Haryana

Kaithal

199/19

Satpal - Complainant(s)

Versus

Aditya Birla Sun Life Insurance Co. - Opp.Party(s)

Sh.Munish Sikri

07 Apr 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.199/2019.

                                                     Date of institution: 11.07.2019.

                                                     Date of decision:07.04.2023.

Satpal S/o Sh. Mohan Lal r/o H.No.854/13, Kamal Colony, Kaithal.

                                                                        …Complainant.

                        Versus

1. Aditya Birla Sun Life Insurance Company Ltd., Regd. Office, 6^th floor Vaman Centre, Makhwana Road, Off Andheri Kurla Road, near Marol Naka, Andheri (E), Mumbai-400059 through its Regional Manager.
2. Aditya Birla Sun Life Insurance Company Ltd., Kalka Branch 697 ZL Kalka Shimla Highway No.22, Kalka through its Managing Director.
3. Aditya Birla Sun Life Insurance Company Ltd., Kaithal Branch through its Branch Manager, Kurukshetra Road, Kaithal.

….Respondents.

        Complaint under Section 12 of the Consumer Protection Act

CORAM:     SMT. NEELAM KASHYAP, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. SUNIL MOHAN TRIKHA, MEMBER.

       

Present:     Sh. Munish Sikri, Advocate, for the complainant.   

                Sh. Sudeep Malik, Advocate for the OPs No.1 & 2.

                OP No.3 exparte.

               

ORDER

NEELAM KASHYAP, PRESIDENT

        Satpal-Complainant has filed this complaint under Section 12 of Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the respondents.

                In nutshell, the facts of present case are that the complainant was insured with the OPs vide policy No.006905274 dt. 14.01.2016 for a sum of Rs.16,00,000/- with the terms the actual annual premium of above-said policy of Rs.1,20,636/-.  After taking the same insurance policy, the complainant has deposited the three installments i.e. Rs.1,25,010/- on 25.01.20216 under the receipt dt. 14.10.2016.  After that deposited a sum of Rs.1,22,900/- on 21.03.2017 and after that a sum of Rs.1,23,351.26 paise on 05.03.2018.  It is further alleged that after deposited the same, the complainant came to know that the detail of the life insured namely Meenakshi has been wrongly entered and the same was asking by the complainant to OPs but the OPs did not rectify the mistake.  The complainant requested the OPs to refund the amount which was deposited by the complainant with the OPs but the OPs did not redress the grievances of complainant.  So, it is a clear cut case of deficiency in service on the part of respondents and prayed for acceptance of complaint.     

2.          Upon notice, the OPs No.1 & 2 appeared before this Commission, whereas OP No.3 did not appear and opted to proceed against exparte vide order dt. 26.08.2019 of this Commission.  OPs No.1 & 2 contested the complaint by filing their written version raising preliminary objections that the proposal was accepted on the standard rates based on the information provided by the LA and consequently, policy bearing No.006905274 dt. 14.01.2016 was issued and the policy documents were received by the complainant on 27.01.2016; that the complainant has not come to this Commission with clean hands as the policy documents delivered to the LA provided him a period of 15 days within which the LA could have returned the policy to the OPs by stating the reason thereof.  There is nothing on record that this document was not received by the complainant from the OPs.  The complainant vide letter dt. 11.01.2019 requested for the change of date of birth of the life insured Smt. Meenakshi.  The said letter dt. 11.01.2019 was duly replied by the company vide reply dty. 19.02.2019 wherein then complainant was requested to visit the nearest branch of the OPs and to submit the required documents as detailed in the letter dt. 19.02.2019 for the change in the date of birth of the life insured Smt. Meenakshi.  However, it is pertinent to mention here that the complainant did not submit any required documents.  It is very pertinent to mention here that the complainant had opted for the annual premium paying mode for a pay term of 18 years and the complainant has paid only three premiums amounting to Rs.3,71,260.22 paise and thereafter, the complainant had not paid/failed to pay the premiums, on account of which the said policy got lapsed on 14.01.2019.  There is no deficiency in service on the part of respondents.  On merits, the objections raised in the preliminary objections are rebutted and so, prayed for dismissal of complaint.

3.             To prove his case, the complainant tendered into evidence affidavit Ex.CW1/A alongwith documents Annexure-C1 to Annexure-C11 and thereafter, closed the evidence.

4.             On the other hand, the respondents No.1 & 2 tendered into evidence affidavit Ex.RW1/A alongwith documents Annexure-R1 to Annexure-R6 and thereafter, closed the evidence.

5.             We have heard the learned Counsel for both the parties and perused the record carefully.

6.             Ld. counsel for the complainant has argued that the complainant was insured with the OPs vide policy No.006905274 dt. 14.01.2016 for a sum of Rs.16,00,000/- with the terms the actual annual premium of above-said policy of Rs.1,20,636/-.  After taking the same insurance policy, the complainant has deposited the three installments i.e. Rs.1,25,010/- on 25.01.20216 under the receipt dt. 14.10.2016.  After that deposited a sum of Rs.1,22,900/- on 21.03.2017 and after that a sum of Rs.1,23,351.26 paise on 05.03.2018.  It is further argued that after deposited the same, the complainant came to know that the detail of the life insured namely Meenakshi has been wrongly entered and the same was asking by the complainant to OPs but the OPs did not rectify the mistake.  It has been further argued that the policy was lapsed by the OPs without giving any notice to the complainant.  There is deficiency in service on the part of OPs and so, prayed for refund of deposited instsallments.  Ld. counsel for the complainant has placed reliance upon the case law titled as Bajaj Allianz Life Insurance Co. Ltd. Vs. Minati Mohaapatra, bearing Civil Appeal No.8140 of 2019, date of decision: 18.10.2019 decided by Hon’ble Supreme Court.

7.             On the other hand, ld. counsel for the OPs No.1 & 2 has argued that the proposal was accepted on the standard rates based on the information provided by the LA and consequently, policy bearing No.006905274 dt. 14.01.2016 was issued and the policy documents were received by the complainant on 27.01.2016.  It has been argued that the complainant has not come to this Commission with clean hands as the policy documents delivered to the LA provided him a period of 15 days within which the LA could have returned the policy to the OPs by stating the reason thereof.  There is nothing on record that this document was not received by the complainant from the OPs.  The complainant vide letter dt. 11.01.2019 requested for the change of date of birth of the life insured Smt. Meenakshi.  The said letter dt. 11.01.2019 was duly replied by the company vide reply dt. 19.02.2019 wherein then complainant was requested to visit the nearest branch of the OPs and to submit the required documents as detailed in the letter dt. 19.02.2019 for the change in the date of birth of the life insured Smt. Meenakshi.  However, it is pertinent to mention here that the complainant did not submit any required documents.  It is very pertinent to mention here that the complainant had opted for the annual premium paying mode for a pay term of 18 years and the complainant has paid only three premiums amounting to Rs.3,71,260.22 paise and thereafter, the complainant had not paid/failed to pay the premiums, on account of which the said policy got lapsed on 14.01.2019.  There is no deficiency in service on the part of OPs No.1 & 2.  Ld. counsel for the OPs No.1 & 2 has placed reliance upon the case law titled as Grasim Industries Ltd. & another Vs. Agarwal Steel bearing Civil Appeal No.5994 of 2004, date of decision: 20.10.2009 reported in 2010(1) SCC 83.

8.             We have perused all the record available on the file.  It is clear that the complainant had deposited the three installments i.e. Rs.1,25,010/- on 25.01.2016, Rs.1,22,900/- on 21.03.2017 and Rs.1,23,351.26 paise on 05.03.2018, receipts of which Annexure-C1 to Annexure-C3 are placed on file.  The grievance of the complainant is that the wrong policy was issued by the OPs as date of birth of his wife namely Meenakshi being nominee in the policy was wrongly entered and in this regard, he had requested the OPs to change the date of birth of his wife as per letter dt. 11.01.2019, Annexure-C4.  The OPs did not redress the grievances of complainant.  The other grievance of the complainant is that the policy in question was purchased by the complainant on 14.01.2016.  The due date of the said policy was on 14.01.2019 and the said policy was lapsed by the OPs on the same day without giving any notice to the complainant.  We have perused the terms and conditions of the policy in question as per Annexure-C11, wherein at page No.8, the relevant portion regarding premium discontinuance is mentioned as under:-

        “Premium Discontinuance:

        If you are unable to pay the installment premium by the due date, you will be given a grace period of 30 days during which time all benefits under the policy will continue.

1. Until 3 full years installment premiums are paid:

If we do not receive the entire installment premium by the end of the grace period, this policy will be deemed lapsed and all benefits will cease immediately.The lapse date is the date the first unpaid premium was due.You will be given a period of two years from the lapse date to reinstate your policy.

2. Once 3 full years installment premiums have been paid:

If we do not receive the entire installment premiums by the end of grace period, this policy will be deemed paid-up and benefits will continue as per the Policy Paid-Up provision.The paid-up date is the date the first unpaid premium was due.You will be given a period of two years from the paid-up date to reinstate the policy for its full benefits.

To reinstate the policy, you must pay all unpaid installment premiums due till date plus interest thereon.  We will charge the interest for policy reinstatement at a rate declared by us determined as (x+2%) 12 rounded to the nearest 0.5%, where x is the base rate of the State Bank of India.  The revival will be effected on receipt of the evidence of insurability satisfactory to us with respect to the life insured.  We may call for additional information/documents to process the revival request.  We reserve the right not to revive the policy on original terms based on the underwriting decision.  The effective date of reinstatement is when these requirements are met and approved by us, at our sole discretion.”

It is clear from the record that in the case in hand, grace period of one month was not given to the complainant and the policy in question was lapsed by the OPs on the due date as mentioned above.  So, we are of the considered view that there is deficiency in service on the part of Ops.  The authority submitted by ld. counsel for the OPs is not disputed but the same is not applicable to the facts of instant case. 

9.             Thus, as a sequel of aforesaid discussion, we direct the OPs jointly and severally to pay the amount of Rs.3,71,260.22 paise to the complainant within 45 days from today and further to pay to pay Rs.5,000/- as compensation on account of physical harassment and mental agony as-well-as Rs.5,000/- as litigation charges to the complainant.  However, it is made clear that if the OPs are failed to make the payment of Rs.3,71,260.22 paise within stipulated period, then they are liable to pay the interest @ 7% p.a. from the date of this order till its realization.  Hence, the present complaint is accepted accordingly.         

10.            In default of compliance of this order, proceedings against respondents-OPs shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both.  A copy of this order be sent to both the parties free of cost.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:07.04.2023.

                                                                (Neelam Kashyap)

                                                                President.

 

(Sunil Mohan Trikha),           (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.