Insurance fraud
Maharshi Chakrabarti
(Querist) 15 April 2013
This query is : Resolved
My father in law aged 70 had been approached by an HDFC Standard Life agent to purchase 3 policies in his name for getting Section 10D benefits. He has been told that he will get a higher rate of interest and this policy is exactly like a fixed deposit. He had been told to provide a copy of the PAN card of my wife as the nominee.
To his dismay, when he received the policies, none of them are in his name. They are all in the name of my wife with him as nominee. The agent has by fraud signed as her in the policy document.
Please help me know how to recover the money for this senior citizen who has lost a large sum in his twilight years due to this fraud.
Sudhir Kumar, Advocate
(Expert) 15 April 2013
go to thana write a complaint. Then alongwith the agent your wife will be arrested and asked following questions after sunset in remand period :-
(i) How did agent came to know her name?
(ii) How did he know correct spelling of name and surname?
(iii)How did he know her date of birth as mentioned in policy document?
(iv) Why it should not be believed that she has connivance with agent?
agent in any case will confess of having acted as per he instructions. The police will also cease originate policy as evidence. The proposal form will be ceased as disputed document. So you will not be able to withdraw money.
In any case the money has come in the name of your wife.
Kumar Doab
(Expert) 15 April 2013
PAN CARD of nominee is not required.
Within 15 days from receipt of the policy (Free LooK Period) can be cancelled.
Write a letter with full details signed by your father and your wife and submit the policies for cancellation and refund.
Keep the photocopy of the policies (each page) and obtain acknowledgment under seal and signature on copy of letter and photocopy of the policies.
While you surrender/cancel you need to submit the pages of Policy Schedule only from policy booklet and not all pages.
It is clear case of fraud, therefore do not think twice to approach your layer and lodge a police complaint against agent, Unit Manager, BM and escalate to MD of the company with a copy to
Rajendra Ghag Sr EVP and Chief Officer of HR of the company. Avoid email and telephonic discussions.
Make a note and record of each phone call made till date and keep the bills and preferably record each call.
In such a situation one should arrange a crowd of well wishers and witnesses and should not shy from recording the transactions (audio/visual).
You have the option of lodging the complaint with Chairman- IRDA.
Relate the deficiencies with “Regulation of Protection of Policy Holders Interest” “Guidelines on Grievance Redressal”
This could not be attached in this thread; however you may send your email or download from another thread;
http://www.lawyersclubindia.com/forum/Insurance-company-wrongly-forecasted-the-benefits-78752.asp
IRDA has initiated a telephonic help line also phone number: 155255.
complaints@irda.gov.in
You may get in touch with them and understand the process and systems and your rights.
Company won’t easily agree and accept the fraud.
The company may deduct the charges for medical tests if any adverse movement in NAV of units, for which you should not agree.
The private insurers sell like this and Brands HDFC is one of the notorious ones……
You will be safe if you stay away from them……..
Please keep this thread updated.
Sudhir Kumar, Advocate
(Expert) 16 April 2013
the advise of Mr Doab is well detailed. The querist must follow it after ensuring that it was not a fraud by his wife.
V R SHROFF
(Expert) 16 April 2013
Act as per Kumar D, and follow up
Raj Kumar Makkad
(Expert) 16 April 2013
I do endorse the advice of Doab and Sudhir.
Raj Kumar Makkad
(Expert) 16 April 2013
If experts have started the new trend to welcome each other then accept Gud Morning from my side also.
ajay sethi
(Expert) 16 April 2013
excellent advise by kumar Doab
V R SHROFF
(Expert) 16 April 2013
Raj ji, we always had that policy to welcome. It is not new trend.
No unwanted incidence took place after Feb 2012, with our united policy... United we stand !! no fall .
How many Jackals we warded off. They used to harass leading Experts!!.
Of course, LCI Adm also keep vigil.
And we are transparent & Happy now.
Adv Shroff
Maharshi Chakrabarti
(Querist) 16 April 2013
Thank you for your advice.
My father in law has submitted a letter to the Kolkata office with tremendous resistance. The staff insisted that the policyholder should submit the complaint whereas she is with me outside Kolkata.
I have raised a complaint with their email contact as per their website. However since this is a forgery, none of the details of my wife and the policy document are matching fro m address to phone number. Will keep you posted.
Kumar Doab
(Expert) 16 April 2013
It is reiterated that you may approach your lawyer at Kolkota, and let your lawyer examine the record and inputs of your father in law , wife and then structure and draft your representations and complaint and decide what is to stated and what is not to be stated in writing and verbally. The company will start making phone calls ( all calls are recorded) and all employees of the company will try to defend the company.
Some error from your end and company may succeed to defeat your contentions.
Learned experts/members have given valuable advice. Kindly follow it.
>>>You have posted that:
“The staff insisted that the policyholder should submit the complaint whereas she is with me outside Kolkata.”
As a supplementary to complaint by your father, your wife can submit a complaint (in any office wherever she is) referring to the copy of the acknowledgment of complaint, issued by Kolkota office of the company and confirm that:
--- She has never applied for any policy and the agent (and Unit Manager or any other manager if accompanied agent) stated during meeting that ID and PAN Card of the nominee is required as per policies of the company and in good faith it was provided.
Pan Card contains photograph and declared DOB of the Pan Card holder.
Latest color photograph of the proposer /Life to be insured is to be affixed on the proposal form.
How did the agent acquire photograph of your wife which was affixed on proposal form?
Did he click it? Or did your wife hand over pan card for photocopy and then he scanned the photograph from Pan Card? Is the photograph on Pan Card and proposal form same?
Was the photograph on the proposal form created by scanning from Pan Card or photo shop in computer?
Then address proof of the life to be insured is also to be attached with proposal form.
How did the agent acquire proof of your wife? Did she give it?
The Kolkota Office which has processed the proposal form must have kept scanned copies of KYC docs of life to be insured e.g. DOB proof, ID proof, address proof, proof of source of funds(as per AML guidelines) like Form16/ITR/salary slip……..etc….
You should get it from company or demand these to be produced.
The grievance redressal guidelines by the company are posted at:
{http://www.hdfclife.com/CustomerService/GrevianceRedressalGuidelines.aspx
“We require written complaints from policy holder for mis-sale related complaints.”}
---If your wife handed over self attested copies of Pan Card, and signatures from this copy has been copied/ forged, company may ask to provide the signatures attested by BM of your bank, verbally or in writing.
The signatures are compared by naked eye and company may claim the signature on proposal form and attested by bank are same.
Who has made the payment of premium: your father or wife and what were the mode of payment: cheque or cash?
Some companies do not accept payment > Rs.20000/ by cash?
If payment of more than Rs.50000/ is made in cash in a day Pan Card is collected.
If your father made the payment his pan card should also have been collected.
---The signatures on the Pan Card are as signatures in her bank a/c or not?
----If signature on proposal form and cheque are two different signatures company asks to sign an addendum for multiple signatures.
Did your father or wife sign it?
---Was she in the city ( Kolkota) if form was filled on that date? She must keep proof.
Here you may go as per advice of your lawyer i.e. to state self attested copies of the Pan card was provided or not, signatures as attested by BM of the bank are to be provided or not?
Please note that if the company agrees to refund it may follow the process explained by IRDA to ensure identification of the customer, and it may ask for cancelled cheque, copy of the updated bank passbook or insist to transfer the amount in same bank a/c from which payment was made.
(Anti Money Laundering programme for Insurers, 3.1.9. Verification at the time of redemption/surrender)
This is stated in Surrender form of the company also which may be available on the web site of the company. You may go thru it in advance.
>>> From the photocopy of the proposal form supplied as part of the policy document you can find out that if agent has signed in a column (along with column for signature of the Life to be insured/proposer) mentioning I (agent ) has filled this form.
If agent has filled the form agent has to sign in the column meant for it.
If there are errors with countersignature in the proposal form, you need to point out that these are also not signatures of your father/wife.
>>> In majority of the life insurance policies the entry age is max. up to 65Y.
You may log onto web site of the policy and go thru all policies.
Apparently the agent has allured your father by showing high returns and your father got swayed, and thereafter the agent being aware that your father is overage made your father nominee, and your wife as life to be insured.
Here you may go thru nomination rules circulated within the company.
If a married female nominates her spouse, children as nominee no question is asked, of she nominates any one outside direct family e.g. brother in law she may be asked to write at least “out of love and affection”. It is felt that as per company’s internal circulars she should have been asked to write why is she nominating her father?
( Although parent can be nominated. Parent is >70Y of age)
You should in fact demand copies of all documents which were made part of the file/folder before issuing policy.
>>> What are the total premium paid/policy and then total premium paid for 3 policies?
If the age of life to be insured is > 45 Y and/or sum assured (Insurance amount) > 5lacs, and/or medical/family history states some disease or death due to disease, height and weight are over company conducts medical tests at its designated/approved hospital/Lab.
Companies take previous policies from all companies into account to decide on it and corresponding medical tests as per medical grid.
Did the company conduct any tests?
If premium and hence SA is above a limit company may send the proposal for reinsurance.
It may not be mentioned in your policy schedule but company shall have it in its records which any one employed in any office of the company can find out by accessing the web forms. Apply your resources and obtain the copy of the web form created for these policies, medical grid of the company, and Medical test advice created by company.
To circumvent this agent, Unit manager, BM might have issued pension Plan without any SA (Insurance).
>>> What is the profession of your wife?
Is she employed or she is housewife? Check in policy proposal form what is her profession mentioned as?
If she is housewife company won’t issue life insurance above a limit and accept premium above a limit (obtain internal document/circular of the company).
The cunning agent might have showed her as self employed::; sewing/embroidery etc, and in that an addendum is to be signed by the lady. You may demand it from company.
>>> As per internal system of the company if premium is say above Rs.20000/ the unit manager or PA/EA to BM of the company, or say >Rs.1 Lac BM/RM etc has to call/meet the client and confirm from client which policy, term, premium, plan, sum assured etc is opted by client and check full address with pin code, email id, phone number, bank a/c number etc.. given by client…and a duly signed report is to be filed.
Did you receive any such call or visit by any one?
The there are third party verifications.
If premium paid is above a limit as per AML guidelines and internal policies of the company proof of source of funds is mandatory.
>>> Irrespective of the premium amount Customer Information report, Memo on file has to be signed and submitted by agent and Unit managers. Above a limit these are to be signed and submitted by BM, Cluster manager, Regional manager etc…..
>>> If in one day or subsequently from one/same company client applies for multiple policies company may ask to sign an addendum for issuing multiple policies and may ask the reason why customer is asking for multiple policies.
Since 3 policies are issued was any such addendum signed?
Apply your resource in the company and obtain as much details and documents you can.
Advocate Ravinder
(Expert) 19 April 2013
Usually the private life insurance companies and its agents do these types of cheatings, frauds and cheap tricks. Normally the company will defend the agent, because the company indirectly encourages the agents for these activities and the companies will be hand in glove with the agents. They will try to sell the policies which will give high benefits and commissions. They will not think of policy holders welfare and benefits. They are not reliable. Instead of that one can rely on LIC and SBI where we have number of policies to suit our requirements.
In the above case, you have to do the following:
Firstly, you have to give police complaint
Secondly, you have to give a complaint to IRDA making the insurance company and the concerned agent as parties. Thirdly, you can also file a consumer case against the Insurance company.
Kumar Doab
(Expert) 19 April 2013
You have submitted a complaint to company by email.
Address the complaint to MD of the company and make him a party, as ap in the complaint already lodged by you and you may lodge in future.
You should lodge a complaint with Anti Fraud cell of Police in Kolkotta, as ap.
The company has to supply before customer signs on proposal form along with brochure of the policy::: PQIS/Benefit Illustration showing name of prospect, age, DOB, address, phone number, email id, name of the policy, annual premium, term, sum assured (BIMA), each charge to be levied in each year of policy and tentative returns @ 6% and 10% (these returns are not guaranteed).
Customer has to sign acceptance of PQIS/Benefit Illustration and submit along with signed proposal form. Company has to supply copy of this signed copy of PQIS/Benefit Illustration along with copy of proposal form as a part of policy schedule/bond ( Booklet ) supplied to customer.
Did your father sign any PQIS/Benefit Illustration?
If no the signature on it are also forged.
Sudhir Kumar, Advocate
(Expert) 21 April 2013
please do not proceed unless you are sure that your FIL or your wife has not signed blank
