IN THE DIST.CONSUMER DISPUTES REDRESSAL FORUM BELAGAVI.
Dated this 1st day of September 2016
Complaint No. 190/2015
Present: 1) Shri.B.V.Gudli, President 2) Shri. V.S. Gotakhindi, Member
3) Smt. Sunita, Member
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Complainant: Mr. Gururaj D. Gokak,
Plot No. 125, Guruprasad Colony
Belagavi-590008
(In person)
V/s.
Opponents: 1. The Manager,
HDFC Life
Khanapur Road, Plot No.13, 1st Floor,
Ganesh Empire,
Near RPD Corner,
Tilakwadi, Belagavi-590006.
2. The Manager,
HDFC Standard Life Insurance Company Limited,
12th & 13th Floor, Lodha Excelus,
Apollo Mills Compound, N.M. Joshi Road,
Mahalaxmi, Maharashtra,
Mumbai-400 011.
( By Sri.S.B.Shaikh , Advocate)
(Order dictated by Sri.B.V.Gudli, President)
ORDER
U/s. 12 of the C.P. Act, the complainant has filed the complaint against the O.Ps. alleging deficiency in service in rejecting the proposal of life insurance policy by the OPs.
2) The O.P.1 and 2 appeared through counsels. OP1 has filed written version.
3) In support of the claim of the complaint, the complainant has filed his affidavit and produced some documents. On the other hand OPs also filed their affidavit and certain documents are produced on their side.
4) For both the parties written argument are filed. We have also heard on both sides and perused the records.
5) Now the point for our consideration is that whether the complainant has proved deficiency in service on the part of O.Ps & entitled to the reliefs sought?
6) Our finding on the point is partly in affirmative, for the following reasons.
:: R E A S O N S ::
7) There is no dispute that the complainant opt for life insurance policy for a sum assured of Rs.50 lakhs at a premium of Rs.8,248/-. The complainant further alleges that on 12.10.2014 complainant gave a requisition along with cheque no.944782 in favour of HDFC Standard Life Insurance under a proposal No.17144516 & the cheque was handed over to the insurance advisor of HDFC Standard Life Insurance on 15.10.2014 and as per the advise of the advisor complainant appeared for medical test empty stomach in Deccan Medical Center on 17.10.2014 and after few days the Deccan Medical Center informed the complainant there were tobacco contents in urine samples as positive on 09.11.2014. The complainant further alleges that, he requested the company by giving hand written letter for re-medical test & the HDFC Standard Life Insurance did not arrange for re-medical test in next 30 days and the complainant again give one request letter to re arrange the medical test, but no initiation was taken from HDFC Standard Life Insurance after 21 days of 2nd letter, the complainant alleges that he approached IRDA on 21st December 2014 with due acknowledgement and on 30th December 2014 complainant received the e-mail from HDFC Standard Life Insurance to resolve the complainant’s problem. The complainant further alleges that, the HDFC Standard Life Insurance requested him to attend the re-medical test within 3 days of receipt of e-mail and it is more than 60 days no action taken by HDFC Standard Life Insurance for doing re-medical test. The complainant further alleges that, the HDFC Standard Life Insurance would have rejected his proposal if there was any medical problem and would have returned the premium amount.
8) On the other hand the OPs filed objections to the complaint filed by complainant & admitted that complainant on 12.10.2014 he submitted a proposal for taking life insurance policy on his name for an assured sum of Rs.50 lakhs & paid premium through cheque for Rs.8,248/- is true & also it is true that the complainant attended the medical test as per the rules and regulations and the lab report of the complainant shown positive (cotinine level) in the urine. The OP contends that, the complainant is in the habit of consuming tobacco, as such the OPs were constrained to send rate up letter on 29.10.2014 and informed the same and premium was enhanced from Rs.8,248/- to Rs.12,349/- & requested the complainant to revised terms and pay the balance premium of Rs.4,101/- within 30 days. The OP contends that, the complainant did not agreed to lab report showing positive nor accepted policy terms and conditions and denied the contents the para 7 of the complaint in total and complainant was to visit the Deccan Medical Center within 3 days for further test, is totally false. The OPs further contends that, Mr.Nitin Jadhav spoke to the complainant & claimed excuse for non converting the policy & the complainant to work on his own omissions has alleged falsely & also it is false that on 31.12.2014 the complainant was opted for medical test within 3 days and as the complainant denied the medical report was advised to take advance medical test for the cost and contents of para.8 that the proposal shall be accepted within 7 – 10 days after medical test is depend upon each policy terms and conditions & the complainant had failed to do the 2nd medical test & there is no negligence on the part of OPs as there was no contractual obligation between the complainant and OPs. Hence they are not liable to refund amount of premium and pay interest and compensation.
9) We have perused the documents and also gone through the allegations and objections. The question arises here that the proposal for HDFC Standard Life Insurance policy opted by the complainant has been accepted by the OPs or not? Here it is no dispute that the complainant paid premium for life insurance policy and proposal was put up by the complainant but after the medical test it was noticed that there was some tobacco contents found in the urine as per the lab report of the Deccan Medical Center. Hence the complainant was advised to go for 2nd test. And as there was a delay in informing the complainant for 2nd test, the complainant was not properly intimated by the OPs to undergo the 2nd test. On the other hand in the objections the OPs have contended that, the premium amount was enhanced from Rs.8,248/- to Rs.12,349/- & requested the complainant to revised terms and pay the balance premium of Rs.4,101/- within 30 days. But the complainant did not accept the enhanced premium. The contention of the OP is that the premium was enhanced due to lab report which contended the tobacco in the stomach of complainant and as per the policy terms and conditions the OPs were ready to accept the proposal if the enhanced amount is paid the complainant. After going through the contents we are of the opinion that, even though there was a proposal and premium was paid by the complainant no further development took place for opting the policy. Therefore looking into the allegations even though there was deficiency in service on the part of the OPs in not intimating the complainant within time prescribed in the policy to opt for further test and to issue the policy. Here it is to be noted that, the complainant did not opt to pay the enhanced premium and nowhere in the affidavit filed by the complainant has admitted the fact that, he was ready to pay the enhanced premium amount. Therefore as contended by the complainant there is unfair trade practice on the part of OPs cannot be believed and accepted though there is deficiency in service in not intimating the complainant within time for re-medical test. Considering the facts above discussed we are of the opinion the complainant is not entitled to any compensation as prayed and the interest as claimed i.e. 18%.
10) Considering the entire facts, contention of parties as well as material on record complainant has partly proved that rejection of proposal for insurance policy.
11) Accordingly the following
ORDER
The complaint filed by the complainant is partly allowed.
The OPs are hereby jointly and severally directed and liable to refund the premium amount of Rs.8,248/- along with interest @ 8% P.A. from 1st January 2015 till realization of entire amount.
The OPs are hereby jointly and severally directed and liable to pay Rs.3,000/- towards cot of the proceedings to complainant.
The order shall be complied within 20 days from today.
(Order dictated, corrected and then pronounced in the open Forum on: 1st day of September 2016)
Member Member President.
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