DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I,

U.T. CHANDIGARH

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Sh.Raj Kumar Gandhi s/o Late Sh.Sat Pal presently r/o H.No.1270, 1^st floor, Sector 8-C, Chandigarh.

…..Complainant

                                      V E R S U S

M/s Max New York Life, Insurance Campus, Operation Centre, Plot No.90-A, Sector 18, Udyog Vihar Gurgaon (122015).

……Opposite Party

QUORUM:   P.L.AHUJA                                                  PRESIDENT

                   RAJINDER SINGH GILL                                MEMBER

                   DR.(MRS) MADANJIT KAUR SAHOTA         MEMBER

ARGUED BY: Sh.Anish Gautam, Counsel for complainant.

                      Sh.Rajneesh Malhotra, Counsel for OP

PER P.L.AHUJA, PRESIDENT

1.                Sh.Raj Kumar Gandhi, complainant has filed this consumer complaint under Section 12 of the Consumer Protection Act, 1986, against M/s Max New York Life - Opposite Party (hereinafter called the OP).  The allegations of the complainant in brief are as under :-

                   One of the agents of OP approached the complainant for selling a life insurance policy and on being explained the benefits of the said policy, the complainant agreed to purchase the policy and paid a sum of Rs.25,000/- through cheque dated 30.11.2007.  The complainant was assured coverage to the tune of Rs.6,44,268/-.  After sometime, the complainant received policy documents dated 12.1.2008, whereby, policy No.338899875, copy of which is Annexure C-1, was issued to the complainant with annual premium of Rs.20,000/-. The said agent had paid back cash amount of Rs.5,000/- to the complainant on account of his commission discount. However, he did not disclose that the coverage of the policy would be reduced. The complainant did not go through the contents of the documents and kept the policy as it is. However, after sometime when the complainant was scanning through the documents and he had a glance through the policy documents, he was surprised to find that the sum insured was also reduced to Rs.3,85,543.18 from Rs.6,44,268/- as mentioned in the policy proposal form by the agent of the OP. The complainant also found that at least at three places his signatures were forged and fabricated by the officials and agents of OP. When the complainant raised this issue, a letter dated 4.6.2012, copy of which is Annexure C-2, was received by the complainant that the Grievance Officer Mr.Vivek Manchanda of OP was investigating the complaint. The complainant received another letter dated 5.6.2012, copy of which is Annexure   C-3, whereby his specimen signatures duly attested by the bank Manager were asked to be furnished. On 9.6.2012 the complainant supplied samples of his signature duly attested by the bank Manager of his bank vide letter dated 9.6.2012, copy of which is Annexure C-4. The complainant received a letter dated 27.6.2012 from the OP, whereby, apologies were tendered to him and his policy was cancelled and an amount of Rs.80413.93 was refunded to him through cheque No.566121 dated 28.6.2012, which the complainant withdrew without prejudice of his rights in the aforesaid policy. It has been alleged that the officials of the OP have forged and fabricated policy documents and manipulated the facts to suit their illegitimate motives.  The complainant has contended that it is not understandable as to how the refund of Rs.80,000/- was made, when the sum insured was Rs.3,85,543.18.  The complainant also sent a legal notice dated 30.7.2012, copy of which is Annexure C-6, to the OP but no response was received. The complainant has made a prayer for a direction to the OP to refund the total sum of Rs.3,85,543.18 excluding sum of Rs.80,000/- already paid to him, apart from making payment of Rs.1 lac as special damages and Rs.20,000/- towards litigation expenses.

2.                In its written statement, the OP has pleaded that this Forum has no territorial jurisdiction to try and decide the complaint because no cause of action arose to the complainant at Chandigarh and no party in the territorial jurisdiction of Chandigarh has been impleaded in the present complaint. It has been averred that the complainant approached the OP Company through Yes Bank Limited for obtaining a policy while he was staying at Pathankot. He applied for Unit Linked Whole Life Participating policy through proposal No.338899875 dated 20.11.2007, copy of which is Annexure A. The complainant had also mentioned the previous policies taken from the OP in Section C of the proposal form showing that he was fully satisfied with the services of the company. On the basis of the proposal form and options filled up by the proposer, the insurance policy No.338899875 was issued on 30.11.2007 along with terms and conditions – Annexure B. The averment of the complainant of receiving back the cash amount of Rs.5,000/- from the agent have been denied for want of knowledge. It has been denied that the OP received an amount of Rs.25,000/- as premium. On the other hand, it has been averred that the premium receipt by the company was to the tune of Rs.20,000/-. As per schedule of insurance policy, the policy was issued for a sum assured of Rs.385543.18 and the modal premium is Rs.20000.49. It has been further stated that the complainant had an option of free look period within 15 days of the receipt of the policy but he did not opt for the same. It has been further stated that vide letter dated 15.11.2011 – Annexure C the complainant sent a request for change in bonus option to cash and a confirmation letter dated 17.11.2011 – Annexure D was sent to him. A letter dated 30.11.2011 along with annual statement with regard to the life insurance policy was also sent to the complainant vide Annexure E.  It has been denied that the coverage of the policy has been reduced from Rs.6,44,268/- to Rs.3,85,543.18. The allegations of the forgery have been denied and it has been stated that such type of allegations cannot be decided in summary jurisdiction under the Consumer Protection Act, 1986 and the case may be relegated to Civil Court.  It has been further stated that the company received a letter dated 28.9.2011 – Annexure F from the complainant on 1.6.2012 i.e. after about 9 months that his signatures were not matching on the policy. An acknowledgment dated 4.6.2012 – Annexure G was sent to the complainant. Thereafter, the complainant was asked vide letter dated 5.6.2012 to furnish his specimen signatures, which he furnished vide his letter dated 16.6.2012 – Annexure I. Then the complainant was written a letter dated 27.6.2012, copy of which is Annexure K, confirming the cancellation of the policy and the refund of the sum of Rs.80413.93 to him. The cheque of Rs.80413.93 was got cleared by the complainant on 6.7.2012. Till the policy was cancelled, the complainant had deposited an amount of Rs.85,862/-. It has been averred that the complainant kept on using the policy for more than four years and, thereafter, the OP immediately took a decision to cancel his policy and to refund the whole amount without making any deductions, therefore, the complainant is not entitled to any relief. It has been stated that the legal notice of the complainant was replied on 25.9.2012 and the sum assured was not payable to the complainant because it was payable only in case of death or maturity of the policy.

3.                The parties led evidence in support of their contentions.

4.                We have gone through the written arguments submitted by the parties and heard the arguments addressed by the learned Counsel for the parties.

5.                As far as the objection raised by the OP regarding the territorial jurisdiction of this Forum is concerned, a perusal of copy of proposal form – Annexure A reveals that the declaration on the proposal form was signed by the proposer and attestation was made by the witness at Chandigarh on 30.11.2007. Similarly the declaration by the agent was also made by Mr.Ramesh Kumar Bhargav, Agent on 30.11.2007 at Chandigarh. Life Insurance Premium Receipt – Annexure B was issued by the OP and the agent advisor was Yes Bank Chandigarh. Therefore, we feel that a part of cause of action arose to the complainant at Chandigarh and this Forum has got territorial jurisdiction to try this complaint.

6.                So far as the allegations of the complainant about forgery of signatures in the proposal form and changing of the coverage amount and the premium in the same are concerned, it is no doubt true that the questions relating to forgery and fraud can be decided after having detailed evidence of both the sides. However, we find that a perusal of the documents on record is a clear pointer to the deficiency in service on the part of OP. A perusal of page No.2 of the proposal form – Annexure A shows that modal premium was initially written as Rs.25,000/- but later on it was changed to Rs.20,000/- and the cutting allegedly initialed by the complainant does not match with his specimen signatures – Annexure I. Likewise in the next column, the amount of premium in words is firstly written as Rupees Twenty Five Thousand only and then the word ‘Five’ has been cancelled. At the same time, the amount in figure is shown to be Rs.25,000/-. It is also significant that in the coverage information, the total amount is mentioned as Rs.6,44,268/- but the policy was issued to the complainant for a sum assured of Rs.3,85,543.18. The complainant has specifically alleged in para No.4 of the complaint that he raised the issue with the OP and then a letter dated 4.6.2012 – Annexure G was received intimating him that Mr.Vivek Manchanda, Grievance Officer was investigating the complaint. The alleged letter dated 4.6.2012 sent by the OP to the complainant has not been produced by him. The OP has contended that it had received a letter dated 28.9.2011, copy of which is Annexure F, on 1.6.2012 from the complainant stating that his signatures were not matching on the policy. The copy of hand written letter dated 28.9.2011 – Annexure F sent by the complainant to the OP shows that he leveled allegations of misdoing by the agents of the OP but it does not show any allegation of mismatching of the signatures on the policy. At any rate, since the complainant vide letter dated 5.6.2012 – Annexure H was asked to provide a specimen of 10 signatures to the OP attested by the Bank Manager, it goes to show that there was a complaint regarding mismatching of the signatures of the complainant on the proposal form. It seems that the OP found some force in the allegations of the complainant, therefore, they apologized for the inconvenience caused to him vide letter dated 27.6.2012 – Annexure K and refunded an amount of Rs.80413.93 against the total amount of Rs.85,882/- deposited by him till that date. A narration of the above facts coupled with the action of the OP in refunding the amount of Rs.80,413.93 point out towards deficiency in service on the part of OP. There is definite evidence leading to this inference that the officials of the OP did some mischief while filling up the proposal form, due to which, the OP was compelled to refund the amount of Rs.80,413.93 to the complainant on 27.6.2012.

7.                The next question that arises for determination is whether the complainant is entitled to the sum assured i.e. Rs.3,85,543.18 or not. Evidently the complainant was entitled to get back the sum assured either at the time of maturity of the policy or on account of his death but none of these two events has taken place. Therefore, the prayer of the complainant for refunding him the sum assured i.e. Rs.3,85,543.18 cannot be accepted. However, it is evident that the complainant has been deprived of the interest on the amount deposited as premium w.e.f. 30.11.2007 on account of misdeeds of the officials of the OP, therefore, he is certainly entitled to get compensation on that account.

8.                For the reasons recorded above, we find merit in the complaint and the same is partly allowed. OP is directed to make payment of an amount of Rs.40,000/- as compensation to the complainant on account of harassment and deficiency in service on its part. The OP is also directed to make payment of litigation expenses of Rs.10,000/- to the complainant.

9.                This order shall be complied with by the OP within one month from the date of receipt of its certified copy, failing which, OP shall be liable to refund the above said awarded amount to the complainant along with interest    @12% p.a. from the date of filing of the complaint, till its realization, besides costs of litigation.

10.              The certified copies of this order be sent to the parties free of charge. The file be consigned.