The case of the complainant is that he purchased one TATA AIG LIFE ASSURE 20 years SECURITY & GROWTH PLAN with effect from 24.06.2005 vide policy No.C202938611 from the OP No.1&2 by the agent OP No.3. for yearly premium amounting to Rs.13592.00 except service charges. He made payment of yearly premium till 2007 through the OP No.3 but due to misunderstanding the yearly premium for year 2008 could not be deposited although he paid cheque in time so the policy became irregular. He got information from the OP No.1 vide letter dated 19.11.2009 and immediately contacted the said office and ultimately the OP No.1 accepted the premium amount for the years 2008,2009 &2010 and also recollected the unused cheque issued in the name of the complainant for returning the premium amount vide cheque No.509886 dated 18.11.2009 for an amount of Rs.13985.00. Thus the OP No.1 accepted Rs.44290.00 from the complainant towards yearly premium from 2008, 2009 & 2010 along with composite fine for late payment of premium with an assurance to regularize and reinstate the said policy with all its benefits already accrued and/or accruable in future. Recent time the complainant received a letter from the office of the OP No.1 dated 23.03.2011 interalia denying to restore the policy benefits in favour of the complainant enclosing therewith cheque No.331459 dated 23.03.2011 for an amount of Rs.44108.00 towards refund of unutilized premium without assigning any cogent reason for non-restoration of the policy benefits in favour of the complainant in spite of receiving and /or acceptance of the up-to date policy premium with composite fine calculated by the office of the OP No.1. The complainant surprised and immediately approached the OP No.3 to look after the matter. Now the complainant has been suffering from tremendous mental agony, anxiety and harassment due to non restoration of the said policy by the office of the OP No.1. The OP knowing fully well that the complainant is a handicapped person with 55% disability though he is harassing the complainant and trying to deprive the complainant from policy benefits without any cogent reason.
The OP appeared by filing written version denied the allegations as leveled against him and he averred that on June,2005 the complainant approached the opposite parties and applied for life insurance policy being “Life Assure 20 years security and Growth Plan”” for himself. On the basis of the application Form the Op issued the said policy w.e.f. from 24th June, 2005 for the sum assured of Rs.2,00,000/- to the complainant on the terms and conditions contained in the policy document. Yearly premium was fixed Rs.13592/- for 20 years. The complainant failed and/or neglected to pay the premium for the next years i.e. 2008 & 2009 so the policy was auto surrendered and the OP refunded the sum of Rs. 44108/- being the unutilized premium amount. Thereafter the complainant approached the OP and asked for revival of the said policy with all benefits. The OP considered the request of the complainant vide its letter dated Dec.31,2011 expressed their intention to regularize the said policy after waiving the late fees and subject to payment of Rs.15,559/- which will settle the premiums from June, 2008 to June 2011 but the complainant did not respond. It is reiterated that all along the OP were willing to regularize the said policy but the complainant did not turn up with the request of the opposite parties. So the complainant has no cause of action and he is trying to take benefit for his own wrong. As such the petition is liable to be dismissed with cost.
The complainant filed evidence on affidavit in which he assailed that the OP collected different amount of premiums like Rs.13731/- in 2007, Rs.13982/- in 2008 although the premium was fixed Rs.13592/- and during the pendency of this complaint petition OP demanded Rs.15559/- for the premium of 2011 instead of Rs.13592/- which again proves malafide intention of OP to extract unauthorized amount from him and other averments supports complaint petition.
The OP filed evidence on affidavit which is nothing but replica of his written version.
Both sides filed written notes of argument which are taken into consideration for passing final order.
Argument as advanced by the agents of both sides heard in full.
From the discussion herein above, we find the following Issues/Points for consideration.
ISSUES/POINTS FOR CONSIDERATION
1. Whether the Complainant Keshaav Chakrabarty ‘Consumer’ of the opposite party?
2. Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
3. Whether the O.Ps carried on unfair trade practice/rendered any deficiency in service towards
the Complainant?
4. 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 Keshaav Chakrbarty 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.The complainant herein being the customer of the OP No.1 insurance company, OP No.2 is the managing Director of the Insurance company and OP No.3 is the agent of the OP No.1, so being a consumer he is entitled to get service from the OP insurance company being the service provider. .
(2).Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
Both the complainant and opposite parties are residents/carrying on business within the district of Hooghly. The complainant prayed for a direction upon the OP to regularize the , reinstate and/ or restore the said policy with immediate effect and force with all its benefits already accrued in the mean time and to intimate the policy holder regarding the status of the policy including the bonus earned by him time to time and in default to refund the entire amount of premium as well as the service and other charges including late payment fees along with interest @ 18% till payment and compensation amounting to Rs.2,00,000/- and litigation cost amounting to Rs.20000/- and other relief or reliefs as this Forum deems fit and proper 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 of throughout the whole 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 on 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 case of the complainant is that he purchased one TATA AIG LIFE ASSURE 20 years SECURITY & GROWTH PLAN with effect from 24.06.2005 vide policy No.C202938611 from the OP No.1&2 by the agent OP No.3. for yearly premium amounting to Rs.13592.00 except service charges. He made payment of yearly premium till 2007 through the OP No.3 but due to misunderstanding the yearly premium for year 2008 could not be deposited although he paid cheque in time so the policy became irregular. He got information from the OP No.1 vide letter dated 19.11.2009 and immediately contacted the said office and ultimately the OP No.1 accepted the premium amount for the years 2008, 2009 & 2010 and also recollected the unused cheque issued in the name of the complainant for returning the premium amount vide cheque No.509886 dated 18.11.2009 and the policy benefits in favour of the complainant enclosing therewith cheque No.331459 dated 23.03.2011 for an amount of Rs.13985.00. Thus the OP No.1 accepted Rs.44290.00 from the complainant towards yearly premium from 2008, 2009 & 2010 along with composite fine for late payment of premium with an assurance to regularize and reinstate the said policy with all its benefits already accrued and/or accruable in future. The complainant received a letter from the office of the OP No.1 dated 23.03.2011 interalia denying to restore amount of Rs.44,108.00 towards refund of unutilized premium without assigning any cogent reason for non-restoration of the policy benefits in favour of the complainant in spite of receiving and /or acceptance of the up-to date policy premium with composite fine calculated by the office of the OP No.1.
The OP by filing written version denied the allegations as leveled against them and they averred that on June,2005 the complainant approached the opposite parties and applied for life insurance policy being “Life Assure 20 years security and Growth Plan”” for himself. On the basis of the application Form the OP issued the said policy w.e.f. from 24th June, 2005 for the sum assured of Rs.2,00,000/- to the complainant on the terms and conditions contained in the policy document and yearly premium was fixed Rs.13,592/- for 20 years. The complainant failed and/or neglected to pay the premium for the next years i.e. 2008 & 2009 so the policy was auto surrendered and the OP refunded the sum of Rs. 44108/- being the unutilized premium amount. Thereafter the complainant approached the OP and asked for revival of the said policy with all benefits. The OP considered the request of the complainant vide its letter dated Dec.31,2011 expressed their intention to regularize the said policy after waiving the late fees and subject to payment of Rs.15,559/- which will settle the premiums from June, 2008 to June 2011 but the complainant did not respond. It is reiterated that all along the OPs were willing to regularize the said policy but the complainant did not turn up with the request of the opposite parties.
It appears from the case record that the complainant insured his life before the OP No.1&2 and paying premiums as fixed by the OP insurance company since 2005 and due to misunderstanding with the OP No.3 i.e. the agent of the OP No.1&2 he could not deposit the premium for the year 2008 as a result his policy became auto surrendered and the OP refunded the sum of Rs. 44108/- being the unutilized premium amount to this complainant. The OP No.1 accepted Rs.44290.00 from the complainant towards yearly premium from 2008, 2009 & 2010 along with composite fine for late payment of premiums vide receipt no.PR 1477899 dt.21.10.2010 with an assurance to regularize and reinstate the said policy and also recollected/ accepted the unutilized cheque issued in the name of the complainant for returning the premium amount vide cheque no.509886 dt.18.11.2009. Thereafter the complainant received a letter from the office of the OP no.1 dated 23.3.2011 interalia denying restoring the policy benefits in favour of the complainant. Subsequently OP insurance company by a letter dated31st Dec.2011 informed this complainant that they are in the process of reapplying an amount of Rs.44108/- towards the impugned policy and in order to regularize the aforesaid policy, an amount of Rs.15559/- is to be remitted within 15.01.2012 at the nearest TATA AIG office. After receiving the amount of Rs.15559/- the premium from June 2008 till June2011 shall be settled and policy will be regularized and next premium shall be due in June2012. But the complainant did not respond at the call of the OP so the policy remained irregular since 2008. The letter dated Dec.31,2011 clearly depicts that the complainant paid some money for the premium of 2008,2009& 2010 and if the complainant paid a sum of Rs.15559/- then his policy will be regularized till June2011 since 2008.
In the reply of the interrogatories filed by the OP the complainant submitted that a cheque vide No.33159 dated 23.03.2011 for an amount of Rs.44108.00 towards refund of the unutilized premium was sent to his address without assigning any cogent reason for non-restoration of the policy benefits in his favour inspite of receiving and/or acceptance of the upto date policy premium with composite fine, calculated by the office of the OP No.1. And he sent the said cheque (unutilized and not encashed and cancelled) back to the OP no.1 through a legal notice of his Ld. Advocate Arghya Acharya vide letter dated 18.04.2011. During the period of argument it is assailed on behalf of the complainant that he prayed for premiums proceed and other relief’s alongwith interest rather reinstating the policy.
As his ambit of his life being assured by the OP insurance company has been frustrated so he has no option except getting refund of premiums deposited alongwith interest since the date of investment. But the deficiency of service of the OP insurance company cannot be ousted as OP insurance company after accepting Rs.44290/- failed to reinstate the policy in question for which this complainant is suffering a lot and compelled to seek redressal of this Forum.
From the above discussion we may hold that the complainant refunded the auto surrendered money amounting to Rs.44,108/- to the OP insurance company and he also deposited a sum of Rs.44290/- for reinstate/regularize his policy to the OP insurance company. And such investments of the complainant are not denied by the OP insurance company. So the complainant is entitled to get the invested amounts alongwith interest till its realization.
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 has abled to prove his case and the Opposite Party No.1&2 are liable to pay the ordered amount. As ordered amount includes the interest at prevailing rate so there is no question of allowing compensation for mental pain and agony.
ORDER
Hence, it is ordered that the complaint be and the same is allowed on contest against the Opposite Party No.1&2 with a litigation cost of Rs.5,000/-.
The whole gamut of the facts and circumstances leans in favour of the complainant. We, therefore, allow the complaint and Opposite Party No.1&2 are directed to pay the sum amounting to Rs.44108/- with interest @9% since23.3.2011 and a sum of Rs.44,290/- alongwith interest @9% since the date of deposit on21.10.2010 till realization to this complainant within 45 days from the date of order.
No other reliefs are awarded to the complainant for harassment and mental agony.
OP No.3 being the agent is exonerated from this proceeding.
At the event of failure to comply with the order the Opposite Party No.1&2 shall pay cost @ Rs.100/- for each day’s delay, if caused, on expiry of the aforesaid 45 days by depositing the accrued amount, if any, in the Consumer legal Aid Account.
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 ordinary Post for information & necessary action.
