DATE OF FILING : 19.5.2011

BEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, IDUKKI

Dated this the 29^th day of November, 2011

Present:

SRI.LAIJU RAMAKRISHNAN PRESIDENT

SMT.BINDHU SOMAN MEMBER

C.C No.120/2011

Between

Complainant : Alocious Joseph,

Kodamullil House,

Thekkumbhagam P.O.,

Thodupuzha, Idukki District.

(By Adv: K.M. Sanu)

And

Opposite Parties : 1. The Manager,

Tata A I G Life Insurance Co. Ltd.,

Branch Office, Muvattupuzha,

Ernakulam District.

2. The Managing Director,

Tata A I G Life Insurance Co. Ltd.,

5^th and 6^th, Pencinsula Towers,

Peninsula Corporate Park,

Ganpatrao Kadam Marg, Tower, Parel,

Mumbai – 400013.

(Both by Adv: Shiji Joseph)

3. The Manager,

Karvy Insurance Broking Ltd.,

Parayil Buildings, 2^nd Floor,

Vadavathoor P.O.,

Kottayam – 10.

4. Anjana D/o Ayyappan,

Mattathil House,

Ithithanam P.O.,

Ponpuzha, Malikakadavu,

Changanacherry, Kottayam.

(Both by Adv: Biju Vasudevan)

O R D E R

SRI. LAIJU RAMAKRISHNAN (PRESIDENT)

The complainant attended a class conducted by the 3^rd and 4^th opposite parties in the month of January, 2010 at Madapparambil Resort, Thodupuzha, as per the invitation of the 4^th opposite party. The 3^rd and 4^th opposite parties explained about the policy of the 1^st and 2^nd opposite parties. As per the insurance of the opposite

(cont....2)

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parties, a premium of Rs.25,000/- was to be paid for 3 years and after 5 years of the payment of the premium, the complainant will get an amount between Rs.1,65,000/- and Rs.1,80,000/- and also the insurance coverage of Rs.25,000/- for his family including wife and two children, for 20 years. It is also offered a gift for the persons who are paying premium at the same day itself. Believing the assurance given by the opposite parties, the complainant joined in the policy with the opposite party by paying an amount of Rs.25,000/- by way of cheque of the Urban Co-operative Bank, Thodupuzha to the 4^th opposite party. After certain weeks, the certificate of the insurance policy was also sent to the complainant by the opposite party. On perusing the same, it is written that the premium should be paid for 20 years with an amount of Rs.25,000/- and after paying Rs.5 lakhs to the opposite party, they have offered an insurance coverage for an amount of Rs.2,50,000/- only. The policy issued by the opposite party was against the conditions illustrated by the 3^rd and 4^th opposite parties. So the complainant informed his unwillingness to continue the policy to the 3^rd opposite party and the 3^rd opposite party directed the complainant to approach the 2^nd opposite party at Thodupuzha for changing the policy. So the complainant approached the 2^nd opposite party for changing the scheme of the policy or getting the premium amount paid by the complainant. But they are not ready to do the same. The conditions offered by the 3^rd and 4^th opposite parties were not of the policy issued by the opposite parties. The complainant never requested for the policy which is having a period of 20 years and never received the same by paying the premium. The complainant paid the premium by the assurance given by the opposite party that the policy will be matured after 5 years and the amount will be refunded at that time and the premium should be paid only for 3 years. But the opposite party issued the policy without discussing the material facts and conditions of the policy and it is a gross unfair trade practice from the part of the opposite party. So this petition is filed for getting the premium paid by the complainant with interest and also for compensation.

2. As per the written version filed by the 1^st and 2^nd opposite parties, after the expiry of the Free Look Period, the policy terms and conditions permits surrender of the policy only after completion of 3 years. So the surrender value as payable in accordance with the policy terms and conditions. As per the proposal form, the complainant offered to pay a premium of Rs.25,000/- annually for a period of 20 years and for which the sum assured sought was Rs.2,50,000/-. The policy holder has a right to reconsider the decision to purchase the policy within 15 days of receipt of the policy document in case he does not agree to the terms and conditions of the policy. The policy was due for premium on 30.01.2011 and intimation pertaining to the premium was sent to the complainant on 3.1.2011. The complainant failed to pay the premium on time as a result of which the said policy lapsed. A letter dated 3.3.2011 was also sent to the complainant. The complainant signed the proposal form

(cont....3)

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only after understanding and deliberating on the terms and conditions of the said plan vide the Sales Benefit Illustration which clearly stated that the said policy is for 20 years. Moreover,it is pertinent to note that the said policy was delivered to the address of the complainant on time, if the complainant was not satisfied with the terms and conditions of the policy he could have got the same cancelled. However, the same was not availed and after getting the benefit under the said policy for three years, the free look cancellation request has been made in order to gain undue advantage and the petition filed is liable to be dismissed.

3. As per the written version filed by 3^rd and 4^th opposite parties, it is admitted that they have conducted a class relating the policy, in the month of January, 2010 at Madapparambil resort, Thodupuzha, in free of cost. The complainant and his family had participated the class and on discussing about the leading insurance policies in India, it was also included the discussion of the Tata AIG Life Insurance Company and its schemes. The complainant was ready to join in the “Tata Optima” scheme of the Tata AIG LIC. As per the scheme, if a person joins by paying a premium of Rs.25,000/- and as per the age of the person, he was offered an insurance coverage of Rs.2 lakhs to Rs.2,50,000/-. The premium was for 20 years and the amount was to be paid in the share market and after the look out period of 3 years, the amount can be refunded. The insurer has the right to withdraw the amount on looking over the loss and gains of the share market. If anything in the policy certificate is against the conditions told by them in the class, the insurer has the right to complaint the same within 15 days of receipt of the policy certificate. The premium amount Rs.25,000/- was received from the complainant and the policy certificate also issued by them. The complainant has the right to continue the policy or can refund the amount after 3 years.

4. The point for consideration is whether there was any deficiency in service on the part of the opposite parties, and if so, for what relief the complainant is entitled to?

5. The evidence consists of oral testimony of PW1 and Exts.P1 to P5 marked on the side of the complainant.

6. The POINT:- The complainant produced evidence as PW1. PW1 attended the class conducted by the 3^rd and 4^th opposite parties at the Madapparambil Resort, Thodupuzha, about the leading insurance policy of the opposite parties, including Tata AIG LIC. As per the assurance of the opposite parties' agents, the complainant has to pay Rs.25,000/- as premium for 3 years and after completing 5 years, they will receive an amount between Rs.1,65,000/- and Rs.1,80,000/-. Moreover, an insurance coverage of Rs.2,50,000/- was offered to the family of the complainant including

(cont....4)

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wife and 2 children for 20 years. Believing the words of the 3^rd and 4^th opposite parties, because it was a policy in which the amount will be refunded after 5 years and also the insurance coverage will exists, the complainant decided to join in the policy and paid Rs.25,000/- as premium amount by way of cheque to the 4^th opposite party. Ext.P1 is the receipt for the first premium for an amount of Rs.25,000/-. When the policy was received after certain weeks, it is stated that the premium should be paid for 20 years with an amount of Rs.25,000/- and the complainant will get only an insurance coverage of Rs.2,50,000/-. But the complainant never needed such a policy having a long time. Ext.P2 is the copy of the policy. The description given by the opposite party was against the policy issued by them. So as per the direction of the 3^rd opposite party, the complainant approached the 1^st opposite party for changing the scheme of the policy, but that was not done. The premium amount was also not refunded as per the request of the complainant. So the opposite party deliberately described false details about the policy in order to receive Rs.25,000/- from the complainant. The complainant several times requested the opposite party to return the premium amount paid by him or change the scheme of the policy to a short term one. So he was constrained to issue lawyer's notice to the 2^nd to 4^th opposite parties and Ext.P3 is the copy of the lawyer's notice with postal receipts for the same. No reply was given by the opposite party and the amount was not at all paid.

As per the complainant, he joined in the policy only as per the assurance given by the opposite parties that it is a short term policy and insurance premium was to be paid only for 3 years and the amount would be repaid after 5 years with benefits and risk coverage was also offered for his family for an amount of Rs.2,50,000/-. But while the policy received, it was understood that the policy is a long term one and the complainant has to pay the premium for 20 years and the coverage for the same is only Rs.2,50,000/-. So he himself approached the 2^nd, 3^rd and 1^st opposite parties for getting back the amount or changing the policy to a short term one, but it was not done. Eventhough they received the lawyers notice, they never replied for the same as per Ext.P3. As per the written version filed by the 3^rd and 4^th opposite parties, they admitted that they have conducted a class about the details of the policies of the Tata AIG Life Insurance Policy. But they described about the terms and conditions of the policy and after knowing the terms and conditions of the policy, the complainant paid Rs.25,000/- to them. They themselves illustrated to the complainant that Rs.25,000/- was to be paid for 20 years and the policy holder will get the benefit of the policy coverage between Rs.2 lakhs and Rs.2.5 lakhs according to their age and after understanding the scheme of the policy named Tata Optima and the complainant joined the same.

It is admitted by the opposite party that the complainant paid Rs.25,000/- and Ext.P1 also shows the same. But after receiving the policy only, he understand that the conditions assured and delivered by the opposite parties were not as per the

(cont...5)

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policy. The time of the policy was also different. So the complainant needed to cancel the policy or change the policy to another scheme. Lawyers notice was also issued by the complainant for the same. But the opposite parties never replied the same, never changed the same. So we think that it is a gross deficiency from the part of the opposite parties. The complainant who is an ordinary prudent person, if he was not ready to agree the conditions of the policy, he can cancel the policy within a limited period. Here the complainant informed the mater to the 3^rd and 4^th opposite parties and also to the 1^st opposite party. But they were not willing to do the same. Even he was ready to change to another policy with the same premium. These matters were not at all challenged by the opposite party in anywhere. So we think that the 3^rd and 4^th opposite parties are the agents of the 1^st and 2^nd opposite parties and the policy was issued by the 1^st and 2^nd opposite parties. The premium amount also has been paid to the 1^st and 2^nd opposite parties. So the 1^st and 2^nd opposite parties are liable to return the amount to the complainant. The 2^nd opposite party is the master of the 1^st, 3^rd and 4^th opposite parties. So the 2^nd opposite party is liable to pay the amount to the complainant. As per the written version of the 3^rd and 4^th opposite parties, the opposite parties are ready to give back the amount to the complainant after 3 years with the profit in the share market.

Hence the petition allowed. The 1^st and 2^nd opposite parties are directed to pay an amount of Rs.25,000/- to the complainant within 30 days of receipt of a copy of this order failing which the amount shall carry 12% interest per annum from the date of default.

Pronounced in the Open Forum on this the 29^th day of November, 2011

Sd/-

SRI. LAIJU RAMAKRISHNAN (PRESIDENT)

Sd/-

SMT. BINDHU SOMAN (MEMBER)

(cont....6)

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APPENDIX

Depositions :

On the side of the Complainant :

PW1 - Alocious Joseph.

On the side of the Opposite Parties :

Nil

Exhibits :

On the side of the Complainant :

Ext.P1 - Copy of the first premium receipt issued by the opposite party.

Ext.P2 - Copy of the policy.

Ext.P3 - Copy of the lawyer's notice with postal receipts for the same.

Ext.P4 - Copy of the letter issued by the complainant to the opposite party

dated 22.4.2010.

Ext.P5 - The statement of Invest Assure Optima Plus policy.

On the side of the Opposite Parties :

Nil.