Order-13.
Date-16/09/2016.
This is an application u/s.12 of the C.P. Act, 1986.
The case of the complainant, in short, is that he is about 73 years old and has got no pension or other source of income. He invested an amount of Rs.3 lakhs to the OPs being convinced by the proposal of OP2 being an agent of OP1 for ICICI Pru Elite Pension II UNI 105L 099V0I. He was stated that if the complainant invests a sum of Rs.3 lakhs in a 6 year term policy, he will be entitled to maturity value of Rs.18 lakhs. Accordingly, the complainant filled up the prescribed application form on 17-02-2010 containing a table showing surrender value of Rs.17,73,741/-. The complainant paid premium of Rs.3 lakhs on 19-02-2010 and on 19-08-2010 by two separate cheques. In the early part of 2015 the complainant was in acute need of liquid money for his treatment and desired to surrender the policy to get the matured value of Rs.17,73,741/-. The complainant handed over the original policy to the said agent. But the OPs refunded a sum of Rs.2,98,101/- on 23-04-2015 against investment of Rs.3 lakhs though he was entitled to surrendered value of Rs.17,73,741/-. It is stated that OPs are duty bound to pay back the surrendered value of Rs.17,73,741/-. It is alleged by the complainant that the OPs have adopted fraud, mal-practice, unfair trade and deficiency of service as service provider to the complainant. Hence, this case.
OP1 has contested the case in filing written version contending inter alia, that the instant complaint is not maintainable in the eye of law. It is stated that the complainant has approached the Forum with unclean hands. It is stated that the complainant as per the policy terms and conditions was required to pay a half yearly premium of Rs.1,50,000/- (Annual Premium of Rs.3 lakhs) for a premium payment term of 6 years. It is alleged that the complainant has cunningly quoted an amount of Rs.17,73,741/- from Benefit Illustration and does not signify the expectation of investment return on investment. It is alleged that the complainant has paid only one annual premium and has failed to pay the subsequent premium. He has failed to show that he is eligible for a sum of Rs.17,73,741/- when he has not paid premium for those four years. Moreover, the complainant had free look period provision but he did not raise any objection towards the policy during the free look period. This OP has prayed for dismissal of the case
OP2 has not contested the case and the case has proceeded ex parte against the OP2.
Point for Decision
- Whether the OPs have been deficient in rendering service to the complainant?
- Whether the OPs have adopted unfair trade practice?
- Whether the complainant is entitled to get the relief as prayed for?
Decision with Reasons
We have gone through the documents on record namely, Xerox copies of application form, policy certificate, policy summary, legal notice and other materials on record.
From the materials on record it appears that the policy in question is a Unit Linked policy i.e. the money of the complainant had been invested in the share market. The complainant as per the policy terms and conditions was required to pay a half yearly premium of Rs.1,50,000/- for a premium payment term of 6 years. We find that as per the illustration the amount of Rs.17,73,741/- is payable against the payment of premiums for 5 years and not one year. It appears that the complainant had paid only one annual premium. It is the grievance of complainant that he is an old person of 75 years and OP2 has misrepresented the whole thing that if the complainant invests a sum of Rs.3 lakhs in a 6 year term policy he will be entitled to a maturity value of about Rs.18 lakhs and being influenced by the Salesmanship of OP2, the complainant invested an amount of Rs.3 lakhs accordingly. It appears that the complainant after expiry of 5 years was paid less than the amount he invested. OP1 as we find refunded a sum of Rs.2,98,101/-. So, it appears that the refund of the amount is less than the amount invested by the complainant 5 years back. OP2 being the agent of the OP1 has not contested the case and has not also challenged the version of the complainant that he was misrepresented by the agent that the complainant would receive maturity value of about Rs.18 lakhs if the complainant invested a sum of Rs.3 lakhs once. But we are afraid the policy condition and the Benefit illustration speaks otherwise. It appears that the complainant was required to pay annual premium of Rs.3 lakhs for a premium payment term of 6 years. So, we find that the complainant paid the first premium for the first year only and has not paid the premium for subsequent years. Accordingly, we think that the complainant is not entitled to the surrendered value of Rs.17,73,741/-. But we think that the OPs are liable to pay compensation for misrepresentation and mis-selling of the subject policy. We think no prudent person would invest in any policy knowingly that he will receive less than the amount he would invest. So, we think that OP2 being the agent of OP1 has misrepresented the structure of the policy to the complainant and mis-sold the subject policy to the complainant. OP1 being the insurance company cannot evade its responsibility as such.
In result, the case succeeds in part.
Hence,
Ordered
That the case be and the same is allowed in part on contest against the OP1 and ex parte against OP2.
OP1 is hereby directed to pay Rs.75,000/- as compensation along with interest @9 percent p.a. from the date of this order till compliance apart from litigation cost of Rs.10,000/- within one month henceforth.
Failure to comply with the order will entitle the complainant to put the order into execution u/s.25 read with Section 27 of the C.P. Act and in that event OP1 is liable to pay penal damages @Rs.5,000/- per month till final and full satisfaction of the decree.
