LCI Learning

Share on Facebook

Share on Twitter

Share on LinkedIn

Share on Email

Share More

g.vijaya kumar (IPF)     10 July 2011

Misspelling of insurance policy by Metlife

On 10/07/2007, one Mr.Jijo & Satheesh Krishnan, Sales Manager, Geogit Alleppey, Branch Corporate Kochi, Financial Advisor Code 14006721 approached me and explained about the attractive features of an Insurance Policy introduced by Metlife India Insurance Co. Pvt. Ltd name as Metsmart Plus for a premium of 1,00,000/-. As further he explained that, one should pay the premium for three years continuously, they will get a lucrative amount after completion of 6 years since the major part of the premium is invested in the share market though the market is expecting a boom in the coming years. Since I am a goverment employee drawing a meagre amount of salary every month, it is not possible to me to pay the premium of 1,00,000/- every year, so I am not interested in his offer. On hearing my reply he further contacted me and asked that if I could able to pay the initial premium, then also I will get a good return after completion of three years. To assure me the same he also introduced one Mr. Salesh P.C, CSO, Metlife and in turn he also assured me that my investment of1 lakh will not ended in loss, for that he shown some projected calculations on the basis that some one not paid the premium in the second or third installments.



Taking on the assurance of the above said representatives of Metlife which is a corporate giant in the market, I undergone a complete medical check-up arranged by the above said persons at Alleppey and on receipt of the positive certificate from medical practitioner who conducted medical exam, Mr.Satheesh Krishnan informed me over phone, that I must deposit a DD for an amount of1 lakh in favour of 'Metlife India Insurance' drawn on SBI, Kottayam. Simultaneously, on 17/07/2007, I send the DD No. 908814 of SBI, Coimbatore dated 17/07/2007 for an amount of1 lakh along with the xerox copy of my Railway salary Slip No.02675 for the periode of 06/07/2007 to 07/07/2007 via courier addressed to Geojit, Alleppey branch with a written request to hand it over to Mr.Jijo.

In return, I received first premium receipt No. FPR/2007/0138583 dated 19/09/2007, statement of account as on 14/09/2007 dated 19/09/2007 showing total balance of units as 4551.7054 with an NAV of20.7692, policy document No.1200700379049  dated 19/09/2007, terms & conditions in 14 pages with Karnataka Stamp Duty seal for Re.0000001 dated 19/09/2007 and photocopy of  Metlife Application For Life Insurance dated 17/07/2007 No. 106940115 in machine numbered & 379049 written by ball pen (three sheets). On 16/10/2007, I received a docket containing covering letter along with illegible photo copies of medical test records, photocopy of Quarterly fund update, January-March 07, Issue VI and other forms related to the plicy. All the correspondence have been made to my Alleppey address.

Further on 14/08/2008, 04/11/2008, 11/11/2008 the company send some correspondence to my Alleppey address and I got all them in bilated date since I was transfered to Trichy, Tamilnadu. On seeing the notices, I tried to log on in to the company portal but ended in vail. But my surprise, I received several calls on my mobile phone No.9443191754 (TN SIM) during the years 2009 and 2010, in which some call centre professionals either from Delhi or from Bangalore contacted me and pressurized me to remit the further premiums. When I explained the whole episode how and under what assurance I invested 1 Lakh, each time when they called, they also assured me that they will convey this remark to the company and soon they will contact me. But nothing has happens and the same routine calls from the call center continues. At last I abruptly warned them that I dont want to hear any thing from call center personals and initiated them to ask some responsible personnel from the company to solve the issue duly returning my deposited amount. Further more no one has contacted and no any communication till date.

 

a) I am in possession with all the documents they send to me, from which is evident that, the application dated 17/07/2007 does not contains anything about the hidden conditions regarding the policy and I signed in the application on the above said date for to read & understand the contents of the application. For my best knowledge, I furnished all the details in true and utmost sincerity.

 

b) The terms and conditions regarding the insurance policy received by me and in other words came to my knowledge only on 19/09/2007 for that the Karnataka Stamp Duty impression is very much evidential.

 

c) If I know the the above said hidden conditions at the time of filling up the application and  before paying an amount of 1 lakh on 17/07/2007, I would have rethink about the plan, since I was not in a position to raise 1 lakh per year to pay the premium from a gross salary of about 16,000/- per month. However, with a good faith to fetch a good profit from my hard earned money from leagal sources, I believed the words of the above said representatives who approached me from a corporate giant.

 

c) From the above it is clear that the corporate business mentality of Metlife that to enroll any poor man with false attractions to their insurance scheme and later harass and pressurize them to continue the policy. If not they will simply forfeit the initial premium without any shame duly quoting the terms & conditions which will communicate to the policy holder on a later stage i.e. after depositing a huge some as first premium.

 

Hence I requested, kindly tell me what I wants to do to get back my hard earned money.

 

G.Vijaya Kumar,

Mob:09443191754

e-mail: gopivijay67@gmail.com



Learning

 11 Replies

Kumar Doab (FIN)     10 July 2011

Kindly check the Proposal Form (PF) signed by you:

-What is the term of the plan filled in it? There is no policy which shall offer 3 years term. After 3 years you can surrender the policy, and can obtain payment (fund value of the units held by you on that date -surrender charge which can be anything from 5% to 50% or ...Please check the policy brochure and policy documents under the head Surrender charge). Surrender charge may be nil after 6 years ( policy years implying 7 years, since premium is paid in advance, hope this was also not explained to you, and this is not explained by almost all agents/managers of all companies)

-It appears the personnel of the company/or partner of the company which can be a broker or bank etc.....has obtained a blank form signed by you and filled it later. There is a provision by which alongside the box where customer is to sign, there is another box where agent of the company has to sign and mention “this form is filled by me" and there may be another where employee of the company e.g. sales manager has to sign.

From copy of your PF you can collect names, codes, and details of all.

-Company has to provide the brochure of the policy (printed not older than six months) and one PQIS( Benefit illustration) to the customer, showing the details like name of the customer, DOB/age, annual premium, policy term (PT), premium payment term (PPT), sum assured i.e. life insurance, charges etc and indicative return @ 6% & 10%.

Customer has to sign on it as a token of acceptance and copy of this is to be supplied along with copy of the PF, as a part of the policy document.

In your case the personnel showed you a PQIS with single premium to be paid by you i.e. for 1st year only. Did they obtain your signatures on it? But they issued a policy with regular premium and PPT of 3 years. This is not possible until or unless they obtain your signatures towards acceptance on a PQIS with PPT of 3 years. It is not clear whether your signatures were forged or were obtained on two PQIS with different PPT and one suitable to them was used. This is a commonly used and reported tactics. Then majority of the companies show  the calculations on laptop which is actually a Microsoft excel worksheet, and the same is legally not allowed.

In a single premium policy the agent gets commission of up to 2%, only and sales credit of 10% only of the 1 year premium. Companies allow pre set and fixed number of single premium policies to a branch. Hence company staff including Branch Managers, and above keep pressure on Sales managers etc, agents no to log in single premium policies.

-It is not necessary to pay the premium by DD only. Since the customer may know the facts and may decided to cancel the PF hence and stop the payment of cheque and above Rs.50000/ payment can only be accepted by cheque/DD, so you were asked to pay by DD.

-The agent of manager can not collect PF or dob/address proof/pan card copy and can not conduct medical tests until or unless payment instrument is enclosed with PF.

- As it is clear from your post the units’ worth app Rs. 80000/ were issued to you and app.Rs.20000/ were deducted from amount paid by you towards various charges.

- You have posted that you came to know that miselling and some fraud has been committed with you on receiving phone calls from tele callers, and you brought the facts in their notice and they stated that senior official of the company shall call you back, but nobody called back to attend you.

-You should have lodged a written complaint. These companies do not have grievance redressal officer but they are supposed to have CRO (Complaint Redressal Officer)  and grievance redressal system, whose details are to be printed in the policy docs.

-Usually companies in case of escalated complaints to the level of CEO and MD, refund the entire premium (without any interest and penalty) to avoid media coverage, bad publicity, etc, and request the customer no to take up the matter to IRDA, consumer forum media etc). Moreover the companies are a joint venture and some of the vigilant customers even escalate to the foreign partner whose details can be obtained from internet, IRDA, Insurance Ombudsman, consumer forum, courts of law, etc.

-You should issue notice to the concerned agents, employees of the company. You can lodge complaint with any of the branch office of the company. Preferably you should involve the local Branch Manager, Cluster manager of the company at your present location.

In a recent case at the website of IRDA, metlife had already paid the entire premium to customer, before the matter was attended by IRDA.

You shall have to contest the matter with Metlife, with full force. Be smart.

g.vijaya kumar (IPF)     10 July 2011

To the attention of Mr.Kumar Doab,

Thank you for your reply and I am furnishing some additional information regarding the case.

-The proposal has been introduced tome by one Mr.Satheesh Krishnan, Sales Manager, FA Code.14006721, FA Name. Geojit Alleppey, Kochi, Branch Office. Corporate, Kochi.

-Later I came to know that rhere is no such policy with Metlife that for single premium.

- what as you say exactly in first para of your reply has senn in the PF signed by me in blank form at Alleppey dated 17/07/2007 witnessed by one Mr.Salesh.P.C, CSO Metlife. The handwriting in the PF is not mine. 

-TheCompany had not provide any brochure of the policy (printed not older than six months),  PQIS( Benefit illustration) showing the details like name of the customer, DOB/age, annual premium, policy term (PT), premium payment term (PPT), sum assured i.e. life insurance, charges etc and indicative return @ 6% & 10% at the time of taking signature in the PF. All the said documents send to me by post on 19th Sep 2007 and no any acknowledgement has given by me . 

-They have collected age proof, copy of PAN card priorly.

-They insisted me to pay by DD.

- The PF and DD dated 17/07/2007 whereas the medical test like urine, blood and treadmill test conducted on 15/07/2007 and medical report dated 25/07/2007.

-I made complaint through email to metlife before a couple of days and also lodeged an email complaint with IRDA and awaiting for their reply.

Kindly guide me for further course of action please.

with regards,

G.Vijaya Kumar,

Mob:09443191754

e-mail: gopivijay67@gmail.com

Kumar Doab (FIN)     10 July 2011

 

The customer is expected to go thru the terms and conditions and policy document carefully and within 15 days of its receipt termed as free look period , customer can cancel the policy and company has to refund the premium paid-stamp duty-medical expenses if any-NAV adverse movement if any. You have not cancelled the policy within free look period. You need to defend on this.

PQIS ( Benefit Illustration ) has to be signed by the customer this was introduced as a rule by IRDA, and the exact date is not known hence can not be given to you. You can find it from IRDA on phone, by email, or from their website. This shall be your defense, kindly obtain it.If IRDA and company confirm in positive you can sue the staff and BM and all staff who processed your documents.

You can use your resources and discreetly obtain the copy of circular issued by the company to its staff , from operations staff, or an old employee of the company.

if this was a rule issued by IRDA and circulated by company, then operations staff of the company should returned the PF with all enclosures to sales, with objections.

Since company has already declared it to you that the policy sold to you is not available as a single premium, the PQIS used in your case and copy of which is supplied to you by the company shall not be showing single premium. You have posted that you were not provided any PQIS, and you have not signed it and submitted it with PF, and if the copy of PQIS supplied to you by the company is bearing your signatures, then your signatures are forged.

If the medical tests are conducted on 15th the test reports  can not be dated 17th.

Self attested copies of PAN card etc are to be collected and the employee who has collected the docs has also to sign mentioning OSV (originals seen and verified), or if the customer is in the branch operations staff/ BM can mark OSV on the copy ( not self attested by customer) and affix his/her seal and signature with employee code. You should use your resources to obtain copies of the circulars from company and IRDA to this effect also.

Be smart.Peruse your case with force and claim principle amount+ penalty+ interest+ damages. Company's MD can settle the complaint by refunding entire premium without any interest etc. If it happens you may collect without signing any form for full and final payment and later you can lodge a complaint with consumer forum.

Consumer forum is better option in such cases. You can take the help of local lawyer.

Kumar Doab (FIN)     10 July 2011

The companies have to follow a process to avoid misselling, and IRDA has issued guidelines on this, the exact date of such guidelines can be obtained from company or IRDA.

-If the annual premium is upto say Rs.20000/pa one designated employee e.g. PA to BM,has to call or meet the customer, and varify name of plan,term,PPT,phoen numbers,address,nominee name,insurnace amount,occupation,PF is filled by self or agent,ID/dob proofs supplied by customer,PQIS was supplied or not and is signed by customer or not etc.and has to submit a signed declaration.

-If the annual premium is say Rs.20000-30000/pa, Sales Manager (SM)has to call and check and submit declaration,as mentioned above.

-If the annual premium is  say Rs.30000-50000/pa,SM has to meet and Deputy/BM has to call or meet and check and submit declaration,as mentioned above.

-If the annual premium is  say Rs.50000-75000/pa,SM/ Deputy/BM has to meet and check and submit declaration,as mentioned above.

-If the annual premium is  say Rs.75000-100000/pa,SM/ Deputy/BM/cluster manager has to meet and check and submit declaration,as mentioned above.

If any of the above mentioned docs is not submitted the operations staff in the branch office has to reject and return the PF to sales.

Another call is required to be made by company call centre to check the info as mentioned above, and if any adverse information is given by customer PF has to be returned.

You may use your resources to obtain such circulars.

g.vijaya kumar (IPF)     10 July 2011

Thank you Doab sir,

I am preparing some questionare to the Insurer regarding the policy based on your reply and guidelines. I will come back once the response come from the Insurer.

with regards

G.Vijaya Kumar,

Mob:09443191754

e-mail: gopivijay67@gmail.com

g.vijaya kumar (IPF)     09 August 2011

Doab Sir,

Sorry for the long gap. One interesting thing happened today and I would like to share it with you. Today at about 10.12am, I received one call from 011203851195 and the caller says his name as Mr.Dwivedi from Consumer Court, Noida. He further stated that my complaint is with him and he is working on it for solution and he wanted to make conference call with one Mr.Singhania of Metlife. The caller didnt disclose any other identity or refernce of my compalint to me. While on conversation with the caller he told me that he will put through the call to the man from Metlife. The Metlife person whether genuine or not, told me that, if I am ready to pay an additional amount of Rs.50,000/- within four days, he will convert my policy as one time policy and I can withdraw the amount on Jan 2012 with interest @ 11.83% PA. In other hand if I surrender the policy I would get only Rs.75,000/- after deducting surrender charge. Further on bargaining he relaxed the term up to Dec 2011. When I explained all the episode that how mI trapped in this buisiness, he simply replied that, the company is not responsible for the fault done by some field executives or agents. Further he clarified that, the company could not violate the rules & regulations framed for the purpose. When I countered that on what rule you arte now negotiating with me the above said solutions ? he had no any answer. Again I requested him that, if the company is ready to return my money with simple interest for the last four years or to return the surrender value with full amount. He hesitated to accept the offer and told me that as per the rules on the policy document in regard to surrender benefit only he can act. 

For your reference I am reproducing the terms and conditions on surrender benefit in the policy document page 7 of 14 given to me.

15. Surrender Benefit

No surrender value is payable during the first three years of the policy. After the first three policy years, the Surrender Value payable on Surrender is equal to the Fund Value in the Unit Account less the surrender charge as mentioned in clause 11(D).

But my surprise, I could not find any such sub clause in clause 11. When the sub clause is very silent about the surrender charge how I can accept the deduction of any surrender charge from my policy.

A valuable is reply is soliciting

G.Vijaya Kumar

gopivijay67@gmail.com

Kumar Doab (FIN)     09 August 2011

Company is fully responsible for its actions.

Company does not and can not state that customer should enter into a conference call. The company employee has to give full identity and you are within your rights to get full identity including full name with sir name, designation, department, full address with pin code, official phone number with STD code, fax number email id of the company official. The phone number mentioned by you has STD code of Delhi. The company if calls the customer from its own office shall usually call from a recorded line, and if you ask shall issue transaction number. Next time you can ask for written reply to your complaint and if the company is inclined to talk to you on phone you can ask them to write the phone number from which their authorized representative shall call, or you can ask them to seek appointment and send their authorized official with company ID card.

If you have not filed a case in consumer court at Noida, why should any one call you from court? Moreover consumer forum does not call complainants and ask them to attend a conference call. What you have faced are tricks, and unethical practices. You can lodge your complaint on this episode and protest the statements issued to you and ask the company to confirm in writing the identity of the company official who called you, and on whose instructions this conference call was arranged, to pressurise to deposit funds.

If you conclude whosoever has called you has expressed that company shall not deviate from its policies, hence until or unless you establish their malpractice you shall not get any relief.

Surrender charges year wise have necessarily to be printed in policy document. If you do not find these in your policy document, you can lodge a compliant on this.

Policy conditions can not be changed. If you have lodged a complaint with Chairman of the company chase it and if no relief is provided to you, you should consult a local lawyer with all records and initiate a lawful action.

g.vijaya kumar (IPF)     11 August 2011

Doab sir,

Yesterday, I discussed with you about one conference call in relation to the policy. Today I traced out the number and find it out that the number belongs to Kotak Mahindra Life Insurance of Noida branch and also confirmed that an employee named Mr.Dwivedi is there. Further I send an e-mail complaint to the company seeking information regarding the call was made by the person has done the same with the knowledge of his administartion to challenge any buisiness rivalry with Metlife.

G.Vijaya Kumar,

Mob:09443191754

e-mail: gopivijay67@gmail.com

Kumar Doab (FIN)     12 August 2011

You have posted That the person posed as employee of Consumer Court, this is impersonation and illegal.

This person arranged a conference call with another employee of another company with whom you have a dispute. Both are wrong.The person of Kotak could be an acuintance of person form Metlife.

You can lodge your protest with Kotak mentioning that their employee posed as employee of consumer court.If you the call recording it shall be good.You can a lodge a protest with Metlife mentioning they are involved in illegal practices thru their employee .

If you have recieved any reply to your original complaint, you should persue it to get relief.

It shall be appropriate to consult a local lawyer with all records.

g.vijaya kumar (IPF)     21 August 2011

Doab sir,

In this mean time, I had several trial mails with the Metlife Grievance redressal forum and I have quoted the following wrong dos of the company while enrolling me as a policy holder in regular term instead of single premium.

1. The sales executives conducted medical tests on 15/07/2007 where the the PF and DD dated 17/07/2007.

2. The DD was drawn at SBI Coimbatore/Tamilnadu dated 17/07/2007 and my signature in PF dated 17/07/2007 place at Alleppey/Kerala which is about 7 hours journey from Coimbatore where my working place. On 17/07/2007, I was at Coimbatore looking after my duties. It clearly shows that they have taken signature of me in a blank PF.

3. The hand writing in the PF is not mine and does not bear any name and signature of the person who filled it except the name and signature of one witness i.e. CSO of Metlife.

When I informed all the above to the company , they have only one recorded reply that the free look periode is already expired so they are not in a position to cancel the policy. Whereas I never asked about the cancellation of the policy, but I queried that all the above mistakes are utter violation of the IRDA guidelines or not as you said. Even on repeted e mails they are not ready to give any answer to all the above questions.

At one stage, they informed me that, I can surrender the policy and the amount payable to me is only Rs.16,328.04 after deducting the charges as mentioned in the T&C of the policy. When I shot back about the Clause 15 which tells about the surrender benfit is applicabe duly deducting the charges in clause 11(D), which I already reproduced to you, they asked me to send the scan copy of the policy document to varify the incorrect details to assist me further. Simulataneously I send the scanned copy of the particular page only to them on 19/08/2011.

For your reference, the T&C contains several clauses from 1 to 37. In which clause 11 named as Charges and sub clauses from 1 to 9 which tells as follows:

11.1 Premium Allocation charge, 11.2 Fund management charge, 11.3 Policy administartion charge, 11.4 Surrender charge, 11.5 switching charge, 11.6 Mortality charge, 11.7 rider premium charge, 11.8 Partial withdrawal charge & 11.9 Miscellanious charge.

From the above clauses, I could not able to find any clause like clause 11(D). Not only this one, they have mentioned some other clauses such as 11(A), 11(E), 11(H), 11(I) etc: which are all not incorporated in the policy document which is an indemnified one. My question is when they are telling these are all incorrect details in the policy document, what is validity of the policy document ? Whether they can tell that is a printing mistake or clerical error ? All these years I believes that, if my policy become lapsed, if at all it is misselled me and not informed the matter in the free look period, I become confident that my money will be returned after completeing 3 years as per clause 15. I further believes that my policy wont attract any type of charges since the clause 11(D) not incorporated to the T&C or not applicable to my policy.

Kindly inform me at this stage, what will be the response of the company ? Whether the above said points will help me to get back my money ?

G.Vijaya Kumar.

Kumar Doab (FIN)     01 September 2011

The Pvt. Life Insurance companies have complaint redressal mechanism and CRO (Complaint Redressal Officer) and not Grievance Redressal mechanism.

The company has completed their process and has supplied you a final reply on the basis of whatever they have decided.

It shall be appropriate to approach a local lawyer will all records and prove mis selling.


Leave a reply

Your are not logged in . Please login to post replies

Click here to Login / Register