It is duty of Service Provider to supply the prescribed form to consumer for settlement of the claims

It is duty of Service Provider to supply the prescribed form to consumer for settlement of the claims
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, Chandigarh

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB

SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

First Appeal No.1416 of 2010.
Date of Institution: 11.08.2010
Date of Decision: 22.10.2014

Sh.Kulwant Rai Batish, retired Sr.XEN PSEB, Opposite New Grain
Market, Budhlada Road, Trio, Bhikhi, District Mansa.…..Appellant
Versus……..
1 ICICI Prudential Life Insurance Company Ltd., 2047/ 2-1, Crown
Plaza, Ist Floor, The Mall, Bathinda.
2 ICICI Prudential Life Insurance Co., Ltd., Water Works Road,
Mansa.
3 ICICI Prudential Life Insurance Company , Ltd., ICICI Prulife
Towers, 1089, Appasheb Maratha Marg, Prabhadevi, Mumbai
400025….Respondents/Complainants.

First Appeal against order dated 29.06.2010 passed by the District Consumer
Disputes Redressal Forum, Mansa.
Quorum:-
Shri J. S. Klar, Presiding Judicial Member.
Shri Jasbir Singh Gill, Member.

Present:-
For the appellant : Sh. Madan Sandhu, Advocate.
For respondent : Sh.K.S Cheema, Advocate.

J. S. KLAR, PRESIDING JUDICIAL MEMBER:-
The appellant (the complainant in the complaint) has filed this appeal against the respondents (the
opposite party in the complaint) challenging order dated 29.06.2010 of District Forum, Mansa.


2 The brief facts of the case are that complainant is policy holder with the OP, with name the maximizer policy, vide policy no.02669033 since 2004.That complainant got his request noted
down to lady employee at the counter of the OP on 17.03.2007 with regard to his request dated 16.03.2007 for one time switch over to such mode of growth, so that the above said payment might not lose on account of fluctuation of the market and of funds and in future, the policy should remain in the same mode of growth, so that it may result into accrual of interest like growth of the sum under deposit with the company. That when complainant enquired about the status of the policy, he was astonished to know that his request for switch over has not been taken care of by the insurance company till that. That the complainant requested to Mumbai office of the OP through
e-mail intimating about the status of the policy, mode of growth, but it was not replied. That copy of the same e-mail was got received to its Bathinda branch on 23.12.2008 from the same lady employee in ICICI Prudential Life Insurance Company asking the office to explain about the lapse on its part. That complainant got noted from that lady employee of the OP that copy of letter dated 21.3.07 was handed over to him on 23.12.2008, which never reached the complainant. The complainant personally approached this office, but to no effect. The insurance company delivered the letter dated 30.12.2008 giving status of the policy lying in the same Maximiser Fund to the complainant suggesting to approach their Bathinda Office or to any First Appeal No.1416 of 2010 other branch in response of written request of the complainant dated 17.3.07. The complainant got his request addressed to Bathinda branch of the insurance company in this regard. The complainant
has filed this complaint against OPs praying for retrospective switch over of policy from 17.3.07 from maximiser to protector fund of the insurance company.

3 Upon notice, the OPs filed written reply raising preliminary objections that complainant concealed the material facts form the consumer forum by twisting them. That complaint of the
complainant is not maintainable. It was further pleaded on merits by the OP that it received duly filled in and signed proposal form from the complainant on 30.3.2006. That complainant was policy holder with the OP for the maximiser policy vide policy no. 02669033. That as per regulation 6(2) of the Insurance Regulatory and Development Authority Regulations, 2002 every policy document sent by the company is accompanied by a forwarding letter, which clearly mentions that in case the policyholder is not satisfied with the features or the terms and conditions of the policy, he could opt for change under free look period within 15 days therefrom. That copy of the proposal form duly signed by the policyholder is also sent to the policyholder along with policy document thereby giving an opportunity to the policyholder to re-examine the replies made in the proposal and got details rectified with regard to discrepancy. It was further averred that complainant made a written fund switch request dated 16.3.07 from Maximizer, which is not subject to market fluctuation. That OP sent reply dated 21.3.07 to complainant asking First Appeal No.1416 of 2010 him to submit a fund switch form, but complainant did not do it and OP could not move ahead with the fund switch. That complainant approached the OP in the month of November 2008 vide e-mail dated 1.11.2008. That complainant again approached the Bathinda branch in the month of December 2008 for switch form. That complainant has not filed mandate form, as required for this purpose.
The complaint was contested even on merits on this point by the OP. and prayed for its dismissal.

4 The complainant tendered in evidence affidavit Ex.C-1 of complainant, Ex.C-2 is letter dated 16.3.07, Ex.C-3 is letter dated 23.10.08, Ex.C-4 is letter dated 21.3.07, Ex.C-5 is receipt dated
23.12.08, Ex.C-6 is acknowledgement, Ex.C-7 is letter dated 9.1.09, Ex.C-8 is application form, Ex.C-9 is letter dated 9.1.09, Ex.C-10 is letter dated 14.1.09 and closed evidence on behalf of complainant. In rebuttal thereto, OP has tendered in evidence Ex.OP-1 is policy document, Ex.OP-2 to 4 are copies of letters, Ex.OP-4/A is copy of letter dated 30.12.08, Ex.OP-5 is e mail dated 15.12.2008, Ex.OP-6 is switch backdate form, Ex.OP-7 is letter dated 14.1.09, Ex.OP-8 is
affidavit of Miss.Punarnava Saha, Sr.Manager-Legal and closed the evidence on behalf of OP. On conclusion of evidence and arguments , the District Forum, Mansa dismissed the complaint of the complainant with special costs, vide order dated 29.6.2010. Dissatisfied with the order
of the District Forum dated 29.06.2010, the complainant now appellant preferred this appeal against the same.

5. We have heard Ld.Counsel for the parties and have also examined the record of the case. We have carefully perused the First Appeal No.1416 of 2010 pleadings of the parties on the record. It is undisputed fact that complainant was policy holder vide policy no.02669033 since 2004.
The complainant was policy holder under original applied mutual fund with name maximizer of the OPs. The complainant firstly applied for switch over in writing to Bathinda branch on 16.3.07,
which was received by a lady employee at the counter on 17.3.07. The complainant enquired about the status of the policy value on 13.12.2008 and was flabberghasted to know that his request for
switch over has not been taken care of by the insurance company till that date. Hard copy of the email was got received to the Bathinda branch on 23.12.08 from the same lady employee of the OP's office.
That the lady employee after searching the computer delivered copy of the letter dated 21.3.2007 on 23.12.2008 to the complainant and complainant was surprised to know that status of non-delivery of
such an important letter. That no acknowledgement was supplied to the complainant by the OP. The affidavit of the complainant Ex.C-1 is on the record in support his allegations contained in the complaint. Ex.C-1 is affidavit on oath by the complainant, Ex.C-2 is letter dated 16.3.07 by the complainant to the OP regarding switch over policy, we find that it was received on 17.3.07 and there is faded receipt with stamp about it. We thus conclud from Ex.C-2 that it was received in the office of OP on 17.3.2007. Ex.C-3 is email sent by the complainant to OP regarding enquiry of this matter. Ex.C-4 is policy document, Ex.C-5 is customer care number, Ex.C-6 is acknowledgment of the application, Ex.C-7 is letter dated 9.1.09 sent by the complainant, Ex.C-8 is request for retrospective switch over. with effect from 17.3.07 by the complainant. Similarly, the letters C-9 and Ex.C-10 have also been examined by us. To counter this, the OPs relied upon Ex.OP-1 the brief of policy description, Ex.OP-2 is password, Ex.OP-3 is letter dated 21.3.07 to the effect that if the
complainant wished to avail the facility of the switch, then he has to submit the form for switch duly filled and signed by the proposer of the policy at the nearest ICICI Prudential branch, Ex.OP-4/A is letter dated 13.12.2008 to the effect that if complainant wished to avail the facility of the switch, he should submit the form for switch duly filled and signed of the policy, Ex.O-5 is email in this regard, Ex.OP-6 is application for switch fund with retrospective effect on 17.3.07,
Ex.OP-8 is affidavit of Ms.Punarnava Saha, Sr.Manager Legal of the OP.
6 From appraisal of the above referred evidence on the record, we conclude that the matter can be resolved on the basis of the letter Ex.C-2 in this regard. We find that complainant moved
request to the OP for switch fund on 16.3.07, which was received in branch by one Gursharan on 17.3.07, It is thus evident from perusal of Ex.C-2 that wish of the complainant for switch over was
communicated to the OPs on 17.3.07, when this letter was received. The OP later on wrote to the complainant to submit the switch form duly filled in for availing this facility. On this point, we find that matter has been settled by the Orissa State Consumer Disputes Redressal Commission, Cuttack in case titled as Postal Life Insurance & Anr….Versus…. Abuli Khan, reported in 2011(2)
CLT Page 161, wherein it was held that respondent (consumer) did not apply in the prescribed format along with the policy bond to settle his claim – It was held that the duty of appellant (service provider) is to supply the prescribed form to respondent for settlement of the matter. The appellant (service provider) should have intimated to the office of OP No.3 regarding the material particulars to be submitted by the respondent to the appellant’s office and appellant was rightly
found liable for deficiency.” Admittedly, the complainant in this case is policyholder and he paid the premium, therefore, the complainant applied to OP for switch over on 16.03.2007 and it was duly received by the OP. The OP was required to supply the form to the complainant for needful but, OP slept over the matter hence the OPs are deficient in providing service to the complainant. We find that the District Forum has not appreciated the matter in the proper perspective in this case. Once, the matter was brought to the notice of the OP by virtue of Ex.C-2, then it was incumbent upon the OPs to supply the switch over form to complainant to get the needful done thereafter. The District Forum dismissed the complaint of the complainant with special cost and order of District Forum is
unsustainable in appeal in our opinion. Consequently, we find that the deficiency in service on the part of the OP is established when complainant specifically intimated the OP on 17.3.07 regarding
switch fund. The OP slept over the matter and took excuses to save their skin. Resultantly, the order of the District Forum is set aside in this appeal and appeal of the appellant is hereby accepted and
complaint filed by the complainant now appellant is also accepted and OPs are directed to switch over funds to the complainant with effect from 17.03.2007 as applied by complainant. Op would also
pay compensation of Rs.10,000/- to the complainant for mental harassment and Rs.5000/- as costs of the litigation.

7 Arguments in this appeal were heard on 17.10.2014 and the order was reserved. Now the order be communicated to the parties.

8 The appeal could not be decided within the statutory period due to heavy pendency of court cases.

(J. S. KLAR)
PRESIDING JUDICIAL MEMBER
(JASBIR SINGH GILL)
MEMBER
(SATINDER PAL KAUR)
MEMBER

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