UTTARAKHAND STATE CONSUMER DISPUTES REDRESSAL COMMISSION, DEHRADUN
Kumkum Rani, President and B.S. Manral, Member
PNB Met Life India Insurance
Company Limited and Anr. – Appellants
versus
Poonam Gambhir and Anr. – Respondents
First Appeal No.11 of 2023
Decided on 8.11.2024

Headnote:

Consumer Protection Act, 2019 – Section 41 – Insurance Policy – Refund of premium amount deducted from account of respondent No.1-Complainant – Home loan – Insurance cover not provided as per assurance give – Deficiency in service – Policy copy was not delivered to complainant in due time to take benefit of Free Look Provision, as contained in terms & conditions of policy – It was a group policy & and Group policy holder was “Punjab National Bank”, but as per proposal form KN Gambhir is shown as applicant & PG depicted as nominee – Applicants have not specifically proved as to why in proposal form, two different application numbers were mentioned – Insurance company has denied to issue policy for 25 years, taking into consideration age of complainant & her husband, but no such letter issued to either complainant or group insurance holder, informing that insurance policy cannot be issued in favour of person beyond age of 70 years’ is available on record so as o prove later on any fresh proposal form was submitted by complainant & her husband with bank or in office of insurance company – Forum considered all the facts & circumstances of case & rightly allowed consumer complaint per impugned judgment & order, which does not suffer from any infirmity.

Held: It is admitted fact that effective date of insurance coverage was 10.03.2018. In para 3 of the consumer complaint, the complainant has stated that premium amount of Rs.11,76,190.96/- was deducted from the loan account on 10.03.2018. Learned counsel for the insurance company submitted that the policy documents were duly provided to the complainant and the same were sent to the complainant through post on 30.04.2018, which was delivered to the addressee on 10.05.2018. In this connection, reliance was placed on Paper No. 43 (copy of the issue dispatch print out). The said document mentions received date as “10.05.2018 at 12:00 a.m.”. It is not understood as to how the consignment can be delivered to the addressee in the mid-night at 12:00 a.m. Therefore, the timing of receipt of document, mentioned in the document, appears to be incorrect and it cannot be assumed that the policy copy was delivered to the complainant in due time to take the benefit of Free Look Provision, as contained in the terms and conditions of the policy. Besides it, it’s group policy number does not mention the name of the bank as an applicant and such document is also a photocopy, which is not admissible in evidence.

It would not be out of place to mention here that it was a group policy and the group policy holder was “Punjab National Bank”, but as per the proposal form (Paper Nos. 41 & 42), Sh. Kamal Nain Gambhir is shown as the applicant and his wife Smt. Poonam Gambhir (as spouse) is depicted as nominee. This proposal form does not show that Sh. Kamal Nain Gambhir and his wife Smt. Poonam Gambhir, both were the joint applicants. In the column of signature of the applicant, there is neither signature of both the above persons, nor it bears the endorsement / signature of Branch Manager, Punjab National Bank. Mere rubber stamp affixed in the signature column does not prove that the Branch Manager signed the proposal form as Group Policy Holder. Thus, it proves that the proposal form was not duly filled it, hence the same cannot be assumed as a valid and legal proposal form. If any policy is issued on such unfilled and incomplete proposal form, then such policy is not enforceable in law. This apart, in the proposal form, the application No. is shown different at two places. At the beginning, the application No. is 677131695, whereas at other place, under the column of Application Form – Group Creditors, the application No. is mentioned as 677131668. The appellants have not specifically proved that as to why in the proposal from, two different application Nos. were mentioned.

In addition to above, the policy cover note (Paper No. 44) does not match with the details mentioned in the proposal form because in the above proposal form, Sh. Kamal Nain Gambhir is named as applicant, but in the above policy cover note, (i) Ms. Poonam Gambhir & (ii) Sh. K.N. Gambhir, both were shown as insured members, whereas the proposal form was filled in by one applicant – Sh. Kamal Nain Gambhir. This fact has also proved that there was some manipulation on the part of the insurance company. The insurance company has also not filed the covering letter sent by the bank along with the documents clubbed with it for taking the insurance policy for securing the loan amount sanctioned by the bank to the complainant, so that it could be proved that the bank has merely applied for taking insurance for 8 years’ and not 25 years’.

It is also pertinent to mention that the concerned bank (respondent No. 2 / opposite party No. 3) did not appear before the District Commission and no written statement was ever filed by it. The appellants, in Commission below, had filed their joint written statement, wherein they have pleaded that at the time of applying for insurance, the age of Sh. Kamal Nain Gambhir was 62 years’ and that of his wife was 45 years’, so considering the age of the applicants, after a period of 25 years’, their age would have been 87 years’ and 70 years’ respectively and as per the terms and conditions of the insurance policy, the insurance policy cannot be issued for such a long period. It was further pleaded in the said para that the insurance company had denied to cover the loan for 25 years’ and the loan application form remained pending. Thereafter, the complainant and her husband had requested to issue the insurance policy for lesser period and given consent for issuance of insurance policy for a period of 08 years’, for which one time premium was payable. Thus, as per the pleading, the insurance company has denied to issue the policy for 25 years’, taking into consideration the age of the complainant and her husband, but no such letter issued to either the complainant or the group insurance holder, informing that the insurance policy cannot be issued in favour of the person beyond the age of 70 years’, is available on record, so as to prove that later on, any fresh proposal form was submitted by the complainant and her husband with the bank or in the office of the insurance company. Further, as per the above contention, the complainant and her husband had also given consent letter, but the same is also not available on record, thereby the insurance company has not been able to corroborate its version as raised in para 20 of the written statement and has not filed any reliable documentary evidence in that regard.

On the basis of aforesaid discussion, we are of the view that the District Commission has considered all the facts and circumstances of the case and has rightly allowed the consumer complaint per impugned judgment and order, which does not suffer from any infirmity. The appeal lacks merit and is liable to be dismissed. (Paras 8, 9 to 12)

Result: Appeal dismissed.