Chandigarh

DF-II

CC/49/2016

Mrs. Rajinder Kaur Dhindsa - Complainant(s)

Versus

SBI Life Insurance Co. Ltd., - Opp.Party(s)

In Person

10 Jun 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

======

Consumer Complaint  No	:	49 of 2016
Date  of  Institution	:	20.01.2016
Date   of   Decision	:	10.06.2016

 

 

 

 

 

1]  Rajinder Kaur Dhindsa wife of Sh.Vikram Singh, resident of House No.2143, Sector 42-C, Chandigarh

 

2]  Rupinder Kaur D/o Vikram Singh, resident of House NO.2143, Sector 44-C, Chandigarh.

 

             …..Complainants

Versus

 

1]  SBI Life Insurance Company Ltd., Chandigarh, First Floor, Sector 7-C, Madhya Marg, Chandigarh.

 

2]  The Insurance Ombudsman, Office of the Insurance Ombudsman, SCO No.101-103, Sector 17-C, Chandigarh 160017 Deleted vide order dated 21.3.2016

 

….. Opposite Parties

 

BEFORE:  SH.RAJAN DEWAN            PRESIDENT

SH.JASWINDER SINGH SIDHU   MEMBER

 

 

Argued by:-

            Sh.N.P.Sharma, Counsel for the complainants.

            Sh.Rajneesh Malhotra, Counsel for OP-1.

            OP-2 deleted.

           

 

PER JASWINDER SINGH SIDHU, MEMBER

 

 

         Succinctly put, on the basis of false promises of gift of gold coin and a dinner set made by the agent of the OPs, at the time of explaining the policy features to the complainants, the Complainant No.1 obtained Policy No.35072458608 for a sum of Rs.30,000/- for a period of seven years and complainant No.2 obtained a policy No.35072217503 in Oct., 2014 for seven years.  It is averred that the Opposite Party No.1 made allurement to the complainants that after making the policy, after 2/3 days, the said company has to gift a Dinner Set for the policy of Rs.30,000/- and for Policy of Rs.1. lacs has to gift a Gold Coin. It is also averred that the complainants did not receive the policy documents and this matter was brought to the notice of Opposite Party No.1, but nothing was done. Ultimately, the complainant NO.1 sent letter to the Opposite Party No.1 for stopping the policy of Rs.30,000/-. Further, the complainant No.1 made several requests to the OPs to handover the gold coin for the policy of Rs.1.00 lakh, but it did not pay any heed. Hence, this complainant has been filed alleging the above acts & conducts of the Opposite Party No.1 as deficiency in service.

 

2]       The Opposite Party NO.1 has filed reply stating therein that complainant No.2-Rupinder Deep Kaur has applied for SBI Life-Shubh Nivesh-Endowment Plan-Series 2, in her name through two Proposals dated 6.10.2014 with a regular yearly mode of premium payment of Rs.29,501/- and Rs.99,902/- for a term of 7 years and accordingly the policies bearing No.35072458608 and 35072217503 (Ann.A-1 & B-1), on receipt of premium amount of Rs.30,000/- & Rs.1.00 lakh respectively, have been issued. The policyholder Ms.Rupinder Deep Kaur has assigned the policy NO.35072458608 in favour of the complainant No.1, Ms.Rajinder Kaur Dhindsa on account of love and affection vide endorsement dated 30.10.2014 (Ann.C- & D).  Then, the policies were sent to the complainants at their address through speed post and the same were not returned undelivered, thus the policies were duly delivered to the complainant.  It is asserted that the policies were issued on the basis of duly signed proposal forms.  It is also asserted that the policyholder has not opted for Free Look Cancellation within the stipulated period of 15 days from the date of receipt of the policy. It is denied that the Opposite Party No.1 promised the complainant to give dinner set as well as Gold Coin as gift on the purchase of policies, as alleged. It is pleaded that the policy No.35072458608 is in lapse status due to non-remittance of renewal premium due on 15.10.2015. Pleading no deficiency in service and denying rest of the allegations, it is prayed that the complaint be dismissed.

 

3]       Rejoinder has been filed by the complainant thereby reiterating the assertions as made in the complaint and controverting that of the reply of Opposite Party NO.1.

 

4]       Parties led evidence in support of their contentions.

 

5]       We have heard the ld.Counsel for the complainant, ld.Counsel for Opposite Party No.1 and have also perused the record.

 

6]       The complainants, who had subscribed for two different policies of Rs.1.00 lakh and Rs.30,000/- each, on the false promises of gifts of a Gold Coin and a Dinner Set, on these policies respectively. On not receiving the policy documents and also the promises gifts, the complainant approached the OPs with their personal visits, telephone calls as well as written representations, copies of which are found annexed at Page-10 to 13 of the Paper book, did not elicit any favourable or concrete reply from the OP No.1.  As all the requests of the complainants fell on deaf ears of the OP No.1, the complainants moved the Office of Insurance Ombudsman, through their complaint No.CHD-L-041-1516-0986, but unfortunately, that too did not reach any conclusion even after the  complainants having given their unconditional and irrevocable consent for the Insurance Ombudsman, to act as Mediator between the OP No.1 & themselves, to give its recommendations for the resolution of the complaint filed by them. 

 

7]       Though the OP No.1 have plainly denied all the allegations of the complainants, but has failed to place on record any proof of delivery of the policy documents at the complainants end and such obligation to prove the delivery of policy documents squarely lay at its door step alone.

 

8]       The complainants right to exercise their free look period of 15 days only began on the date when the policy documents come to their hand physically and this aspect was to be conclusively proved by the OP No.1. In the absence of any cogent evidence of delivery of policy documents, the complainants’ right to exercise free look option did not began at all. A judgment of Hon’ble National Consumer Disputes Commission, in Revision Petition No. 1324 of 2012, wherein it is held that the onus to prove the delivery of the policy terms & conditions to the consumer was on the Insurance Company and in order to substantiate this, a cogent proof of such delivery by way of a receipt duly signed by the consumer was the only evidence, that could satisfy such factor. Hence, in the present case, the Opposite Party No.1 has failed to bring on record any proof that policy documents, were delivered to the Complainants, by preserving such receipt signed by the consumers, as a token of proof of its delivery, enabling them to appraise the same.  

 

9]       The OP No.1 even after coming to know about the false promises of gift of Gold Coin as well as a Dinner Set, did not ask its agent, whose name is found mentioned as Aseem Verma, bearing Code-990396540, on Ann.A at Page 13 of its reply, about the veracity of these allegations nor did it investigate the matter to its logical end to find out the truth, which certainly amounts to deficiency in service on its part.  Though the Insurance Company may claim that the Agent at the time of handing over the proposal form along with the premium, acted as an agent of the complainants, but it cannot be denied or falsify that all these insurance agents, are either on the payrolls of the insurance companies or are deriving commissions/benefits, which are paid by the insurance companies on each such sale of the insurance policy. Therefore in these set of circumstances, the insurance agent, while approaching a perspective client, acts as an agent of the Insurance Company while explaining the features of the policy, which he intends to sell, so as to derive maximum benefit/commission for himself and the insurance company.  Thus, at this point of time, all actions of the Insurance Agent for making false promises, allurements, misinterpretation of insurance document and its terms & conditions & clauses, the Insurance Company/OP No.1 alone is answerable.  Even the IRDA Guidelines, which bound a registered Insurance Agent, clearly mentioned that an Insurance Agent has to act in a professional manner and explain all the policy features in a dispassionate & unbiased manner.

 

10]      That the INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY, vide NOTITICATION dated 16th October 2002 – under Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002  has stipulated under Regulation 11 - Clause-4, as below:-

(4) Any breaches of the obligations cast on an insurer or insurance agent or insurance intermediary in terms of these regulations may enable the Authority to initiate action against each or all of them, jointly or severally, under the Act and/or the Insurance Regulatory and Development Authority Act, 1999. 

 

11]      Therefore, in the light of aforementioned regulation, it was obligatory upon OP No.1 to investigate the allegations of the complainants about the act & conduct of its agent and recommend proper action to the IRDA, which it had failed to do so. Such an act of sleeping over the complaints of the complainants, amounts to deficiency in service as well as an irresponsible act, on the part of the OP No.1, which must not go unaddressed.

 

12]      In the light of above observations, we are of the concerted view that the Opposite Party No.1 is found grossly deficient in rendering proper service to the complainants. Hence, the present complaint of the Complainants is allowed qua Opposite Party No.1. The Opposite Party No.1 is directed as under:-

[a]      To refund the premium amounts of Rs.1.00 lakh and Rs.30,000/-to the complainants, respectively, along with saving interest @6% p.a. from the date of deposit till it is paid;

 

[b]      To pay Rs.35,000/- to the complainants as consolidated amount of compensation for causing mental agony and harassment on account of deficiency in service.

 

[c]      To pay litigation expenses to the tune of Rs.10,000/-

 

         The above said order shall be complied within 45 days of its receipt by the Opposite Party No.1; thereafter, it shall be liable to pay an interest @18% per annum, on the awarded amount as at sub-para [a] from the date of deposit till it is paid & also on the amount as at sub-para [b] above from the date of filing of the complaint till it is paid, apart from paying litigation expenses as aforesaid.

 

        The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

Announced

10^th June, 2016                                                            Sd/-

                                                        (RAJAN DEWAN)

PRESIDENT

 

Sd/-

(JASWINDER SINGH SIDHU)

MEMBER