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Category - MISCELLANEOUSOrder no BPL/LI/04-09/60CASE No. BA/127-20/07-09/PuneOrder dated 26.11.2009Santosh Sena ………………………………………….. ComplainantBajaj allianz lifeIns.Co.ltd.…………………………………...…….RespondentBrief BackgroundShri Santosh Sina, resident of Bhopal, M.P. complained that he haspurchased policy no. 0102314936 under Unit Gain Plan for Rs. 20000/-with SA of Rs. 2.0 lakhs with the understanding only under singlepremium plan. However, the agent has mis-guided him and issuedthe policy under annual premium for 20 years. After completion of oneyear he received intimation/telephone calls for subsequent premium, hecame to know that premium is payable for every years for 20 years,which is beyond his income. Hence, wrote to the company on 16.03.2009to cancel the policy and refund the amount.Aggrieved from the action of respondent Complainant has lodged thecomplaint on dt.13-07-09 to the Hon’ble ombudsman seeking direction tothe respondent to refund the premium with interest.The complainant presents himself and submitted that he is uneducatedand working in Pvt. Firm having a income of Rs. 1.00 lakh annually andwith a liability of 06 family members. The agent has assured him that theamount will be double within three years for which he has to pay a singlepremium of Rs. 20000/- and obtained a signature on blank proposal formwhich he did in good faith. Subsequently, on receipt of the call forrenewal premium payment then only he came to know the policy wasissued under annual plan for 20 years term instead of single premiumwhich is beyond his capacity.The respondent represented by Ms. Ruchi Shukla, Astt. Manager,submitted that the policy was issued as per the proposal form and he hasnot also availed option of free look period i.e.within 15 days from thereceipt of the policy document, hence we are unable to refund thepremium as per the policy condition.
FINDINGS & CONCLUSIONS:-There is no doubt that the policy no. 0102314936 under Unit Gain for Rs.20000/-. It is a known fact that proposal form are being filled in by theagents only and only signature are being obtained of the policy holder.The Q. No. 5, premium frequency column is also misguiding. The columnof annual income of the proposer is 1.00 lakh only. It is also difficult toconvince that a person having income of only 1.00 lakh p.a. with aliability of 06 family members can pay the premium of Rs. 20000/- everyyear, which proves that it is a mis-representation of facts for the personalinterest.The insurance is a contract of utmost good faith. Both the parties areexpected to reveal the facts only. Any mis-representation of facts oneither side vitiates the contract ab-initio.In view of the above for the sake of equity and justice the respondent isdirected to cancel the policy and refund full amount of premium i.e. Rs.20,000/- with interest @ 9% p.a. from the date of receipt to till the dateof payment within 15 days from the date of receipt of this order.
Page 1: AHMEDABADAhmedabad Ombudsman Centre
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Page 7 and 8: FINDINGS & CONCLUSIONS:-There is no
Page 9 and 10: Category - MISCELLENEOUSShri Kailas
Page 11 and 12: Category - MISCELLENEOUSShri OP Sri
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Page 49 and 50: FINDINGS & CONCLUSIONS:-8. There is
Page 51 and 52: Brief Background - Non receipt of P
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Page 55 and 56: information that the they have sent
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Page 63 and 64: FINDINGS: The insurer clarified the
Page 67 and 68: FINDINGS & DECISION: The insurer wa
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FACTS: The complainant Sh. Navdeep
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DELHICase No.LI-165/ICICIPru/09In t
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Case No.LI-JP/108/08In the matter o
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Case No.LI-185/Furture/09In the mat
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Case No.LI-135/HDFC/09In the matter
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Case No. LI-ICICI Pru/183/09In the
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from her profession she had intenti
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Case No. LI-ICICI Pru/123/09In the
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Case No.LI/HDFC/114/09In the matter
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1. This is a complaint filed by Shr
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5. Copies of the Order to both the
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2. Complainant had proposed for Kot
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5. Secondly, I find that at this st
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1. Shri Sachin Kumar has made a com
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2. The main complaint seems to be t
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Case No.LI-ICICI Pru/187/09In the m
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Case No.LI-DL-II/96/09In the matter
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2. The respondent company though ho
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policy as mentioned on the face of
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5. The question for consideration i
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After hearing the parties to the di
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Facts and Submissions:-This is a pe
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OFFICE OF THE INSURANCE OMBUDSMAN,
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INSURER:The insurer has not submitt
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Hence, the insurer is directed to s
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any loss or put to any disadvantage
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The Company was asked to provide th
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MUMBAI OMBUDSMAN CENTREComplaint No
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cash and the rest was to be convert
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coronary arteries and the branches
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MUMBAI OMBUDSMAN CENTREComplaint No
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MUMBAIMUMBAI OMBUDSMAN OFFICECompla
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y the company vide their letter dat
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The Company has also not denied the
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fair nor reasonable. It would be fa
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Jayshree Bipin Shah for the sum ass
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Respondent : Life Insurance Corpora
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2(B) The benefit of the policy sche
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