Date of filing : 18-02-2011
Date of order : 29 -09-2011
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.39/2011
Dated this, the 29th day of September 2011
PRESENT
SRI.K.T.SIDHIQ : PRESIDENT
SMT.P.RAMADEVI : MEMBER
SMT.K.G.BEENA : MEMBER
Chandran.V, } Complainant
Vainingal House,
Po.Uppilikkai, Nileshwar.Via,
Kasaragod.Dt.
(In Person)
1. M/s. Bajaj Allianz, } Opposite parties
Life Insurance Company Ltd,
G.E. Plaza, Airport Road, Yerwada,
Pune. 411006, Maharashtra State.
(Adv. K.V.Jayaraj, Hosdurg)
2. Chandran Nair,
S/o. Appunhi Nair, Kozunthil,
Nileshwaram. 671314, Kasaragod.Dt.
(Exparte)
O R D E R
SRI.K.T.SIDHIQ, PRESIDENT
Succinctly stated the grievance of the complainant is that he joined in the Insurance scheme launched by opposite party No.1 on 18-12-2007 on the assurance of opposite party No.2 , the agent (Insurance Consultant) of the 1st opposite party. At the time of proposal the 2nd opposite party made him believe that he will get ``40,000/-, if he remits `20,000/- as single premium. But inspite of this assurance in January 2011 he received a letter demanding premium. Thereafter he received a letter from opposite party No.1 stating that his policy is lapsed. He also find enclosed a cheque for `3919/- being the value of his policy. He also came to know that the opposite parties deceived a number of policy holders in this manner. Hence this complaint for the refund of `20,000/- together with a compensation of `5000/-.
2. Opposite partyNo.1 filed version. But opposite party No.2 remained absent inspite of receipt of notice. Hence opposite party No.2 had to be set exparte.
3. According to opposite party No1, complainant had placed a proposal for Unit ‘Gain Gold Plus’ a unit linked policy on 18-12-2007 and it’s premium was `20,000/- per annum and the premium term was 10 years. A policy certificate and policy documents were issued to the complainant. There is no inducement in the matter of Life Insurance Proposal. All proposals and issue of policies are done through written documents. The insurer and insured are bound by the terms in the proposal form and the policy documents. The rights and liabilities of the insurer and the insured are to be determined in the light of the terms in the proposal form and the policy documents. As per the policy issued to the complainant he is bound to pay premia as specified in the proposal form and policy document. The complainant failed to pay the yearly premia for the mandatory 2 years consecutively after issuing the policy to him. This breach compelled the opposite party. No.1 to foreclose the policy and return the unit value as per the specification in the policy document. The 2nd opposite party is an agent qualified and certified by IRDA by conducting examinations. He is qualified to canvass people for any insurance company and can propose to choose any product of any company. The 2nd opposite party had proposed the complainant’s proposal before 1st opposite party and 1st opposite party issued policy accepting the proposal. There is no master servant relationship between the 1st and 2nd opposite parties. The complainant has not utilized the ‘free look’ period facility. Hence the complainant is not entitled for the relief claimed and the complaint deserves a dismissal.
4. Complainant examined himself as PW1 and Exts A1 & A2 marked through him. Complainant faced cross-examination by the learned counsel for opposite party No.1. On the side of opposite party No1. Exts B1 & B2 marked. Both sides heard and documents scrutinized.
5. PW1 deposed that he availed the policy through opposite party No.2 and at the time of proposal opposite party No.2 made him believe that he won’t lose anything if he remits `20,000/- as one time premium and he will get `40,000/- plus the accumulative bonus. Therefore he opted to buy the said policy. But when he received a notice demanding subsequent premium after one year he could not pay the amount and subsequently he contacted opposite party No.2. At that time opposite party No.2 told him that the amount has to be paid and even if it is not paid the first premium will not loss. On the next year also he received a letter demanding premium but he did not pay the amount. Later he received a foreclosure notice with a cheque for `3919/-. When the said cheque is received he again contacted opposite party No.2 and opposite party No.2 told that the said amount may be the bonus and he is no more the agent of 1st opposite party. Opposite party No.2 directed him to approach the Kanhangad branch office of opposite party No.1, so he contacted them but they told that they could not do anything.
6. PW1 was cross-examined by learned counsel for opposite party No.1 Sri. K.V.Jayaraj In cross-examination PW1 has deposed that he opted to join in the scheme on the assurance made by opposite party No.2 that there will be no loss of money and he will get `40,000/- after 10 years and will have the assurance for `1,00,000/- for 10 years. He further stated that he has not read the policy document and hence did not aware above the terms and conditions contained in the policy.
7. From the version of complainant as PW1 it is clear that he opted to purchase the policy issued by opposite party No.1 only due to the misrepresentations made by opposite party No.2 the insurance agent who acted on behalf of opposite party No.1. So the signing of proposal form involved a concealed trap. The duty of disclosure is a persuasive duty and a failure or concealment involves drastic consequences. The agent is engaged to obtain a valid and enforceable contract disclosing all the terms and conditions and riders and the risks involved in the policy. Misrepresentation makes the contract of insurance void of voidable if the misleading statement of the agent to the insured is material.
8. After the entry of private insurance companies in the insurance sector they are doing aggressive business. Earlier it was service oriented. But now a days it is purely business motivated as they are hell bent upon selling what they call ‘products’. As part of their aggressive business drive they offer ‘bonanza’ gala galore to their agents and who in turn grab the prospective policy holders by their throat by making tall promises. In most cases insurance policies contain numerous terms and conditions that normally are not disclosed to the insured. No insurance agent would explain terms and conditions those appears be adverse to the interest of the policy holder. The agent of the insurance company turns out to be a most vital factor. It is he who undertakes the insurance business on behalf of the insurer. He should make it a point to explain each and every condition or clause of the policy to the prospective policy holders which is printed in ‘small print’ of which ordinary persons would not be in a position to read between the lines. Most of the policy holders rely blindly on the assurance of the Insurance Consultant and in most cases even the literate people will not spare time to read the full text of the policy.
9. Relief & Costs:
The complainant has deposited `20,000/- on 27-12-2007 on the assurance of opposite party No.2 that he will get `40,000/- in return with accrued bonus apart from the life insurance cover for `1,00,000/-. But he did not get the said benefits instead of the return of `3919/-. The complainant is entitled to get the refund of the amount he spent for the policy with interest from the date of deposit with costs.
The complaint is therefore allowed and opposite parties 1 & 2 are directed to pay `20,000/- with interest @ 9% from 18-12-2007 till date of payment less `3919/- which they already paid. Opposite parties further directed to pay `3000/- towards the cost of these proceedings. Time for compliance is limited to 30 days from the date of receipt of copy of the order.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exts.
A1.18-12-2007 photocopy of first premium receipt
A2. Photocopy of Payment receipt.
B1. Proposal Form For Life Insurance Issued by Bajaj Allianz
B2. Bajaj Allianz Unit Gain Plus Gold Policy Document.
PW1. V.Chandran.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
SENIOR SUPERINTENDENT
Pj/
