BEFORE THE PRESIDENT, DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR
C.C NO-29/2020
Present-Sri Dipak Kumar Mahapatra, President, Smt. Smita Tripathy,Member (W).
Prafulla Kumar Barad,aged about 67 years,
S/O- Late Dolagobinda Barad,
R/O- At/P.O-Dhankauda,
Dist-Sambalpur-768006, Odisha. …..Complainant
Vrs.
- The Divisional Manager,
Life Insurance Corporation of India,
Office At-Jeevan Prakash, Ainthapali,
P.O- Budharaja, Sambalpur-768004.
- Prasanta Kumar Sahoo,
(Authorised LIC Agent),
R/O- Sahajog Nagar,P.O- Budharaja,
P.S-Ainthapali,Dist- Sambalpur.
- The Zonal Manager ,
Life Insurance Corporation of India,
East Central Zone Office, “Jeevan Deep”,
Office at 6th Floor,Exhibition Road,
Patna-800001.
- The General Manager,
Customer Affairs Department,
Insurance Regulatory and Development Authority of India(IRDA),
Office at –Sy No-115/1,Financial District,Nanakramguda,
Counsels:-
- For the Complainant:- Sri Bighneswar Shroff, Advocate & Associates.
- For the O.P-1& 3 :- Sri Ardhendu Kumar Dash, Advocate & Associates.
- For the O.P-2 :- Dr. R.K Maharana, Advocate & Associates.
- For the O.P-4 :- Sri T.S Naik(Authorised Person)
DATE OF HEARING : 17.02.2021, DATE OF ORDER : 22.03.2021
SRI DIPAK KUMAR MAHAPATRA,PRESIDENT:- Brief facts of the case is that the Complainant is a school teacher and the O.P-2 is an authorised LIC agent vide Agent Code NO-04502/587 who sales and promote the business of the Life Insurance Corporation of India. The O.P-2 repeatedly visited the house of the Complainant to promote his sale for a LIC policy named JEEVEN SARAL-165 with published pamphlets where the name and address of the O.P-2 was endorsed. It also contains a comparison of the return profits more than 8%/ 9% on maturity value in comparison to other banks. The O.P-2 anyhow managed to motivate the Complainant by telling him the eye catching offers for which the Complainant agreed to avail the policy. The O.P-2 advised the Complainant to invest Rs.15,313/-as quarterly premium for 11 years as basing on his age limit and the maturity amount was assured to Rs.12,59,091.50/-. Thereafter the Policy was issued vide policy no-59362469, the date of commencement was 28/09/2009 and date of maturity 28/09/2020. That the Complainant has paid the total premium amount of Rs. 6,73,728/-in 11 years (Rs.15,312/- X 44 nos. premiums). Prior to the maturity, the O.P-1 sent a letter to the Complainant that he will get Rs. 4,89,572/- on maturity. The Complainant tried to contact with the O.P-2 but he did not make him avail to the Complainant and ignored him every time. The O.P-2, as he had initiated the policy, for an expectation of service, the Complainant met him and requested to help in realisation of maturity amount but instead of helping him he abused the Complainant with filthy language and assaulted her daughter in a public place for which the Complainant lodged a FIR in Ainthapali Police station at Sambalpur, against the O.P-2 vide P.S Case No-2026 dtd. 14.08.2020. But till the filling of this case the O.P-1 & 3 has not taken against the O.P-2 (respondent superior). The Complainant feels that the O.P-1 & 3 in connivance with the O.P-2 has cheated him. This issue was published in the SAMBAD daily newspaper. The Complainant is retired school teacher who has not been allotted his pension and other benefits after retirement and waiting for the maturity amount to solemnise his daughter’s marriage. Being the service provider it was the duty of the O.Ps to provide adequate services to the customers but in the present case the O.Ps have deficient in rendering necessary services for which the Complainant prays for certain reliefs . The Complainant demanded the video footage of the occurrences captured by the CCTV camera fitted in the premises of the O.P-1 to strengthen the allegation made against the O.P-2 who is working for the O.P-1,3 & 4.
According to the O.P-4 the actual case is between the O.P-1 & 3 and their authorised agent O.P-2 but the O.P-4 i.e IRDA has nothing do with this matter. As the onus lies on the Insurance company regarding the grievance the O.P-4 is least concerned about the disputes between the Complainant and the O.P-1,2 & 3. Again it is stated that the O.P-4 has put in a system called Integrated Grievance Management System (IGMS), where the policy holder could have register a complaint against the Insurance company. As the IRDA who is the O.P-4 has not the obligation to rendered or provide any service directly to the Complainant as contemplate in C.P Act-2019. Hence he has not committed any deficiency in services.
The version of the O.P-1 & 3 is that, as per the policy condition the complainant was returned with a sum of Rs.4,89,572/- as Maturity Sum Assured along with Loyality Addition before maturity of the policy to discharge the duty of said Opp. Parties. When the Complainant went to the LIC office, the O.P-1 once again explained the terms and conditions of the policy to the Complainant and expressed that he cannot go beyond that. The allegations made by the Complaint are all false and the O.P-1 has rendered necessary services as and when needed. The Complainant has published the news in the daily newspaper having some ulterior motive. The O.P-1 has paid Rs.4,89,572/-(maturity Sum assured Rs.3,23,150/- as has been mentioned in the policy bond + Loyality Addition Rs.1,66,422/-)which has been remitted to the account of the Complainant A/C No-10856863935 of SBI, Main branch, Kacheri Road, Sambalpur. Hence the question of deficiency in service and unfair trade practice against the O.P-1 & 3 does not arise. The LIC’s JEEVAN SARAL PLAN contains higher death cover, a smooth return, liquidity and lot of flexibilities. Hence the plan is not related to age at entry and term of plan. In the policy taken by the Complainant it has been clearly mentioned that “In the event of Life Assured surviving the date of maturity a sum equal to maturity Sum assured in force after partial surrenders, if any, along with the corresponding loyalty additions, if any, shall be payable”. The Complainant cannot escape from the plea that the agent has not explained regarding the maturity of policy. That the Complainant after receiving the Policy bond had not opted for return of the Policy in case he was not willing to go further. He further clarifies the difference between the Death Sum Assured and Maturity Sum Assured i.e Death Sum assured is related to premium and Maturity Sum Assured is based on Age at entry of life Assured, Terms and Premium. The above contact was on Maturity Sum Assured. The O.P-1 & 3 has submitted the video footage of the occurrences captured by the CCTV came fitted in the premises of the O.P-1 for the perusal of this Commission.
According to the O.P-2 he has explained the policy to the Complainant and handed over a pamphlet and told that if the complainant will agree then he will come to start a policy. It was mentioned in the pamphlet in Oriya that it is relevant up to the age of 30 years only and not for the Complainant as the complainant’s age is 56 years. As being an Agent his duty is to conduct the business of the principal according to the direction given to him. The primary role of the Agent is to bring the customer and principal on platform for the meeting of their minds and after that the role of the Agent is over. According to the O.P-2 the policy is an unique policy where in case of natural death or accidental death during the policy period, the complainant will get Rs12,50,000/- and Rs.25,00,000/- respectively. But if the Policy holder would remain alive after the maturity of the policy then he would get the amount which less than the premium as has been clearly mentioned in the policy bond. He again added that the son and daughter of the Complainant had come to the O.P-2 in the LIC premises and assaulted and insulting him in a public place for which the reputation of the O.P-2 got lowered. They assaulted the O.P-2 with a criminal intent, thereafter police came to the premises and a case and a counter case were lodged vide P.S case No-412.2020 dtd. 14.08.2020. The matter was published in the newspaper from the Complainant side to defame the O.P-2. There is neither any criminal record is found nor and case is pending in the name of the O.P-2 till now in any court. The O.P-2 has provided services to the Complainant at his best hence there is no question of deficiency in service in the part of the O.P-2 for which the petition needs to be dismissed.
POINTS OF DETERMINATION:-
- Whether the Complainant is comes under the purview of Consumer Protection Act-2019?
- Whether the O.Ps has committed any Deficiency in Service to the Complainant?
From the above discussion and materials available on records we inferred that the Complainant comes under the purview of Consumers as he has availed a JEEVAN SARAL POLICY by paying premium. After going through the proposal form we observed that the page containing “Declaration by the Proposer” the para no-1 is left blank intentionally by the O.P-2/agent which contains the note that “I hereby declares that I have fully explained the above question to the proposer and I have truthfully recorded the answers given by the proposer”. So it is evident that the contents of the form are mot explained to the proposer at all. Again it is seen that the proposal form was not filled in by the proposer/policy holder/Complainant himself. The agent of the LIC/O.P-2 had obtained the policy holder's signatures on the proposal form and the various entries of the proposal form were filled in by the said agent. The Complainant’s contention was that the insurance agent was simply asked him to append his signature and all other answers were filled in by the agent, in his own handwriting. The Complainant cannot be held responsible for concealing any facts. This aspect is well covered by judgment in “LIC vs. Bina Joshi” where the entries filled by agents, the policy holders were not blamed for concealing information. The O.P-2 has misrepresented the terms and conditions, sum assured ,death benefits relating to the policy thus suppress the material facts to fetch the policy anyhow. In the case of “Moneylife India Foundation and others vrs. Life Insurance Corporarion of India” in writ petition no-435/2019, Hon’ble Supreme Court has made some observation that LIC has mis-sold the JEEVAN SARAL Plan-165 policy to millions of people in India. The policy was launched in February 2004 promising maturity sum assured along with loyalty additions at the time of policy holder's death or maturity of the policy term. In case of death, the nominee would get sum assured and return of premium deposited. This amount was to vary based on the age of entering the policy and its total term. By 2014, the policy began to mature and it is then the investors realized they were duped. In the Plan the policy holder is paying premium for 10-11 years and being reimbursed just one-third of the premiums paid over the years. The Plan Jeevan Saral, has gobbled up hard-earned savings of policyholders (especially senior citizens) has also agitated LIC agents and their association. A Public Interest Litigation(PIL) was filed on behalf of thousands policyholders of Jeevan Saral, seeks to have Life Insurance Corporation of India (LIC) and Insurance Regulatory Development Authority (IRDA) to "amend to Jeevan Saral Plan 165 policy accordingly. This matter has been well settled in the case of LIFE INSURANCE CORPORATION OF INDIA vrs. JASWINDER KAUR decided by National Commission,New Delhi on dtd. 05 April 2018. Again in the case of United Insurance Co. Ltd. vs. Harchand Rai Chandan Lal, AIR 2004 SC 4974,Hon’ble Supreme Court also observed that, “it is settled law that the terms of the contract has to be strictly read and natural meaning be given to it. No outside aid should be sought unless the meaning is ambiguous.” As per the above discussion it is clear that the O.P-1 & 3 have knowingly sold the policy to the customers to amass a huge amount of money. Also from is CCTV footage it is seen that the O.P-2 has misbehaved and assaulted the Complainant and his daughter Gayatri Barad in the office premises O.P-1 which reflects the antisocial behavior and is against the professional ethics of the O.P-2 leads to deficiency in service and unfair trade practice on his part. The responsibility of the O.P-1 & 3, being the employer of the O.P-2, cannot be overlooked. Again it is inferred that to escape from misconduct shown to the Complainant and his daughter Gayatri Barad, the O.P-2 also lodged a counter FIR in the same police station. The allegations against the O.P-4 are not proved hence discharged from all the liabilities in this case. Hence we opined that the allegation against the O.P-1, 2 & 3 have been proved and we order as under:- ORDER The Complaint petition is allowed. The O.P-1 & 3 are jointly and severally directed to refund the maturity value of Rs. 12,05991.50 of the policy assured by the authorised LIC agent at the time of inception of policy with interest @ 9% per annum from the date of maturity of the policy till payment. The O.P-2 is directed to pay an amount of Rs.1,00,000/-as compensation to the Complainant towards the harassment, mental pain and agony caused. The O.P-1,2 & 3 are jointly and severally directed pay Rs.10,000/- towards the cost of litigation to the Complainant. All the orders are to be carried within a period of 30 days from the date of receipt of the order passed by this Commission failing which the OPs shall pay interest @ 9% per annum on this amount till its realisation." Order pronounced in the open Court today i.e, on 22nd day of March 2021 under my hand and seal of this Commission. Office is directed to supply copies of the Order to the parties free of costs receiving acknowledgement of the delivery thereof. I agree, -sd/-(22.03.2021) -sd/-(22.03.2021) Smt. S.Tripathy Sri. D.K. Mahapatra MEMBER.(W) PRESIDENT Dictated and Corrected by me. -sd/-(22.03.2021) Sri. D.K. Mahapatra PRESIDENT |
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