Order No. 16 dt. 12/06/2017
The fact of the case in brief is that the complainant purchased a policy from M/S Birla Sunlife Insurance Co Ltd, 39A , Harish Mukherjee Road, P.S –Kalighat, Kolkata-700025 ( OP - 1) being policy no 00066145 dt 17.05.2006 with half yearly premium of Rs 8933/- only through ECS for a payment term of 15 years yielding maturity benefit of 25 years. The policy was issued in the name of Mehak Agarwal ( Date of birth 16.07.1987 ), son of Santosh kr Agarwal who was the nominee in this policy and the policy had been proceeded continually with half yearly payment of Rs8933/- up to accumulation of Rs71464/-. Thereafter, father as well as nominee of the policy had immersed into acute financial crisis and failed to contin ue it any further. The policy was surrendered by submitting a letter dt18.07.2013 requesting for refund of the surrendered value. OP-1 apprised the complainant the surrender value being Rs 53422.98 only . At this point of time representative of op-1 arrived at the office of the outgoing policy holder and succeeded to convince him to issue cheque amounting to Rs17866/- . There after a new policy being no.6132732 in the name of Mr Santosh Kr Agarwal was issued. Complainant then wrote a letter alleging that the representative of the company cheated the complainant by signing a new form for issuing another policy in the name of his father. The opposite party -1 has taken initiative to disburse a sum of Rs 53422.98 only which is according to complainant a gross deficiency in service and unfair trade practice against which complainant has issued legal notice on 06.05.14 . Finding no solution complainant has lodged this complaint seeking direction to disburse Rs 62670.22 with interest @ 18% per annum , to cancel policy no 6132732, to pay compensation of Rs 2 lakh and to pay cost of Rs20,000/-
O.p has contested the case by filing written version. In their w/v o.p denied all material allegations against them inter alia stated that the complainants are educated businessmen and as such it is well established that the complainants were aware of the features of the insurance policy they were taking for himself and his family. It is further stated that the subject policy No.661465 is a Unit Linked Policy which is a combination of insurance coverage and market related investment. However growth of fund totally depends on its fund performance and market fluctuation. On receipt of premium, units are added to the existing policy fund. The cost of insurance, administration charges and service tax are deducted from the policy fund on a monthly basis by cancellation of units. Complaints had admitted that the policy was issued as per his choice and there was no deficiency in service with regard to the policy number 661465 and complainant had subsequently issued a cheque of Rs.17,866/- and along with the cheque the complainant submitted an application for issuance of a fresh insurance policy. After processing the application form and on encashment of the cheque the policy number 006132732 was issued to the complainant. Complaint filed by the complainant suffers from mis joinder of necessary parties as the alleged agent has not been made a party to the proceeding with the sole intent to suppress material facts from the Ld Forum. It is further stated that the complainant had mentioned in the complaint petition that he was having financial difficulty in continuing with the policy. However in the surrender form he had mentioned that he was surrendering the policy as the return was not satisfactory. It is stated that the complainant was well aware that he was surrendering the policy for low returns and was taking a new policy for tax benefit and higher returns on investment which was not getting reflected in the previous policy. As such the present complaint should be dismissed with cost. Complainant has not suffered any loss or injury as alleged and, therefore, the occasion of filing the complaint does not arise.
From the pleading of the parties and the materials on record the following points are to be decided-
- Whether there was any deficiency in service on the part of the o.ps.;
- Whether the complainant no.1 is entitled to get relief as prayed for;
Decision with reasons
Ld lawyer of the complainant argued that the averments stated in the w/v filed by the o.ps are totally false and fabricated and are speculative one in nature and at the outset is denied . Complainant also has said that at the time of signing the forms the agents of the o.ps hurriedly obtained signatures without giving them any opportunity to verify and go through the policy details. Complainant has said that the agents of the o.ps by suppressing all material facts in a fraudulent manner had obtained his signature in new policy form which is beyond his knowledge. Complainant immediately after receiving a new policy had informed the o.ps for cancellation of the same but they refused to do so. Complainant had invested and deposited premium of Rs.71,464/- and also thereafter additional amount of Rs.17,866/- for which the o.ps had assured the complainants to refund a total sum of Rs.1,16,129/-, but the o.ps had only disbursed a sum of Rs.53,422.98 only, which is gross deficiency in service and unfair trade practice.
We have gone through the pleadings of the parties and materials on record evidence in particular. It is admitted fact that father of the policy holder as well as nominee of the policy had suddenly faced acute financial trouble and decided to surrender the policy by submitting a letter dt18.07.2013 requesting for refund of the surrendered value. It is also an admitted fact that op -1 received a total premium of Rs71464/-, the policy was surrendered inJuly 29, 2013 and surrendered value was Rs 53422.98/-
OP-1 apprised the complainant the surrender value being Rs 53422.98 only . At this point of time representative of op-1 arrived at the office of the outgoing policy holder and persuaded him to issue cheque amounting to Rs17866/- . A new policy being no.6132732 in the name of Mr Santosh Kr Agarwal was issued. Complainant then became astonished and wrote a letter alleging that the representative of the company cheated the complainant by signing a new form for issuing another policy in the name of his father.
ld lawyer of the op-1 argued on this point that complainant & his father being highly educated the question of mis sell never arose.
The policy no.661465 dated 17.05.2006 was ULIP policy, the market value of which was dependent on share prices of the shares to which the ULIP policy was linked. Therefore , op-1 had no hand to re-orient the policy regarding enhancement of its value in their favour or in favour of the policy holder. And as such no deficiency in service regarding policy no 661465 on the part of the op-1 has arised.
Complainant said that the agents of the o.ps by suppressing all material facts in a fraudulent manner had obtained his signature in new policy form which is beyond their knowledge. When complainant was unwilling to invest further, representative of op-1 had made complainant no.1 convinced to issue cheque of Rs17866/- and persuaded to sign an investment form And thereafter the said representative of the op-1 disappeared from the field by issuing a policy in favour of complainant no -2 when complainant raised question before the op-1 against the said representative. The role & activity of the op-1 in this field amounts to an unfair trade practice on their part. Complainant immediately after receiving a new policy had informed the o.ps for cancellation of the same but they refused to do so. O.P -1 had only disbursed a sum of Rs.53,422.98 against the previous policy. As a result the complaint petition partially succeeds. Accordingly, we hold that the complainant is entitled to get relief as ordered hereunder.
Hence, ordered
That the case no.553/2014 is allowed on contest with cost.
The o.p-1 is directed to refund Rs.17,866/- to the complainant along with compensation of Rs.10,000/- and litigation cost of Rs.4,000/-. O.p-1 is also directed to pay the aforesaid amount within 30 days from the date of communication of this order i.d., an interest @ 10% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.
Supply certified copy of this order to the parties free of cost.
