Date of Filing : 17.08.2012
Date of Order : 02.03.2013
BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KOLAR
Dated 2nd MARCH 2013
PRESENT
Sri. J.N. HAVANUR, B.Sc., LLB (SPL) ……. PRESIDENT
Sri. H.M. SHIVALINGAPPA, B.Sc., LLB …….. MEMBER
CC No. 94 / 2012
Sri. Nagaraja.T.,
S/o. Late Thimmaiah,
No. 1268/1, I Main Road,
2nd Cross, Kurubarapet,
Kolar – 563 101.
(By Sri. M.P. Narayanaswamy, Adv.) ……. Complainant
V/s.
1. M/s. Bajaj Allianz Life Insurance Co. Ltd.,
Opp. Kolar Nursing Home, Near Bus Stand,
Kolar – 563 101.
2. The Divisional Manager,
Bajaj Allianz Life Insurance Co., No. 897/B,
Silver Line Arcade, 80 Feet Road, 6th Block,
II Floor, Pizza Hut, Koramangala,
Bangalore – 560 045.
3. M/s. Bajaj Allianz Life Insurance Co. Ltd.,
SLS Towers, 2nd Floor, No. 68, Cherry Road,
Hasthapatty,
Salem – 636 007, Tamil Nadu.
4. M/s. Bajaj Allianz Life Insurance Co. Ltd.,
54-1, Adjacent Bharathi Super Market,
Hasthampatty,
Salem – 636 007, Tamil Nadu.
(By Sri. J.R. Jagadish & Ors, Adv. for Ops 1&2)
(By Sri. A. Lakshmi Narayana, Adv.) …… Opposite Parties
ORDER
By Sri. J.N. HAVANUR, PRESIDENT
This Complaint is filed by the Complainant against the Ops 1 to 4 u/s. 12 of the C.P. Act praying to pass an order directing the Ops to pay an amount of Rs.43,680/- + interest as per Chart produced by the OP after deducting the surrender value of Rs.14,550/- received by the Complainant already, to pay Rs.10,000/- towards deficiency of service and mental agony and to pay Rs.2,000/- towards cost of litigation. The brief facts of the Complaint can be stated as under:
On 02.12.2008, the Agent of the Ops approached the Complainant to take life insurance policy and explained various benefits under the policy and assured that after completion of three years returns will be Rs.43,680/- by showing Chart as per Annexure-1. He also told that premium will have to be paid only for 3 years and any time after 3 years policy can be surrendered with good returns. Being attracted by the benefits offered by the OP1, Complainant had taken life insurance policy bearing No. 0115273414 on 02.12.2008 by paying half yearly premium of Rs.5,000/-. The sum assured under the Policy was Rs.1,00,000/-. Complainant had paid half yearly premium for 3 years i.e., Rs.30,000/-. After completion of 3 years, Complainant enquired with OP1 about surrender value of the policy. Complainant was shocked to hear from the OP that surrender value was less than the amount paid by him. Then the Complainant questioned about this with the OP and they gave evasive answers. The surrender value was kept on reducing day by day. Hence, without any alternative, Complainant finally decided to surrender the policy to avoid further reduction in the amount as he had invested his hard earned money with the OP hoping that he could get some benefit for his future needs. Complainant has requested OP1 for surrender of the Policy and OP has paid only Rs.14,549.70 as against the amount of Rs.30,000/- paid by him. Complainant could get only about 50% of the amount what he has paid. Collecting investments from the general public by assuring good benefits and giving lesser benefits that too less than the amount invested is not fair on the part of Ops. There is negligence and unfair trade practice on the part of Ops. Hence, the Complainant has come up with the present Complaint.
2. After service of notice, Ops have appeared through their Counsels and filed objections contending inter-alia as under:
The Complaint of the Complainant is not maintainable either in law or on facts and it is liable to be dismissed in limine. All the material allegations made in the Complaint are false. Complaint is not maintainable. At the outset, the present Complaint is misconceived, misconstrued, contrary to the contract between the parties and therefore untenable in Law and deserves to be dismissed. Complaint of the Complainant is barred by limitation and the same is not maintainable. Complaint is liable to be dismissed on this ground alone. The Insurance Policy is based upon contract whereby the proposal along with the first insurance premium is received from the proposer who intends to take the insurance policy. The proposer who intends to procure insurance policy has to fill-in the material details in the proposal form and also nomination details and the same is as per Insurance Act. The insurance policy contents all the terms & conditions which are mentioned therein and these terms & conditions govern the relationship between the policy holder and the Insurance Company. The Insurance Company on receipt of proposal form, verifies the same, if the details and documents provided by the proposer fulfill the Company’s requirements, then the insurance policy will be issued. If there are ambiguities in the proposal form or if any additional details or documents are required, then the same will be informed to the proposer who has to comply with the same. The contract of Insurance is only concluded when the policy holder receives the copy of insurance policy from the Insurance Company. Thereafter, both policy holder and the Company are bound by the terms & conditions of the Insurance Policy. Complainant had availed the said policy after agreeing to the terms & conditions and as declared by him in the proposal form submitted to the OP Company for issue of the said policy. Complainant was and is well aware of the terms & conditions of the said policy. The present complaint is malicious, baseless & manufactured to suit the Complainant’s ill motives. Complainant with malafide intention has created this false & fabricated story to suit his ill motives. All the averments made in the Complaint except one which are specifically admitted are denied as false. Complainant is an educated person and can understand the terms & conditions of the proposal form and policy documents. Even assuming the Complainant relied on the statements of the agent of OP, without going through the terms & conditions of the proposal form, it is a mistake of the Complainant and Company cannot be held liable for the same. There is no mistake or negligence or there is no deficiency of service or unfair trade practice on the part of Ops. Policy issued to the Complainant was Unit Linked Policy and as per terms of the Policy and provisions of Insurance Law. In this Policy, the investment risk in investment portfolio is borne by the policy holder. Complainant had option to go through the terms of the policy bond which was issued to him on 11.12.2008 and if the same were not acceptable to him, then the Complainant was provided with option of 15 days free look period from the date of receipt of the policy as per the policy bond. The said option is also provided by the Insurance Regulator in its guidelines. However, Complainant at no point of time raised any grievance before the OP for more than 3 years. In the absence of any such steps being taken, Complainant is barred from raising any grievance. Surrender of the policy was processed in accordance with terms & conditions of the Policy agreement wherein both the parties are bound by the said agreement. Policy issued to the Complainant was Unit Linked Policy and as per terms of the Policy and provisions of Insurance Law in regard to Unit Linked Insurance Policy, risk of investment in the market under the policy has to be borne by the policy holder. As per the policy conditions, Ops are not liable to return Rs.43,680/- + interest after deducting surrender value of Rs.14,550/- and are not liable to pay Rs.10,000/- towards compensation and Rs.2,000/- towards litigation costs. Complainant is not a layman. Complainant is an educated person and he is an Advocate who is well aware of Insurance Law and his policy conditions. Complainant is not entitled for any of the relief claimed in the Complaint. Complainant has suppressed the material facts to make wrongful gain from the Ops. Hence, it is prayed to dismiss the Complaint with exemplary costs in the interest of justice.
3. So, from the averments of the Complaint of the Complainant and objection of the OP, following points arise for our consideration:
(i) Whether the Complainant proves that Ops are negligent and there is deficiency of service and unfair trade practice on the part of Ops ?
(ii) If the Point No. (i) is answered in the affirmative, what relief the Complainant is entitled to?
(iii) What Order ?
4. Our findings to the above points are:
(i) Negative
(ii) Negative
(iii) As per final order
REASONS
5. Point No. (i) - So as to prove the case, Complainant has filed his affidavit by way of evidence and produced copy of policy documents and one Xerox copy of Chart as Annexure-1. On the other hand, one Remya who being Senior Branch Manager of OP has filed her affidavit by way of evidence and produced copies of the policy holder details and policy documents. Mr. T. Nagaraj who being the Complainant has stated in his affidavit filed by way of evidence that the agent of the OP approached him on 02.12.2008 to take life insurance policy and explained the various benefits under the policy and assured that after completion of 3 years they will return Rs.43,680/- by showing the Chart and maturity amount as per Annexure-1 and they also assured him that the premium will have to be paid only for 3 years and any time after 3 years policy can be surrendered with good returns. Being attracted by the benefits offered by the OP1 as per chart, he has taken life insurance policy bearing No. 0115273414 on 02.12. 2008 by paying half yearly premium of Rs.5,000/- and sum assured under the Policy was Rs.1,00,000/-. He had paid half yearly premium upto 3 years without lapse, i.e., Rs.30,000/-. After completion of 3 years, he enquired with the OP about surrender value of the Policy. He shocked to hear from Ops that surrender value was lesser than the amount paid by him. When he questioned about this with the OP, they gave him evasive answers. Surrender value was kept on reducing day by day. So he has decided to surrender the policy to avoid further reduction in the amount as he has invested his hard earned money and he requested the OP for surrender of the Policy and OP has paid only Rs.14,545.70 as against the amount of Rs.30,000/- paid. Collecting the investments from the public by assuring good benefits and giving lesser benefits is not fair on the part of OP. There is clear negligence and unfair trade practice on the part of Ops. So he has filed the Complaint and prayed to allow the Complaint and pass orders as prayed for.
6. By careful reading of the averments of the complaint and evidence of the Complainant as mentioned supra, it is made crystal clear that the Complainant has tendered evidence in conformity with the averments of the complaint. Let us have a look at the relevant documents of the Complainant so as to know whether the oral testimony of the Complainant stands supported by any documentary evidence or not. Complainant has produced copies of the policy documents. In the copies of the policy documents, we have found one letter of OP dtd. 11.12.2008 addressed to Complainant stating that Policy No. 0115273414 was issued in the name of the Complainant on the basis of the proposal form given by the Complainant and on the back page of the said letter in the last paragraph it is stated by the OP informing the Complainant that the Complainant has free look period of 15 days from the date of receipt of the policy documents to return the policy if he disagrees to any terms & conditions and any application for free look cancellation made after lapse of 15 days shall not be entertained. Policy schedule is filed in the policy documents and the said policy was issued in the name of the Complainant and death benefit is also covered upto Rs.1,00,000/- and regular premium is of Rs.5,000/- half yearly and term of the policy is 10 years. Complainant has agreed to the terms & conditions of the Policy and taken the said policy of OP. The copy of the proposal form duly filled-in and signed by the Complainant is also found in the policy documents. One letter of OP dtd. 18.06.2012 is found in the policy documents and as per the said letter it is transpired that the surrender value of the policy of the Complainant is Rs.14,549.70 as per their calculation. Complainant has produced one Chart as Annexure-1, but that copy of the Chart is neither signed by the officials of the Ops nor the seal of the Ops. So, in the absence of having seal and signature of the officials of the OP, the said Chart produced by the Complainant at Annexure-1 is unworthy of acceptance and on the basis of the said Chart Complainant is not entitled to claim surrender value of Rs.43,680/- for the premium amount paid. This is all about material evidence of the Complainant.
7. Let us have cursory glance at the material evidence of OP. One Ms. Remya who being a Senior Branch Manager of OP has deposed in her affidavit that the present Complaint is misconceived and it is liable to be dismissed. Complaint is barred by limitation. The insurance policy is based upon the contract between the parties. Proposer who intends to procure the policy has to fill-in material details in the prescribed proforma and nomination details. Insurance policy contains all the terms & conditions. The Insurance Company on receipt of proposal form verifies the same. The contract of insurance is only concluded when the policy holder receives copy of issued insurance policy from the Insurance Company. Both the policy holder and Company are bound by the terms & conditions of the Insurance Policy. Complainant has availed the policy in question after agreeing to the terms & conditions. The averments of the Complaint that the agent of the OP approached the Complainant and explained the various benefits under the policy and assured that after completion of 3 years return will be Rs.43,680/- by showing Chart as per Annexure-1 is hereby denied as false and baseless. The Complainant after understanding the explanation and after accepting the amount he is entitled to decide surrender of the policy in question and accordingly requested the OP to pay the surrender amount. Accordingly, after making deduction as per terms of the policy OP made calculation and a sum of Rs.14,549.70 has been sent to the Complainant. OP has acted as per terms & conditions of the Policy. There is no unfair trade practice on the part of the OP. Ops are not liable to pay any amount as prayed in the Complaint. Complainant is not entitled to any relief. He has suppressed the material facts to make wrongful gain from the Ops, so Complaint be dismissed. OP has produced one letter dtd. 18.06.2012 issued by the OP addressed to the Complainant informing the surrender value of the policy i.e., Rs.14,549.70. Documents No. 2 of the OP is the surrender request form given by the Complainant dtd. 18.06.2012 duly signed by the Complainant. After submitting the surrender request form and receiving the amount of Rs.14,549.70 from OP1, Complainant has come up with the present Complaint making allegations of negligence and unfair trade practice and deficiency of service on the part of OPs. Copis of the policy documents were also produced by the OP. On making careful scrutiny of the oral & documentary evidence of both the parties, it is made unambiguously clear that the Complainant has taken life insurance policy from OP by filling-up and signing the proposal and paid Rs.5,000/- half yearly premium for a period of 3 years and submitted the application to the Ops to surrender the policy on 18.06.2012 and accordingly Ops have calculated the amount and paid Rs.14,549.70 to the Complainant being surrender value of the policy bearing No. 0115273414. After receiving the amount, Complainant has come to the Forum with present complaint on 17.08.2012 praying to pass an order directing the OPs to pay Rs.43,680/- as per the Chart given by OP and interest after deducting Rs.14,550/- received by him and to pay Rs.10,000/- towards deficiency of service and mental agony and costs of litigation. We do not understand how the Complainant has relied on the alleged Chart produced at Annexure-1 since the alleged chart produced by the Complainant is neither signed by any of the officials of the OP nor having seal of the OP office. So, claim of the Complainant basing on the said alleged Chart cannot be accepted. Whatever calculation made by the Complainant on the basis of the alleged Chart with regard to surrender value of the policy is based on the presumption or assumption. The evidence of the Complainant that he is entitled to surrender value of Rs.43,680/- from the OP is not countenanced by any documentary evidence. The material evidence in this regard is lacking in its credibility. Complainant who comes to the Forum seeking relief has failed to establish with convincing material evidence that Ops are negligence and there is unfair trade practice and deficiency of service on the part of OP. On the other hand, Ops have shown before the Forum with material evidence that they have accepted the proposal form of the Complainant signed by the Complainant and issued the policy bearing No. 0115273414 and the date of commencement of the policy is 09.12.2008 and death benefit is also covered for Rs.1,00,000/-, premium payable is Rs.5,000/- half yearly and policy is for a period of 10 years. After payment of premium for a period of 3 years, Complainant has submitted application for getting surrender value and accordingly Ops have made calculation as per the terms & conditions of the policy and paid an amount of Rs.14,549.70 and after receiving the said amount Complainant has come up with the present complaint. Looking to the policy documents and also terms & conditions of the Policy and evidence of the OP, it is vivid & clear that the Ops have acted strictly in accordance with terms & conditions of the policy and there is no unfair trade practice and deficiency of service, as such on the part of the Ops and thereby we are of the view that the oral & documentary evidence of the Ops are more believable, trustworthy and acted upon than the material evidence of the Complainant. Accordingly, we are inclined to come to straight conclusion that the Complainant who knocks the door of the Forum seeking relief has failed to prove his case by placing clear & tangible evidence. So, we answer this point in the negative.
8. Point No. (ii) - In view of the negative finding on Point No. (i), Complainant is not entitled for any relief as prayed in the Complaint. For the foregoing reasons, we proceed to pass the following order:
ORDER
Complaint of the Complainant is hereby dismissed. So, under the circumstances, parties to bear their own costs.
Supply free copy of the Order to both the parties.
(Dictated to the Stenographer, got it transcribed and corrected and pronounced in the open Forum on this the 2nd day of March 2013)
H.M. SHIVALINGAPPA J.N. HAVANUR
Member President
