Order No.  12  dt.  31/08/2018

            The case of the complainant in brief is that the complainant was asked by the agent of o.p. insurance company to pay the premium of Rs.12,267/- along with blank signed proposal form which the complainant duly paid. The complainant was not informed regarding the terms and conditions of the policy. The complainant, thereafter, received the original policy document being policy no.004964803 in the last week of July, 2011. The complainant was informed at the time of opening the policy that if the premium is paid for 3 years and after 3 years the complainant can withdraw the amount. The complainant, thereafter, visited the office of o.p. insurance company and came to learn that he will be entitled to get Rs.14,000/- as surrender value  and he was again informed by o.ps. that if he pays the premium of 5 years he can get back the entire premium amount. Since the complainant had the financial stringency at the relevant point of time he wanted to surrender the policy and asked for refund of the amount deposited by him to the tune of Rs.61,462.35 along with interest. The o.ps. did not take any step for which the complainant filed this case praying for direction upon the o.ps. for refund of the amount paid by the complainant to the tune of Rs.61,462.35 as well as compensation and litigation cost.

                The o.ps. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the name of Birla Sunlife Insurance Co. Ltd. has been changed to Aditya Birla Sunlife Insurance Co. Ltd. In the w/v it was categorically stated that the complainant had filed the proposal form duly filled and signed along with the benefit illustration and all necessary supporting documents for a BSLI Vision Plan – GSB Pay 15 vide application no.A42375030 and on receipt of the proposal form the same was processed. The complainant after understanding the terms and conditions of the policy has signed on the proposal form with his free will and consent. The policy document containing the policy no.004964803 was dispatched to the complainant on 11.7.11. The complainant did not raise any objection regarding the terms and conditions of the policy within the free look period. The complainant came to surrender the policy in Dec. 2013 i.e. after completion of 2 policy years. As per the policy terms and conditions which is in the consonance with the IRDA guidelines the lock in period is 3 years before which the policy cannot be surrendered.  After completion of 3 years the surrender value provided the life insurance attained age is 18 years or older. The guaranteed surrender value is 30% of the premium paid to that date excluding the 1^st premium and the premium paid towards underwriting extras and any attached riders. The policy has acquired a special surrender value as it has completed 5 policy years and as per the terms of the policy the cash surrender value will be paid to the complainant subject to production of some documents viz. surrender form, policy document, ID and address proofs, cancelled cheques. The complainant on 2.11.15 submitted a customer retention form wherein he requested to continue the policy. As per the terms of the policy o.ps. wanted to pay the amount, but the complainant by making false allegations against the o.ps. filed this case. On the basis of the said fact o.ps. prayed for dismissal of the case.

                On the basis of the pleadings of parties the following points are to be decided:

1. Whether the complainant had the policy with o.ps.?
2. Whether the complainant failed to pay the premium as per the terms of the policy?
3. Whether o.ps. wanted to pay the surrender value to the complainant as per the terms of the policy?
4. Whether there was any deficiency in service on the part of o.ps.?
5. Whether the complainant will be entitled to get the relief as prayed for?

Decision with reasons:

                All the points are taken up together for the sake of brevity and avoidance of repetition of facts.

                Ld. lawyer for the complainant argued that the complainant was asked by the agent of o.p. insurance company to pay the premium of Rs.12,267/- along with blank signed proposal form which the complainant duly paid. The complainant was not informed regarding the terms and conditions of the policy. The complainant, thereafter, received the original policy document being policy no.004964803 in the last week of July, 2011. The complainant was informed at the time of opening the policy that if the premium is paid for 3 years and after 3 years the complainant can withdraw the amount. The complainant, thereafter, visited the office of o.p. insurance company and came to learn that he will be entitled to get Rs.14,000/- as surrender value  and he was again informed by o.ps. that if he pays the premium of 5 years he can get back the entire premium amount. Since the complainant had the financial stringency at the relevant point of time he wanted to surrender the policy and asked for refund of the amount deposited by him to the tune of Rs.61,462.35 along with interest. The o.ps. did not take any step for which the complainant filed this case praying for direction upon the o.ps. for refund of the amount paid by the complainant to the tune of Rs.61,462.35 as well as compensation and litigation cost.

                Ld. lawyer for the o.ps. argued that the name of Birla Sunlife Insurance Co. Ltd. has been changed to Aditya Birla Sunlife Insurance Co. Ltd. In the w/v it was categorically stated that the complainant had filed the proposal form duly filled and signed along with the benefit illustration and all necessary supporting documents for a BSLI Vision Plan – GSB Pay 15 vide application no.A42375030 and on receipt of the proposal form the same was processed. The complainant after understanding the terms and conditions of the policy has signed on the proposal form with his free will and consent. The policy document containing the policy no.004964803 was dispatched to the complainant on 11.7.11. The complainant did not raise any objection regarding the terms and conditions of the policy within the free look period. The complainant came to surrender the policy in Dec. 2013 i.e. after completion of 2 policy years. As per the policy terms and conditions which is in the consonance with the IRDA guidelines the lock in period is 3 years before which the policy cannot be surrendered.  After completion of 3 years the surrender value provided the life insurance attained age is 18 years or older. The guaranteed surrender value is 30% of the premium paid to that date excluding the 1^st premium and the premium paid towards underwriting extras and any attached riders. The policy has acquired a special surrender value as it has completed 5 policy years and as per the terms of the policy the cash surrender value will be paid to the complainant subject to production of some documents viz. surrender form, policy document, ID and address proofs, cancelled cheques. The complainant on 2.11.15 submitted a customer retention form wherein he requested to continue the policy. As per the terms of the policy o.ps. wanted to pay the amount, but the complainant by making false allegations against the o.ps. filed this case. On the basis of the said fact o.ps. prayed for dismissal of the case.

                Considering the submissions of the respective parties it is an admitted fact that the complainant had the policy with o.ps. During the argument ld. lawyer for the complainant stated that in the policy document there was no mention of the pay term of the policy, but on perusal of the policy it appears that the policy no.004964803 was issued on 30.6.11 and the pay term was for 15 years and the annual premium in the said policy was of Rs.12,474.79 and the mode of premium was annual and the sum assured was of Rs.1,60,530/-. The complainant continued the policy for 5 years and he wanted to surrender the policy. Though in the petition of complaint the complainant made allegations against the agent of o.ps. that he was not informed regarding the terms and conditions of the policy, but the complainant after receiving the policy document did not pray for cancellation of the policy within the free look period as per the IRDA guidelines. Therefore, the question of misguiding the complainant at the time of opening the policy is ruled out. It is pertinent to mention here that the complainant paid the policy premium for 3 years and he wanted to surrender the policy and thereafter, coming to know of the surrender value he continued the policy for 2 more years. It is also pertinent to mention here that the complainant failed to pay the premium within the stipulated period and on his prayer he had to pay the penalty and the prayer of the complainant was accepted and the premium was received by o.ps. Since the complainant failed to continue the policy and after the lapse of 5 years he wanted to surrender the policy and has claimed the premium amount paid by him for the last 5 years. But since the sum assured was of Rs.1,60,530/- and if there would have been any unfortunate event the insurance company would have to pay the sum assured in spite of payment of the premium of the lesser amount by the complainant. In this respect ld. lawyer for o.ps. relied on some judgments as decided by Hon’ble Supreme Court in Vikram Greentech (I) Ltd. vs.  New India Assurance Co. Ltd. and also United India Insurance Co. Ltd. vs. M/s Harchand Rai Chandan Lal. On the basis of those judgments cited by Hon’ble Supreme Court we hold that once the policy has been opened the terms and conditions of the policy are binding upon the parties to the said policy. In the policy document itself it was categorically mentioned what will be the surrender value and o.ps. wanted to pay the surrender value on furnishing the documents as sought for by o.ps. to ensure the payment of the amount to the complainant. On perusal of the documents and materials on record we hold that that amount wanted to be paid by o.ps. was rightly settled as per the terms and conditions of the policy. Having regard to the facts and circumstances as stated above, we hold that o.ps. did not commit any deficiency in service on their part and as such, the complainant will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.

                Hence, ordered,

                That the CC No.318/2017 is dismissed on contest without cost against the o.ps.