BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PATIALA. Complaint No.CC/10/301 of 27.4.2010 Decided on: 12.5.2011 Chander Shekher Verma son of Sh.Tulsa Ram resident of House No.3571/2, Dushala Mal Street,Sirhindi Bazar, Patiala. -----------Complainant Versus Aviva Life Insurance Company India Pvt. Ltd. Branch Office at SST Nagar, Opposite Narain Hospital, Patiala through its Branch Manager. ----------Opposite party Complaint under Section 12 of the Consumer Protection Act. QUORUM Sh.D.R.Arora, President Sh.Amarjit Singh Dhindsa, Member Smt.Neelam Gupta, Member Present: For the complainant: Sh.D.P.S.Anand , Advocate For opposite party: Sh.Mayank Malhotra, Advocate ORDER D.R.ARORA, PRESIDENT It is the case of the complainant that he had purchased the insurance policy No.LLG1205866 dated 28.2.2006 from the op. The complainant had been paying the premiums regularly upto 28.2.2009. However, the op failed to pay the maturity amount and rather returned the amount of the premiums of the amount of the last three premiums arbitrarily so as to make out a ground to cancel the policy and to grab the amount of the premiums paid by the complainant. 2. It is further averred that the complainant is entitled to the payment of Rs.1,20,000/- under the terms and conditions of the policy. The op returned the amount of Rs.18000/-in respect of the three premiums arbitrarily so as to avoid the payment of the payment of the policy. Accordingly, the complainant approached this Forum through the present complaint brought under Section 12 of the Consumer Protection Act,1986 (for short the Act)for a direction to the op to pay the amount of Rs.1,20,000/- alongwith interest @12% ; to pay Rs.25000/- by way of compensation for the harassment and the mental agony suffered by the complainant and further to pay Rs.10000/- as costs of the litigation. 3. On notice, the op appeared and filed the written version. It is the plea put forth by the op that policy had been issued in favour of the complainant on the basis of the proposal form submitted by the complainant. The policy documents included the policy schedule, the “right to reconsider” notice, the standard terms and conditions , copy of the proposal form and the first premium receipt. 4. It is further averred by the op that thereafter, the complainant had paid two more premiums in time. A premium notice and a premium reminder notice were sent on 23 July,2007 and 7th September,2007 to the complainant to pay the 4th premium due under the policy. As the 4th premium under the policy was not received by the op, the policy had lapsed on 16th October 2007. The complainant was informed in this regard vide letter dated 23 October,2007. 5. It is further averred that on 14th November,2007, the complainant had sent a policy reinstatement form alongwith a declaration of good health and premium amount of Rs.6000/- for the reinstatement of the policy. The op asked the complainant vide letter dated 14.11.2007 to send the declaration of good health with full details for the reinstatement of the policy as the signatures of the life insured were missing. The complainant failed to comply with the said letter and therefore, the premium amount of Rs.6000/- was refunded vide Blue Dart Courier docket No.30122014031 dated 16.1.2008. 6. Again the complainant on 4th of February 2008 paid the renewal premium of Rs.12000/- for the reinstatement of the policy but the same was declined by the op as the complainant had not sent the declaration of good health which was necessary for the reinstatement of the policy. Again on 16th October 2008 the op received request for reinstatement of the policy alongwith declaration of good health and the outstanding premiums amount of Rs.18000/- from the complainant. The op again wrote a letter dated 17th October 2008 to the complainant asking him to submit a fresh declaration of good health singed by Mrs Usha Rani. As the said letter was not complied with by the complainant, the reinstatement was declined and a letter dated 18th October, 2008 was sent to the complainant having informed him about the same. The premium amount of Rs.18000/- for the reinstatement of the policy had also been refunded. 7. Thereafter, op received a complaint from the complainant on 7th January 2010 having alleged that the policy was mis sold to him by the insurance agent having represented that money will be doubled in three years. The op vide letter dated 15th January 2010 informed the complainant that the policy was issued on the basis of his consent and the proposal form and that during the period of three years no complaint was received by the op from him. 8. It is the plea taken up by the op that the complainant is entitled to the surrender value after commencement of the 3rd policy year subject to the payment of premium in the first two policy years. But the complainant had paid the premiums due in the first one and a half years and therefore, the policy had lapsed. The op has acted in accordance with the terms and conditions of the policy , under which the op could ask the complainant for compliance of the additional requirement in the matter of the reinstatement of the policy. Ultimately the op prayed for the dismissal of the complaint. 9. To substantiate his claim the complainant produced in evidence his sworn affidavit, Ex.C1,alongwith the documents, Exs.C2 to C12. 10. On behalf of the ops, its learned counsel tendered in evidence the sworn affidavit,Ex.R1 of Mr.Gaurav Malhotra, Manager, alongwith documents,Exs.R2 to R10 and closed the evidence. 11. The parties filed the written arguments. We have examined the same, heard the learned counsel of the parties and gone through the evidence/record on the file. 12. It is the plea taken by the op that the complainant having failed to deposit the 4th premium despite the premium notice and a premium reminder notice dated 23.7.2007 and 7.9.2007, the policy had lapsed on 16th October 2007. 13. The complainant has not approached the Forum with clean hands and he failed to disclose with regard to his having failed to deposit the 4th premium due on 28.8.2007 and the policy having lapsed. He has also failed to disclose that he had applied the op for the reinstatement of the policy, as per the pleas taken up by the op and that the amount of Rs.6000/- sent by him on 14.11.2007 for the reinstatement of the policy was returned to him by the op vide Blue Dart Courier Docket No.30122014031 dated 16.1.2008 and similarly the renewal premium of Rs.12000/- sent by him on 4.2.2008 for the reinstatement of the policy was again returned to him and similarly the amount of Rs.18000/- sent by him on 16.10.2009 again for the reinstatement of the policy was returned to him. Ex.R4 is the copy of the policy reinstatement request form submitted by the complainant on 7.11.2007 alongwith a cheque of Rs.6000/-. Ex.R4 is also attached with the copy of the letter dated 14.11.2007 written by the op to the complainant whereby he was requested to fill in afresh “Declaration of good health form, enclosed with the letter.Ex.R5 is the copy of the request for the reinstatement submitted by the complainant alongwith the declaration of good health dated 14.10.2008.Ex.R6 is the copy of the letter written by the op to the complainant whereby the complainant was called upon to submit DGH form in respect of Mrs.Usha Rani and he was further advised that in case of non receipt of the said DGH of Mrs.Usha Rani in the next 30 days it would initiate the process for the refund of the premium amount lying with them. Ex.R7 is the copy of the letter dated 18.11.2008 written by the op to the complainant having informed him that they were unable to process the reinstatement application for want of the evidence called by them and that the refund amount will be dispatched within 10 working days. 14. It is not the case of the complainant that he had applied for the reinstatement of the policy and the op failed to reinstate the same and rather he has put forth the plea that he had sent three premiums and the same were not accepted by the op arbitrarily and who returned the amount of the three premiums of Rs.18000/- in order to avoid the payment of the policy of Rs.1,20,000/-. 15. It was submitted by Sh.D.P.S.Anand, the learned counsel for the complainant that the complainant may be made the payment of the amount of the units purchased by the op with the help of the premiums to have been deposited by the complainant, the policy being a unit linked. 16. On the other hand it was submitted by Sh.Mayank Malhotra, the learned counsel for the op that it is not the case of the complainant that he is entitled to the payment of the value of the units, if any purchased by the op and rather the policy having lapsed, the complainant could not ask for such a relief. 17. We have considered the submissions. Ex.R3 is the copy of the standard terms and conditions of the policy. Article 7 relates to Non Payment of the Premium and Non Forfeiture provisions. Article 7.1 provides that if any installment of regular premium is not paid within the period of grace from its due date as defined in Article 4.1 and the due date is less than 24 months from the commencement date then the insurance will be deemed to have immediately lapsed without value. If any additional single premium has been paid the surrender value of all units held in the unit account in respect of additional single premium at the date the insurance lapsed will be paid subject to Article 15.The complainant had paid the three premiums, firstly of Rs.6000/- on 28.2.2006, as would appear from,Ex.C4, secondly on 28.8.2006, as would appear from,Ex.C5 and 3rdly on 28.2.2007 as would appear from Ex.C6. The next installment was due on 28.8.2007, in respect of which the op had sent premium notice dated 23.7.2007 and a premium reminder notice dated 7.9.2007. In that way the 4th premium had fallen due less than 24 months from the commencement date of the policy. It had commenced on 28.2.2006 as would appear from,Ex.C3, the copy of the policy schedule. Therefore, in view of the provisions contained under Article 7.1 of the standard terms and conditions,Ex.R3, the policy had lapsed immediately without value. The complainant had not paid any additional single premium in terms of article 6 and therefore, there can not be any case made out for the surrender value of all units held in unit account in respect of additional single premium at the date the insurance had lapsed. 18. As an up shot of our above discussion, it would appear that the policy of the complainant having lapsed under article 7.1 because of his having not deposited the regular premium due on 28.8.2007, which had fallen less than 24 months of the commencement date of the policy, the complainant is not entitled to any relief and therefore, the complaint he hereby dismissed. Pronounced. Dated:12.5.2011 Neelam Gupta Amarjit Singh Dhindsa D.R.Arora Member Member President
| | Smt. Neelam Gupta, Member | HONABLE MR. D.R.Arora, PRESIDENT | Mr. Amarjit Singh Dhindsa, Member | | 
