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Order No.BPL/LI 10-11/ 97Case No. RI-249-22/11-09/MumSmt. Kaushalya Sharma ……..………….……..ComplainantReliance Life Insurance Co. …………………..…RespondentBrief Background – MissaleSmt. Kaushalya Sharma, resident of Bhopal (M.P.) lodged the complaint that she hasinvested Rs. 2.00 lakhs towards the single policy No. 14746147 on 25.06.2009. On receiptof the policy document she came to know that policy was issued for regular premiuminstead of single premium, she immediately wrote to the company to cancel the policy andrefund the premium amount. Despite of several personal follow up and reminders she did notreceived any response from the respondent.Aggrieved from the action of the respondent the complainant lodged the complaint on27.11.2009 seeking the direction to refund of premium amount with interest.Complainant present herself with her husband submitted that they have invested Rs. 2.00lakhs out of his post office recurring deposit to get higher return on investment and it wasclearly told that it is for the single premium and no further premium will be paid by her. Shesigned the blank proposal form relying on the agent. After receipt of the policy documentshe did not bother to check it but after some time her husband checked the policy documentand shocked to see that the policy was issued for 10 years term under annual premium of Rs.2.00 lakhs. He also further observed that the proposal form has shown the complainant asBHEL employee, the income source has been shown as pension with annual income of Rs.1.00 lakh. In fact her husband is a retired since from long aged 72 years and having apension of Rs. 12000/- per month, out of which it is very difficult to save and pay thepremium Rs. 2.00 lakhs per annum. Hence they complaint to the respondent pointing out thediscrepancies and convert the policy into single premium on 08.07.2009, despite of severalfollow up the complainant did not received any response from the respondent.Ultimately, he complaint to this forum seeking the direction to refund of money with interest.The respondent presented by Shri Abhishek Kathuria, Dy. Zonal Operation Manager, CentralZone submitted that the policy was issued to the complainant as per the proposal form signedby the complainant and policy was issued & delivered accordingly on 14.07.2009. Theapplication is received for to convert the policy into a single premium after the free lookperiod is over. Hence, we are unable to proceed with the same. On inquiring on what basis,the respondent has issued a policy of Rs. 2.00 lakhs premium p.a. for 10 years term to a ladyaged 58 years having a income of Rs. 1.00 lakh p.a.? Is it not an over looked of financialunderwriting rules? The respondent could not replied satisfactorily.
FINDINGS & CONCLUSIONS:-8. There is no doubt that the above policy was issued to the complainant.9. The proposal form has shown the complainant as a BHEL employee whereas sheis a house wife.10. In the same proposal the source of income has been shown as pension amount ofRs. 1.00 lakh p.a.11. It is very difficult to convince that the persons having a income of Rs. 1.00 lakhp.a. can afford a premium amount of Rs. 2.00 lakhs per annum, which proves thatit is a clear cut case of miss-selling and overlooking of financial under-writingrules.12. Insurance is a contract of utmost good faith, any mis-representation on either sideis vitiate the contract ab-initio.In view of the above, it is found that it is a clear cut case of miss-sellling, hence vitiate thecontract ab-initio. The action of the respondent is not just & fair. Therefore, the respondentis directed to refund Rs. 2.00 lakh with @9% interest from the date of receipt of thepremium amount to till the date of making the payment, within 15 days to receipt of thisorder.Dated at BHOPAL, on 17 th of FEBRUARY 2010.Order No.BPL/LI 10-11/ 98Case No. AVA-245-22/11-09/MumShri Akil Kutubuddin ……..………….……..ComplainantAviva Life Insurance Co. ……..…RespondentBrief Background – Non receipt of Policy documentShri Akil Kutubuddin, resident of Indore (M.P.) lodged the complaint that he has taken thelife insurance from the respondent i.e. ASV 2022157,ELP 2027498,ASV 2025360and 2026595 and paid total amount Rs. 6,92,500 for the first year, but he did not received theoriginal policy document till Sept.2009. He reminded to the Agent many times verbally andcomplained in writing on 01/10/2009 to the respondent; thereafter they issued duplicatepolicy documents on 20/10/2009. He gone through the terms & conditions of the policydocuments and came to know that the policies were unit linked plans, he could not satisfiedbecause he never intended to purchase any kind unit linked plans. Thereafter he wrote to thecompany for cancellation on 21/10/2009, but respondent refused to cancel the policy andrefund the premium as the free look period was over.Aggrieved from the action of the respondent the complainant lodged the complaint on01.12.2009 seeking the direction to refund of premium amount with interest.
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Page 9 and 10: Category - MISCELLENEOUSShri Kailas
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Page 55 and 56: information that the they have sent
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Page 59 and 60: CHANDIGARH OMBUDSMAN CENTRECASE NO.
Page 63 and 64: FINDINGS: The insurer clarified the
Page 67 and 68: FINDINGS & DECISION: The insurer wa
Page 69 and 70: FACTS: The complainant Sh. Navdeep
Page 71 and 72: DELHICase No.LI-165/ICICIPru/09In t
Page 73: Case No.LI-JP/108/08In the matter o
Page 76 and 77: Case No.LI-185/Furture/09In the mat
Page 78 and 79: Case No.LI-135/HDFC/09In the matter
Page 81 and 82: Case No. LI-ICICI Pru/183/09In the
Page 83 and 84: from her profession she had intenti
Page 85 and 86: Case No. LI-ICICI Pru/123/09In the
Page 87 and 88: Case No.LI/HDFC/114/09In the matter
Page 89 and 90: 1. This is a complaint filed by Shr
Page 91 and 92: 5. Copies of the Order to both the
Page 93 and 94: 2. Complainant had proposed for Kot
Page 95 and 96: 5. Secondly, I find that at this st
Page 97 and 98: 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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