DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II U.T. CHANDIGARH [Consumer Complaint Case No: 572 of 2011] -------------------------------- Date of Institution : 15.12.2011 Date of Decision : 26.10.2012 -------------------------------- Prof. Arun K. Lall, #653, Punjab Engineering College Campus, Sector 12, Chandigarh – 160012. ---Complainant V E R S U S [1] Financial/Insurance Advisor, M/s ICICI Prudential Life Insurance Company Limited, First Floor, SCO No.9-10-11, Sector 9-C, Chandigarh – 160017. [2] Unit Manager, M/s ICICI Prudential Life Insurance Company Limited, SCO No. 70, Top Floor, Phase-9, Mohali (Pb.). ---Opposite Parties BEFORE: SH. LAKSHMAN SHARMA PRESIDENT Mrs.Madhu Mutneja Member SH. JASWINDER SINGH SIDHU MEMBER Argued By: Complainant in person. Sh. Gaurav Bhardwaj, Counsel for Opposite Parties. PER JASWINDER SINGH SIDHU, MEMBER 1. Complainant has filed the present complaint, against the Opposite Parties on the ground that the Complainant in the year 2007 had subscribed for three different policies by filling up the proposal forms and as advised by the agents of the Opposite Parties Mr. Atul Vij and Mr. Amit Rai, who were having the company I.D. cards to prove their identity and status in the organization. On the advice of these two agents, the Complainant allured by the display of rosy picture about the strength of the company in managing the funds of the Complainant, preferred to invest three lac rupees by subscribing for three insurance policies with the name Life Stage RP (2 Nos) and one Life Stage Pension. The Complainant paid an amount of Rs.3,00,000/- in total and the policies were issued in his name on 4/9/2007, 22/9/2007 and 31/12/2007 respectively. The receipt of the same are annexed as Annexure Appendix-I, II and III respectively. The Complainant claims that as he was made to believe that the insurance policies subscribed by him would fetch him 20-25% returns. As per the advise of the agents of the Opposite Parties, complainant did not finding anything concrete, and inquired about the status by communicating with the agents and in reply of which Complainant received an e-mail dated 13/1/08 wherein he was told that as he may not have received the details, a brief detail of the same was again provided to him. The Complainant in order to support his version had annexed Appendix-IV through which one of the agents of the Opposite Parties had claimed of the high returns to the tune of 20-25% on the fund. The Complainant thereafter, continuously remained in touch with the Agents, reminding them about the commitment and also registering his grievance. On not getting a proper response from that end and finally feeling disgusted had once again mentioned that no complete information was forthcoming as mentioned in Appendix-VII dated 10/8/2009. The Complainant was thereafter advised that in order to maintain the quantum of profit, he must pay the premium amount due towards him as the policies were nearing renewal for the 2nd premium and was also advised to cancel one of the policies so as to meet the requirements of fresh policy, as the Complainant had expressed difficulty in arranging money. The Complainant claims that he did not wish to continue with the different policies he had subscribed for on the advise of the Opposite Parties but under compelling circumstances preferred to revive the policies, after going through the required formalities of filling up the form, as well as undergoing a medical examination, as advised by the official of the Opposite Parties. The Complainant claims that even after this exercise no response was forthcoming from the side of the Opposite Parties. Thus, aggrieved of mis-selling, misrepresentation and also on the ground of ill advising, the Complainant has preferred the present complaint, seeking the relief of exemplary maximum penalty permissible under rules/ provisions against the Opposite Parties, so as to compel them to stop the illegal activities of collecting money by raising false commitments. The complaint of the Complainant is duly supported by his short affidavit. 2. Notice of the complaint was sent to Opposite Parties seeking their version of the case. 3. The Opposite Parties have contested the claim of the Complainant by filing their joint reply to the effect that the present complaint being an absolute abuse of law and judicial process and being false, frivolous and vexatious deserves to be dismissed. Furthermore, claiming that the allegations as mentioned in the present complaint deserve a proper trial by a civil/ criminal court requiring detailed evidence, thus, the jurisdiction of this Forum to entertain the same is also objected upon. The Opposite Parties also claimed that as all the issues mentioned in the present complaint are due to the Complainant’s own omissions and commissions, and the subject policies were foreclosed and/or have acquired the paid up status, thus, there is no cause of action qua Opposite Parties on the issues mentioned in the complaint. The Complainant is also claimed to have defaulted in payment of regular premiums, thus, was himself disqualified, due to the default on account of premium amount. The Opposite Parties have also claimed that the Complainant is a well educated person and it was not expected of him to have either singed blank documents or could be carried away by any amount of misrepresentation. The Opposite Parties have also reproduced the Clause 4.1 for the payment of premium and Clause 10 and 2.2 dealing with the qualification of the Complainant to claim any amount towards these policies only on completion of three policy years for which a full premium amount has been paid. The surrender clause as mentioned in clause 2.2 of the policy document is also mentioned wherein the surrender charges towards different policy years are mentioned. Finally, in response to the status of the three different policies the first policy NO. 06121385 is claimed to be in force; whereas Policy No. 06174600 is claimed in the foreclosed status and the Policy No. 07219597 is claimed to be in a paid up status. The Opposite Parties claims that the policy certificate along with policy documents in original was dispatched to the Complainant and the same was duly received by him and that the assurances if at all were made to him could have been corroborated from the policy documents and there was no reason for any ambiguity in understanding the same. It is also mentioned that the investments in the units are subject to market and other risks thus there cannot be any assurance with regard to the objective of any of the funds that they may achieve. The Opposite Parties have categorically stated that the document Appendix-IV of the complaint is not an authorized communication issued by the company as it does not bear the company’s seal or name of an authorized signatory. It is further stated that the company had received a Standard Benefit Illustration (SBI) signed by the Complainant wherein it demonstrates/ illustrates the returns under the policy; thus, the Complainant was bound by the terms and conditions of the policy and the market situation. The claim of the Complainant that there was guarantee of 20-25% returns on his investment is totally out context of the present policy subscribed by him. On merits, the Opposite Parties have repeated their preliminary objections, while replying to the averments of the present complaint, in their para-wise reply. Thus, claiming no deficiency in service or unfair trade practice on their part, the answering Opposite Parties have prayed for the dismissal of the complaint with heavy costs. The reply of the Opposite Parties is not verified but supported a detailed affidavit of Ms. Sudha Sharma, Chief Manager, ICICI Prudential Life Insurance. 4. Having gone through the entire complaint, version of the Opposite Parties, the evidence of the parties, and with the able assistance of the Complainant and learned counsel for the Opposite Parties, we have come to the following conclusions. 5. The present complaint filed by the Complainant is actually a second complaint after withdrawing the first complaint (CC No.700 of 2010) filed with this Forum on 03/11/2010. The Complainant has claimed that during the arguments of this particular complaint #700/2010 a specific inquiry was made so as to ascertain the jurisdiction of this Forum to entertain his complaint and thereafter the Complainant claims that on the advice of this Forum, he withdrew the complaint and has preferred the present complaint after making necessary changes and annexing additional documents, so as to qualify in filing the present complaint. 6. The main allegations of the Complainant in the present complaint, which is, though not in the desired format, are against the Agents of the opposite parties and also that the Complainant has not elaborated upon the relief sought. We feel that as the present complaint has been filed by the Complainant in person, minor shortcomings on account of his not being conversant with the legal requirements or its implications while preferring a consumer complaint, deserves to be ignored. 7. The main allegations of the Complainant are with regard to the mis-selling of the policies as well as the tall claims of exponentially high returns to the tune of 20-25% of the amount invested by the Complainant as promised by the agents of the Opposite Parties. The Complainant had started inquiring about the status of his investments and that the agents of the Opposite Parties continued to give assurances about the status of the market, is revealed from the voluminous e-mail communications made by the Complainant beginning 23/1/2008 i.e. within days of having subscribed for the policy as the 3rd policy commencement date is found mentioned as 31/12/2007. We are of the view that the agents of the Opposite Parties who had presented the features of the policy to the Complainant before he had subscribed for the same, as well as the manner in which they conducted themselves after the Complainant had invested Rs.3,00,000/- through different policies were actually conducting themselves in their capacity as the representatives of the Opposite Parties. The false promises, though which were conveyed to the Complainant verbally, cannot be substantiated but are found corroborated from the document Appendix-IV which is a certificate on the letter head of the Opposite Parties claiming a return of 20-25% with the able management of the fund portfolio by the team from Opposite Parties, though the Opposite Parties have denied this document, as the same not being signed by an authorized signatory, but the same is found to have been used by their Agents in whatsoever capacity that is left to be explained by them alone, and not by the Complainant. The Opposite Parties also claims that the Complainant was duly advised about the benefits of the investments in the different policies of the Opposite Parties subscribed by him, by filling up the proposal forms and on signing the standard benefit illustration after understanding the same, but the Opposite Parties have failed to bring on record this Standard Benefit Illustration pertaining to any of the policies, duly signed by the complainant, meaning thereby that the Complainant was not adequately made to understand and nor the benefits demonstrated/ illustrated to him, as claimed by them. Hence, the allegations of the Complainant that the agents of the Opposite Parties while making tall claims about very high quantum of returns, have actually misled him, is proved in the absence of duly signed Standard Benefit Illustration Document, which was mandatory as per the IRDA Guidelines, before issuance of the policy. 8. One more aspect that flows from the bare perusal of the three different proposal forms is that the Complainant is shown to be having an annual income of Rs.5,00,000/- as mentioned in proposal form bearing No. 9243386 Annexure R-1. However, this factor is not found mentioned in other the proposal form (Annexure R-2); whereas, the annual income of the life assured is mentioned as Rs.4,50,000/-. The Opposite Parties have failed to bring on record the fact that how could they entertain the proposal forms for subscription of polices worth Rs.3.00 lacs annual premium even though the annual income of a salaried person was only to the level of Rs.4.5 to 5 lacs, meaning thereby that the Opposite Parties failed to adhere to the KYC guidelines which require that the actual income status of the subscriber of the policy must be ascertained before issuance of the policies of very high premium, by obtaining proper income proof. Hence, the Opposite Parties found have failed to adhere to the KYC & AML (Know Your Customer & Anti Money Laundering) Guidelines, as envisaged by the IRDA before issuing the policies to the complainant and the same amounts to an unfair trade practice on its part. 9. The agents of the Opposite Parties who remained in the service of the Opposite Parties, till Sept., 2010 and were continuously communicating with the Complainant asking him to pay the premium due so as to revive the policies. The complaint on their advice had undergone the medical tests as per Personal Health Declaration Form (Pg.49) and the admission of the agent of the Opposite Parties in his communication dated 20/7/2010 (pg.52) which confirms that a cheque of Rs.2,00,000/- was lying with him goes on to prove that the Agents of the Opposite Parties had actually not acted in a proper manner for the reasons best known to them, as the money handed over to them by the Complainant, was not deposited with the Opposite Parties, promptly. However, this amount was realized by the Opposite Parties from the account of the complainant, as the Complainant mentions the same in his e-mail communication dated 14/8/2010. The Complainant also claims through this communication that though the money has been debited form his account but he has not received the any policy issued against it or the status of its fund value, inspite of repeated requests. This allegation of the Complainant has not been emphatically answered by the Opposite Parties while arguing the same, and we are of the view that the opposite parties alone were responsible for all the acts of omission and commission of its Agents and deserve to be answered by it alone and none else. We have not come across any communication from the side of the Opposite Parties till the date when the present complaint was reserved for orders, as to what was the fate of this Rs.2,00,000/- and what the Opposite Parties intended to do with the money. There is a long duration of 2 ½ years since the money is lying with the Opposite Parties and the Opposite Parties have failed to come up with any reason as to why did they debit this amount from the account of the Complainant without any written authorization or specific purpose, from the side of the Complainant. This aspect goes on to explain the working of the Opposite Parties. This act of the opposite parties also makes it amply clear that they are interested only in collecting money by all means, and sleep over the matter indefinitely, even though they may not have the mandate for their actions. 10. The Complainant claims that he has received a cheque of Rs.20,837/- dated 23/9/2010 along with a letter dated 24/9/2010, through which his policy bearing No. 06174600 stood foreclosed; however no mention is found on record about the policy bearing No. 2842319 which was subscribed by the Complainant prior to this as well as the policy No.6121385 subscribed by him on 11/9/2007. We are surprised that the Opposite Parties do not adhere even to the schedule of foreclosure as per their own terms & conditions as the policy subscribed prior to it is still claimed to be in a state of premium holiday and in force, however, they preferred to foreclose the policy, which was subscribed much later. 11. The Complainant through his e-mail has confirmed that the amount of Rs.2,00,000/- is found debited from his account, but the deafening silence maintained by the Opposite Parties by ignoring any mention of this fact in their reply/ version goes on to explain that they did not want to admit this aspect on oath. There is not even a simple denial to this effect, which goes on to prove that the same is admitted. 12. In the light of above observations, we are of the view that the Opposite Parties are found deficient in rendering proper services and having indulged in unfair trade practice by not adhering to the mandated IRDA Guidelines while issuing different policies to the Complainant. Hence, the present complaint of the Complainant succeeds against the Opposite Parties, jointly and severally, and the same is allowed. The Opposite Parties are, directed, to:- [a] To pay Rs.1,00,000/- as compensation on account of deficiency in service and unfair trade practice and causing mental and physical harassment to the Complainant; [b] To release Rs.2,00,000/- illegally retained by the Opposite Parties, along with interest @9% p.a. since its deposit, till it is paid; 13. The above said order shall be complied within 45 days of its receipt by Opposite Parties; thereafter, they shall be liable for an interest @18% per annum on the amount mentioned in sub-para [a] & [b] above, from the date of this order, till it is paid. 14. Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room. Announced 26th October, 2012Sd/- (LAKSHMAN SHARMA) PRESIDENT Sd/- (MADHU MUTNEJA) MEMBER Sd/- (JASWINDER SINGH SIDHU) MEMBER ‘Dutt’
| | MRS. MADHU MUTNEJA, MEMBER | HONABLE MR. LAKSHMAN SHARMA, PRESIDENT | MR. JASWINDER SINGH SIDHU, MEMBER | |
