject to underwriting and fulfillment of requirements. No doubt the opposite party had adjusted five policies of both the complainants in a single premium policy of both the complainants i.e. two policies bearing nos. 501-3188478 and 501-3188569 for an amount of Rs.5,61,250/- and Rs.3,12,500/- respectively, but the opposite party kept the lock-in period of 10 years instead of 5 years. According to the award dated 19.12.2014 the opposite party was bound to keep lock- in period of five years. Therefore, the contention of the complainants that the opposite party has not implemented the award in its letter and spirit has force. The award passed by Ombudsman are binding upon the Insurance Companies. The complainants have produced the brief note on the function of the offices of the Insurance Ombudsman. The relevant part of the same is reproduced herein after:-

Award

“The ombudsman shall pass an award within a period of three months from the receipt of the complaint. The awards are binding upon the insurance companies.

If the policy holder is not satisfied with the award of the Ombudsman he can approach other venues like Consumer Forums and Courts of law for redressal of his grievances.”

 

8.             In view of the above, it is very much clear that the opposite party was bound to implement the award completely i.e in the letter and spirit. But as already stated above, according to the award dated 19.12.2014, the lock-in period of the policy should be five years and the opposite party has issued the policies with lock-in period of 10 years. This fact is very much clear from the documents Ex.C97, Ex.C99 and Ex.C100 that the lock-in period of both the polices are 10 years. In these facts and circumstances of the case, we are of the considered view that the opposite party has not implemented the award dated 19.12.2014 of the Insurance Ombudsman, Chandigarh in its letter and spirit and hence the opposite party is deficient in providing services to the complainant.

9.             The complainants prayed that that opposite party would issue fresh policy bond from back date i.e.8.7.2013, but the opposite party contended that it is not possible to issue the policies from retrospective date i.e. from back date. On one hand, the opposite party stated that it is not possible to issue policies from back date/retrospective effect and on the other hand the opposite party has not implemented the award dated 19.12.2014 of Ombdusman in its letter and spirit, therefore the opposite party is harassing the complainants. So in these circumstances, we are of the considered view that the complainants are entitled for refund of the amounts of both the polices/policy bonds. The arguments of the complainant that the FDR interest @ of 10.25% compoundable quarterly be awarded has no force because during this period life of the life assured were remained cover under the policies and the complainants were entitled for the benefits of insurances. It is pertinent to mention here that on maturity of the policies, the complainants were entitled to bonus etc. besides the amounts of the policies. In these circumstances, in our view the interest of justice will be met if we grant interest @ 8% per annum from the date of the polices.

10.           Thus, as a sequel to the foregoing discussions, we accept the present complaint and direct the opposite party to cancel the polices/policies bond bearing nos.501-3188478 and 5013188569 and refund the amount of Rs.5,61,250/- and Rs.3,12,500/- (i.e. Rs.5,61,250+3,12,500=8,73,500/-) with interest @ 6% per annum from the date of issue of these two policies till its realization. We further direct the opposite party to pay Rs.10,000/- to the complainants on account of mental agony and harassment suffered by them and for the litigation expenses. This order shall be complied within 30 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 15.09.2017

                                                                        (Jagmal Singh)

                                                                           President,

                                                         District Consumer Disputes

                                                       Redressal Forum, Karnal.

 

                     (Anil Sharma)

                          Member