State Consumer Disputes Redressal Commission
Icici Prudential Life Insurance Co. ... vs Swaran Kaur on 9 September, 2021
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
First Appeal No.224 of 2021
Date of Institution : 21.06.2021
Date of Reserve : 18.08.2021
Date of Decision : 09.09.2021
1. ICICI Prudential Life Insurance Company Ltd., Moga Road,
Kot Isse Khan, Moga through its Manager.
2. ICICI Prudential Life Insurance Company Ltd., Tower
Regional Office, Plot No.12, Gachilomli, Hyderabad-50032
through its Manager.
3. ICICI Purdential Life Insurance Company Ltd., Unit No.1-A-Q-
2A, Raheja Tipco, Plaza Rani Sata Marg, Malad East
Mumbai through its Manager. (Present address:Prufile
Tower, 1089, Appasaheb Marathe Marg, Prabhadevi,
Mumbai 400025.
(All appellants through the Senior Manager I-Legal, ICICI
Prudential Life Insurance Company Ltd. Prulife Tower, 1089,
Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025).
....Appellants/opposite parties
Versus
Swaran Kaur, W/o Chamail Singh, Galgoti Road, Kot Ise
Khan, District Moga-142043, Punjab, India.
.....Respondent/complainant
First Appeal against the order dated
16.04.2021 of the District Consumer Disputes
Redressal Commission, Moga.
Quorum:-
Hon'ble Mrs. Justice Daya Chaudhary, President
Mrs. Kiran Sibal, Member
Present:-
For the appellants : Sh.Rajesh Gupta, Advocate For the respondent : Sh.Chamail Singh, SPA First Appeal No 224 of 2021 2 KIRAN SIBAL, MEMBER The instant appeal has been filed by the appellants/opposite parties against the order dated 16.04.2021 passed by District Consumer Disputes Redressal Commission, Moga (in short, "District Commission"), whereby the complaint filed by the complainant under Section 12 of Consumer Protection Act, 1986 (in short 'the Act') was allowed and the opposite parties were directed to refund the amount of Rs.1,80,000/- (Rs.1,20,000/- + Rs.60,000/-) to the complainant along with interest at the rate of 8% per annum from the date of its respective deposit i.e. 07.03.2017 and 09.04.2018 respectively, till its realization. The opposite parties were also directed to pay lumpsum compensation of Rs.10,000/- to the complainant on account of harassment and litigation expenses.
It would be apposite to mention that hereinafter the parties will be referred, as have been arrayed before the District Commission.
Facts of the Case
2. Brief facts of the case are that the complainant purchased a policy bearing No.20803145 from the opposite parties having sum assured of Rs.12,00,000/- with annual premium of Rs.1,20,000/-. Accordingly, the complainant deposited Rs.1,20,000/- with the opposite parties on 07.03.2017. The complainant alleged that at the time of purchase of policy, she completed all the formalities and also filled the correct particulars in the form with the opposite parties. However, the opposite parties sent the policy, in question, First Appeal No 224 of 2021 3 with wrong particulars of the complainant as Ms.Swaran Kaur S/o Massa Singh, Galoti Road, Kot Ise Khan, District Moga, whereas the correct identity of the complainant is Swaran Kaur wife of Chamail Singh. After receiving the policy, the complainant immediately approached the opposite parties to make the necessary correction, but the opposite parties kept the matter pending on lame excuses and the complainant was asked to deposit the second instalment and said that thereafter, the necessary correction will be made in the policy. As per the advice of the opposite parties, the complainant deposited a sum of Rs.60,000/- on 09.04.2018 as part payment of the second instalment, but till date, the opposite parties lingered on the matter and did not make the correction in the policy. Thereafter, the complainant decided not to continue with the policy and asked the opposite parties to refund the premium paid along with interest but with no effect. This act and conduct of the opposite parties amount to deficiency in service and unfair trade practice. Hence, the complainant filed the complaint before the District Commission and sought the following reliefs against opposite parties:
i) to pay a sum of Rs.1,80,000/- vide Policy No.20803145 along with interest at the rate of 12% per annum from the date of payment till its realization;
ii) to pay Rs.50,000/- as compensation for causing mental tension and harassment; and
iii) to pay Rs.5,000/- as costs of litigation expenses. First Appeal No 224 of 2021 4
Defence of the Opposite Parties
3. Upon notice, opposite parties appeared and filed their written statement with preliminary submissions that the complaint filed by the complainant was not maintainable. It was submitted that the complainant provided the incorrect and false address to the opposite parties. The District Commission had no jurisdiction to entertain the complaint as the investment made under Unit Linked Policy is a speculative gain and speculative investment and speculative investment does not fall under the purview of the Consumer Protection Act. The complainant failed to approach the opposite parties within free look period and as per the terms and conditions of the policy, the complainant waived off her right to seek cancellation of the subject policy. As per the information provided by the complainant in proposal form, the policy, in question, was issued and after receipt of the policy documents, the complainant never approached the opposite parties for any rectification. The policy, in question, was issued on 07.03.2017 and at the time of issuance of the subject policy, the address that was provided by the complainant in the proposal form was Swaran Kaur S/o Massa Singh, Galoti Road, Kot Ise Khan, District Moga- 142043, Punjab, India and the same address was corroborated by the Pass Book submitted by the complainant along with the proposal form. The complainant after receipt of the policy documents never approached the opposite parties for any rectification. The policy, in question, was issued on 07.03.2017 and at the time of issuance of the subject policy, the address was First Appeal No 224 of 2021 5 provided by the complainant in the proposal form was Swaran Kaur S/o Massa Singh, Galoti Road, Kot Ise Khan, District Moga- 142043, Punjab, India, and the same address was corroborated by the Pass Book submitted by the complainant along with the proposal form as address proof and the same has been annexed by the complainant herself along with the complaint. Accordingly, as per the address so submitted by the complainant, the opposite parties issued the policy, in question, with the address of the complainant. However, on 28.03.2017, the complainant approached the opposite parties at the branch office with the request to update the address details and thereafter, the request of change in address of the complainant was instantly adhered to and honoured by the opposite parties and consequently, the same has been updated in the records of the opposite parties and hence, there is no deficiency in service on the part of the opposite parties. Rest all the other averments as detailed by the complainant in her complaint were denied and a prayer for dismissal of the complaint with costs was made.
Evidence of the Parties
4. To support her averments, the complainant tendered into evidence her affidavit as Ex.C-1 along with photo copies of documents i.e. copy of policy as Ex.C-2 and copy of paper cutting as Mark-A.
5. On the other hand, the opposite parties tendered into evidence the affidavit of Sh.Thejus Joseph, Manager Legal of ICICI First Appeal No 224 of 2021 6 Prudential Life Insurance Co. as Ex.OP2&3/1 along with photocopies of documents as Ex.OP2&3/2 to Ex.OP&3/10. Finding of the District Commission
6. The District Commission after going through the evidence and hearing learned counsel appearing on behalf of the parties passed the impugned order. Aggrieved with the same, this appeal by the appellants/opposite parties for setting aside the impugned order.
Contentions of the Parties
7. We have heard the learned counsel for the appellants and SPA of the respondent and have carefully gone through the record as well as written arguments filed by the parties.
8. Learned counsel for the appellants vehemently argued that the District Commission without appreciating the reply, evidence and arguments of the appellants/opposite parties, allowed the complaint and directions were passed against them. The District Commission failed to appreciate that the name and address i.e. "Swaran Kaur S/o Massa Singh Galgoti Road, Kot Ise Khan, District Moga - 142043, Punjab, India" was provided by the respondent herself in the proposal form at the time of issuance of the subject policy. The District Commission had also committed irregularity by not relying upon the evidence adduced by the appellants/opposite parties that the respondent's/complainant's request to update the address details was duly complied with and the correct address was updated on the same day itself i.e. 28.03.2017. It has also not relied upon the evidence which was a First Appeal No 224 of 2021 7 snapshot from appellant's system database, which reflected the updated address. The District Commission has passed its order solely on the ground that the new welcome kit was not issued to the respondent. The appellant does not have any liability to send new welcome kit after any changes in the policy documents are made. It has failed to consider the fact that the respondent has approached the appellant on 07.04.2018 to change the premium payment mode from 'annual' to 'half-yearly' which was processed on the same day itself and duly communicated to the respondent vide letter dated 07.04.2018. Hence, the respondent on her own will made payment of Rs.60,000/- which was due since 07.03.2018. The respondent did not approach the appellants even after receiving the policy during the Free Look period. She approached the appellants twice for making changes in the policy documents which was acknowledged by them, which shows that the respondent was well aware of the touch points of the appellants and terms and conditions of the policy. The District Commission while allowing the complaint has gone beyond the terms and conditions of the policy and the appellants have not done anything in contravention thereof. It is argued that as per the law, the Court cannot rewrite the contract of Insurance nor can the Court add to or modify the terms and conditions of the Contract of Insurance. The appellants / opposite parties relied upon the following judgments passed by the Hon'ble National Commission in support of his contentions:
(i) Mohan Lal Bengal Vs. ICICI Prudential Life Insurance Co. Ltd.First Appeal No 224 of 2021 8
(ii) Ram Lal Aggarwalla Vs. Bajaj Allianz Life Insurance Co. Ltd.; and
(iii) Harish Kumar Chadha Vs. Bajaj Allianz Life Insurance Co. Ltd.
It has been pleaded that there is no deficiency in service or unfair trade practice on the part of the appellants/opposite parties. Hence, the appellants/opposite parties filed this appeal for setting aside the impugned order.
9. On the other hand, the Special Power of Attorney holder, appeared, in person, and argued that the order of the District Commission is legal, valid and well reasoned and is sustainable in the eyes of law. The District Commission has passed the order after going through the documents and evidence available on the record. There is no illegality and infirmity in the order passed by the District Commission. Finally, it is prayed to dismiss the appeal with costs and uphold the order passed by the District Commission. Consideration of the Contentions
10. We have given our thoughtful consideration to the contentions raised by the learned counsel for the appellants/opposite parties as well as SPA of respondent.
11. Admittedly, the Insurance Policy bearing No.20803145 was issued in the name of the complainant, Swaran Kaur on 07.03.2017. The sum assured of the policy was Rs.12,00,000/- and the policy terms was of 10 years. It is also not disputed that the complainant paid a sum of Rs.1,80,000/- as premiums.
12. Now the issue is to decide whether there is any deficiency in service or unfair trade practice on the part of the opposite parties or not? To determine this issue, we have gone through the record, First Appeal No 224 of 2021 9 policy documents issued by the appellants-Insurance Company as well as findings of the District Commission.
13. The complainant in her complaint alleged that she availed an Insurance Policy from the opposite parties, who issued the policy with wrong particulars and mentioned as "Swaran Kaur S/o Massa Singh, Galgoti Road, Kot Ise Khan, District Moga-142043, Punjab" whereas as the correct particulars are "Swaran Kaur W/o Chamail Singh, Galoti Road, Kot Ise Khan, Near Pollothin Factory, Moga-142043, Punjab". The complainant in para 7 of her complaint specifically pleaded that she approached the opposite parties with the request to make the necessary correction in the Insurance Policy. In reply thereto, the opposite parties themselves admitted that the complainant approached them on 28.03.2017 with the request to make the changes in her address, which was accepted by the appellants/opposite parties and they made the necessary changes in her address. However, the opposite parties failed to produce any document to prove that the necessary changes were done and informed to the complainant in response to her request or issued a new policy with necessary changes or made any endorsement on the policy already issued. The opposite parties to prove the necessary changes referred the receipt as Ex.OP-2&3/8, which was issued on 07.04.2018. However, the referred document does not support the contention of the appellants as the changes are required to be done in the policy document itself. In the absence of any endorsement on the previous policy or issuance of new policy with necessary changes, it cannot be said that the First Appeal No 224 of 2021 10 request of the complainant was complied within timely manner by the opposite parties.
14. The opposite parties in their reply alleged that at the time of issuance of the policy, the address that was provided by the complainant in the proposal form was "Swaran Kaur S/o Massa Singh Galgoti Road, Kot Ise Khan, District Moga-142043, Punjab, India and the same address was corroborated by the Pass Book submitted by the complainant along with the proposal form as address proof. Even if, we are to consider this contention of the opposite parties, then why the appellants/opposite parties did not produce the proposal form, in original, which bears the signatures of the complainant. Moreover, as per the policy document attached with Ex.OP2&3/10 at page 319 of the record, the address which was mentioned as "S/o Massa Singh Galoti Road, Kot Ise Khan, Moga-142043, Punjab, India" is under the head of 'Contact Details', whereas under the head 'Proposer/Life Assured KYC Details', the document provided by the complainant is Aadhaar Card and the Aadhaar Card Number has been specifically mentioned in the application form under the Life Assured KYC details. In the said Aadhaar Card of the Life Assured, it is categorically stated as "W/o Chamail Singh, Galoti Road, Near Pollothin Factory, Kot Ise Khan, Moga, Punjab, 142043" over there by the opposite parties themselves. However, the opposite parties despite considering the KYC Details, issued the policy on the basis of Contact Details which they have taken from the corresponding Bank. Therefore, the contentions raised by the opposite parties that the complainant First Appeal No 224 of 2021 11 submitted her passbook at the time of submitting the proposal form as address proof does not carry any weight. Moreover, there is not even a single column in the proposal form, which talks about pass- book being given as address proof etc. It proves that the complainant never provided the copy of passbook for KYC or address details as the Aadhaar Card is mentioned as the KYC document. This act of the opposite parties draws adverse inference. The contentions raised by the opposite parties without having any supportive evidence are not tenable.
15. The appellants also alleged that the respondent did not approach the appellants/opposite parties within the Free Look Period after receiving the policy documents. It is not the case that the respondent/complainant wanted to discontinue the policy. It is the case where the respondent/complainant approached the appellants/opposite parties for correction of the wrong particulars, which the appellants/opposite parties failed to comply. Therefore, the contention raised by the appellants/opposite parties that the respondent/complainant did not approach the appellants/opposite parties within the Free Look Period is not tenable.
16. The reference made by the appellants in their appeal to the judgments passed by the Hon'ble National Commission are not applicable to the present case as the facts as detailed in the referred judgments are different from the present case. Therefore, the judgments cannot be relied upon.
17. The District Commission while deciding the complaint has rightly held that the opposite parties are deficient in rendering their First Appeal No 224 of 2021 12 services and allowed the complaint. There is no illegality or infirmity in the order passed by the District Commission.
18. Sequel to the above discussions, there is no merit in the appeal filed by the appellants and the same is dismissed. The order passed by the District Commission is upheld.
19. The appellants had deposited a sum of Rs.1,23,274/- at the time of filing of the appeal. This sum, along with interest which has accrued thereon, if any, shall be remitted by the Registry to the District Commission, after the expiry of 45 days of the sending of certified copy of the order to them. The concerned party may approach the District Commission for the release of the above amount to the extent of her/their entitlement and the District Commission may pass the appropriate order in this regard, in accordance with law.
(JUSTICE DAYA CHAUDHARY) PRESIDENT (KIRAN SIBAL) MEMBER September 09th ,2021 parmod