This is an interesting thread.
You have raised valid points.
As it happens the offender employees are not made to appear in DCDRF and courts of law and the attitude of habitual offender gets encouraged.
You may analyze the following information and fine-tune it to suit you.
>> It is usually printed in the proposal form itself that “The..................... must authenticate any cancellation or alterations in this form.”
e.g;
FAQ by Aegon Religare
https://buyonline.aegonreligare.com/iMax_FAQs.pdf
HDFC Life :” The annuitant must authenticate any cancellation or alterations in this form. Insurance is a contract of utmost good faith,”
https://www.hdfclife.com/iwov-resources/pdf/products/retirement/annuity_proposal_form.pdf
Birla SunLife;
https://liuat.birlasunlife.com/Pages/Individual/Customer-Service/Help-Desk.aspx
Any alteration is to be validate in writing by customer.
https://www.licindia.in/policy_conditions.htm#7
Proposal Forms and Instructions for filling proposal form by LIC are at:
https://www.licindia.in/download_forms.htm
>> You have posted that:
-----“I got one Important case,where in customer has asked for accident benefit and requested for accident benefit in proposal form.Insurance company has collected excess premium towards accident benefit and without the knowledge of the customer,insurance company has tampered the proposal forms in columns related to term and sum assured and misappropriated the excess premium by enhancing the sum assured.”
This is forgery. Police complaint should be lodged.
>> The alterations, non availability of rider in the policy being proposed to the customer, violate the guidelines of IRDA e.g;
Insurance Regulatory and Development Authority Notification Hyderabad 16 Feb 2013:
Insurance Regulatory and Development Authority (Standard Proposal Form for Life Insurance) Regulations 2013.
2 Definitions; (3) Suitability
7 (2) , (3) (a)
8:1 (b) (c) (d)
10
Instructions to Intermediary (agent........): clause3
>> Any overwriting, correction should be validated by customer with his signatures by hand. If not proposal from and issuance of the policy should have been rejected and premium should have been refunded.
In case of LIC usually local office where the proposal form is submitted conducts the financial, medical, and general underwriting and the same office issues the policy, hence you may demand to produce the proceedings and comments of each official involved in issuance o policy and to submit the names of each LIC employee involved in the process and charge them by name and let them appear in court and state that they can process and they have allowed the proposal form with alterations.
While all such officials are bound for proper scrutiny of the proposal form and reject it due to unauthorized alterations.
If LIC is claiming that the customer should have objected to the unauthorized changes on proposal form in Free Look Period then the stand of the LIC is wrong and it basically wants the DCDRF to pass an order to do so (usually DCDRF levies a monetary penalty and does not invoke serious penalty) and does not want to accept the mischief.
However even after the decision of the DCDRF or during it no one can prevent you to highlight the malpractice, forgery, and volt faced approach of the agent and DO to the Chairman of LIC. You can also approach DY. Manager CRM and lodge complaint under acknowledgment.
You must submit a written complaint to the Chairman of IRDA highlighting that accidental rider was not available and term and Premium etc was altered to issue the policy.
IRDA has been levying huge penalties.
You can also demand and obtain the internal guidelines that prohibit to accept proposal form with alterations and if required pursue the RTI route.
Some of the companies had stopped accepting proposal forms having overwriting/correction even if these were countersigned.
If signature against overwriting/correction is not place then these should not be accepted.
If signature against overwriting/correction is forged then it is also forgery.
Why the agents and officials of the company connive and indulge in such practices.
The insurance company may have a policy to pay commission on Base premium and not on total annual premium (AP). The riders may fetch additional sum assured (SA) and there may be a need for medical examination.
In current case if the agent/DO cited that accidental cover is not available then customer would have felt offended and might have decided to take back the proposal form.
This would mean loss of business.
You may even now take a stand that you have been in touch with agent and DO, LIC and they did not accept to cancel the policy as FLC and did not guide you to lodge a complaint.
The insurance companies due to the malpractices had introduced in house policies/rules e.g: the DO/BM/outside agencies/HO etc as per SA, shall call the customer to check and verify the Term, AP, riders, address, countersignatures etc.
You may get hold of such policies and this would be an imp. document.
The inclusion criteria, exclusion criteria have to be sated in policy brochure and policy schedule.
In addition to brochure the company has to provide benefit illustration showing tentative returns @ 6% and 10% that has to be signed by both agent/DO and customer.
Copy of proposal form and benefit illustration has to be supplied as part of policy bond.
If term, rider on proposal form have been forged then it should have been forged on benefit illustration also. You may check n compare if details in proposal form and benefit illustration match or not?
In such a case not only the agent but DO and everyone involved in the processing the proposal form including the underwriters and offenders.
Peruse the case properly.
Tame and shame them.
The decisions rendered by IRDA are available on its website.
The decisions rendered by Insurance Ombudsman are also available on website.
The decisions rendered by Distt/State/National Consumer Disputes Redressal Forum can be downloaded at:
confonet.nic.in/
and
https://www.policyholder.gov.in/Case_laws_or_Judgements.aspx
