Date of filing : 30-11-2009
Date of order : 01-04-2011
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC. 260/2009
Dated this, the 1st day of April 2011
PRESENT
SRI.K.T.SIDHIQ : PRESIDENT
SMT.P.RAMADEVI : MEMBER
Mrs.Jessy Praveen,
W/o.Dr.Praveen Arora, Anwar Manzil, } Complainant
TB Road, Hosdurg, Kanhangad,
Po. Kasaragod.
(Adv. T.V.Rajedndran, Hosdurg)
1. Reliance Life Insurance Corporation Ltd } Opposite parties
(Reg.No.121), H Block, 1st floor,
Dhirubhai Ambani Knowledge City Navi Mumbai,
Maharashtra, 400 710 rep. By Customer
Service Manager.
2. P.P. Sooraj, Sales Manager,
Reliance Life Insurance Corporation Ltd,
Branch office, Nileshwar.
3. Branch Manager,
Reliance Life Insurance Corporation Ltd,
Branch office, Near Municipal Bus Stand,
Kasaragod.
(Adv. A.Vidhyadharan, Hosdurg)
O R D E R
SRI.K.T.SIDHIQ, PRESIDENT
Bereft of unnecessaries the case of the complainant is that attracted by advertisements and the explanation by the insurance agent 2nd opposite party about the insurance policies offered by opposite party No.1 she proposed for Reliance Automatic Plan policy having a single premium. The proposal Form was duly filled by her husband Dr. Praveen Arora and signed by the complainant. It was handed over to second opposite party with supporting documents and premium `25,000/-. A temporary receipt dt. 17-2-2009 was also issued after 3 days. But the policy was not issued in April 2009. On 02-05-2009 an open packet containing the policy was handed over to the complainant by a relative of the insurance agent. On verifying the policy it is found that the policy issued by the complainant was not that applied for and the copy of the proposal issued with the policy was not that is submitted by the complainant. The actual proposal form entrusted with the agent was duly filled by the complainant’s husband in his hand writing for a single premium plan. But the copy of the proposal attached with policy was seen filled by some body else and the plan was changed to that of regular premium payment plan instead of single time premium. The details shown in the proposal form was also found incorrect on many particulars. Though the complainant made complained through E-mail the reply was quite unsatisfactory and according to opposite parties the ‘free look’ period was over and hence they are unable to comply with the request for change in policy. When enquiry made with 2nd opposite party, they initially assured that they will solve the problem soon but later nothing was done. Hence the complaint.
2. Though Notice to opposite party No.1 served, they did not care to appear and defend the case. Hence opposite party No.1 had to be set exparte. Opposite parties 2 & 3 filed version jointly. According to opposite parties 2 & 3 complainant applied for a Reliance Super Automatic Investment Plan (Regular) with policy bearing No.13827370 by paying Annual Premium 25000/- with the risk commencement date (RCD) was 12-2-2009. The said policy was despatched to the complainant on Feb 20, 2009 vide Processional HO Courier bearing No.VPL 4015088640 at the address provided by the complainant as mentioned in application form which was duly received and acknowledged by the complainant. But the complainant has not opted to avail the free look cancellation or modification within 15 days of receipt of the policy document. This was informed to the complainant as per their letters dated July 01, 2009 and August 17, 2009. Therefore the complaint is liable to be dismissed.
3. Complainant filed proof affidavit in support of her claim as PW1. Exts A1 to A9 marked through her. PW2, Dr. Praveen Arora the husband of the complainant examined as PW2. On the side of opposite parties Sri. Prasannakumar, Branch Manager of Reliance Life Insurance Corporation Ltd, Kasaragod Branch filed affidavit. No documents produced or marked on the side of opposite parties.
4. The issues to be settled in this case are
1) Whether there is any deficiency in service on the part of opposite parties?
2) Whether complainant is negligent in not availing the ‘free look’ period for the cancellation and migration from the policy she received?
3) Whether the complainant is entitled for any order in her favour?
4) What order as to relief and costs?
For the sake of brevity issue Nos 1 to 3 are discussed together
5. The definite case of the complainant is that the 1st opposite party had advertised through its Website and other medias that they are selling attractive insurance policies. Apart from that lured with the explanations and offers by the insurance agent and 1st opposite party she agreed to join in Reliance Automatic Plan on 16-2-2009 and the proposal form was signed by her husband Dr.Praveen Arora and entrusted the form with 25000/- as the premium to 2nd opposite party. But the policy was not issued till April 2009. Hence the husband of the complainant made repeated enquiry with 2nd opposite party and later on 2-5-2009 a packet was handed over to the applicant by a third person who is a relative of the Insurance agent. The packet was not closed and on verification she could see that the policy issued to her was not the policy she applied and apart from that the copy of the proposal form attached with the policy was neither filled by her husband nor signed by her. Hence she made enquiry with the 2nd opposite party on 6-5-2009. The 2nd opposite party met the applicant and assured to solve the issue, later they did not do anything to redress her grievance.
6. According to opposite parties the policy was sent to the complainant through courier service on20-02-2009 which was duly acknowledged by her. As per Sec 6(2) of the Insurance Regulatory and Development Authority (Protection of Policy holders Interests Regulations-2002) the complainant should have availed the ‘free look’ cancellation or modifications within 15 days of the receipt of the policy documents, but in this case the free look period has lapsed hence 1st opposite party declined complainant’s request for change the term of the policies. In the reply letters dated 1-7-2009 and 17-8-2009 sent to the complainant also it was informed her that the policy cannot be converted since free look period is over.
7. Ext.A1 is the copy of the policy issued by opposite party No.1 under Reliance Super Automatic Investment Plan (Regular). Ext.A2 is the copy of the proposal Form received by the complainant is along with the policy. Though as per the request of the complainant the original proposal form is produced by the opposite parties it is not marked through either side. Ext.A3 is the copy of Premium Collection Receipt dated 17-2-2009 issued to the complainant. Ext.A4 is the E-Mail dated 23-6-2009 sent by complainant to opposite party No.1. Ext.A5 is the reply marked dated 10-07-2009 issued by opposite party No.1. Ext. A6 is the copy of letter dated nil issued by complainant to opposite party No.1 Ext.A7 is the copy of reply dated 01-07-2009 issued by opposite party No.1 to company. Ext.A8 is the copy of letter dated 24-07-2009 issued by complainant to opposite party No.1. Ex.A9 is the reply dated 17-8-2009 to Ext.A8 issued by opposite party No.1 to complainant.
8. In all the documents produced above the stand of opposite party No.1 is that the policy was dispatched to the complainant on Feb 20,2009 and she did not opt the free look period of 15 days to cancel or modify the policy. Hence they are unable to reconsider the request of the complainant.
9. But to prove the dispatch and delivery of the policy to the complainant as contended by opposite parties no Proof Of Delivery is produced which is a vital document to substantiate their contentions. The non-production of the said POD itself shows that the contention of opposite parties regarding the dispatching and delivering of the policy to complainant on after Feb 20, 2009 is baseless and unsustainable. Therefore they were bound to honour the request of the complainant and the non-compliance of the demand of the complainant to modify her policy to Reliance Automate Plan (single premium) is a deficiency in service on the part of opposite parties.
10. Further the serious allegation of the complainant regarding the substitution of her proposal form by another one with forged signature also casts serious doubts about the nature and manner of business of opposite party No.1.It is pertinent to note that even after such an allegation by the complainant they did not made any enquiry in to that issue. This shows that all those were done with their implied consent which is ethically indefensible.
11. 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. To make the matter more worse in this case the duly filled form submitted by the complainant’s husband Dr. Praveen Arora is substituted by another proposal form which is filled by another that is totally unrelated to the complainant. It was not according to her option or choice and it was solely for the benefit of opposite parties.
12. This is nothing but a very serious deficiency in service which has to be dealt severely. The non-production of the proof of delivery ( P.O.D) of the policy to the complainant further proves that the complainant was not negligent in availing the benefits of free look period, as she did not get a chance to avail such benefits.
13. Therefore the issues 1 to 3 are found in favour of the complainant.
14. Relief & Costs.
The prayer of the complainant is to issue a fresh policy recalling the issued one with a single time premium plan or to refund the premium `25,000/- with 18% interest from 16-2-2009 to till date of complaint with a compensation of `5,000/- and cost of the proceedings.
15. On an over all appraisal of the facts and circumstances of the case we are of the view that the refund of the amount with interest, cost and compensation will redress the grievance of complainant.
Therefore the complaint is allowed with a cost of `5,000/- and opposite parties are directed to take back the policy issued to the complainant and refund `25,000/- with interest @ 12% per annum from the date of receipt of the amount i.e. 16-2-2009 to till date of payment together with a compensation of `5,000/-. Time for compliance is limited to 30 days from the date of receipt of copy of the order. Failing which the rate of interest for `25,000/- will be @ 15% from today till payment.
Sd/- Sd/-
MEMBER PRESIDENT
Exts.
A1.Policy of complainant. 13827370 Client ID No. 008667648
A2. Photo copy of application for Reliance Super Automatic Plan.
A3.Receipt for payment of premium of `25,000/- dated 17-2-2009.
A4. Complaint dt. 23-6-09 Email by Jessy Praveen.
A5.Reply dt. 23-6-2009 E-mail.
A6. Letter sent by complainant to Customer Service Manager.
A7. Reply sent by Reliance Life Insurance to complainant.
A8. 24-7-09 complaint sent by complainant to OP.
A9.17-8-2009 reply sent by OP to complainant.
PW1. Jessy Praveen
PW2. Dr. Praveen Kumar Arora.
DW1. Prasanna Kumar.K.
Sd/- Sd/-
MEMBER PRESIDENT
Pj/ Forwarded by Order
SENIOR SUPERINTENDENT
