DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

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Peeush Gagneja son of Sh.Raghjbir Chand resident of 2507/3 D.P.House Building Society, Sector 67, Mohali, now at 336/2, Govind Vihar, Baltana, Zirakpur, District Mohali.

                               …..Complainant

                 V E R S U S

    1.  Aviva Life Insurance Company India Limited, through its General Manager, 5^th Floor, JMD Regent Square, Gurgaon Mehrauli Road, Gurgaon-122001 Haryana.

2.  The Manager Claims, Aviva Life Insurance Company India Limited, 2^nd Floor, Prakashdeep Building, 7, Tolstoy Marg, New Delhi-110001.

3.  The Manager, Aviva Tower, Sector Road, Opposite DLF Golf Course, DLF Phase V, Sector 43, Gurgaon-122003.

    4.  The Manager, Aviva Life Insurance Company Limited, Sector 9, Chandigarh.

         ……Opposite Parties

CORAM:   SH.P.D.GOEL                 PRESIDENT

         SH.RAJINDER SINGH GILL       MEMBER

Argued by:        Complainant in person.

Sh.Mahipal Biswas, Proxy counsel for Sh.Sandeep Suri, Counsel for OPs.

PER RAJINDER SINGH GILL, MEMBER

          In brief, the case of the complainant is that he purchased Policy No.NLG-1226854 from OP Insurance Company, with commencement date 23.3.2006, for a sum assured of Rs.2 lacs. The annual premium of the policy was Rs.20,000/-p.a. The complainant had deposited all the three installments with OP No.4 on 23.3.2006, 23.3.2007 and 15.7.2008 respectively. As per the complainant, in the year 2009 i.e. after the expiry of three years, when he approached the office of OP No.4 to know the status of his policy, he was informed that against the deposited amount of Rs.60,000/-, an amount of Rs.27,000/- was payable, and the remaining amount of Rs.33,000/- was to be adjusted against expenses, and the complainant was advised to wait for further two years. As per advise, the complainant again waited for two years and the visited the OP Insurance Company on 27.3.2011 to surrender the policy, where he was informed that the total refund value of the policy was Rs.30,000/-. As per the advise of the official of the company, the complainant requested to complete all the formalities in regard to surrender the policy. The official of the company assured the complainant that the amount will be transferred to his account, within 10 working days. However, when the said amount was not transferred in his account, the complainant again approached the office of OP No.2 on 15.4.2011, where he was asked to give the required documents again, upon which, he again supplied all the documents to OP No.2, except the cancelled cheque and original policy because both the documents were already with the company. It was further stated that even after 10 days, there was no response from the company, as such the complainant sent a legal notice through Regd. Post dated 3.5.2011 but to no avail. Hence, this complaint.  

2]       OPs filed written statement and took some preliminary objections that the complainant being an educated person had made the investment by his own free will, without any pressure and after thoroughly understanding the specification and details thereof. Therefore, at this stage nothing lies in the mouth of the complainant to turn around and refuse to comply with the requirements of the policy and to claim refund of the premium amount. It was stated that the complainant had not paid any premium after 3^rd installment. The OP had issued the policy on the basis of proposal form. It was also stated that the complainant had duly received the policy schedule and key feature documents, but he never approached them for cancellation under the Free Look provisions of the policy. It is further stated that the complainant was well aware that in case the policy was surrendered mid stream then he was not entitled to the full amount, as deposited. The complainant had opted for the surrender of the policy. However, the complainant had not completed the full formalities and he was asked to apply again for the same with a self attested identification proof. The same was also intimated to the complainant vide letter dated 7.4.2011 but he failed to fulfill the requirements and as such, the surrender value could not be processed. It was further stated that the said policy is unit linked policy and dependent on the market fluctuations. It was further stated that the policy issued to the complainant, as per the requirements of the complainant and he duly paid premiums for 3 years and never approached the OPs with any kind of complaint for more than 3 years. Therefore, the complainant cannot allege at the belated stage that he was not aware about the terms and conditions of the policy. The policy was issued to the complainant on 23.3.2006 and the complainant for the first time, disputed the features of the policy in the year 2011 and as such, more than 5 years have elapsed, the complaint may kindly be dismissed, as per the provision of Limitation Act. On merits, it was stated that the policy being a unit linked policy and the returns could be more or less. The complainant failed to pay any premium after the third installment and as such, he cannot ask for the refund of amounts based on 5^th year. The complainant was asked to pay continuing premium, however, he failed to pay after the third year. The complainant failed to fulfill the requirements for claiming surrender. Denying all the material allegations of the complainant and pleading that there has been no deficiency in service on their part and prayer for dismissal of the complaint with exemplary costs has been made.  

3]      Parties led evidence in support of their contentions.

4]      We have heard the complainant in person and ld.Counsel for OPs and have also perused the record. 

5]       The case of the complainant is that he purchased a Life Long-Unit Linked Policy from OP Insurance Company and paid regular annual premium of Rs.20,000/- for three years and thereby deposited a total sum of Rs.60,000/- towards said plan.

6]       The contention of the complainant is that after completion of three years, when he approached the OPs to enquire about the value of his insurance plan, he was told that he will be entitled for a sum of Rs.27,000/- only against the amount of Rs.60,000/-, paid by him towards the premium of said policy.  However, on the advice of OPs, he waited for further two years and then visited the OPs to surrender the policy, but inspite of that, the Opposite Parties did not pay anything.   

7]       Admittedly, the complainant has not returned the policy document to the Opposite Parties within 15 days from the date of receipt of the policy, as stipulated in the policy, under Right to Reconsider, wherein it has been categorically mentioned that:-

“You have the option to cancel the policy. You would need to return the policy document, policy schedule and premium receipt, along with a letter clearly stating the “Terms and Conditions” with which you disagree, within 15 days of receipt of the policy document, marked to “Customer Service” at the above mentioned address….”

8]       As the complainant himself has failed to return the policy document, within the above said period of 15 days under Right to Reconsider, therefore, he cannot, now seek the cancellation of the policy purchased by him, alleging false allurement on the part of OPs.

9]       The contention of the OPs is correct that the policy purchased by the complainant is a Unit Linked Product, which is a market linked policy and it depends on the market fluctuations. The investment risk is borne by the Policyholder.  The Policyholder may achieve gains and losses on his investment depending upon the performance of the unit linked funds. So, there is no question of repayment of full premium amount to the complainant and the same depends on the market situations. Therefore, we are of the view that the plea of the complainant that he should be refunded complete deposited amount is not sustainable and the same will be paid as per the market rate. 

10]      So far as the non-payment of surrender value to the complainant is concerned, the OPs have contended that since the complainant had not completed the full formalities, he was asked to apply again for the same with a self attested identification proof vide letter dated 7.4.2011. In our view, when the complainant himself has failed to fulfill the requirements, as demanded by OPs, naturally the surrender value cannot be paid to him. The complainant has to complete the formalities to get the surrender value.

11]      In view of the above discussion, we are of the opinion that the complaint deserves to be partly allowed. The same is accordingly allowed partly. The OPs are directed to pay the surrender value to the complainant against his policy on his furnishing requisite documents. However, there is no order as to compensation and litigation costs.

        Certified copies of this order be sent to the parties free of charge.  The file be consigned.