ORDER

05.07.2024

Sh. Sanjay Kumar, President

1. The factual matrix of the present case is that complainant is a senior citizen and approached  by Mr. Rajbir and Mr. Ravinder Pal Sharma in the month of August 2009 introduced as representative of OP1 and 2. It is stated that complainant told them that he is about to retire and wanted to make some investment in short term plan for three to five years which  would give good return and complainant might use the return for his needs after retirement as complainant attained the age of 55 years.
2. It is stated that the said representative  induced the complainant by telling only  lucrative features of the policy and misrepresented and concealded the other terms and conditions of the policy. It is stated that the said representative of OP2 to win the faith of complainant told that being in Rohini bound to provide best services. It is stated that representative of OP2 further told that there is  a very good policy for  those who wanted to invest in short term plan have to pay premium initially for three years and investor could opt for the half yearly or  yearly installment payment method and would be entitled to withdraw the entire amount alongwith interest earned after 5 years from the date of  purchase  of policy, if desires or could continue with the plan for further period.  It is stated that if complainant would not be satisfied with the policy he might not continue with it and stop  paying premium after depositing initial six half yearly installment and could withdraw the amount after five years which would be just double of the amount deposited.
3. It is stated that complainant as advised by Mr. Rajbir purchased the  policy with half yearly  payment plan with Rs.25,000/- and kept  depositing the hard earned money  for his retirement for next three years  i.e till 2012. It is stated that complainant deposited Rs.1,50,000/- with OP2 through OP1, however,  neither OP1 nor OP2 ever issued any receipt or statement of  account nor given any information regarding policy status or performance  of the policy.
4. It is stated that the complainant as per advise given by Mr. Rajbir/RavinderPal Sharma regarding payment terms, stopped depositing investing the money,  installments as it was told by the representative of OP2 that the complainant would have to deposit the money  for period of initial three years only and thereafter had to block the money deposited for further period of two years and could withdraw the money with handsome return after five return or could leave the money remain invested with OP2 and the policy would remain in force as long as the sufficient money is there. It is stated that complainant visited OP1 on various occasions to enquire  about the policy but representative started avoiding meeting and OP1 refused to entertain the complainant and told to visit Connaught Place branch.
5. It is stated that in the month of Febraury-March 2014 the complainant started receiving various call from the people who represented themselves as the authorized representative of OP2 and belong to Loyalthy Customer Relation Department and as the complainant was shortlisted by OP2 for the special benefits asked to invest in other invest plans of OP2. It is stated that complainant tried to enquire from them about his policy as the period of five years had been  over but they showed their ignorance and told to make call to those customers who had been shortlisted for new launched plan of OP2.
6. It is stated that complainant visited regional branch office of OP situated at 16/17 WEA, Arya Samaj Road, Karol Bagh, New Delhi in the month  of  2014 to enquire about his policy and to make a request for withdrawal of amount than shocked and surprised  to know that the policy of the complainant has been lapsed due to non payment  of the premium and complainant can get only Rs.47,490/- towards the policy. It is stated that complainant was stunned and traumatized to hear  this, when he wanted to lodge a grievance/complaint, the representative of the regional branch refused to entertain and advised to write an email to the head office at email address
7. It is stated that the OP1 and 2 from the acts, deeds and chain of events illegally and wrongfully  withheld a huge amount of complainant utilizing the same at their end and earning interest thereon and when after completion of initial period of 5 years the complainant wanted to withdraw his hard earned money with the belief that the amount deposited must  have gone double but was shocked to know that the value of policy had come down to Rs.47,490/- whereas the complainant had deposited Rs.1,50,000/- with OP2 as per assurance given by representatives at the time of issuance of the policy.
8. The complainant is seeking direction against OP to refund Rs.1,50,000/- alongwith compoundable interest @ 24% per annum till the actual payment of money, to pay Rs.1,00,000/- as compensation towards the mental tension, agony and harassment and to pay  Rs.35,000/- towards the cost of litigation.
9. OP1 and 2 filed detailed reply and taken preliminary objection that present complaint is liable to be dismissed on account of non joinder of necessary parties Mr. Rajbir/Ravinderpal Sharma i.e the insurance agent/advisor who had allegedly misinformed the complainant about the terms and conditions of the insurance  policy, relying upon which the complainant alleges misselling of the policy as they can testify as to what terms of  the insurance complainant was informed by them. It is stated that there is no cause of action for  filing of present complaint and it is an after thought  and filed to extort money from OP1 and 2, therefore, liable to be dismissed. It is stated that complainant had himself approached OP for insurance policy and after the satisfied with all terms and conditions of the policy had agreed to take the policy. It is stated that there is no negligence of deficiency of service on the part of OP1 and 2, therefore, present complaint is liable to be dismissed.
10. The OP1 and 2 made preliminary submissions that complainant does not  fall under the definition of ‘consumer’ and refer to the judgment of Ramlal Aggarwala Vs. Bajaj Allianze Life Insurance Co. Ltd. & Anr. and Smt. Shanti Kumari Sahu Vs. Bajaj Allianz Life Insurance Co. Ltd. Appeal No. 162/2010 (State Commission  of Orissa). The OP1 and 2 also referred to judgment of  Prema & Ors. Vs. Life Insurance Corporation of India Ltd. IV (2006) CPJ 239 (LC).
11. The OP1 and 2 referred to the clause 6 (2) of the  Insurance Regulatory and Development Authority Regulations 2002. It is stated that the complainant with best  known reasons has not pleaded that he had voluntarily applied for the insurance policy after knowing fully well about the terms and conditions of the policy. It is stated that the proceedings before this Hon’ble Forum are essentially summary in nature  and adjudication of issues such as fraud, forgery which involves disputed factual questions should not be adjudicated before the Hon’ble Forum as  it requires examination whether in view of the disputed facts it would  exercise the jurisdiction. The matter  should be examined by an appropriate court of law and not by the commission. The OP referred to the case of Oriental Insurance Company Ltd. Vs. Muni Mahesh  Patel 2006 (IV) CPJ 1, Harbans and Co. Vs. State Bank  of India, II (1994) CPJ 476, Jayantilal Keshavlal Chauhan Vs. The National Insurance Company Ltd. 1994 (1) CPR 396 and General Assurance Society Ltd. Vs. Chandmull Jain (1996) 3 SCR 500.
12. It is stated that complainant after complete understanding of the terms and conditions of product “Reliance Premier Life Plan” a unit link plan voluntarily applied for an insurance policy vide proposal form and in the proposal form all the relevant details and information has been provided in the prescribed  form for an assured sum. It is stated that the policy no.15203829 was duly  dispatched to the complainant at the address provided in the application form and the same was duly delivered to the complainant. It is stated that complainant has approached after five years at a belated period on 14.05.2014 with a malafide intention to get the policy cancelled, although documents received in the Month of October 2009. It is stated that as per the policy contract complainant has to pay the premium annually but he did not pay the premium annually due to which the policy of the complainant was got lapsed due to non payment of premium. However, the complainant is entitled to the fund value (if any) of the lapsed policy after the deduction of applicable charges as per  the terms and conditions of the policy accordingly, due to non payment the policy has been foreclosed.
13. It is stated that complaint has been crafted to show that there is deficiency of service on the part  of OP1  and 2 and wrongly portrayed that complainant has fulfilled his part whereas OP has failed to  fulfill his part of contract. It is stated that the claim is paid by any insurance company out of the common pool of funds belonging to all policy holders of the company and insurance company has to check the genuineness of a claim before settling it. It is stated that the insurance company cannot do injustice to genuine policy holders by allowing ingenious and false claims.
14. On merit all the  allegations are denied and contents of preliminary objections and submissions are reiterated. It is stated that OP has sent a letter dated 04.07.2013 to the complainant in respect of termination of his policy no.15203829 post revival expiry period but the complainant did not pay any heed to this letter. It is stated that complainant had  taken an investment policy and paid premium upto three years and as  per the terms and conditions  of the policy  due to non payment of premium the policy was foreclosed. It is stated that complainant  is not entitled to any relief claimed in the complaint.
15. As per record complainant has not filed rejoinder to the WS of OP1 and 2.
16. Complainant filed evidence by way of his affidavit. In the affidavit contents of complaint reiterated. The complainant relied on copy of first premium receipt Ex.CW1/1, policy schedule Ex.CW1/2, policy plan Ex.CW1/3, copy  of email dated 14.05.2014 Ex.CW1/4 and reply email of OP dated 16.05.2014 Ex.CW1/5.
17. OP1 and 2 filed evidence by way of affidavit of Sh. Naresh Verma Executive Territory Manager. In the affidavit contents of WS reiterated. OP1 and 2 relied on the copy of policy delivered to complainant Ex.OP1/1, copy of letter dated 04.07.2013 Ex.OP1/2 and copy of email dated 16.05.2014 Ex.OP1/3.
18. Complainant as well as OP1 and 2 filed written arguments.
19. We have heard Sh. Dilip Arya counsel for complainant. The counsel for  OP  did not address arguments on 20.05.2024, however we have perused the written arguments filed by OP1 and 2. 
20. The complainant alleged that he was approached by one Mr. Rajbir and Mr. Ravinderpal Sharma, who introduced themselves as advisor and representative of OP2 insurance company. The OP has taken objection that the present complaint is bad for mis joinder of Mr. Rajbir and Mr. Ravinderpal Sharma who allegedly misinformed and mis sell the policy to the complainant. The complainant has not filed any reply to the same objection by filing rejoinder and also not given any explanation in the evidence why both are not made party who alleged to misrepresent and mis sell the insurance policy of OP2. According to OP  the complainant had taken the policy “Reliance Premier Life Plan” a unit link plan and voluntarily applied and filled up the proposal form. It is admitted by complainant that after five years he had approached to the OP on 14.05.2014 although the policy documents were received in the month of October 2009. According to OP a letter dated 04.07.2013 was also sent to the complainant of “termination of his policy no. 15203829 post revival expiry period but complainant did not pay any heed.
21. The complainant filed on record the policy documents. As per policy the plan name if Reliance Premier Life, paying term is for 15 years and date of commencement is 30.09.2009, the basic sum assured is Rs.10,00,000/-, frequency of payment is half yearly installment premium of Rs.25,000/-. It also has copy of common proposal form for life insurance link plan. As per policy documents the agent is Mr. Rajbir. The complainant also admitted  the fact that he had received the letter dated 04.07.2013. The circumstances established that present case is based on allegation of “Mis selling” by the agent Mr. Rajbir. Admittedly, complainant did not impleaded as party in the present complaint. According to OP the policy and policy documents alongwith proposal  form were sent to complainant with an opportunity to review/cancel the policy within 15 days i.e “free look period” as per clause 4 (1) and 6 (2) of IRDA (protection of policy holders interest) Regulations 2002. Admittedly, complainant did not raise any objection after receiving the policy documents within free look period, therefore, complainant failed to establish the deficiency of service or unfair trade practice against OP insurance company.
22. On the basis of above observation and discussion, present complaint is dismissed. No order as to cost. File be consigned to record room.
23. Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving an application from the parties in the registry. The orders be uploaded on www.confonet.nic.in.

Announced in open Commission on  05.07.2024.

     SANJAY KUMAR                 NIPUR CHANDNA                       RAJESH

       PRESIDENT                             MEMBER                                MEMBER