BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL FORUM, JALANDHAR.
Complaint No.427 of 2016
Date of Instt. 03.10.2016
Date of Decision: 28.02.2018
Palwinder Singh son of Sh. Paramjit Singh R/o 5 FF LIG Flat, Bhagat Singh Colony, Jalandhar.
..........Complainant
Versus
1. PNB Metlife India Insurance Company Ltd., Brigade Seshamahal 5, Vani Vilas Road, Basavanagudi, Banglore- 560004, Karnataka, Through its CEO/Managing Director.
2. PNB Metlife India Insurance Company Ltd., T.F. 3rd Floor, Eminent Mall, Guru Nanak Mission Chowk, Lajpat Nagar, Jalandhar Through its Branch Head/Authorized Representative.
3. M/s Devanshi, Agent, PNB Metlife India Insurance Company Ltd., T.F. 3, 3rd Floor, Eminent Mall, Guru Nanak Mission Chowk, Lajpat Nagar, Jalandhar.
….….. Opposite Parties
Complaint Under the Consumer Protection Act.
Before: Sh. Karnail Singh (President)
Smt. Harvimal Dogra (Member)
Present: Sh. Rohit Gambhir, Adv Counsel for the Complainant.
Sh. HS Kohli, Adv Counsel for the OP No.1 and 2.
OP No.3 exparte.
Order
Karnail Singh (President)
1. This complaint is filed by the complainant, wherein alleged that the OP No.1 is an Insurance Company and OP No.2 is its Branch Office, whereas OP No.3 is Agent of the OP No.1 and 2. The complainant being a layman purchased a policy from OPs, in the year 2015 for Medical Insurance. At the time of issuing the policy, OP No.3 told the complainant that it is an one time premium policy and it covers a total claim of Rs.10,00,000/- for the life time and its premium is Rs.10,844/-, which has to be deducted from complainant's bank account. After the above said explanation from OP No.3, the complainant agreed to purchase the policy and signed the documents for the said policy and OP No.3 said that the cover note and policy document will be delivered at mailing address of the complainant within 15 days and Rs.10,844/- has been deducted from the complainant's bank account No.2221000109108099 dated 06.07.2015. After the expiry of 15 days, when no policy/cover note received at mailing address of complainant and the complainant approached the OP No.2 for the policy documents, but who again said that the complainant has to wait for further 10-15 days. Then again the complainant after expiry of said period, approached the OP No.2 personally as well as through telephonically, but no satisfactory reply was given. The complainant was surprised, when he received text message from his bank on 18.07.2016, the amount of Rs.10,673/- has been deducted from complainant's bank account No.2221000109108099 and then complainant inquired about the same and came to know that the amount of Rs.10,673/- has been credited in the account of the company of OPs. After that the complainant approached at the office of OP No.2 and disclosed about facts of receiving message from bank as well as regarding deduction of the premium amount and inquired about the actual picture from the staff of OP No.2.
2. That it was also conveyed by official of the OPs to the complainant that his policy is for 10 years with annual premium plan and the premium of Rs.10,500/- approximately will be deducted automatically from complainant's bank account. On further investigation into the matter that till the complainant has not received any single document/correspondence regarding the premium of policy or any policy cover note. Then it create suspicion in mind of the complainant that when he has not received a single correspondence or any policy cover note from the OPs, then how the amount of premium has been deducted from his account as such, complainant further make inquiry into the matter and it transpired that the official/agent of the OP No.1 and 2 i.e. OP No.3 in a very clandestine manner with connivance of OP No.1 and 2, firstly prepare the policy on some other conditions, which were not disclosed to the complainant and secondly, OP No.3 mentioned wrong address of the complainant on the policy cover note, so that complainant may not be able to reach at the truth. The OPs committed a fraud and cheating with complainant, which further proves from the record of the office of OPs on which correspondence address of the complainant has been mentioned as 5 FF, LIG Flats, Bhagat Singh Colony, Jalandhar, whereas the address mentioned on the policy is 5-FF Shaheed Udham Singh Colony Jalandhar. The ID Proofs furnished by the complainant also reflects his address as 5 FF, LIG Flats, Bhagat Singh Colony, Jalandhar. The cover note of the policy documents was handed over by officials of OP No.2 to the complainant on 29.07.2016, when the OP No.2 called the complainant at their office and thereafter, the complainant moved a complaint on 02.08.2016 with the request to cancellation of the policy and to refund the premium amount deducted, but no action was taken by the OP No.2 upon aforesaid complaint of the complainant and it is clear cut deficiency in service as well as unfair trade practice and thus, the instant complaint filed with the prayer that the complaint of the complainant may be accepted and OPs be directed to cancel the insurance policy No.21619888 and to refund the amount of Rs.21,517/-, which has been deducted from the bank account of the complainant alongwith interest @ 18 % per annum and further OPs be directed to pay compensation of Rs.1,00,000/-, to the complainant and be also directed to pay a sum of Rs.25,000/- as litigation expenses.
3. Notice of the complaint was given to OPs, but despite service OP No.3 did not come present and ultimately, OP No.3 was proceeded against exparte, whereas OP No.1 and 2 appeared through their counsel and filed their joint written reply, whereby contested the complaint by taking preliminary objections that the instant complaint is false, malicious, incorrect and with malafide intention and is noting but an abuse of the process of law and therefore, the complaint is liable to be dismissed and further averred that the complaint filed by the complainant does not fall within the definition of a consumer dispute under the act as there is neither any unfair trade practice adopted by the OP nor any deficiency in services being established against the OP, hence, this complaint is liable to be dismissed and further submitted that as per guidelines of the IRD that the Insurer shall inform by letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy or to get cancel the policy, but the complainant has not approached within a Free Look Period of 15 days, therefore, the complainant is not entitled to claim the relief as alleged in the complaint. It is further averred that the complainant after completely understanding the terms and conditions and had voluntarily applied for a policy by filling up the Proposal Form on 04.06.2015 and complainant also offered to pay the premium of Rs.10,477/- yearly towards the premium under the said Plan for a proposed sum assured amounting to Rs.10,00,000/-. It is further submitted that the complaint is neither maintainable in law nor on facts and the same is liable to be dismissed and further alleged that there is a deficiency in service on the part of the OPs. On merits, the factun in regard to purchase of an insurance policy by the complainant is admitted and making payment of the premium is also admitted, but the other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merits and the same may be dismissed.
4. In order to prove the case of the complainant, the counsel for the complainant tendered into evidence affidavit of the complainant Ex.CA alongwith some documents Ex.C-1 to Ex.C-12 and closed the evidence.
5. Similarly, counsel for the OP No.1 and 2 tendered into evidence affidavit Ex.OP/A alongwith document Ex.OP/1 and closed the evidence.
6. We have heard the learned counsel for the respective parties and also gone through the case file very minutely.
7. The case of the complainant in regard to purchase of medical insurance policy in the year 2015, for a sum of Rs.10,00,000/- and premium of Rs.10,844/- was deducted from the account of the complainant, is admitted. Now, the further claim of the complainant is that the Agent of the OP No.1 and 2 i.e. OP No.3 categorically explained to the complainant that it is an one time premium of Rs.10,844/- for total insured amount of Rs.10,00,000/- for the life time, but later on, it was inspired to the complainant that a sum of Rs.10,673/- was deducted from his bank account on 18.07.2016 and he accordingly inquired the matter and came to know that the policy given to him is for 10 years Annual Premium Plan, but these factum have not been disclosed to the complainant, even no policy document or its terms and conditions were ever supplied to the complainant because the address of the complainant have been intentionally and willfully wrongly given by Agent on the Insurance Form, infact the address of the complainant is 5 FF LIG Flats Bhagat Singh Colony, Jalandhar, whereas the address mentioned on the policy document is 5 FF Shaheed Udham Singh Colony, Jalandhar and if the address of the complainant is not correctly mentioned on the insurance document, then how an insurance policy or other terms and conditions reached to the complainant rather the said documents were received by the complainant himself, when he was called by the official of the OP on 29.07.2016 and after knowing through the aforesaid facts, the complainant immediately filed an application on 02.08.2016 with the request to cancel the insurance policy and to refund the premium amount deducted from the account of the complainant, but the request of the complainant was not accepted and as such, the instant complaint filed.
8. On the other hand, the case set up by the OP No.1 and 2 is only that there is no deficiency in service nor any unfair trade practice, rather the complainant himself choose the said policy and gave bank account number for making a deduction of the insurance premium and terms and conditions of the Insurance Policy were read over and made understood to the complainant and as per terms and conditions, 15 days Free Look Period from the date of receipt of the copy of Insurance Policy, given to the complainant to accept the terms and conditions or to get cancel the policy, but the complainant never approached within a stipulated period and therefore, the complainant is not entitled for the relief claimed.
9. We have considered the version of both the parties and find that the complainant has categorically stated that his permanent resident is 5 FF, LIG Flats, Bhagat Singh Colony, but the OP has intentionally mentioned his address on the Insurance Policy as Shaheed Bhagat Singh Colony, Jalandhar, for that purpose, we have gone through the insurance policies placed on the file by the complainant Ex.C1 and Ex.C2, wherein the wrong address of the complainant is apparently given i.e. 5 FF Shaheed Udham Singh Colony, Jalandhar and thereafter, when the complainant made objection regarding that, then the OP make a correction in the address of the complainant as 5 FF, Shaheed Bhagat Singh Colony, Jalandhar and that having a correct address, policy is Ex.C-3. So, it is clearly established that the insurance policy as well as other documents i.e. terms and conditions never reached up to the complainant and moreover, the OP has not brought on the file any Postal Receipt or other mode of proof for sending the said document alongwith policy to the complainant, if so then, the version put forth by the complainant that he received the policy document alongwith terms and conditions on 29.07.2016 is correct version and accordingly, if we see the case of the OP that the complainant has to approach to the OP within a Free Look Period of 15 days, from the receipt of the insurance policy for cancellation of the insurance policy and accordingly, as per version of the complainant, he received the document on 29.07.2016 and filed a complaint for cancellation of the insurance policy on 02.08.2016, vide application Ex.C-5 and this version of the complainant is not rebutted by the OP in any manner rather the OP has brought on the file an affidavit of the Rajiv Sharma, employee of the Insurance Company i.e. Ex.OPA as well as Insurance Form including Proposal Form i.e. Ex.OP/1, if we considered that the Insurance Form Ex.OP-1 is signed by the complainant after understanding the terms and conditions, whatsoever mentioned therein, even then we conclude the complainant has applied for cancellation of the policy within a Free Look Period of 15 days from the date of receipt of the policy i.e. 29.07.2016 and applied for cancellation of policy on 02.08.2016, but no contrary document has been brought on the file by the OP to rebut this version of the complainant, to establish that the policy document alongwith the terms and conditions was delivered to the complainant, if so then, on which date and by which mode, but evidence came on the file. So, accordingly, we come to conclusion that the version of the complainant is totally proved and therefore, we find that the complainant is entitled for the relief claimed.
10. As an upshoot of our above detailed discussion, the complaint of the complainant succeeds and accordingly, the same is partly accepted and OP No.1 and 2 are directed to cancel the insurance policy bearing No.21619888 and to refund the amount of premium Rs.21,517/- alongwith interest @ 9% per annum from the date of filing complaint, till realization and further, OP No.1 and 2 are directed to pay compensation of Rs.7000/-, to the complainant for mental harassment and further, OP No.1 and 2 are directed to pay litigation expenses of Rs.3000/-. The entire compliance be made within one month from the date of receipt of the copy of order. This complaint could not be decided within stipulated time frame due to rush of work.
10. Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.
Dated Harvimal Dogra Karnail Singh
28.02.2018 Member President
