Order-8.

        AUTHOR.  SRI RABIDEB MUKHOPADHYAY, MEMBER.

This is an application u/s.12 of the C.P. Act, 1986. It is stated that the complainant invested an amount of Rs 19992/- on 30/9/2013 with the OP Company in Policy No

51236976 under RLI Money Multiplier Plan as a yearly premium for the first time. It is stated that the complainant again paid Rs 19685/- on 18/10/2014 for his second annual income.

        The complainant stated that he could not pay the third premium in time and on a phone call (9434026941) from the local branch of OP at Contai requested to sign a Form (which he did), received an amount of Rs 20863/- including late fee and had him some pathological tests.

        It is stated that after a few days, the third premium was refunded to the complainant and the Shyambazar branch of OP intimated him that the Policy had already lapsed.

        The complainant expressed grievance that he had not been properly informed of the lapse of the Insurance Policy in spite of the OP having received the 3^rd premium with late fee.

        The complainant prayed for refund of Rs 39677/- being the amounts of first two premiums with 8.5 percent interest from the date of deposit, Rs 30000/- as compensation and Rs 15000/- as litigation cost.

WRITTEN VERSION.

No participation in the proceedings has been done and no WV has been filed by the OP.Postal Track report shows that the summon has been delivered to the OP.

Points for Decision

1. Whether the complainant is a consumer;
2. Whether the OP is deficient;
3. Whether the complainant deserves relief.

Decision with Reasons

1) We have perused the copies of documents including first two premiums and the Policy filed by the complainant. The complainant did not file copy of the Receipt of 3^rd Premium which was returned to him by the OP.

 2) The fact remains that as admitted by the complainant, he could not deposit the 3^rd Premium in time. There are provisions to deposit premiums with late payment charges. The same was done in this case also. One representative of the Contai local branch called the complainant from his cell number 9434026941 and received Rs 20863/- as 3^rd Premium including late payment of about Rs one thousand rupees. As the said of 3^rd premium amount has been returned to him by the OP and as the complainant did not claim in the prayer, he did not file documents in this regard, it is presumed.

3) So, the Policy should have run smoothly after clearance of the hurdle. But astonishingly the said amount was returned to the complainant by the Shyambazar branch of OP intimating the complainant that the Policy had already been lapsed.

        4) Question arises if the Policy had already been lapsed, why the representative of Contai local branch phoned him and asked him to pay the 3^rd Premium with late payment charges? It is admitted by the complainant that he was subjected to some clinical tests by the OP after payment of the 3^rd Premium. The report of such tests was not intimated by the OP to the complainant. For the sake of argument, if it is guessed that the report was not in favour of the complainant, then how was the Policy got lapsed already?

5) It was the duty of the OP to put the complainant to medical test before issuing any Insurance Policy. Since the OP issued the Policy on payment of the 1^st Premium, it is presumed that the complainant was medically fit to be issued the Policy unless otherwise was proved by the OP.

6) The OP did not intimate why it had lapsed the Policy, that too after receiving the 3^rd Premium. If it was already lapsed, then why did OP contact the complainant and receive the amount of 3^rd installment of Premium?

7) So, such alleged lapse of the Policy has no reasonable explanation and clearly seems to be arbitrary and one sided. This is not the example of ‘Uberima Fides’. It is not the duty of only the insured to maintain the condition of Good Faith which makes the foundation of insurance contract. The OP is is seriously deficient in this conduct.

8) Experience reveals that every tactis is played by most of Insurance Companies with sugar coating behavior of Insurance Agents who virtually rush to insures’ residences while procuring cases of Insurance but their hidden gesture and posture surfaces after running of Policy or at the time of making payments. Most of the Insurance Companies, mainly of Private Sector, do not even bother the directives of IRDA in respect of Foreclosure and Late Payments.

        9) Though documents have been produced by the complainant in support of his case and claim, it could be controverted by the OP. But the Evidence on Affidavit in support of the contents of the complaint remained unchallenged and uncontested. As the OP did not bother to reply to the allegations leveled against it by the complainant It is presumed under the thumb rule of Evidence that OP admitted such allegations.

        10) In such a situation, the complainant who paid consideration in the form of Premiums to the OP is a consumer under it and the OP who was expected to render assured service to the Insured/complainant but failed to do so, is deficient. In real sense, the complainant could not understand what his fault for the lapse of the Policy was. The complainant seems to have been the victim of devastating policy of the OP Insurance Company to collect Premiums and deny duties and liabilities. The OP is highly deficient and the complainant deserves relief retrieving the complainant in his pre-insurance condition.

        In the circumstances of above analysis, we are constrained to pass

ORDER

        That the complaint be and the same is allowed exparte against the Opposite Party, Reliance Life Insurance Company, u/s 13(2)(b)(ii) of the C. P. Act, 1986;

        That the O.P. is directed to return Rs 39677/- with 8 percent interest from the date of deposit of the amounts (OnRs 19992/- from 30/9/2013 and on Rs 19685/- from 18/10/2014) till date actual payment along with compensation of Rs 5000/- for physical harassment and mental agony and litigation cost of Rs 5000/-, to the complainant within 30 days from the date of this order;

        That on failure of the O. P. to comply with the above order within the stipulated time, the complainant shall have the liberty to put the order into execution in terms section 27 of the Act ibid.

Let copy of this order be handed over to the parties when applied for.