State Consumer Disputes Redressal Commission
Tushar Sanjay Ghadge vs Branch Manager, Birla Sunlife ... on 7 May, 2024
1
Date of filing :09.02.2022
Date of order :07.05.2024
MAHARASHTRA STATE CONSUMER DISPUTE REDRESSAL
COMMISSION,MUMBAI, BENCH AT AURANGABAD.
FIRST APPEAL NO. : 98 OF 2022
IN COMPLAINT CASE NO.: 856 OF 2019
DISTRICT CONSUMER COMMISSION : AURANGABAD.
Tushar Sanjay Ghadge, Appellant
R/o Loni (Khurd), (Adv.R.V.Jadhav)
Tq- Vaijapur, Dist.Aurangabad.
VERSUS
Aditya Birla Life Insurance Company Ltd,. Respondent
Through its Authorised Representative, (Adv.A.M.Kedar)
Having its office at-
One World Centre, Tower 1, 16th floor,
Jupiter Mill Compound, 841, Senapati Bapat
Marg, Elphinstone road, Mumbai 400013.
CORAM: Milind.S.Sonawane, Hon'ble Presiding Member.
Dr.Nisha.A.Chavhan, Hon'ble Member.
Nagesh C.Kumber, Hon'ble Member.
JUDGMENT
(Delivered on 07/05/2024) Per Dr.Nisha Amol Chavhan, Hon'ble Member.
The Appellant has challenges in this appeal, Order and Judgment passed by the Ld. District Consumer Disputes Redressal Commission, Aurangabad dated 23.11.2021 in C.C. No. 856/2019.
2. The facts giving rise to this appeal are as under.
3. It is the case of appellant that, the father of the appellant died due to the cause sudden heart attack on 28/11/2018. 2 After the death of appellant's father, he came to know about the life insurance policy No.05945153 by premium paid of Rs.1,74,992/- to the respondent insurance company on dated 21/2/2013. Appellant visited to the respondent office about the policy but he received the policy termination letter on dated 31/12/2018.
4. Appellant submitted that, his father during his life time received a telephonic call from unknown person from the respondent company informing him that, in order to claim the accrued bonus of Rs. 10 Lakhs on his existing insurance policy, he has to take another/additional 3 insurance policies from Respondent Company. Appellant's father has refused to avail any additional policy, the respondent company by giving false assurance obtained cheques from him and using the documents of the existing policies, forged the signature on the proposal form and issued 3 different insurance policies.
5. It is submitted that, the respondent company informed the appellant's father that if he wanted to get the refund of entire premium, he has to pay at least 2 premiums. Accordingly, appellant's father had paid initial premium amount of RS.1,75,000/- for the policy No. 005945153 on 31/1/2013. That the appellant's father noticed that the address on the 3 policy was incorrect which was informed to the officers of the respondent company however appellant's father did not receive any satisfactory reason from the respondent company.
6. It is submitted that, appellant's father realized that he was cheated by the respondent company, therefore he filed a police complaint in the police station but no cognizance was taken by the police, so appellant's father filed an application U/S 156(3) of CRPC, 1973 before the JMFC, Aurangabad on 17/12/2015. This matter is converted in Revision petition U/S 397 of CRPC bearing Case No. 521/2016. Court has passed the order U/S 202 of CRPC in this matter, and issued letter dated 3/3/2017 in favour of investigation officers of Jinsi Police station and stated that the factual things as the policy were issued by them and they are ready to repay the premium amount. Appellant filed an application U/S 156(3) of CRPC, 1973 before the JMFC, Aurangabad. Accordingly, appellant's mother had preferred Revision petition U/S 397 of CRPC bearing Case No. 185/2019 before the Principal District and Session Judge, Aurangabad and said matter is pending for adjudication.
7. It is further submitted that, Respondent Company engaging into unfair trade practices, giving false assurance have extorted the insurance premium. Appellant further submitted that, this 4 information was received by him from his advocate after the death of his father (insured) and hence he filed Consumer Complaint NO. 856/2019 alleging the deficiency service and claiming the refund of Rs.1,74,992/- along with interest @18% per Annum from 21 February 2013, Rs.1 Lakhs towards mental Agony and Rs.45,000/- towards cost of complaint.
8. Ld. District Consumer Dispute Redressal Commission Aurangabad allowed the complaint and directed the respondent to refund the premium of Rs.1,74, 992/- within 30 days to the appellant. Being aggrieved by the judgment and order of District Commission Aurangabad preferred this appeal on the following ground.
1. The order dated 23/11/2021 passed by Ld. District Consumer Dispute Redressal Commission Aurangabad in CC No.856/2019 may be modified.
2. The respondent is directed to pay the premium of Rs.1, 74, 992/- to the appellant with 18% PA interest from the date of the receipt of the premium amount dated 21/2/2013 till realization.
3. The respondent to impose a cost of Rs.10,000/- towards deficiency in service and Rs.10,000/- for physical and mental agony.
5
4. Any other appropriate relief.
9. Adv. R.V. Jadhav appeared for Appellant. Adv. A.M. Kedar appeared for respondent. On 9/2/2024, direction was given to the both parties to argue the matter finally on next date without fail; else only present party would be heard alone. Accordingly on 12/3/2024, Adv. A.M. Kadar was absent. We heard the Ld. Adv. R.V. Jadhav for appellant as well as perused the record which has been by the both parties on record. This commission has made following observation.
OBSERVATION
10. Against this background, we perused the copy of the Complaint and written version given by the Appellant in original proceedings before the District Consumer Commission Aurangabad. We have also gone through the impugned judgment. It is found that, there is no error committed by the Ld. District Consumer Commission Aurangabad on the factual aspects. But District commission has not awarded the interest on the premium amount; therefore, order needs to be modified
11. It is admitted fact that, respondent company had issued a letter dated 3/3/2017 in favour of the investing officer of Jinsi police station and stated that, as per policy issued by them, 6 they are ready to repay the premium amount as per their rules, to the appellant.
12. On a discussion of the aforesaid principle, we would conclude that insurer is statutorily mandated as per Clause 3(ii) of the Insurance Regulatory and Development Authority (Protection of Policy Holder's Interests, Regulation 2002) Act dated 16.10.2002 (hereinafter referred to as IRDA Regulation, 2002) to the effect that the insurer and his agent are duty bound to provide all material information in respect of a policy to the insured to enable him to decide on the best cover that would be in his interest. Further, sub-clause (iv) of Clause 3 mandates that if proposal form is not filled by the insured, a certificate has to be incorporated at the end of the said form that all the contents of the form and documents have been fully explained to the insured and made him to understand. Similarly, Clause 4 enjoins a duty upon the insurer to furnish a copy of the proposal form within thirty days of the acceptance, free of charge. Any non-compliance, obviously would lead to the irresistible conclusion that the offending clause, be it an exclusion clause, cannot be pressed into service by the insurer against the insured as he may not be in knowhow of the same. 7
13. In view of the above, the impugned judgment and order dated 23/11/2021 passed Ld. District Commission Aurangabad in CC No 856/2019 is need to be modified as the District Commission has not awarded interest on the premium amount. In view of the above discussion and the reasoning we are of the opinion that the appeal is allowed. Hence we pass the following order.
ORDER
1. The appeal is allowed.
2. The impugned judgment and order dated 23/11/2021, passed by the Ld.District Consumer commission Aurangabad, in C.C. No.856/2019 is to be modified.
3. The respondent is directed to pay the premium of Rs.1,74,992/- to the appellant with 18% PA interest from the date of the received premium amount dated 21/2/2013 till realization.
4. The respondent is directed to pay a cost of Rs.10,000/- towards deficiency in service and Rs.10,000/- for physical and mental agony.
5. Copies of the judgment are supplied to both the parties free of cost.
6. No order as to cost.
Palce :- Aurangabad.
Date :- 07/05/2024.
N.C.Kumbre Dr.N.A.Chavhan M.S.Sonawane
Member Member Presiding Member
UNk
8
Date of filing :09.02.2022
Date of order :07.05.2024
MAHARASHTRA STATE CONSUMER DISPUTE REDRESSAL COMMISSION,MUMBAI, BENCH AT AURANGABAD. FIRST APPEAL NO. : 99 OF 2022 IN COMPLAINT CASE NO.: 858 OF 2019 DISTRICT CONSUMER COMMISSION : AURANGABAD.
Tushar Sanjay Ghadge, Appellant
R/o Loni (Khurd), (Adv.R.V.Jadhav)
Tq- Vaijapur, Dist.Aurangabad.
VERSUS
Aditya Birla Life Insurance Company Ltd,. Respondent Through its Authorised Representative, (Adv.A.M.Kedar) Having its office at-
One World Centre, Tower 1, 16th floor, Jupiter Mill Compound, 841, Senapati Bapat Marg, Elphinstone road, Mumbai 400013.
CORAM: Milind.S.Sonawane, Hon'ble Presiding Member.
Dr.Nisha.A.Chavhan, Hon'ble Member.
Nagesh C.Kumber, Hon'ble Member.
JUDGMENT (Delivered on 07/05/2024) Per Dr.Nisha Amol Chavhan, Hon'ble Member.
The Appellant has challenges in this appeal, Order and Judgment passed by the Ld. District Consumer Disputes Redressal Commission, Aurangabad dated 23.11.2021 in CC. No. 858/2019.
2. The facts giving rise to this appeal are as under. 9
3. It is the case of appellant that, the father of the appellant died due to the cause sudden heart attack on 28/11/2018. After the death of appellant's father, he came to know about the life insurance policy No.005872885 by premium paid of Rs.1,24,994/- to the appellant insurance company on dated 31/12/2012. Appellant visited to the respondent office about the policy but he received the policy termination letter on dated 31/12/2018.
4. Appellant submitted that, his father during his life time received a telephonic call from unknown person from the respondent company informing him that in order to claim the accrued bonus of Rs.10 Lakhs on his existing insurance policies, the appellant's father has to take another/additional 3 insurance policies from respondent company. Appellant's father has refused to avail any additional policies, the respondent company by giving false assurance obtained cheques from him and using the documents of the existing policies, forged the signature on the proposal form and issued 3 different insurance policies.
5. It is submitted that, the respondent company informed the appellant's father that if he wants to get the refund of entire premium, he has to pay at-least 2 premiums. Accordingly, 10 appellant's father paid initial premium amount of RS.1,24,992/- for the policy No. 005872885 on 31/12/2012. That the appellant's father notices that the address on the policy was incorrect which was informed to the officers of the respondent company however he did not receive any satisfactory reason.
6. It is submitted that, appellant's father realized that he was cheated by the respondent company therefore he filed a police complaint in the police station but no cognizance was taken by the police, so appellant filed an application U/S 156(3) of CRPC, 1973 before the JMFC, Aurangabad. Accordingly, appellant's mother had preferred Revision petition U/S 397 of CRPC bearing Case No. 185/2019 before the Principal District and Session Judge, Aurangabad and said matter is pending for adjudication.
7. It is further submitted that, respondent company engaging into unfair trade practices, giving false assurance have extorted the insurance premium. Appellant further submitted that, this information was received by him from his advocate after the death of his father (insured) and hence he filed Consumer Complaint NO. 858/2019 alleging the deficiency service and claiming the refund of Rs.1,24,994/- along with interest @18% 11 per Annum from 31/12/2012 till realization. As well as Rs. 1 Lakhs towards mental Agony and Rs.45,000/- towards cost of complaint.
8. Ld. District Consumer Dispute Redressal Commission Aurangabad allowed the complaint and directed the appellant to refund the premium of Rs.1,24,994/- within 30 days to the respondent. Being aggrieved by the judgment and order of District Commission Aurangabad preferred appeal.
1. The order dated 23/11/2021 passed by Ld. District Consumer Dispute Redressal Commission Aurangabad in CC No.858/2019 may be modified.
2. The respondent is directed to pay the premium of Rs.1,24,994/- to the appellant with 18% PA interest from the date of the receipt of the premium amount dated 30/12/2012 till realization.
3. The respondent to impose a cost of Rs.10,000/- towards deficiency in service and Rs.10,000/- for physical and mental agony.
4. Any other appropriate relief.
9. Adv. R.V. Jadhav appeared for Appellant. Adv. A.M. Kedar appeared for respondent. On 9/2/2024, direction was given to the both parties to argue the matter finally on next date without 12 fail; else only present party would be heard alone. Accordingly on 12/3/2024, Adv. A.M. Kadar was absent. We heard the Ld. Adv. R.V. Jadhav for appellant as well as perused the record which has been by the both parties on record. This commission has made following observation.
OBSERVATION
10. Against this background, we perused the copy of the Complaint and written version given by the Appellant in original proceedings before the District Consumer Commission Aurangabad. We have also gone through the impugned judgment. It is found that, there is no error committed by the Ld. District Consumer Commission Aurangabad on the factual aspects.
11. It is admitted fact that, appellant company had issued a letter dated 3/3/2017 in favour of the investing officer of Jinsi police station and stated that, as per policy issued by them, they are ready to repay the premium amount as per their rules of the respondent.
12. On a discussion of the aforesaid principle, we would conclude that insurer is statutorily mandated as per Clause 3(ii) of the Insurance Regulatory and Development Authority (Protection of Policy Holder's Interests, Regulation 2002) Act dated 16.10.2002 (hereinafter referred to as IRDA Regulation, 13 2002) to the effect that the insurer and his agent are duty bound to provide all material information in respect of a policy to the insured to enable him to decide on the best cover that would be in his interest. Further, sub-clause (iv) of Clause 3 mandates that if proposal form is not filled by the insured, a certificate has to be incorporated at the end of the said form that all the contents of the form and documents have been fully explained to the insured and made him to understand. Similarly, Clause 4 enjoins a duty upon the insurer to furnish a copy of the proposal form within thirty days of the acceptance, free of charge. Any non-compliance, obviously would lead to the irresistible conclusion that the offending clause, be it an exclusion clause, cannot be pressed into service by the insurer against the insured as he may not be in knowhow of the same.
13. In view of the above, the impugned judgment and order dated 23/11/2021 passed Ld. District Commission Aurangabad in CC No 858/2019 is no need to be modified as the District Commission has not awarded interest on the premium amount. In view of the above discussion and the reasoning we are of the opinion that the appeal is devoid of merits and deservers to be 14 dismissed. Hence we pass the following order.
ORDER
1. The appeal is allowed.
2. The impugned judgment and order dated 23/11/2021, passed by the Ld. District Consumer commission Aurangabad, in C.C. No.858/2019 is to be modified.
3. The appellant is directed to pay the premium of Rs.1,24,994/- to the respondent with 18% PA interest from the date of the received premium amount dated 30/12/2012 till realization.
4. The appellant is directed to pay a cost of Rs.10,000/- towards deficiency in service and Rs.10,000/- for physical and mental agony.
5. Copies of the judgment are supplied to both the parties free of cost.
6. No order as to costs.
Palce :- Aurangabad.
Date :- 07/05/2024.
N.C.Kumbre Dr.N.A.Chavhan M.S.Sonawane
Member Member Presiding Member
UNK
15
Date of filing :09.02.2022
Date of order :07.05.2024
MAHARASHTRA STATE CONSUMER DISPUTE REDRESSAL COMMISSION,MUMBAI, BENCH AT AURANGABAD. FIRST APPEAL NO. : 100 OF 2022 IN COMPLAINT CASE NO.: 857 OF 2019 DISTRICT CONSUMER COMMISSION : AURANGABAD.
Vaishali Sanjay Ghadge, Appellant
R/o Loni (Khurd), (Adv.A.M.Kedar)
Tq- Vaijapur, Dist.Aurangabad.
VERSUS
Aditya Birla Life Insurance Company Ltd,. Respondent Through its Authorised Representative, (Adv.R.V.Jadhav) Having its office at-
One World Centre, Tower 1, 16th floor, Jupiter Mill Compound, 841, Senapati Bapat Marg, Elphinstone road, Mumbai 400013.
CORAM: Milind.S.Sonawane, Hon'ble Presiding Member.
Dr.Nisha.A.Chavhan, Hon'ble Member.
Nagesh C.Kumber, Hon'ble Member.
JUDGMENT (Delivered on 07/05/2024) Per Dr.Nisha Amol Chavhan, Hon'ble Member.
The Appellant has challenges in this appeal, Order and Judgment passed by the Ld. District Consumer Disputes Redressal Commission, Aurangabad dated 23.11.2021 in CC. No. 857/2019.
16
2. The facts giving rise to this appeal are as under.
3. It is the case of appellant that the husband of the appellant died due to the cause sudden heart attack on 28/11/2018. After the death of appellant's husband, she came to know about the life insurance policy No.005964008 by premium paid of Rs.1,74,992/- to the respondent insurance company on dated 28/02/2013 and second premium was paid of Rs.1,76,587/- total amount paid by the respondent's husband was of Rs.3,51,589/-. Appellant visited to the respondent office about the policy but he received the policy termination letter on dated 31/12/2018.
4. Appellant submitted that, his husband during his life time received a telephonic call from unknown person from the respondent company informing him that in order to claim the accrued bonus of Rs.10 Lakhs on his existing insurance policies, the he has to take another/additional 3 insurance policies from Respondent Company. Appellant's husband has refused to avail any additional policies, the respondent company by giving false assurance obtained cheques from him and using the documents of the existing policies, forged the signature on the proposal form and issued 3 different insurance policies.
17
5. It is submitted that, the respondent company informed the Appellant's husband that if he wanted to get the refund of entire premium, he has to pay at least 2 premiums. Accordingly, appellant's husband had paid initial premium amount of RS 1,74,992/- /- for the policy No. 005964008 on 28/02/2013 and second premium was paid of Rs.1,76,587/- total amount paid by the respondent's husband was of Rs.3,51,589/. That the Appellant's husband noticed that the address on the policy was incorrect which was informed to the officers of the respondent company however he did not receive any satisfactory reason from the respondent company.
6. It is submitted that, Appellant's husband realized that he was cheated by the respondent company, therefore he filed a police complaint in the police station but no cognizance was taken by the police, so Appellant's husband filed an application U/S 156(3) of CRPC, 1973 before the JMFC, Aurangabad on 17/12/2015. This matter is converted in Revision petition U/S 397 of CRPC bearing Case No. 521/2016. Court has passed the order U/S 202 of CRPC in this matter, and issued letter dated 3/3/2017 in favour of investigation officers of Jinsi Police station and stated that the factual things as the policy were issued by them and they are ready to repay the premium 18 amount. Appellant filed an application U/S 156(3) of CRPC, 1973 before the JMFC, Aurangabad. Accordingly, appellant had preferred Revision petition U/S 397 of CRPC bearing Case No. 185/2019 before the Principal District and Session Judge, Aurangabad and said matter is pending for adjudication.
7. It is further submitted that, Respondent Company engaging into unfair trade practices, giving false assurance have extorted the insurance premium. Appellant further submitted that, this information was received by her from his advocate after the death of his husband (insured) and hence she filed Consumer Complaint NO. 857/2019 alleging the deficiency service and claiming the refund of Rs.1,74,992/- and second premium of Rs.1,76,587/- total amount paid of Rs.3,51,589/- along with interest @18% per Annum from 21 February 2013, Rs. 1 Lakhs towards mental Agony and Rs.45.000/- towards cost of complaint.
8. Ld. District Consumer Dispute Redressal Commission Aurangabad allowed the complaint and directed the respondent to refund the premium of Rs 3,51,589/- within 30 days to the appellant. Being aggrieved by the judgment and order of District Commission Aurangabad preferred this appeal on the following ground.
19
1. The order dated 23/11/2021 passed by Ld. District Consumer Dispute Redressal Commission Aurangabad in CC No.857/2019 may be modified.
2. The respondent is directed to pay the premium of Rs.3,51,589 /- to the appellant with 18% PA interest from the date of the received premium amount dated 21/2/2013 till realization.
3. The respondent to impose a cost of Rs.10,000/- towards deficiency in service and Rs.10,000/- for physical and mental agony.
4. Any other appropriate relief.
9. Adv. R.V. Jadhav appeared for Appellant. Adv. A.M. Kedar appeared for respondent. On 9/2/2024, direction was given to the both parties to argue the matter finally on next date without fail; else only present party would be heard alone. Accordingly on 12/3/2024, Adv. A.M. Kadar was absent. We heard the Ld. Adv. R.V. Jadhav for appellant as well as perused the record which has been by the both parties on record. This commission has made following observation.
OBSERVATION
10. Against this background, we perused the copy of the Complaint and written version given by the Appellant in original 20 proceedings before the District Consumer Commission Aurangabad. We have also gone through the impugned judgment. It is found that, there is no error committed by the Ld. District Consumer Commission Aurangabad on the factual aspects. But District commission has not awarded the interest on the premium amount; therefore, order needs to be modified
11. It is admitted fact that, respondent company had issued a letter dated 3/3/2017 in favour of the investing officer of Jinsi police station and stated that, as per policy issued by them, they are ready to repay the premium amount as per their rules, to the appellant.
12. On a discussion of the aforesaid principle, we would conclude that insurer is statutorily mandated as per Clause 3(ii) of the Insurance Regulatory and Development Authority (Protection of Policy Holder's Interests, Regulation 2002) Act dated 16/10/2002 (hereinafter referred to as IRDA Regulation, 2002) to the effect that the insurer and his agent are duty bound to provide all material information in respect of a policy to the insured to enable him to decide on the best cover that would be in his interest. Further, sub-clause (iv) of Clause 3 mandates that if proposal form is not filled by the insured, a certificate has to be incorporated at the end of the said form 21 that all the contents of the form and documents have been fully explained to the insured and made him to understand. Similarly, Clause 4 enjoins a duty upon the insurer to furnish a copy of the proposal form within thirty days of the acceptance, free of charge. Any non-compliance, obviously would lead to the irresistible conclusion that the offending clause, be it an exclusion clause, cannot be pressed into service by the insurer against the insured as he may not be in knowhow of the same.
13. In view of the above, the impugned judgment and order dated 23/11/2021 passed Ld. District Commission Aurangabad in CC No 857/2019 is need to be modified as the District Commission has not awarded interest on the premium amount In view of the above discussion and the reasoning we are of the opinion that the appeal is allowed. Hence we pass the following order.
ORDER
1. The appeal is allowed.
2. The impugned judgment and order dated 23/11/2021, passed by the Ld. District Consumer commission Aurangabad, in C.C. No.857/2019 is to be modified.
3. The respondent is directed to pay the premium of Rs. 3, 51,589/- to the appellant with 18% PA interest from the date of the received premium amount dated 21/2/2013 till realization.
22
4. The respondent is directed to pay a cost of Rs. 10,000/- towards deficiency in service and Rs. 10,000/- for physical and mental agony.
5. Copies of the judgment are supplied to both the parties free of cost.
6. No Order as to cost.
Palce :- Aurangabad.
Date :- 07/05/2024.
N.C.Kumbre Dr.N.A.Chavhan M.S.Sonawane Member Member Presiding Member UNK