Chandigarh

DF-II

CC/777/2022

YOGESH K SHARMA - Complainant(s)

Versus

ADITYA BIRLA SUNLIFE INSURANCE COMPANY - Opp.Party(s)

23 Jan 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II,

U.T. CHANDIGARH

 

Consumer Complaint  No	:	777 of 2022
Date  of  Institution	:	15.11.2022
Date   of   Decision	:	23.01.2024

 

 

 

 

 

Col.Yogesh K.Sharma (Retd.) son of Dr.M.L.Sharma, aged 70 years, Resident of House No.452/1, Sector 44-A, Chandigarh

             …..Complainant

 

Versus

 

Aditya Birla Sun Life Insurance Company, 226-227, Sub City Center, Sector 34-A, Chandigarh

 

     ….. Opposite Party

 

 

BEFORE:      MR.AMRINDER SINGH SIDHU,  PRESIDENT

                            MR.B.M.SHARMA             MEMBER

 

Present:-       Sh.Yogesh K Sharma, Complainant in person

Ms.Shruti Sharma, Adv. proxy for Sh.Nitin Thatai, Counsel for OP

 

 

ORDER BY AMRINDER SINGH SIDHU, M.A (Eng.), LLM, PRESIDENT

 

1]       By this common order, we propose to dispose off two connected consumer complaints i.e. present consumer complaint as well as another consumer complaint No.778/2020 – Pooja Sharma Vs. Aditya Birla Sunlife Insurance Company.

2]       The facts are gathered from C.C.No.777/2022 – Yogesh K Sharma Vs. Aditya Birla Sunlife Insurance Company.

3]       The complainant has filed the present complaint pleading that the complainant purchased Policy No.004502898 from himself and Policy No.004502779 for her daughter/Pooja Sharma in the year 2010 from the OP and regularly paid three yearly premium of Rs.One Lakh each.  It is averred that after completion of 10 years period of the policy, the complainant surrender it with the OP and seek refund of Guaranteed Surrender Benefit under the policy (ann.C-1 & c-2).  It is submitted that the OP Company instead of paying the total sum of Rs.3,64,473/- being Guaranteed Surrender Amount along with accumulated Bachat Additons as per the policy, remitted an amount of Rs.2,40,748/- to the complainant which is Rs.1,23,725/- less than the guaranteed surrender amount as on 26.1.2021. The complainant agitated the matter with the OP with a request the pay the balance amount under the policy (Ann.C-5 & C-6) but they did not pay any heed.  Hence, this complaint has been filed alleging the said act of the OP as deficiency in service and unfair trade practice with a prayer to direct the OP to refund the less amount of Rs.1,23,725/- with interest as well as compensation and litigation cost.

4]       After notice of the complaint, the OP has put in appearance, filed written version and stated that the complainant on 10.11.2020 purchased Birla Sun Life Insurance Bachat (Endowment) Plan bearing Policy No.004502898 having term of 20 years with basic premium amount of Rs.8592/- with basic sum assured of Rs.5,15,520/-. It is stated that before acceptance of proposal by the OP, the contents of the proposal along with terms & conditions were read and explained to LA in the language best known to him by the concerned financial consultant.  It is stated that the complainant paid premium of Rs.1,00,000/- for three consecutive years amounting to Rs.3,01,017.49 inclusive of taxes but did not pay further premiums as result the policy was lapsed and did not revived it.  It is submitted that the complainant surrendered the policy in question on 12.1.2021 (Ann.OP-4 colly) and the OP has remitted the surrender amount of Rs.2,40,748/- in favour of the complainant as per terms & conditions of the policy and nothing is due & payable to the complainant against said policy.  It is also submitted that as per the terms & conditions of the policy, the policy would acquire a Guaranteed Surrender Benefit once the three full years installment premium have been paid.  It is denied that a sum of Rs.1,23,725/- is more payable to the complainant by the OP. Denying other allegations, the OP lastly prayed for dismissal of the complaint.

6]       Parties led evidence in support of their contentions.

7]       We have heard the complainant in person, ld.Counsel for the OP and have perused the entire record including written arguments.

8]       The issue involved in the present case first is that whether the complainant is entitled to Guaranteed Surrender Value under the policy and second is that whether OP has sold the policy(s) in question to the policyholder by mis-representing the facts about Guaranteed Surrender Value or not ? 

9]       In order to find out answer to the above mentioned interlinked issues, it is important to take into consideration the following facts and circumstances of the present complaint.

10]      The complainant has argued that the OP has mis-sold the policy to him by giving false assurances/promises about getting Guaranteed Surrender  Value in case of payment of three full years installment premiums, which he had already paid and surrendered the policy only after a period of 10 years.  However, the OP instead of refunding the whole deposited amount with accrued benefits under the policy as assured, has wrongly deducted an amount of Rs.1,23,725/- out of Rs.3,64,473/- and paid only an amount of Rs.2,40,748/-.  The OP stated that they have rightly paid the amount under the policy to the complainant after making necessary deductions.  However, it is observed that the non-releasing of the full amount with accrued benefit, if any, to the complainant under the policy under Guaranteed Surrender Benefit even after a period of 10 years, as assured at the time of issuance of the policy clearly amounts to deficiency in service and unfair trade practice.

 

11]      It is important to mention here that the consumers rights as enshrined in Section 2 of the Consumer Protection Act 2019, the consumers has right to be informed about the quality, potency, purity, standard and price of the goods, products or services as the case may be so as to protect him from unfair trade practice.

         Definition of ‘unfair trade practice’ as defined under Section 2(47) of the Consumer Protection Act 2019 states as under:

(47) "unfair trade practice" means a trade practice which, for the purpose of promoting the sale, use or supply of any goods or for the provision of any service, adopts any unfair method or unfair or deceptive practice including any of the following practices, namely:—

(i)             making any statement, whether orally or in writing or by visible representation including by means of electronic record, which—

(a) to (c)   xxxxxx

(d)            represents that the goods or services have sponsorship, approval, performance, characteristics, accessories, uses or benefits which such goods or services do not have;

 

12]         In the present case, the agent of the OP has mis-sold the policy to the complainant by misrepresentation of its benefits which such policy does not have. So it is a clear-cut case of unfair trade practice conducted by the representative of the OP to make a wrongful loss to the complainant and wrongful gains to the OP. Hence, the OP is liable to refund the balance deducted amount along with interest and compensation.

            In similar set of facts the Hon’ble Punjab & Haryana High Court in the case titled as New India Assurance Company Limited Vs. Smt.Usha Yadav & Others 2008(3) RCR (Civil) Page 111 went on to hold as under:-

“It seems that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. All conditions which generally are hidden, need to be simplified so that these are easily understood by a person at the time of buying any policy. The Insurance Companies in such cases rely upon clauses of the agreement, which a person is generally made to sign on dotted lines at the time of obtaining policy. Insurance Company also directed to pay costs of Rs.5000/- for luxury litigation, being rich”.

13]      It is usual with the insurance company to show all types of green pastures to the customer at the time of selling insurance policies, and when it comes to payment of the insurance claim, they invent all sort of excuses to deny the claim. In the facts of this case, ratio of the decision of Hon’ble Apex Court in case of Dharmendra Goel Vs. Oriental Insurance Co. Ltd., III (2008) CPJ 63 (SC) is fully attracted, wherein it was held that, Insurance Company being in a dominant position, often acts in an unreasonable manner and after having accepted the value of a particular insured goods, disowns that very figure on one pretext or the other, when they are called upon to pay compensation.  This ‘take it or leave it’, attitude is clearly unwarranted not only as being bad in law, but ethically indefensible.  It is generally seen that the insurance companies are only interested in earning the premiums and find ways and means to decline claims. The principle of law settled in the aforesaid judgments is squarely applicable to the facts and circumstances of the present case.

                The Hon'ble Supreme Court of India in Lucknow Development Authority Vs. M.K.Gupta, reported as III (1993) CPJ 7 (SC) observed as under:-

“To begin with the preamble of the Act, which can afford useful assistance to ascertain the legislative intention, it was enacted, 'to provide for the protection of the interest of consumers'. Use of the word 'protection' furnishes key to the minds of makers of the act. Various definitions and provisions which elaborately attempt to achieve this objective have to be construed in this light without departing from the settled view that a preamble cannot control otherwise plain meaning of a provision. In fact the law meets long felt necessity of protecting the common man from such wrongs for which the remedy under ordinary law for various reasons has become illusory. Various legislations and regulations permitting the State to intervene and protect interest of the consumers have become a haven for unscrupulous ones as the enforcement machinery either does not move or it moves ineffectively, inefficiently and for reasons which are not necessary to be stated. The importance of the Act lies in promoting welfare of the society by enabling the consumer to participate directly in the market economy. It attempts to remove the helplessness of a consumer which he faces against powerful business, described as, 'a network of rackets' or a society in which, 'producers have secured power' to 'rob the rest' and the might of public bodies which are degenerating into store house of inaction where papers do not move from one desk to another as a matter of duty and responsibility but for extraneous consideration leaving the common man helpless, bewildered and shocked. The malady is becoming so rampant, widespread and deep that the society instead of bothering, complaining and fighting for it, is accepting it as part of life. The enactment in these unbelievable yet harsh realities appears to be a silver lining, which may in course of time succeed in checking the rot.”

 

14]      Similar facts have been pleaded in another connected complaint and similar evidence has been led in it.  Therefore, in both the consumer complaints, deficiency in service as well as unfair trade practice on the part of the OP is proved.

 

15]      Resultantly, both the consumer complaints of the complainants stands partly allowed with directions to the OP as under:-

1. To refund the balance deducted amount of Rs.1,23,725/- in CC No.777/2022 & Rs.61,858/- in CC No.778/2022 to the respective complainant(s) along with interest @9% from the date of surrendering the policy i.e. 12.1.2021 till the date of its actual payment to the complaint.
2. To pay Rs.10,000/- to each of the complainant(s) as compensation on account of mental agony and physical harassment.
3. To pay Rs.7,000/- as costs of litigation in each complaint.

         This order be complied with by the OP(s), within 90 days from the date of receipt of its certified copy.

16]      The pending application(s) if any, stands disposed of accordingly.

         The Office is directed to send certified copy of this order to the parties, free of cost, as per rules & law under The Consumer Protection Rules & Act accordingly. After compliance file be consigned to record room.

Announced

23.01.2024                                                               

Sd/-

 (AMRINDER SINGH SIDHU)

PRESIDENT

 

 

Sd/-

(B.M.SHARMA)

MEMBER