DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II U.T. CHANDIGARH [Consumer Complaint Case No: 510 of 2011] -------------------------------- Date of Institution : 08.11.2011 Date of Decision : 19.09.2012 -------------------------------- M.M. Bakshi son of Late Shri S.S. Bakshi, resident of Flat No. 504, Lotus Block, Amravati Enclave, P.O. Chandimandir, Panchkula – 134 107. ---Complainant V E R S U S [1] Shreeganesh Corporate Services, SCO No. 46, N.A.C. Manimajra, Chandigarh. [2] MAX New York Life Insurance Co. Limited, SCO No. 36-38, Sector 8-C, Madhya Marg, Chandigarh. ---Opposite Parties BEFORE: SH. LAKSHMAN SHARMA PRESIDENT MRS.MADHU MUTNEJA MEMBER SH. JASWINDER SINGH SIDHU MEMBER Argued By: Complainant in person. Opposite Party No.1 ex-parte. Sh. Rajneesh Malhotra, Counsel for Opposite Party No.2. PER JASWINDER SINGH SIDHU, MEMBER 1. Complainant has filed the present complaint, against the Opposite Parties on the ground that the Complainant had earlier subscribed for a life insurance policy from Opposite Party No. 2 in the year 2007 by paying an annual premium of Rs.1,00,000/- each for a period of 03 years, vide Policy No. 442852596 and was insured for a sum of Rs.5,00,000/-. The said policy matured in July, 2010 and the Complainant received a sum of Rs.3,39,285.23P, vide Cheque No. 986222, dated 15.11.2010. The Complainant having faith in Opposite Party No.2 on being approached subsequently in the year 2008 by their Agent subscribed for another policy with an understanding that the new policy too would be on the same lines of the previous policy of the year 2007 preferred to pay an annual premium of Rs.1.5 lac and with a life insurance cover of Rs.10.00 lacs for a period of 03 years. The Complainant issued a Cheque No. 368781 dated 3.7.2008 drawn on IndusInd Bank, Panchkula for this purpose. The Complainant claims to have received the said Policy Document No.490344702 at his residence in Sept.2008, but preferred not to go through this document believing it to be on the same lines as the previous policy of the year 2007. The Complainant paid the three premiums due towards him on time and in the year 2011, inquired about the payment of the fund value of the said policy as mentioned in para 9 of the present complaint but was shocked to know that the term of the said policy was not for three years, but for ten years. The Complainant checked the policy documents lying with him and having gone through the proposal form, copy of which was supplied to him with the policy document, noticed that the original proposal form filled up by him in his own hand was not the same but another proposal form though signed by him and filled up by the agent was found attached with the policy document. The Complainant claims in para 11 of his complaint that as many as 06 (six) discrepancies mentioned under sub-para (a) to (f) of para 11 were found in the policy document, thus, claiming that the proposal form was deliberately changed and the policy document did not match with policy desired by him. The Complainant claims to have written a letter dated 7 July, 2011, to Opposite Party No.2 (pg.19 & 20) as well as to different offices of Opposite Party No.2. However, the Complainant not satisfied with the replies dated 9 July, 20 July and 25 July, in response to his letter, claims that his grievance was not properly addressed, but a simple communication was made and nothing concrete was done by the Opposite Parties. The Complainant further wrote another letter dated 22.9.2011 requesting the Opposite Parties to supply him the photo copy of the document with his signatures to prove that the date of delivery of the policy document so that he could ascertain the free look period; Secondly, to correct the father’s name of the nominee in the said policy document. The Complainant claims that no response was received at his end in reply to the request dated 22.9.2011 till the time of filing of the present complaint. The Complainant claims that as the said policy no. 490344702 be declared incomplete and illegal for the aforementioned reasons, as well as other reasons e.g. the same not having been completely signed with regard to the declaration that the Complainant had understood all the terms and conditions of the Policy, thus claiming deficiency in service on the part of the Opposite Parties, the Complainant has preferred the present complaint, claiming the following relief: - [a] Refund of Rs.4.50 lacs (paid against 03 annual premiums of the year 2008, 2009 & 2010) along with interest @18%p.a. from the date it is due, till the actual realization; [b] To pay Rs.1.00 lac as compensation for concealing the terms and conditions of the said policy and causing harassment and mental agony to the Complainant;. [c] To pay Rs.10,000/- as cost of present complaint; The complaint of the complainant is supported by his detailed affidavit. 2. As Opposite Party No.1 being duly served has failed to put in its appearance in person or through its representative, therefore, it was proceeded against ex-parte vide order dated 01.02.2012. 3. The Opposite Party 2 has contested the claim of the complainant by filing its reply, taking preliminary objections to the effect that the policy in question was dispatched on 26.7.2008 by Overnight Courier, Airway Bill No. 566757234 and was handed over to the Complainant on 28.7.2008. Secondly on the ground that the admission of the Complainant of having received the policy document in the month of September, 2008 precludes the Complainant in raising this issue in the year 2011 as he had the opportunity to cancel the same there and then. The Complainant had himself did not prefer to exercise his option of the free look period as per cl. 25 of the policy document within 15 days from the date of its receipt, thus, claiming no deficiency in service on their part, Opposite Party No. 2 pray for the dismissal of the present complaint on this ground alone. Other objections with regard to the Complainant not being a consumer as defined under the Consumer Protection Act, 1986 as well as the territorial jurisdiction are taken. Furthermore, Opposite Party No.2 claims that as the present dispute involves a disputed question of facts and law, hence, the same cannot be adjudicated upon by way of summary procedure under the provisions of Consumer Protection Act, 1986. On merits, the Opposite Party has repeated their preliminary objections, while replying to the averments of the present complaint, in their para-wise reply. The contents of para 1 and 2 are denied being wrong and for want of knowledge. Contents of para 3 with regard to the proposal form number 442852596 related to the product name ‘LIFE INVEST UNIT LINKED INVESTMENT 3 PAY PLAN’ is admitted. The same having been surrendered and payment of Rs.3,39,285.23P made to the complainant, is admitted. In reply to para 4 Opposite Party No. 2 claims that the Complainant submitted the proposal for ‘SMART ASSURE UNIT LINKED INVESTENT PLAN’ with a commencement date of 23.6.2008, the terms and conditions of this policy are annexed as Annexure R-1 and R-2. The contents of Para 5, 6 and 7 of the complaint are denied being wrong and the policy having been issued on the basis of the proposal form. In reply to para 8 the receipt of 3 premiums of the year 2008, 2009 and 2010 is admitted. In reply to para 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 and 21 are stated to be wrong and denied. In reply to para 22 of the complaint, the Opposite Party No.2 claim that the contents of this para are wrong and denied and as already explained in preceding paras the policy in question stands canceled and the refund has already been sent to the Complainant and therefore, the present complaint becomes infructuous and deserves to be dismissed accordingly. Thus, claiming no deficiency in service or unfair trade practice on their part, the answering Opposite Party has prayed for the dismissal of the complaint with heavy costs. The reply of the Opposite Party is duly verified and supported by detailed affidavit of Sh. Juhi Kulshrestha, Assistant Manager (Customer Care). 4. Having gone through the entire complaint, version of the Opposite Party No.2, the evidence of the parties and with the able assistance of the Complainant and learned counsel for the Opposite Party No.2, we have come to the following conclusions. 5. We have perused the letter dated 7.7.2011 written by the Complainant (Pg.19), wherein the Complainant for the 1st time had raised his objections with regard to the policy no. 490344702 and demanded a categorical response from the Opposite Parties on different issues mentioned under different headings and finally, in the last paragraph No.10 (Pg.20) the Complainant categorically states that he is a 73 years old person and does not prefer to pay any further premium, requested that as the policy would complete three years time on 23 July 2011, a refund under the said policy on the basis of fund value be made in his favour. This letter was also forwarded to the different offices of Opposite Party at Gurgaon, Chandigarh and Insurance Ombudsman, Chandigarh. We have gone through the reply dated 9 July, 20 July and 25 July, 2011 from the side of the Opposite Party No.2, but we could only find a single line answers, without touching any aspect of the letter dated 7.7.2011 from the side of the Complainant. The Complainant thereafter, again wrote a letter dated 30th July, 2011, which too on being replied by the Opposite Parties through their communication dated September 8, 2011, claims that the request of the Complainant was outside the free look period. The request of the Complainant made through his letter dated 22nd Sept., 2011, with regard to the supply of his signed receipt of policy document, as well as the corrections of the name of the father of the nominee mentioned in the policy document was not replied at all by the Opposite Parties. 6. We feel that as the Complainant had himself admitted that though he had signed the proposal form for the said policy but the contents thereof were entered into by the agent of the Opposite Parties and it was on the basis of this proposal form the Opposite Party No. 2 had raised the policy document bearing no. 490344702, hence in this matter, the objections of the Complainant carry no force, as it was incumbent upon him to go through the each and every clause before appending his signatures. 7. We are also of the view that the agent of the Opposite Parties had acted as an agent of the Complainant, at the time of filling up the proposal form and any discrepancy that may have arisen while filling up this form did deserve to be rectified by the Opposite Parties if raised by the subscriber of the policy at a later stage. We are also of the view that as the policy document is raised after having accepted the proposal form and if the Complainant does not exercise his option of 15 days free look period, to return the policy document, the same also does not take away his right to raise any objection about bonafide correction that may have escaped his observation during the free look period. As the policy was to run for a period of ten years and that during this currency of the policy the Complainant wanted the name of father of the nominee to be corrected was very much within his right to demand the same. The Opposite Parties would not have lost anything if this simple demand of the Complainant was met. But the Opposite Parties preferred to ignore this aspect altogether and kept on beating around the bush by claiming that the Complainant had lost his opportunity to seek any change as he did not prefer to do so during the free look period. The Opposite Parties are found deficient in service on this count. 8. The Complainant in his very first communication dated 7.7.2011 had expressed his desire to not to continue the said policy and requested the payment towards the said policy on the basis of fund value as on 23rd July, 2011, on completion of three years but the Opposite Parties however kept on dilly-dallying on this genuine request and failed in giving any conclusive and certain answer to his request. The Complainant while reiterating his stand through his addl. evidence in the shape of an affidavit in response to the affidavit of the Opposite Party filed on 30.3.2012 has claimed that his letter dated 7.7.2011 was completely ignored and that their reply dated 9 July, 20 July and 25 July, 2011 were totally out of context and the issues raised by him through his letter dated 7.7.2011. Thus, the Opposite Parties are also found deficient in not addressing the request of the Complainant of refund of his dues as on 23 July, 2011 on the basis of fund value as mentioned in his letter dated 7.7.2011. 9. It would not out of place to mention here that the Opposite Party No.2 in para 22 of the present complaint with regard to the policy no. 490344702 in question claim that the policy in question stands cancelled and the refund has already been sent to the Complainant. We are surprised as to how the Opposite Party No.2 has mentioned this aspect which they have reiterated in the affidavit signed by one Juhi Kulshrestha, Assistant Manager (Customer Care), without bringing on record any document to prove the payment of money, towards this refund, with regard to the policy in question. The Opposite Party No. 2 in this context has made a false submission on oath, because no money has been released in favour of the Complainant towards the surrendered amount of the policy no. 490344702, as the present complaint is based on issue alone. 10.6 We feel that the request of the Complainant made through his communication dated 7.7.2011 was not acted upon by the Opposite Parties, which is a clear cut deficiency in service on the part of the Opposite Parties. We find that the Opposite Parties should have released the money lying with the Opposite Parties on the basis of Net Asset Value (NAV) as on 23.7.2011 i.e. when the policy had completed 03 years, as desired by the complainant. The Opposite Party No.2 has tendered the detailed N.A.V. of the policy in question as applicable on 7.7.2011, 23.7.2011 and 12.9.2012, by tendering Annexure R-5, wherein the value of the policy on these dates is mentioned. Thus, the Opposite Party No.2 has itself proved that the policy in question is still alive and has not been cancelled, and that no refund has been made to the Complainant, as claimed by them in para 22 of their reply. 11. In the light of above observations, we find a definite deficiency in service on the part of the Opposite Parties. Hence, we allow the present complaint against them and direct the Opposite Parties, jointly & severally, to:- [a] To pay Rs. Rs.2,47,201.05P the value of the policy payable as on 23.7.2011 as per the N.A.V. disclosed by Opposite Party No.2, along with interest @9% from 23.7.2011, till the date of order i.e. 19.09.2012; [b] To pay Rs.10,000/- as cost suffered by the Complainant towards the present complaint. 12. The above said order shall be complied within 45 days of its receipt by Opposite Parties; thereafter, they shall be liable for an interest @18% per annum instead of 9% per annum on the amount mentioned in sub-para [a] of para 11 above, apart from cost of present complaint Rs.10,000/-, from the date of institution of the present complaint i.e. 08.11.2011, till it is paid. 13. Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room. Announced 12th September, 2012 Sd/- (LAKSHMAN SHARMA) PRESIDENT Sd/- (MADHU MUTNEJA) MEMBER Sd/- (JASWINDER SINGH SIDHU) MEMBER
| | MRS. MADHU MUTNEJA, MEMBER | HONABLE MR. LAKSHMAN SHARMA, PRESIDENT | MR. JASWINDER SINGH SIDHU, MEMBER | |
