State Consumer Disputes Redressal Commission
Subhash Bhagoji Sable vs Icici Prudential Life Insurance ... on 8 June, 2022
1 A/141/2018
Date of filing :22.01.2018
Date of order :08.06.2022
MAHARASHTRA STATE CONSUMER DISPUTE
REDRESSAL COMMISSION, MUMBAI.
FIRST APPEAL NO. : 141 OF 2018
IN COMPLAINT CASE NO.: 93 OF 2015
DISTRICT CONSUMER FORUM : ADDITIONAL THANE.
Subhash Bhagoji Sable,
R/o C: 55-2/9, Gharkul-1, Co-operative Housing
Society Ltd,. Sector 24, Juinagar,
P.O.Sanpada, Navi Mumbai- 400705 APPELLANT
VERSUS
1. ICICI PRUDENTIAL LIFE INSURANCE CO.,Ltd.
(Registered Office at - ICICI Prulife Towers, 1089
Appasaheb Marathe Marg, Prabhadevi,
Mumbai- 400025
Through its Executive Vice President Tecnology &
Service Delivery, having its main office at Vinod Silk
Mills Compound, Chakravarthy Ashok Road,
Ashok Nagar, Kandivali (E), Mumbai 400101.
2. ICICI Prudential Life Insurance Company Ltd,.
Thrugh it's Branch Manager, Vashi Branch,
Having it's office at 1st floor, C-wing, Office No 111/118,
Bsel Tech Park, Opp. Vashi Station, Sector 30A, Vashi,
Navi Mumbai 400703. RESPONDENT No.1&2.
CORAM :Smt.S.T.Barne, Hon'ble In-charge President.
Mr.K.M.Lawande, Hon'ble Member.
Present : Adv.S.K.Dhara for Appellant.
Adv.Himanshu Shinde for respondent.
2 A/141/2018
JUDGMENT
(Delivered on 08/06/2022) Per Smt.S.T.Barne, Hon'ble In-charge President.
1. This Appeal is arising out of judgement and order in C.C.No. 93/2015 decided on 14th August, 2017 by District Consumer Dispute Redressal Commission, Thane. The present appellant is the complainant and this respondents are the opponents in the original complaint. They are hereinafter referred as per their status in the complaint.
2. It is the case of complainant that, in the month of February 2014 the employees of opponents ICICI Prudential Life Insurance Company Limited, namely Anuja Patil, Senior Financial Service Manager and employee Virendra Singh singlani, Assistant Finance Service Manager came to him and introduced themselves by showing their visiting/ employee card. They informed him that, his old policy number 023 042 73 dated 18th January, 2006 and 06624 827 dated 14th November, 2007 will not give him good returns and asked him to surrender those policies and to take new policies, with one time premium plan, with maturity after 5 years, which would offer him good returns in comparison to earlier policies. Therefore, he obtained two policies in the name of his grandson Kumar Asit Sable. Thereupon on 17th February, 2014 said Anuja Patil obtained his signatures on blank proposal forms and told him that 3 A/141/2018 they were already having his details and she would fill up the forms on reaching to office. He has also issued two cheques of Rs. 2,50,000/- each of Indian Overseas Bank Fort, branch Mumbai to her. Miss Anuja Patil arraged part payment of surrender value on 22nd February, 2014, of Rs. 4,99,500/- by RTGS to enable the complainant to make payment for new policies. Thus out of surrender value of Rs. 10,19658.54 Rs. 5 Lakhs were paid by two cheques for purchase of two policies.
3. It is the contention of complainant that two new policies of Rs. 5 lakhs are subject matter of this complaint. It is the case of complainant that in the month of March 2014 he found two envelopes in his letter box. There were two unsigned draft policies bearing policy number 18435070 dated 3.3.2014 styled as IPRU EliteLifeII_UIN105L 14 1V01 and another bearing policy number 184 347 09 dated 10th March, 2014 IPRUElite life II - UIN 105L 141V01 and both policies are non participating unit link life insurance plan. Both policies were of assured sum of Rs. 25 lakhs with maturity term of 13 years with yearly premium for 5 years with maturity date of 27 February 2018. While another Policy was 13 years yearly premium for 13 years with date of maturity was shown as 27 February 2026. Those policies were not of One Time Premium policies as promised. The information given in the policies was not correct. The phone number was mentioned incorrectly. The address and occupation of the complainant was also shown 4 A/141/2018 incorrectly. Though he is retired on super annuation, it is mentioned as, self employed. There were no Babaji Enterprises Private Limited exist at any time. However, it is shown as such in the column of organisation. His annual income was shown as Rs.20 lakhs when his anual income was Rs.1,50,000/- only. The age of Asith sabale is 5 years in policy related 3.3.2014 age proof was shown as 'baptism and certificate from church'. And in the policy dated10. 3.2014 age proof was birth certificate on the basis of notarized affidavit when the birth certificate was issued by Navi Mumbai municipal corporation. In both policies income of child was shown as Rs.50,000/- when the child was having no income.
4. It is the contention of complainant that on 3rd week of March 2004 when Anuja Patil approached him, she told that there was correct data information with office as regards new policies. It was told that he need not worry about data recorded. As regard to one time premium, maturity after five years of policy, she said that, he need not pay further premium. He was told that, he will get the chance to verity the policies and after confirmation the signed draft policies will be issued. However, on 31.5.2014 the complainant received sms message from opponent to pay premium of Rs. 250000/- and due date was shown as 27.2.2015. Thereupon, the complainant tried to confirm the authenticity of assurances given by Anuja Patil. Then he approached Grievance Redressal Machinery of opponent party, at all 5 A/141/2018 the 4 levels, such as, customer service representative Grievance Redressal Office (GRO), Sr.GRO, Grievance Redressal Committee (GRC), and exhausted all the 4 channels. At first level he was informed for discontinuation of premium which was disastrous to complainant itself. On approaching the authority at 2nd level of GRO he was told to approach the local branch for refund of money. He was told at local branch that his case was wrongly closed and refund is declined. At third level he has issued letter dated 27.10.2014 Manager Grievance Redressal committee (SGRO) but no reply was received. On 4th level he has issued letter by RPAD to (GRC) Grievance and Redressal Committee. But his complaint was not replied or resolved. Hence, he constrained to file consumer complaint.
5. The respondent denied all the adverse allegations made by the complainant. It is the contention of opponent that, the opposite parties had already as a special case offered cancellation to the complainant, of his new policies bearing No.18435070 and 18434709. However, the complainant with malafied intention did not submit the necessary documents for processing the cancellation within the stipulated time. The present complaint is not maintainable and is liable to be dismissed for non-joinder of necessary parties. Policies were processed by individual agents namely Dharamveer Sharma, Dinesh Baburao Patil and Virender Singh Siglani. The said agents have not been made a party to 6 A/141/2018 the present complaint. Based on the information provided in the said application / proposal forms, the company issued the subject policies to the complainant. Complainant is graduate by profession, therefore he is an educated and diligent person to understand the policy terms and conditions. It is also stated that, the company neither endorsed nor authorized any statement, that is in violation of the terms and conditions of the respective policy. The complainant approached the opposite party company for the first time on 15.2.2014 for partial withdrawal from his policy no.06624827. The company duly processed his request and transferred Rs. 4,99,500 to the complainant's account through NEFT on 21.2.2014. The complainant further approached the company for the surrender of his policies bearing no. 06624827 and 01304273 on 3.3.2014. The company duly processed his request and transferred Rs. 328,828.77 under policy no. 06624827 and Rs. 191,329.97 under policy no. 01304273 to the complainant's account on 04.03.2014 and 06.03.2014 respectively.
6. It is further contention of opponents that, the new policies bearing no. 18435070 and 18434709 were issued only on the basis of receipt of duly filled and signed proposal form the complainant. The complainant had applied for the subject policies after clear knowledge and understanding of the terms and conditions. The complainant is not a novice in subscribing to any 7 A/141/2018 insurance polices from the respondent. The complainant must have definitely read the proposal forms carefully before signing the same. The respondent states that the subject policies bearing no.18435070 and 18434709 are sell online policies. Complainant had duly signed the customer declaration form giving declaration that he is willingly applying for the said policies. The opposite party company had issued the subject policies on the basis of duly filled and signed proposal forms and customer declarations received from the complainant. The complainant retained the policy documents of all the policies and did not approach the company with any discrepancies regarding premium payment, premium frequency, fund value and the policy terms and conditions, neither did he approach the company for cancellation of the said policies during the free Look Period thereby implying that, he had agreed to all the terms and conditions of the said policies.
7. It is the contention of opponent that, the complainant approached the opposite party on 16.06.2014 i.e. after almost 3 and half month after the issuance of the new policies stating that he was asked to surrender his old policies as they were not giving good returns and buy new policies with attractive returns. He was further told that the new policies will be of one time payment. When he received the policy documents for new policies, he came to know that his address, education, occupation and income details were wrongly 8 A/141/2018 mentioned in the proposal form therefore, wants refund with interest. The company duly replied him vide its letters dated 26.06.2014 and 14.08.2014 stating that, the company cannot comply with his request for cancellation of his policies as he failed to approach during the free look period. The company thereupon reinvestigated the case and as a special case decided to refund the premium amount invested by the complainant in his new policies bearing no. 18435070 and 18434709. The company vide its letters dted 6.10.2014, 30.10.2014 and 02.12.2014 informed the complainant that his request for cancellation has been accepted and further asked him to submit necessary documents to process his request. The complainant did not approach the company with the necessary documents for processing his cancellation request, for the reasons best known to him and filed the present complaint.
8. On giving opportunity of hearing to the parties the learned District Consumer Forum pleased to allow the complaint partly and has given directions to the opponent to pay Rs. 5 Lakhs the premium amount within 45 days of passing the order. Failing which the opponents are directed to pay the amount with interest at the rate of 9% p.a. from the date of order till realisation of entire amount.
9 A/141/2018
9. The complainant being aggrieved by said order, in not awarding interest, amount of mental agony and cost, has preferred the appeal on the following grounds.
That, the District Consumer Forum has misconstrued the documents and evidence on record. It is ignored that, the complainant's letter dated 16.6.2019 was replied by opponent on 26.6.2014 thereby denying to refund the premium amount. The District Consumer Forum failed to consider that, the opponents have falsely stated that, vide letter dated 6.10.2014, 30.10.2014 and 21.12.2014 he was informed the complainant that his request was accepted and he was asked to submit the original documents.
10. It is further submitted that, the opponents are not speaking truth. They have not submitted postal receipt, & acknowledgment on record. The alleged letters issued by opponents in the month of Oct. And December 2014, are false. His contention that, the representative of opponent Anuja Patil, when approached to him he brought to her notice that, there were wrong mentioning in the policy and it was not one time premium policy. That time she further assured him not to worry and she would get cure those corrections. Due to which complainant could not raise grievances earlier. And thereupon the opponents refused to satisfy the claim, on the ground that, the complainant did not approach to company within 15 days from receipt of policies. District Consumer Forum failed to consider that, the opponent gave false promise that on 10 A/141/2018 surrendering the old policies she would have issued one time premium policies. It is wrongly observed that, complainant has not proved deficiency in service on the part of opponents. Though it is held that, complainant is eligible for refund of Rs.5 Lakhs. The District Consumer Forum committed error in not allowing the amount of mental agony and cost of proceeding, to the complainant. Hence, this appeal.
11. In view of respective submissions of the parties following points arise for our determination. We have noted them along with our findings against it accordingly for the reasons to follow.
Sr.No. Points. Findings.
1 Whether, the appellant proved Yes.
deficiency in service on the part of
opponent?
2 Whether, appellant is entitled for Yes.
the relief of interest claimed,
amount towards mental agony and
costs?
3 Whether, there requires interference Yes.
in the order of District Consumer
Forum?
4 What relief and order? As per final order.
REASONING
Points Nos. 1to3 :-
12. Heard learned Advocate for complainant and
opponent. The learned Advocate for complainant argued in the line of his pleading, evidence and appeal memo. He mainly gave emphasise on the point that, the District 11 A/141/2018 Consumer Forum arrived at conclusion that he is eligible for the refund of premium. However, failed to consider the other aspect as to unfair trade practice on the part of opponent and the fact that, it has caused mental agony and harassment to complainant and delayed the payment for about 3 years and 9 months. He was constrained to file consumer complaint after exhausting all the four channels of opponents for redressal of his grievance. That, the opponent's employee Anuja Patil and representative Virender Sing have given false advise and assurance to the complainant that when he found that, new policies issued were not single premium policies but there was one policy of 5 years premium and another was of 13 years, yearly premium and there were incorrect mentioning about age proof, address and income & source of income. Said Anju Patil approached to him along with Virendra Singh. He disclosed these facts to them they assured him that, he need not worry about incorrect data received in the policy and that he need not pay the premium and they would make necessary corrections and would issue policy with his confirmation. Therefore, he could not approach to opponent within free look period. Admittedly on said ground the opponents denied to refund him the amount of premium without considering the real fact, though immediate grievances made to the authority for redressal. Even opponents issued him reply that his request cannot be processed in the month of July and August 2014.
12 A/141/2018
13. It is further argued that, however, in the reply to consumer complaint the opponents came with defence that as a special case his request was accepted and that in the month of Oct. & December 2014 letter were issued to complainant and he was asked to produce documents, but he has not complied it. The District Consumer Forum without any proof as to service of those letters, relied upon submission of opponent and with wrong observation denied amount of interest, mental agony and cost of complaint. When the complainant held entitled for refund, the District Consumer Forum ought to have awarded interest, compensation for mental agony and cost of proceeding. However, the District Consumer Forum failed to consider the evidence and documents of complainant.
14. On the other hand the learned Advocate for opponent/respondent has argued that, appeal is preferred only for interest denied by the District Consumer Forum. The District Consumer Forum has categorically observed that the opponent was ready and still ready to refund the premium yet complainant has not submitted original documents and there is no evidence to establish deficiency in service on the part of opponent. In the circumstances complainant is liable only for amount of Rs. 5 Lakhs. He has further drawn our attention towards the letter dated 29.12.2017, with which the opponents have complied the order of District Consumer Forum by paying the amount to complainant.
13 A/141/2018 Once the complainant has accepted the amount, which signifies that, he has accepted the order of District Consumer Forum. Secondly, the complainant himself admitted that, policy were dispatched to him in the month of March 2013, and he approached to opponent on 16.6.2017 for cancellation of policies for the first time i.e. after free look period of 15 days as mentioned in terms and conditions. Hence, he is not entitled for refund of amount of premium beyond free look period. Even the complainant has earlier obtained policies and also he is an educated person. Therefore, it is to be considered that, he must have read the terms and conditions of policies carefully. The opponent is a reputed company and its officials are not supposed to commit false representation. The opponents are not privy to the communication between complainant and local agents. The company has issued letters dated 6.10.2014, 30.10.2014 and 2.12.2014, that his request for cancellation is accepted and to submit original document. But the complainant failed to produce it. Hence, company could not proceed with his request for refund of premium amount. The complainant with malafied intention did not submit the documents and filed the complaint.
15. It is important to note that it is not disputed that complainant has taken two policies in his name in the year 2005 & 2007 respectively. According to complainant opponent's employee Anuja Patil and representative 14 A/141/2018 Virender Singh approached him and told that, his old policies are not so beneficial. If he has invested said amount in new policies they could give him better return to that of old policies. Hence, he has submitted proposal to surrender those policies and decided to take two policies with one premium, in the name of his grandson. Said Anuja Patil has collected his old policies and made arrangement to refund the surrender value partially of Rs. 4,99,000/- so as to enable him to make payment of premium of Rs. 2,50,000/- towards two new policies. The copies of those old policies are produced on record bears endorsement of Anuja Patil with her signature on the rear page of his old policy is at page no. C-57. It bears the signature of Anuja Patil and name of virender Singh from Mulund Branch along with mobile number. These facts are not rebutted by the opponent by adducing evidence of said Anuja Patil or Virender Singh. It supports the contention of complainant that on the assurance of Anuja Patil he has surrendered his old policies and agreed to purchase two new policies.
16. Secondly, it cannot be ignored that, the complainant is a retired person. He has invested the surrender value by surrendering the old policies and issued two cheques of Rs. 2,50,000/- premium each for purchase of new policies. If at all he would have agreed to purchase the policies with yearly premium of Rs. 2,50,000/- for 5 years and 13 years premium, it was for opponent to scrutinise his proposal. His source of income or yearly income and 15 A/141/2018 that whether it is affordable for such retired person, to pay yearly premium of Rs. 2,50,000/- each against two policies, that too when he was taking it, in the name of grandson Asit then aged about 5 years.
17. According to complainant his signatures were obtained on blank proposal forms, and he was told that opponents were having details about him and that they would fill up the data in the office. The person who has no income besides monthly pension of Rs.4,775/- as reveal from his passbook, how he could submit the proposal with yearly premium for 5 years or 13 years of Rs. 2,50,000/- each against two policies for such a longer period as mentioned in the policies. When the person required to utilize surrender value received against old policies for payment of premium which support the contention of complainant that he agreed to purchase policies with one time premium only, in the name of his grandson at the age of his retirement. However, he received the policies with premium payable yearly for 5 years in one policy and for 13 years in another policy, with maturity of 13 years. It is quite possible that, he acted on believing these two representatives of opponents for single premium policies. And they assured him that they would correct the mistake, and asked him, that he need not pay the further premium. Therefore, he waited for some period. When he made inquiry, he found that their assurance were false. He approached opponents and then to their officer of Grievance 16 A/141/2018 Redressal Committee and when he could not get the refund of amount he is constrained to file the complaint before District Consumer Forum.
18. In support of his contention the complainant has produced the letter forwarded to opponent ICICI prudential Ltd,. dated 16.6.2014 at page no. 107, reply of opponent to said letter is dated 10.7.2014 at page no. 111 with which the opponent informed him that they are unable to process with the application as the same is not submitted within 15 days of receipt of policy. The another letter addressed to Grievance Redressal Officer dated 14.8.2014 is at page no. 115, wherein entire details about representatives Anuja Patil and Virender Singh, as alleged in the consumer complaint were mentioned. The reply issued to said letter is at page no. C-118 wherein same reply is given to him vide letter dated 14.8.2014. He has further issued letter to GRO on 8th Spet. 2014 which states that, the opponents have not considered the grievance raised by complainant or held any inquiry into his complaint submitted to GRO. He therefore, constrained to file the consumer complaint.
19. It is submitted by opponents that, the letter dated 6.10.2014, 30.10.2014 & 02.12.2014, were issued to complainant informing him that, his request is accepted. According to complainant those letters were not served to him. They are procured subsequently. There is no postal 17 A/141/2018 receipt or acknowledgement as to service of those documents is on record.
20. It is pertinent to note that, since beginning the complainant was raising grievances against Anuja Patil and Virender Singh. There is no inquiry made in those grievances. Moreover, there is no evidence affidavit denying those allegations made by complainant are submitted by opponents or their aforesaid representative. This fact itself shows that, the contention of complainant remained uncontroverted. It is also not denied by the opponent that, they are not the employee or authorised representative of opponents. It is simply mentioned that, the local agents if any would have advised to complainant, the opponents are not privy to those assurances.
21. Apart from this when the opponents were harping that the parties are bound to follow the terms and conditions of policy. Then how the opponents agreed to refund the amount of premium if at all the complainant has not asked for cancellation within free look period i.e. 15 days of receipt of policy.
22. Therefore, there appears substance in the submission of complainant that, Anuja Patil and Virendra Singh had given assurance to complainant. However, there occurred mistakes in mentioning address, occupation, the information regarding age proof.
18 A/141/2018 Therefore, when the complaint is filed they come with the defence that they had informed to complainant that, his request was accepted which is sufficient to infer that there is no proper scrutiny of proposal form, and that the policy were not been issued as claimed by the complainant. Therefore, the opponent under the ground of special case have shown their readiness to refund the amount, in the written statement.
23. The District Consumer Forum only relied upon the copies of letters allegedly issued by the opponent without any proof of service of these letters upon complainant, and relied upon the affidavit of opponent that they have informed the complainant that they have accepted his request for cancellation and complainant himself failed to comply said letters to produce original documents.
24. In fact there are letters issued by opponent in the month of June and August 2014 denying the request of complainant on technical grounds that he did not approach to opponent within 15 days from receipt of the policies. Then question arose what made them to issue subsequent alleged letters in the month of Oct. And December 2014 to accept his request. There is no acknowledgement, no service proof. Therefore, there appears substance in the contention of complainant that, no such letter were issued to him till filing the complaint and disclosing the same in the written statement.
19 A/141/2018
25. The documents which are consistent to file grievances of the complainant, are ignored by opponent and also not considered in proper perspective by the District Consumer Forum and it is thereby ignored that, the opponents in issuing the incorrect policies with wrong contentions committed deficiency in service and again adopted unfair trade practice in denying to accept the request of complainant. The opponents keep on harping that he has not submitted request for cancellation within 15 days and also not submitted original documents. Thus, the opponents them self were at fault. Therefore, in written statement they have accepted his request as a special case.
26. Admittedly the amount is paid by the opponents on 29.12.2017 after judgment of District Consumer Forum. Which itself shows the amount of complainant is withheld by opponents for about 3 years and 9 months i.e. up to the date of judgment and deposited it after 4 months of the judgment.
27. The District Consumer Forum considering the fact that, the complainant was constrained to approach the opponents and Grievance Redressal officers and the opponents and its officials of Grievance Committee have denied his request for cancellation of policy and also issued letter to him in the month of July and August. This itself was sufficient to grant him an amount for mental agony, for causing harassment and deficiency in 20 A/141/2018 service and subsequently in reply the opponent pleaded that, they have accepted his request for cancellation, is without any proof of service of letters, which is not acceptable or justifiable to deny him interest and compensation and cost of proceeding.
28. Therefore, there requires interference in the order of District Consumer Forum.
29. With the aforesaid discussion we are of the opinion that, the complainant is entitled for interest an amount of Rs. 5 Lakhs from the date of policy till the date of order of District Consumer Forum dated 14.08.2017. As the opponents have deposited the amount after the lapse of 45 days after judgment, with 9 % interest from the date of order till 29.12.2017. The complainant is also entitled for amount of Rs. 20,000/- towards mental agony considering the fact that he is constrained to file consumer complaint at old age of his retirement. He was required to approach and his official of Grievance Committee time and again to get his hard earned amount which was invested in policies, due to wrongful act of opponents or deficiency in service by the officials of the opponents towards the complainant. Therefore, the complainant is also entitled for mental agony and cost of proceeding and interest on unpaid amount. Hence, the order.
ORDER
1. Appeal is partly allowed.
21 A/141/2018
2. The order dated 14.08.2017 of Additional District Consumer Forum, thane at Belapur in C.C.No. 43/2015 as to clause No.2to5 is set aside and it is modified and it be read as follows.
3. (a) The opponents shall pay amount of Rs. 5 Lakhs to the complainant along with interest at the rate of 9 % p.a. from the date of premium paid by the complainant i.e. on 17.02.2014, till date of realisation of amount by complainant.
(b) The opponents have already paid amount of Rs. 5,16,300/- on 29.12.2017 along with interest from the date of order passed by Dist. Commission dated 14.08.2017. Hence, the complainant is entitled for interest as specified in clause (a) from 17.02.2014 to 14.08.2017 on adjusting the amount already paid by the opponent.
(c) The opponents shall pay amount of Rs. 20,000/- to complainant towards mental agony, within 45 days from receipt of this order.
(d) The opponent shall pay the amount of Rs.10,000/- towards cost of proceeding within 45 days of receipt of this order.
4. No order as to costs in appeal.
Mr.K.M.Lawande Smt.S.T.Barne, Member Presiding Judicial Member UNK