In the District Consumer Disputes Redressal Forum, Murshidabad
Berhampore, Murshidabad
Case No. CC/123/2013
Date of filing: 01 /11 /2013 Date of Final Order: 27/02/2015
Rashbehari Sinha
Son of Lt. Probodh Chandra Sinha,
Of 47/6, Madhupur Road,
P.O.- Berhampore,
Dist- Murshidabad ………………………………….Complainant
Vs
Sr.Branch Manager,
Life Insurance Corporation of India,
Berhampore Branch, Krishnath Road,
P.O.- Berhampore,
Dist.- Murshidabad. PIN-742101…………………. Opposite Party
Mr. Prasanta Kumar Sinha, Ld. Advocate………………………………for the Complainant.
Mr.Saugata Biswas, Ld. Advocate………………………………………….for the Opposite Party.
Present: Anupam Bhattacharjee ...………………. President.
Samaresh Kumar Mitra ......…….…..……..Member.
Pranati Ali ............................................Member.
FINAL ORDER
Samaresh Kumar Mitra, Member:
The simple version of this complainant as enumerated in the complaint is that he purchased a policy from the OP, being policy No.426860082 and as per terms and conditions of the policy he had to pay Rs.25,000/- in each year for a period of 5 years. He paid all the premiums and the policy matured on 14.03.2013 and the maturity value becomes Rs.1,41,773/-.That after the maturity he claimed the matured amount and deposited all the documents along with policy certificates. That, on 16/07/2013 he received an unsigned letter bearing Ref. No. 446/ULIP-IPP/Claim-DV/181 informing that the whole amount of Rs.1,41,773/- has been utilized for purchasing a pension policy and this complainant is entitled to get Rs.10,179/- as pension. The aforesaid letter contains that the complainant had given his option to purchase the said policy by a letter but the Ref No or the date of the said letter was not mentioned. The complainant never opted to purchase such pension policy by utilizing the fund. The complainant visited the office of the OP and ventilated his grievances both orally and written but OP turned a deaf year to his cry. The complainant further assailed that the OP negligently, arbitrarily and to make a wrongful gain utilized the fund to purchase the pension policy without obtaining consent from the complainant. The complainant being a patient of heart disease with severe diabetes is badly needed the policy proceeds and not getting such, filed the instant complaint for getting reliefs as prayed for in the prayer portion of the complaint.
By appearing through the agent the OP filed W/V on 29.10.2014 after elapsing a lot of dates and denied the allegations as leveled against him and averred that the complainant purchased a pension policy and the complainant is entitled to get Rs.10,179/- per annum and the bid value of Rs.1,41,773/- is not the matured value and for getting money the complainant attached the medical certificate of a Doctor of Amdanga Block Pry. Health Centre, North 24 Parganas which is ridiculous to this OP. The answering OP assailed that he/they rightly send a letter to the complainant on 16.07.2013 and informed that the bid value of the policy of the complainant is Rs.1,41,773/- and for that reason the yearly annuity of the complainant is of Rs.10,179/-. According to the version of the answering OP that the complainant being an educated man knows very well that he purchased the pension policy and when he requested money for his medical expenditure the OP paid a sum of Rs.1,33,711/- as surrender value of the policy on 18.01.2014 though the complainant did not submit any estimate and or accounts of his medical expenditure to this OP. Hence the claim of the complainant is baseless as the bid value of the policy of the complainant is Rs.1,41,773/- and the OP rightly paid the sum of Rs.1,33,711/- on humanity so the OP is not deficient in providing service to this complainant as such the complaint is liable to be dismissed with cost.
The complainant filed evidence on affidavit on 11th August,2014 in which he stated that he paid Rs.25,000/- as premium for 5 years in a policy of OP and it was matured on 14.03.2013 and matured value was Rs.1,41,773/-. That after the maturity the complainant claimed the amount so matured and submitted all relevant documents along with policy certificate. That on 16.07.2013 through an unsigned letter the OP informed that whole amount of Rs.1,41,773/- has been utilized for purchasing a pension policy and he is entitled to get a sum of Rs.10,179/-p.a. as pension. But he assailed that he never gave any option to purchase the pension policy through a letter. So the conversion of scheme by the OP is voluntarily i.e. without the consent of the complainant. The complainant several times visited the office of the OP to ventilate his grievances but the OP turned a deaf ear at his utterances but paid a sum of Rs.1,33,711/- at his bank account on 18.11.2014 although the balance amount was not paid till date. So this complainant being aggrieved by the act or omission of the OP filed the complaint before this Forum praying to get the rest amount of Rs.8,055/- including interest @10% till the payment, Rs.30,000/- for mental agony and Rs.10,000/- for litigation cost. The complainant filed the letter dated16.07.2013 & Renewal Premium Receipt dated 28.03.2011 of Rs.25,000/- for reference.
Argument as advanced by the agent of the parties on 11.02.2015 has been heard in full.
From the discussion herein above, we find the following Issues/Points for consideration.
ISSUES/POINTS FOR CONSIDERATION
- Whether the Complainant ‘Rash Behari Sinha’ is a ‘Consumer’ of the opposite party?
- Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
- Whether the O.Ps carried on unfair trade practice/rendered any deficiency in service towards the Complainant?
- Whether the complainant proved his case against the opposite party, as alleged and whether the opposite party is liable for compensation to him?
DECISION WITH REASONS
In the light of discussions here in above we find that the issues/points should be decided based on the above perspectives.
(1).Whether the Complainant ‘Rash Behari Sinha’ is a ‘Consumer’ of the opposite party?
From the materials on record it is transparent that the Complainant is a “Consumer” as provided by the spirit of section 2(1)(d)(ii) of the Consumer Protection Act,1986. As the complainant herein being the consumer of the OP, who insured his life before the OP company.
(2).Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
Both the complainant and opposite party are residents/carrying on business within the district of Murshidabad. The complaint valued rest amount Rs.8,055/-+Intt.,Rs.30,000/-as mental agony and litigation cost of Rs.10,000/-ad valorem which is within Rs.20,00,000/- limit of this Forum. So, this Forum has territorial/pecuniary jurisdiction to entertain and try the case.
(3).Whether the opposite party carried on Unfair Trade Practice/rendered any deficiency in service towards the Complainant?
The opposite party being the largest Insurance Company of the Nation associated with the insurance of a lot of people throughout the nation since a long back with self generated assets i.e. goodwill of the business. So, the credibility of the OP Insurance Company is unquestionable and that is why the complainant insured his life before the said company without any doubt. It is well settled proposition of law that a contract of insurance is based on the principles of utmost good faith-uberrimae fidei, applicable to both the parties. The rule of nondisclosure of material facts vitiating a policy still holds the field. The bargaining position of the parties in a contract of insurance is unequal. The insured knows all the facts, the insurer is unaware of anything which may be material to the risk. Very often, it is the insured who is the sole person who has this knowledge. The insurer may not even have the means to find out facts which would materially affect the risk. The law, therefore, enjoins on the insured an absolute duty to disclose correctly all material facts which is within his/her personal knowledge or which he ought to have known had he made reasonable inquiries. A contract of insurance, therefore, can be repudiated for non disclosure of material facts.
The expression “material fact” is not defined in the Insurance Act,1938 and therefore, as observed by the Supreme Court in Satwant Kaur Sandhu -vs- New India Assurance Company Ltd. 2013 (3) CPR 644 (sc),it has to be understood in general terms to mean as any fact which would influence the judgment of a prudent insurer in fixing the premium or determining whether he would like to accept the risk. Any fact, which goes to the root of the contract of insurance and has a bearing on the risk involved, would be “material” and if the proposer has knowledge of such fact, he is obliged to disclose it, particularly while answering questions in the proposal form. Any inaccurate answer will entitle the insurer to repudiate their liability because there is clear presumption that any information sought for in the proposal form is material for the purpose of entering into a contract of insurance.
The main contention of the complainant is that he being the consumer insured his life before OP and invested Rs.25, 000/- as premium for 5 years for getting insured amount at a time. After the completion of 5 years his policy matured on 14.03.2013 and to get the matured value he submitted relevant documents with policy certificate. That on 16.07.2013 he was informed that his amount was reinvested for purchasing a pension policy to get Rs.10,179/- p.a. as pension from the end of OP at this act of the OP complainant rushed at the office of OP to ventilate his grievance but OP pit no bid at the utterance of complainant. So getting no alternative the complainant compelled to take the recourse of law before this Forum alleging that he suffered metal agony and harassment due to deficiency of service and unfair trade practice of the OP.
After perusal of documents from the records, it appears that not a scrap of paper has been produced by the OP to show that the complainant gave his consent to reinvest his assured money. This is the utmost question that who prompted the OP to invest the sum of the complainant in the pension scheme without the consent of the policy holder. In the written version the OP assailed that the complainant did not submit any estimate and or account of his medical expenditure to this OP and also raised a question as to place of treatment. But complainant is not bound to make this OP regarding his necessity of expenditure and place of treatment. The act of the OP is tantamount to breach of contract which is not expected from such insurance Company who eventually performs their business as self generated assets. The OP Company never showed humanity by paying a sum of Rs.1,33,711/- but after getting notice from this Forum tried to show good gesture.
But the complainant suffered from mental pain and agony at behest of deficiency of service and unfair trade practice on the part of the OP. So the complainant is entitled to get compensation from the OP as the complainant could prove the his case beyond reasonable doubt and we are in a considered opinion to allow the claim of the complainant in part. 4. Whether the complainant proved his case against the opposite party, as alleged and whether the opposite party is liable for compensation to him?
The discussion made herein before, we have no hesitation to come in a conclusion that the Complainant is able to prove his case beyond any doubt and the written version or the OP also contributed his role in such proof and the Opposite Party is liable to compensate the Complainant as we deem fit and proper.
ORDER
Hence, it is ordered that the complaint be and the same is allowed on contest against the Opposite party, without cost.
The Opposite party is hereby directed to pay the remaining amount of Rs.8,055/- within 45 days from receiving this order.
The Opposite Party is further directed to pay Rs.5,000/-to the Complainant for deficiency in service of the O.P. and mental pain and agony of the Complainant within 45 days of this order.
At the event of failure to comply with the order the Opposite Party shall pay cost @ Rs.50/- for each day’s delay, if caused, on expiry of the aforesaid 45 days by depositing the accrued amount, if any, by depositing in the State Consumer Welfare Fund.
Let a plain copy of this Order be supplied free of cost to the parties/their Ld. Advocates/Agents on record by hand under proper acknowledgement/ sent by Registered Post with A/D forthwith, for information & necessary action.
Dictated and corrected by me.
Member, President,
District Consumer Disputes District Consumer Disputes
Redressal Forum, Murshidabad. Redressal Forum, Murshidabad.
Member, Member,
District Consumer Disputes District Consumer Disputes
Redressal Forum, Murshidabad. Redressal Forum, Murshidabad.
