Haryana

Karnal

CC/423/2021

Vikram Singh - Complainant(s)

Versus

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

Naveen Kherarpal

19 Feb 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                      Complaint No.423 of 2021

                                                      Date of instt.21.08.2021

                                                      Date of Decision:20.02.2024

 

Vikram Singh son of age 40 years, resident of house no.F-102, Palm Residency, Sector-35, Karnal-132001.

                                               …….Complainant.

                                              Versus

 

1. Aditya Birla Sun Life Insurance Company Limited Registered office at-One World Center Tower-1, 16^th floor, Jupiter Mill Compound, 841 Senapati Bapat Marg Elphinestone Road, Mumbai-400013 through its Manager/authorized Person.

 

2. HDFC Bank Limited at Assandh Karnal Road Nr. LIC office Assandh District-Karnal through its Branch Manager.

 

3. Aditya Birla Sun life Insurance Company Limited Branch office at-SCO-138 2^nd floor Sector-13, Karnal-132001 through its Manager.

                                                                        …..Opposite Parties.

               

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Shri Jaswant Singh……President.

              Shri Vineet Kaushik…….Member

              Dr. Suman Singh…….Member

       

Argued by:   Shri Dheeraj Sachdeva, counsel for the complainant.

                     Shri Lalit Chopra, counsel for the OPs no.1 and 3.

                     Shri Vineet Rathore, counsel for the OP no.2.

 

                    (Jaswant Singh, President)

ORDER:                     

      

                 The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that the complainant is consumer of HDFC Bank, vide saving account and the representative of OP no.2 being agent of OP no.1 approached to the complainant and allured to the complainant for the investment/insurance policy of OP no.1. OP no.2 told to complainant that there is an insurance plan of OP no.1 and is every beneficiary for complainant in terms of monetary benefits and also told the details of the said insurance policy. The complainant had to pay the premium of Rs.1,00,000/- for 5 years and after five years i.e. from sixth year onwards, the insurance company will return the policy benefits yearly and at the end of 12^th year a huge amount of approximate ten lakhs will be given by the insurance company as total policy amount and the sum assured is of Rs.15,00,000/-. Under the influence of OP no.2, the complainant purchased the insurance policy from OP no.1 through OP no.2, vide policy no.007605894. The premium of the said policy was of Rs.1,04,500/- and the policy start date was 31.07.2018. At the time of policy in the year 2018, complainant was working at Dhingra Trucking Pvt. Ltd. and he shifted to a new job at M.G. Motors Dealer of Tata and was drawing a handsome salary. The complainant had paid two annual installments of the policy for the year 2018 and 2019. The complainant was working with M.G. Motors and on 22.03.2020, the prime Minister of India announced complete lockdown in the whole country due to Covid-19 outbreak all over the world, which is still persisting and all the business/works of the general public were stopped due to complete lockdown in the country, many employees in many companies have lost their jobs due to lockdown and complainant was one of them and left  his job in the month of May, 2020. Due to said situation, complainant was unable to pay the annual installment of the insurance policy.

2.             It is further averred that complainant requested the OPs to provide a moratorium benefits as announced by the Reserve Bank of India but Ops did not bother to genuine request of complainant and remained adamant to get the insurance premium and also agent of OP no.1 threatened the complainant in case the premium has not been deposited, the policy would be cancelled. Thereafter, complainant requested to the OPs to change the mode and amount for the payment of policy premium but the OPs only adjusted the mode of payment and refuse to decrease the amount of premium policy. After that complainant requested the OP to close the policy and to pay the premium paid amount, upon which OPs told the complainant that the policy given by the company is a traditional plan wherein the complainant has to pay six premium of Rs.1,04,500/- and the benefits would be given only after 12 years from the date of policy. Complainant made a complaint to the customer care of OP no.1 stating about the mis-representation by the agent of OP no.1 and the complainant also demanded the terms and conditions from the OP no.1 as the same has never be provided to the complainant but OPs refused to do so. Now complainant came to know that the OPs are trying to terminate the insurance policy arbitrarily and there is no opportunity has been ever granted or communicated to complainant. Complainant requested to the OPs to either to return the installments amount or reschedule the installments of policy or to decrease the installment amount so as the complainant would be able to continue with the lesser amount of installments but the OPs are adamant not to reschedule the insurance policy to lesser amount installments and threatening to complainant that they will terminate the policy and no amount would be returned to the complainant in lieu of the two installments of policy paid by the complainant. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

3.             On notice, OPs no.1 and 3 appeared and filed their written version raising preliminary objections with regard to maintainability; cause of action; locus standi and concealment of true and material facts. On merits, it is pleaded that complainant had submitted an online application form dated 13.07.2018 for the purchase of “BSLI Guaranteed Milestone Plan”. The proposal was accepted on the standard rates based on the information provided by the complainant and consequently a policy was issued on 31.07.2018 bearing policy no.007605894 originally commencing from 31.07.2018. The sum assured in the policy was Rs.15,00,000/- and the premium of the policy was Rs.1,04,500/- per annum. The policy term was of 12 years and the premium paying term is 6 years. Since the policy opted by the complainant was an e-policy, therefore, the proposal/application was processed only after confirmation from complainant through an OTP on his mobile phone. The supervisor Shri Rahul Rana signed the online Addendum-Supervisory declaration Form which further depicts that the complainant was made aware of the terms and conditions of the policy. On the basis of the information furnished in the application form, the same was processed by the OPs and thereafter the said certificate of insurance alongwith the terms and conditions were issued to the complainant.  It is further pleaded that OPs have only received two installments in the abovesaid insurance policy. Rs.1,04,500/- was received on 31.07.2018 and Rs.1,02,250/- on 31.07.2019, a total sum of Rs.2,06,750/- was received. However, no amount has been received against the third premium payment of the insurance policy. The complainant only after understanding the terms and conditions paid premium of the said insurance for two consecutive years and now complainant cannot be allowed to wriggle out of the terms and conditions of the policy. Since the complainant has paid two premiums of the policy and premium paying terms is less than 10 years therefore, the complainant has an option to surrender his policy before the lock in period then he will be paid around Rs.1,25,000/- (approximately) as on today after deduction of surrender charges as per the terms and conditions of the policy. It is further pleaded that every policy document sent by the insurance company is accompanied by forwarding a letter. It has been clearly mentioned in the said letter that in case, if the policyholder is not satisfied with the features/the terms and conditions of the policy then policyholder can withdraw/return the policy within 15days of the receipt of the policy documents i.e. under “Freelook Period” provision. In the present complaint, complainant did not approach with the OPs within freelook period.  It is further pleaded that the moratorium benefits announced by the Reserve Bank of India were only applicable on Banks and Financial Institution not on the insurance Company or their premium payments. There is no deficiency in service and unfair trade practice on the part of the OPs no.1 and 3. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

 4.            OP no.2 appeared and filed its written version raising preliminary objections with regard to maintainability and cause of action. On merits, it is pleaded that complaint is unwarranted and against the basic principles of the doctrine of utmost good faith. The complainant is having account no.01871000141804 since 11.08.2007 with OP, which he opened from his own free will and consent by admiring and appreciation the world class service delivered to its customer by OP. Complainant opted to purchase insurance policy floated by remaining OPs herein after comparing the other policies in the market. The complainant purchased the policy in question which best suited to his needs and as per his requirements.  OP is nothing to do with the decision of complainant for purchase of the policy in question and the terms and conditions of the policy contract. There is no privity of contract in between the complainant and OP in regard to policy contract. There is no deficiency in service and unfair trade practice on the part of the OPs no.1 and 3. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint qua OP no.2.

5.             Parties then led their respective evidence.

6.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of premium details Ex.C1, copy of demand letter Ex.C2, copy of email conversation Ex.C3 and closed the evidence on 07.11.2022 by suffering separate statement.

7.             Learned counsel for the OPs no.1 and 3 has tendered into evidence affidavit Ex.OP1-3/A, power of attorney Ex.OP1-3/1, copy of application form Ex.OP1-3/2, copy of insurance policy Ex.OP1-3/3, copy of premium paid certificate Ex.OP1-3/4 and closed the evidence on 21.02.2023 by suffering separate statement.

8.             Learned counsel for the OP no.2 has tendered into evidence affidavit of Mukesh Kalyan working Manager Ex.OP2/A, copy of statement of account Ex.OP2 and closed the evidence on 01.08.2023 by suffering separate statement.

9.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

10.           Learned counsel for complainant, while reiterating the contents of complaint, has vehemently argued that on 31.07.2018, complainant purchased “BSLI Guaranteed Milestone Plan” from OPs. The premium of the said policy was of Rs.1,04,500/-. The complainant had paid two annual installments of the policy for the year 2018 and 2019. Due to covid-19 complainant could not paid next installments and requested to the OPs either to return the deposited installments amount or reschedule the installments of policy, but the OPs are adamant not to reschedule the insurance policy and terminated the policy without any cogent reason and no amount has been refunded  to the complainant in lieu of the two installments of policy paid by the complainant and lastly prayed for allowing the complaint.

11.           Per contra, learned counsel for the OPs no.1 and 3 while reiterating the contents of written statement, complainant purchased  “BSLI Guaranteed Milestone Plan” from the OPs. The sum assured in the policy was Rs.15,00,000/- and the premium of the policy was Rs.1,04,500/- per annum. The policy term was of 12 years and the premium paying term was 6 years. Complainant has paid only two installments in the abovesaid insurance policy. Since the complainant has paid two premiums of the policy and premium paying terms is less than 10 years therefore, the complainant has an option to surrender his policy before the freelook period then he will be paid around Rs.1,25,000/- (approximately) as on today after deduction of surrender charges as per the terms and conditions of the policy but complainant neither deposited the remaining installments nor applied for surrender the policy. Thus, the complaint is not entitled for any relief and lastly prayed for dismissal of the complaint.

12.           Learned counsel for the OP no.2, while reiterating the contents of written version, has vehemently argued that the complainant is having account with OP. The complainant purchased the policy in question own his free will. OP is nothing to do with the decision of complainant for purchase of the policy in question. There is no privity of contract in between the complainant and OP in regard to policy contract and prayed for dismissal of the complaint qua OP no.2.

13.           We have duly considered the rival contentions of the parties.

14.           Admittedly, on 31.07.2018, the complainant purchased “BSLI Guaranteed Milestone Plan” having policy term 12 years and premium paying term is 6 years. It is also admitted that the sum insured under the policy was Rs.15,00,000/-.  The premium of the policy in question was of Rs. 1,04,500/- per annum and complainant has deposited only two installments with the OPs. It is also admitted that complainant has not applied for surrender the policy in question.

15.           The complainant has paid two annual installments for the year 2018 and 2019 and thereafter no premium was paid by the complainant. The complainant has alleged that due to complete lockdown in the whole country due to covid-19 complainant has lost his job and could not deposit the remaining premium. The complainant further alleged that he requested the OPs to provide a moratorium benefits and change the mode and amount for the payment of policy premium. The onus to prove the his version was relied upon the complainant but he has miserably failed to prove the same by leading any cogent and convincing evidence.

 16.          As per the terms and conditions of the insurance policy Ex.OP1-3/3, complainant has an option to surrender his policy was entitled for the surrender value. Undisputedly, at the time of depositing the 3^rd premium, the covid-19 was spread in the country and complete lockdown was imposed by the Government of India, due to that complainant could not deposited the premium. As per the terms and conditions of the policy, if any, insured failed to deposit the  premium amount in that eventuality, he is entitled for the surrender value of the insurance policy. The guaranteed surrender value under the policy is reproduced as under:-

Guaranteed Surrender Value

Guaranteed Surrender Value as the sum of the percentage of premium paid (excluding loading for modal premium, applicable taxes, any applicable rider premiums and underwriting extras, if any) and the percentage of the accrued Guaranteed Additions is as shown below-

For Premium Payment Terms of 10 and 12 years.

Year of surrender	% of premium paid				% of Guaranteed Additions
Policy term Premium payment term            1.            2.            3.            4.	20	22	24	26	20	22	24	26
	10	10	12	12	10	10	12	12
	-	-	-	-	-	-	-	-
	-	-	-	-	-	-	-	-
	30%	30%	30%	30%	20%	20%	20%	20%
	53%	52%	52%	52%	23%	23%	22%	22%
5.	50%	50%	50%	50%	26%	25%	25%	24%
6.	55%	54%	54%	54%	29%	28%	27%	27%
7.	58%	57%	56%	55%	32%	31%	30%	29%
8.	60%	59%	58%	57%	35%	33%	32%	31%
9.	63%	61%	60%	59%	38%	36%	34%	33%
10.	65%	63%	62%	61%	41%	38%	37%	35%
11.	68%	66%	64%	63%	44%	41%	39%	37%
12.	70%	68%	66%	65%	46%	44%	41%	40%
13.	73%	70%	68%	66%	49%	46%	44%	42%
14.	75%	72%	70%	68%	52%	49%	46%	44%
15.	78%	74%	72%	70%	55%	52%	49%	46%
16.	80%	77%	74%	72%	58%	54%	51%	48%
17.	83%	79%	76%	74%	61%	57%	53%	50%
18.	85%	81%	78%	75%	64%	59%	56%	53%
19.	88%	83%	80%	77%	67%	62%	58%	55%
20.	90%	86%	82%	79%	70%	65%	60%	57%
21.	-	88%	84%	81%	-	67%	63%	59%
22.	-	90%	86%	83%	-	70%	65%	61%
23.	-	-	85%	-	-	-	70%	66%
24.	-	-	86%	-	-	-	-	68%
25.	-	-	88%	-	-	-	-	68%
26.	-	-	90%	-	-	-	-	70%

 

17.           Admittedly, the terms of the policy was 12 years and complainant has to pay six annual installments and he has paid only two installments. The complainant has claimed to refund the entire  amount, which was deposited in the year 2018 and 2019. Complainant himself fault for not depositing the remaining installments. Thus, the complainant is not entitled for refund the entire deposited amount but only entitled for surrender value. The OPs have also not refunded the surrender value of the policy in question for which the complainant was entitled. OPs should have to refund the surrender value of the policy but despite of refunding the surrender value of the policy, they are enjoying the hard earnest money of the complainant since the year 2018. Hence, the act of the OPs no.1 and 3 amounts to deficiency in service and unfair trade practice. Hence, complainant is entitled for surrender value of the policy alongwith interest, compensation for mental pain and agony, harassment and towards the litigation expenses.

18.           Thus, as a sequel to abovesaid discussion, we partly allow the present complaint and direct the OPs no.1 and 3 to pay the surrender value to the complainant alongwith interest @ 9% per annum from the date of deposition till its realization. We further direct the OPs no.1 and 3 to pay Rs.25,000/- to the complainant on account of mental agony and harassment and Rs.11,000/- towards the litigation expenses. The complaint qua OP no.2 stands dismissed. This order shall be complied with within 45 days from the receipt of copy of this order. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:20.02.2024                                                                                                 

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

 (Vineet Kaushik)       (Dr. Suman Singh)

                          Member                           Member