IN THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SAMBALPUR
Consumer Complaint Case No. 11 of 2016
Prasanta Kumar Dora, aged about 35 years, S/O.- late Madan Mohan Dora, R/O.- At- Malipada Hirakud near Hirakud Medical, P.O./P.S- Hirakud, Dist.- Sambalpur- 768016, (Odisha). ……..…. Complainant
-VERSUS-
1 The Divisional Manager,
Reliance Life Insurance Company Ltd., At- R.N.Complex, 2nd Floor, Budharaja, Sambalpur, Orissa-768004.
2 The General Manager,
Reliance Life Insurance Company Ltd., At- No. 5, Janpath, 4th Floor, Unit 3, Behind Kalsi Petrol Pump, Kharvela Nagar, Bhubaneswar, Khordha district, Orissa-751001.
3 The Chairman,
Reliance Life Insurance Company Ltd., At- 9th floor/10th floor, Building No. 2,R-Tech Park, Nirlon Compound, Next to Hub Mall, Behind I- Flex building, Goregaon, (East), Mumbai-400 063. ….Opposite Parties
For Complainant : SHRI B.K.SHROFF, SHRI D. BEHERA, MISS D. SHROFF
For O.P.s : SHRI S. DAGA, SHRI M.K. PRADHAN, SHRI S.A. GURU
PRESENT: SHRI A.P.MUND, PRESIDENT
MRS. S.TRIPATHY, MEMBER
SHRI K.D.DASH, MEMBER
Date of Order : 05.06.2018
Shri A.P. Mund, President
1. The complainant’s case is that the complainant’s father late Madan Mohan Dora at the age of about 63 years, had purchased one Reliance life Insurance policy namely ‘Reliance’s Guaranteed Money Back’ as policy holder where his major son Prasanta Kumar Dora, present complainant of this case who was aged about 33 years, and his life was assured by this policy at Sambalpur vide ‘Application No. D8667957, Policy No. 51647564’ on 30.05.2014, total policy term was 15 years and payment of premium term was for 10 years and he was issued a booklet which contained first premium receipt, details of the policy holder, life assured etc in briefly.
2. Late Madan Mohan Dora was the policy holder/ owner and nominee in the said policy, a sum of Rs. 6,60,000/- (Rupees Six lakhs Sixty Thousands) only was assured by this policy. As the payment frequency was yearly the first premium of Rs. 75,121.68/- was paid by the policy holder. He unfortunately passed away on dated 21.11.2014, so the next premiums could not be paid.
3. After the death of his father the complainant appraised the details to the Insurer-cum-O. P. No.1 and his agent and expressed his willingness to deposit the premium but the O.P No.1 refused to accept the amount on behalf of deceased policy holder, thereafter the complainant expressed his willingness to surrender the policy before the O.P No.1 and for realization of money payable to him.
4. The version of the complainant is that the O.P. No. 1 neither repudiated nor entertained his claim, though the complainant/ life assured is innocent, rustic person having no knowledge about the law keeping all these things in mind, the Reliance life Insurance office personnel are illegally making financial gain and tried to play mischief with the complainant.
5. The complainant also averred that Insurance Company personnel were preventing the complainant to receive his justifiable claim. This is mala fide in nature and in order to escape from their duty to release the claim the O.Ps rebuked him in vulgar and filthy language and told to go out from the office and told him not to come again to the office of the O.P. No.1, otherwise the complainant will have to face the dire consequences, as a result of which the complainant was insulted and sustained mental agony due to non cooperation from O.P. No.1 and such harassments embarrassed him much less before other persons, who were present at that time in the office.
Documents filed on behalf of complainant ;
- Policy document - Xerox copies
- Voter I Card & PAN card - Xerox copies
- Death Certificate - Xerox copies
- Advocate notice & Regd. Post - Xerox copies
6. The complainant produces the copies of Legal Notice sent through his Advocate to the O.P. No.1 and their administrative officer i.e. (Opp. Party No. 2 and 3) by Regd. Post with AD. There is no reply till the date of hearing.
7. The O.P’s were duly noticed and filed their version. But after that they did not appear or participate in the proceeding, for which the O.P.’s were saddled with a cost of Rs. 500/- on Dt. 2.8.16. They did not pay the cost nor did they participate in the proceeding for which they were set ex parte on Dt. 23. 3.2017.
8. Heard the argument from the side of complainant on 11.5.2017.
9. The counsel for the complainant argued on the following points:
(a) That O.P’s did not file any written version within 45 days as required under the law. So, the written version cannot be taken into consideration as filing of the written version by the O.Ps. and accepting it by the Hon’ble forum is completely without jurisdiction, and such version cannot be treated as part and parcel of the record and cannot be looked into. It cannot be treated as a pleading or version. As there was no pleading or version denying the claim of the complainant by the O.P-1 under the law, the factual aspects, i.e., the basis of claim made by the claimant was not denied by the O.P-1 so, any submission made without pleading does not deserve anything in relation to the claim made by the complainant and also cannot deny the basis of claim.
On this count alone the O.Ps right to say anything without pleading cannot be taken into consideration, not only that the Hon’ble forum has imposed the cost to the O.Ps. worth Rs 500/-, after that order the O.Ps did not come to court and also did not comply the order of the forum it seems how they dishonor the Order of the forum, on 23.03.2017 this forum after perusing the case record set Ex-parties all O.Ps.
(b). In the present case the authorized agent of the insurance company had shown the said policy to Mr. Madan Mohan Dora then Mr. Dora filled up the proposal form as per the instruction of the agent of the insurer, after complete verification with full satisfaction of the duly authorized officer of the insurer Company issued the said Policy to Mr. Madan Mohan Dora as Policy Owner and his major son’s life was assured by this policy.
(c). Insurance Policy is a contract in between the policy holder or owner of the policy and the insurance Co. or insurer. Both the parties are bound by the law subject to certain terms and conditions of the policy. Here the Policy Holder/owner insured his son’s life and the same is not the matter of dispute by the O.Ps.
(d). The policy holder/owner paid first premium of Rs. 75,121.68/- and a policy certificate was issued by the OP Company, unfortunately the policy owner/holder died on dated 21.11.2014, so the next premiums could not be paid by the policy holder.
(e). In absence of Policy Holder the complainant appraised the details to the Insurer-cum-O. P. No.1 and his agent and expressed his willingness to deposit the premium but the Op-1 refused to accept the amount on behalf of deceased Policy Holder, thereafter the complainant expressed his willingness to surrender the policy before his agent and O.P No.1 and also realization of money payable to him.
Here the policy is not the subject of issue so; there is no question of free look period of 15 days arise which is highly raised by the O.Ps in their written version filed in a very later stage in this case.
(f). Inter-alia the OP-1 neither continued the policy nor released the premium amount paid by the deceased Policy holder with an excuse that there is no such provision to refund the premium amount to the life insured in case of death of the policy owner.
(g). in contrary without service of any prior notice to the insured, the insurance Company closed the said policy and kept silent which is unfair trade practice.
As per decision of Hon’ble Supreme Court in Syed Khuresi Ali Vs. State of Orissa reported in AIR 2007 ORISSA 56. B.P.Das and M.M.Das JJ. Verdict that “Impossibility to perform contract in case of force majeure and not vis-majure-forfeiture of security deposit, illegal.”
In another decision of Hon’ble Supreme Court in Mary Vs. State of Kerala & others reported in AIR 2014 SUPREME COURT 1 passed verdict-that “Doctrine of fairness- cannot be invoked to alter, amend or very terms of contract-Be it statutory-Contract granting privilege to trade in liquor- R. 5(15) providing for forfeiture of earnest deposit in case of breach of contract- Not liable to be struck down on ground of being unreasonable”.
(h). On the basis of the above the learned counsel for complainant, made a prayer that the complainant be paid the first premium of worth Rs. 75,121.68/- (Rupees Seventy five thousands one hundred twenty one and sixty eight paise) only on account of death of the policy holder and to pay interest @ 18% p.a from the date of death till the actual date of final payment for unfair trade practice which caused mental harassment as well financial loss and physical stress so compensation of a sum of Rs. 30,000/- (Rupees Thirty Thousands) only towards mental agony, harassment and inconveniences.
(j). To pay Rs. 15, 000/- (Rupees Fifteen Thousands only) towards Cost of litigation and other relief.
8. This Forum sent notice to the O.Ps, the O.Ps appeared in this case and filed their written version beyond prescribed time, barred as per C.P. Act and subsequently the O.Ps, did not care to contest this proceeding. So, the O.Ps were set ex-party.
We heard the counsel for the complainant, perused the case record and documents filed by the complainant. The O.P’s in their version only harped on the Free Look Policy and continuation of the Policy and who is liable to receive compensation in case of death of the beneficiary or Life Assured. But are silent as to the Policy Holder or terms of payment. If the Policy Holder of Life Assured dies or could not pay the annual premium, the O.P’s are silent as to how the policy will be dealt with or if there is any guideline as to how the premium already paid will be dealt with. This is a one sided contract and only O.P’s will settle the Terms and Contract which is in standard form. When a vital part is missing from the contract we believe that the complainant should get benefit for the silent part of the contract. Hence we hold that the O.Ps have deliberately did not give adequate service and were deficient in providing proper service and made ill treatment towards complainant by the O.Ps personnel is unfair trade practice for which the complainant suffered mentally and hence we accept the case of the complainant, there is no reason to disbelieve the unchallenged allegation of the complainant about deficiency in services, ill treatment meted to the complainant along with unfair trade practice. They also kept the money for long three years with them for which they are to pay interest.
The case of the complainant is allowed against the O.Ps or ex-parte. As the contract is silent on surrender value of the Policy, the O.Ps are jointly and severally liable to pay the amount and they are directed to pay to the complainant Rs. 75,121.68/-(Rupees Seventy five thousands one hundred twenty one and sixty eight paise) towards first premium of this policy with interest @ 9% from the date of payment of 1st premium i.e. 305.14 till payment, Rs. 3,000/- (Rupees Three Thousands) towards mental agony, harassment and inconveniences, Rs. 1,500/- (Rupees Fifteen hundred) towards Cost of litigation, expenses within 30 days, failing the aforesaid amount will carry interest @ 12% per annum from the date of this order till the date of payment.
Accordingly, this case is disposed of.
Order pronounced in the open Court.
Sd/- . Sd/-
SHRI A.P.MUND, I agree SMT S.TRIPATHY
PRESIDENT Member
.
. Sd/- Sd/-
SHRI K.D.DASH. Member I agree. Dictated and corrected by me.
Member.
