IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Thursday, the 30th day of November, 2017
Filed on 27.09.2016.
Present
1) Smt. Elizabeth George (President)
2) Sri. Antony Xavier (Member)
3) Smt. Jasmine D (Member)
in
CC/No.314/2016
Between
Complainant: Opposite parties:
Ramachandran 1. The Asst. General Manager
S/o Ramasubrahmanyan Business development and Planning
Vaishnavam Dhanalakshmi Building
Sanathanam Ward Naickanal, Trissur
Alappuzha
(Adv.Devi.R. Raj) 2. The Manager Bajaj Allianz,
Life Insurance company Ltd
GE Plaza, Airport, Yerwada, Pune
Maharashtra
3. The Branch Manager
Bajaj Allianz Life Insurance
Company Ltd, Near Passport Office
2nd Floor, Alleppey Avenue Centre
West of Kannanvarkkey Bridge,
Alappuzha
(Adv.Pramel & Adv.Jeswin.P.Varghese
for opposite party 2 and 3)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
The case of the complainant is as follows:-
Complainant had taken an insurance policy by the representation of the 1st opposite party. Accordingly an account was opened on 28/11/2010 and a policy was taken under Group Unit Gain Policy by paying a single premium of Rs. 1,00,000/-. The 2nd opposite party issued a certificate of insurance through the 1st opposite party. At the time of taking policy, the 1st opposite party categorically informed the complainant that the premium for the members of master policy for the aforesaid insurance coverage is one time premium of Rs. 1,00,000/-. Further they have also assured that the coverage will be for 20 years from 28-11-2010 without any additional cost. Believing the words of the 1st opposite party, the complainant paid the single premium of Rs. 1,00,000/-. After availing the insurance policy and issuance of insurance certificate through the 1st opposite party there was no correspondence of any sort between the complainant and any of the opposite parties with respect to the said policy. On 30-06-2015 the complainant received a correspondence from Axis Bank Ltd, as authorized by the 2nd opposite party stating that the policy was terminated and the surrender value of Rs. 9,251/- is paid by the cheque enclosed together with. The reason for termination of the policy was stated as nonpayment of regular premium during the revival period of 2-3 years. Immediately the complainant tried to contact to the 1st opposite party to ascertain the true facts as no policy schedule or cover note having terms and condition of the Master Policy or the individual policy was issued neither by the 1st opposite party nor by the 2nd opposite party at any point of time. Opposite party committed deficiency in service and unfair trade practice with respect to both the insurance policy as well as the termination of policy.
2. Version of 1st opposite party is as follows:-
The 2nd opposite party, after the receipt of duly filled proposal form along with the other requisite documents and the amount of premium deposit, had issued the subject policy. Thereafter the policy documents were delivered to the complainant. As per the terms and conditions in the policy if the single premium funds value in respect of the member fell below 1/10th of single premium or became insufficient to meet the charges the policy shall immediately/ automatically terminate. In the instant case the single premium fund value in respect of the complainant’s policy fell below 1/10 th of single premium and hence the policy is terminated and the fund value has been paid to him. The said action of the 2nd opposite party is in tune with the terms of contract. From the allegation in the complaint is seems that the issue involved in the dispute is a creature of contract and its breach, which is not a deficiency in service but an act done as per the tenor and spirit of the contract of insurance. Through the present complaint, complainant is first time rising the misleading issue or false assurance about the premium. It is to be noted that the opposite party has never received any complaint/ request or intimation from the complainant in regard to any allegation leveled in the present complaint. The allegation in the complaint that the complaint has deposited the money believing the word of this complaint is not having any merit and hence denied. Further the role of the 1st opposite party in this transaction is very limited and at no occasion this opposite party handled the money deposited by the complainant in the said scheme. Complainant filed the complaint before the insurance Ombudsman and the authority dismissed the complaint.
3. Version of the 2nd and 3rd opposite party is as follows:-
Complaint is not maintainable. The policy availed by the complainant is Unit Linked Policy for speculative gain. Complaint is barred by limitation. The insurance policy availed by the complainant is admittedly a Group Insurance Policy bearing No. 0183725596 of the Dhanalakshmi Bank Ltd. with Membership No. 0191939804 wherein the complainant had availed the said policy under single premium policy and the complainant had never disputed/Challenged the terms and conditions of policy. The complainant was enrolled as a member to Group Insurance Policy and the terms are well conveyed to the member by the Group Insurance Policy holder Dhanalakshmi Bank Ltd. In the event the complainant member had any concerns on the applicable terms, the complainant was very much free to raise the concerns immediately after availing the policy, which he had not raised. The complainant has availed the policy under Group Unit Gain by payment of single premium amount of Rs.1,00,000/- only through the Master Policy bearing No. 0191939804. There is no deficiency in service on the part of the opposite party.
4. Complainant was examined as PW1 documents produced were marked as Ext.A1 to A6.
5. Points for consideration are:-
Whether there is any deficiency in service on the part of the opposite parties?
If so the reliefs and costs?
6. According to the complainant he availed an insurance policy on 28/3/2010 by paying a single premium of Rs. 1,00,000/-. The 2nd opposite party issued certificate of insurance through the 1st opposite party. While taking the policy the complainant was informed by the 1st opposite party that the premium for the members of the policy for the insurance coverage is one time premium of Rs. 1,00,000/-. Believing the words of the 1st opposite party complainant paid single premium of Rs. 1,00,000/- Thereafter on 30/6/15 complainant received a letter stating that policy was terminated and the surrender value of Rs.9251/- paid by the cheque enclosed together with. According to the complainant the 1st opposite party is the Master Policy Holder of the 2nd opposite party and acted as the agent of the 2nd opposite party in the matter of issuance of policy to the complainant and they have colluded together in the matter of suppression of material facts with the complainant at the time of availing the said policy and till its termination and hence jointly and severally liable to compensate the complainant. Opposite party filed version stating that the complaint is not maintainable, since the policy taken by the complainant is Unit Link Policy and cannot be brought under the subject matter of the Consumer Protection. According to the 2nd and 3rd opposite party complainant availed the policy under the Group Unit Gain by payment of single premium amount of Rs. 1,00,000/- only through the master policy bearing No. 0191939804. They further stated that the policy was terminated and foreclosure amount of Rs. 9251/- the paid by the way of cheque to the complainant. The policy certificate produced and marked as Ext.A1. On verifying the Ext.A1 policy under the title Non forfeiture condition, it is stated that in case of single premium if the value of units fall below 1/10th of the single premium or become insufficient to meet charges the membership will be foreclosed and value of such units would be paid upon such termination. In this case the 2nd opposite party terminated the policy without any notice to the complainant. They have not produced any documents to prove that the value of the unit fell down below 1/10th of the single premium. Hence they have no right take unilateral decision to terminate the policy and that amounts to deficiency in service in their part. But while cross examing the complainant he admitted that he had taken the policy knowing that it was a Unit Linked Policy. In a decision reported in Ramlal Agarwal Vs. Bajaj Allianz Life Insurance Co.ltd reported in 2013(2) CPR 389, Hon’ble National Commission held that “If the money of the complainant can be invested in share market for a speculative gain, the matter does not come under the purview of Consumer Protection Act.” Relying the said decision this Forum is opinion that complainant is not maintainable and hence complaint is dismissed without prejudice to the complainant’s right to approach before the appropriate Forum.
Dictated to the Confidential Assistant transcribed by him corrected by me and pronounced in open Forum on this the 30th day of November, 2017. Sd/-Smt.Elizabeth George (President) :
Sd/- Sri. Antony Xavier (Member) :
Sd/- Smt.Jasmine.D. (Member) :
Appendix:-
PW1 - R.Ramachandran (witness)
Ext.A1 - Certificate of Insurance
Ext.A2 - Payment reference
Ext.A3 - Copy of letter dtd. 12/8/2015.
Ext.A4 - Copy of E mail dtd.09/09/2015
Ext.A5 - Copy of Statements of Account
Ext.A6 - Copy of Order from Ombudsman
// True Copy // By Order
Senior Superintendent
To
Complainant/Opposite parties/S.F.
Typed by:- br/-
Compared by:-
