Before the District Consumer Disputes Redressal Commission, Rohtak.

                                                                   Complaint No. : 405

                                                                   Instituted on     : 20.08.2019.

                                                                   Decided on       : 04.10.2023

Usha Rani age 45 years, w/o Sh. Sandeep Nandal R/o H.No.474/30, Gali No. 2, Dev Colony, Rohtak.                                                                                   

                                                                   ......................Complainant.

                             Vs.

1. Bharti AXA Life Insurance Company Ltd.. Registered office: Unit no. 601 602, 6th floor, Raheja Titanium, off Western Express Highway, Goregaon (E), Mumbai-400063, through its Director/ CMD.
2.  Bharti AXA Life Insurance Company Ltd., 105/30, 2 floor, above jockey showroom, Near D-park, opposite hotel Tandoori nights, main Delhi Road, Rohtak, through its M.D.
3. RFL Insurance Broking Private Limited, Agent of Bharti AXA Life Insurance Company Ltd., 506-B, Cello Triumph, IB Patel Road, Goregaon, Mumbai, Maharashtra. PH: 02224915800  through its director.
4. SMC Insurance Brokers Private Limited, Agent of Bharti AXA Life Insurance Company Ltd., 11/6B, Shanti Chambers Pusa Road, New Delhi-110005. PH: 180026663666, through its director.

...........…….Opposite parties.

          COMPLAINT U/S 35 OF CONSUMER PROTECTION ACT,2019

BEFORE:  SH.NAGENDER SINGH KADIAN, PRESIDENT.

                   DR. TRIPTI PANNU, MEMBER.

                   DR.VIJENDER SINGH, MEMBER

Present:       Sh.Pardeep Mittal, Advocate for the complainant.

                   Sh.Rajesh Sharma Advocate for the opposite parties No. 1 and 2.

                   Opposite party no. 3 & 4 already exparte.

                                      ORDER

NAGENDER SINGH KADIAN, PRESIDENT:

1.                Brief facts of the case as per the complainant are that in the month of September and November 2012, the complainant and her husband had purchased two life insurance policies from Max Life Insurance Company vide policy number 869636274 and 873321970 respectively. It is further submitted that in the month of March 2018, she started receiving telephonic calls from number 8376031205 and 9355169308 who named herself as Mandakini and asked that complainant and her husband will get bonus of Rs.5,80,000/- in the aforesaid policies when the complainant or her husband invest about Rs.6,80,000/- in various policies as per directions of said Mandakini. She also assured the complainant that this is one time investment and she will get the policies canceled and will return the entire amount alongwith said bonus to the complainant. Opposite parties in collusion with Mandakini and some others, misappropriated an amount of Rs.6,80,000/- of the complainant in following policies which were issued in the name of the complainant and her husband:-

The payment for the aforesaid all the policies were made from the account of the complainant and her husband i.e. A/c No. 204010100096025 and 204010100067421 respectively maintained with Axis Bank, Rohtak. It is further submitted that policy no.1& 2 in the above said table was issued by the opposite parties no. 1 & 2 wherein opposite party no. 3 and 4 was named as agents. Thereafter the complainant did not receive any bonus amount even after the aforesaid investment and thus the complainant and her husband talked with said Mandakini but she did not give any satisfactory reply. Complainant asked to Mandakini many times to return the amount and get the said policies cancelled. Upon this she got cancelled above said two policies of HDFC Standard Life Insurance Co. Ltd. and one policy of India First Life Insurance. The complainant again requested to get cancel all the policies and return the amount alongwith bonus but she did not pay any heed towards genuine requests of complainant. Thereafter on 17.12.2018, the complainant moved a complaint to Bharti AXA Life Insurance Company Limited and on 18.12.2018 to Max Life Insurance Company in this regard. The complainant also moved an application to Shri Ram Life Insurance on 02.01.2019 and on 04.01.2019 the complainant informed respondent through email. She also got lodged a complaint in IRDA. In March 2019 a representation was also given to opposite party through IRDA but they did not pay any heed towards the genuine requests of the complainant. The act of opposite party is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite party may kindly be directed to refund an amount of Rs.1,97998/- alongwith interest @ 18% per annum w.e.f. April 2018 to till its actual realization. It is also prayed that opposite parties be directed to pay Rs.50,000/- as compensation and Rs.21,000/- as litigation expenses to the complainant as explained in relief clause.

2.                After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 & 2 filed their reply submitting therein that the complainant had submitted two proposals for insurance in her name vide policy no.501-7243162 and 501-7243261 by paying the proposal deposit amount Rs.98999/- each. The opposite parties after receipt of duly filled proposal forms alongwith the other requisite documents and the amount of first yearly premiums deposit had issued the subject policies for a term of 12 years with annual renewal premium as opted by the complainant. The policy documents were dispatched to the communication address of the complainant and the same was delivered to her well within time. On receiving the policy document, the complainant did not raise any objection towards the policy and had not approached the opposite party during the free look period with any grievance regarding the policy or its terms and conditions. It is further submitted that 2^nd annual premium fell due on 24.04.2019 and 13.04.2019 respectively which were not paid by the complainant.  As such, policies have lapsed. And in case he does not pay further premiums, the policies will be terminated.   All the other contents of the complaint were stated to be wrong & denied and opposite parties prayed for dismissal of complaint with costs. 

3.                Opposite party No.3 did not appear despite service of notice through registered post and as such opposite party No.3 was proceeded against exparte vide order dated 03.10.2019 of this Commission. Opposite party No.4 appeared and filed its reply submitting therein that opposite party No.2 is the authorized representative of the company and only facilitated the complainant to get the insurance policy. The complaints which are related with the policy are only settled by the insurance company i.e. opposite party No.1 & 2 respectively. All the other contents of the complaint were stated to be wrong and denied and opposite party No.4 prayed for dismissal of complaint with costs. However, opposite party no.4  failed to appear later on before this Commission and was proceeded against exparte vide order dated 13.10.2021 of this Commission.

3.                Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C27 and has closed his evidence on dated 28.09.2020.  Ld. counsel for the opposite parties No. 1 & 2 has tendered affidavit Ex.RW1/1, documents Ex.R1 to Ex.R6 and closed his evidence on 18.02.2021. 

4.                We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.

5.                In the present case, complainant has alleged that the insurance policies were sold by the agent of the opposite parties fraudulently and she has also specifically mentioned the telephone numbers through which the telephone calls were made to the complainant or her husband. It is the prime duty of the insurance company when they received a complaint that the policy has been sold out fraudulently by their agent or any authorized person, the insurance company should enquire their whereabouts or about these telephone numbers or also enquire about the agent or any authorized person who sold these policies to the customers/consumers. Complainant has no source of such a huge income that she can purchase the alleged 7 polices during the 3-4 months. Now it has been established that these policies have been sold out by the authorized agents or their representative fraudulently after giving assurances that if they invest a sum of Rs.680000/- in different companies, in that situation they have a chance to get bonus of Rs.5,80,000/-. It was also assured that this was one time investment and the entire amount will be returned after cancellation of these policies. But despite repeated requests of the complainant, policies were not cancelled by the opposite parties. At the time of arguments, ld. counsel for the complainant has placed on record a document  ‘Annexure-JN-A’. Perusal of this document itself shows that on the request of complainant, policy no.10511428 has been cancelled by India First Life Insurance company and the premium paid by the complainant amounting  to Rs.79999/- has been credited in the account of complainant. Similarly an amount of Rs.50000/- has been credited twice by the HDFC STD life Insurance Co. on account of refund of premium in the account of complainant. Hence it is proved that the policies were fraudulently sold by the agent or authorized representative of the opposite parties but the amount of insurance policies            no.501-7243261 and 501-7243162 respectively issued by the opposite parties have not been refunded to the complainant despite her repeated requests. Hence there is deficiency in service on the part of opposite parties and opposite parties are liable to refund the premium of both the policies to the complainant amounting to Rs.98999/- each i.e. total Rs.197998/-.

6.                In view of the facts and circumstances of the case we hereby allow the compliant and direct the opposite parties to refund the amount of Rs.197998/-(Rupees one lac ninety seven thousand nine hundred and ninety eight only) alongwith interest @ 9% p.a. from the date of filing the present  complaint i.e. 20.8.2019 till its realization and shall also pay a sum of Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant.

7.                Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.

Announced in open court:

04.10.2023.

                                                          ........................................................

                                                          Nagender Singh Kadian, President

                                                          ..........................................

                                                          Tripti Pannu, Member.

                                                          ……………………………….

                                                          Vijender Singh, Member