DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
CC.No.351 of 26-08-2013
Decided on 27-11-2013
Sukhwinder Kaur aged about 59 years W/o Sukwant Singh R/o St.No.1, Jujar Singh Nagar, Bathinda.
........Complainant
Versus
Aviva Life Insurance, through its Manager, The Mall, First Floor, above Axis Bank, Bathinda.
.......Opposite party
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM
Smt.Vikramjit Kaur Soni, President.
Sh.Amarjeet Paul, Member.
Smt.Sukhwinder Kaur, Member.
Present:-
For the Complainant: Sh.Ashu Bansal, counsel for the complainant.
For Opposite party: Sh.Sanjay Goyal, counsel for opposite party.
ORDER
VIKRAMJIT KAUR SONI, PRESIDENT:-
1. The instant complaint has been filed under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act') by the complainant. The brief facts of the complaint are that the opposite party approached the complainant for selling of the life insurance plan and stated that she has to make the payment of Rs.20,000/- for 5 years and would be insured for Rs.5 lacs and conveyed her that after the completion of 5 years, she would be paid Rs.1 lac plus bonus. Accordingly, the complainant has purchased one insurance policy bearing No.APG1904855 as informed on telephone and paid 5 premiums of Rs.20,000/- each for the period from 2008 to 2012, in this way she has paid the total premiums of Rs.1 lac. The complainant further alleged that neither any cover note nor any separate terms and conditions were ever supplied to her by the opposite party and even free look period was not provided to her. The complainant has retired and is need of money, so she approached the opposite party to seek the refund of Rs.1 lac plus bonus but the opposite party refused to refund her any amount without assigning any reason. Hence the complainant has filed the present complaint to seek the directions to the opposite party to refund the amount of Rs.1 lac alongwith bonus, interest, cost and compensation.
2. The opposite party after appearing before this Forum has filed its written statement and pleaded that after duly going through the terms and conditions of the policy, the complainant, Sukhwinder Kaur has purchased the 'Pension Plus Unit Linked' plan, filled and signed the proposal form bearing No.NNU12079851 dated 7.3.2008 for the proposed premium amounting to Rs.20,000/- which has to be paid yearly for 5 years. The key features document of 'Pension Plus' policy clearly mentioned that on maturity the customer/complainant has the following options:-
On maturity, the complainant will get the fund value (units pertaining to regular premiums/single premium and top up premiums and additional regular premium) to purchase an immediate annuity, at rates prevailing at the time of vesting. The complainant has choice to take up to one third of the fund value as lump sum and use the balance to purchase an annuity from Aviva and buy an annuity from any other life insurance company. Aviva will apply no charges for this facility.
On the basis of the declaration made and information provided in the proposal form, the policy bearing No.APG1904855, commenced from 10.3.2008, has been issued to the complainant. The policy documents has been dispatched to the mailing address of the complainant through overnite courier AWB No.560722063 and the same was delivered/received by her on 20.3.2008. It is clearly mentioned in the policy schedule that the abovesaid policy is a Pension Plus Unit Linked policy. There is a Free Look Period option in which the policyholder has the right to reconsider his decision to purchase the policy within the period of 15 days from the date of receipt of the policy documents, in case he does not agree to the terms and conditions of the policy. If the complainant was not satisfied with the abovesaid policy, she would have availed the option of free look period. As per Article 3(B) of the terms and conditions, on maturity the maturity value is payable. The relevant portion of Article 3(B) is reproduced:-
“Maturity Benefit
i) If the insured is living on the Maturity Date, then at the option of the policyholder, we will will apply the fund value (and any loyalty additions as per Article 3(b)(ii) below) as at that date, in the following manner:-
1) 100% towards the purchase of an annuity (on insured's own life or jointly with his spouse) with us or any other Indian insurance company; or
2) Up to one third towards cash lump sum and the balance towards the purchase of an annuity (on Insured's own life or jointly with his spouse) with us or any other Indian insurance company.
ii) We will add a loyalty addition to the Fund Value on the Maturity Date if:
1) The schedule indicates that payment of regular premium has been opted for by the policyholder.
2) All regular premiums due have been paid to us; and
3) The policy term is atleast 20 years.”
As the complainant has purchased the 'Pension Plus Plan', hence she is not entitled for any refund.
3. The parties have led their evidence in support of their respective pleadings.
4. Arguments heard. The record alongwith written submissions submitted by the parties perused.
5. Admitted facts of the parties are that the complainant has purchased one insurance policy bearing No.APG1904855 and paid 5 premiums of Rs.20,000/- each for the period from 2008 to 2012, in total she has paid the premiums of Rs.1 lac till date.
6. The disputed facts are that at the time of selling of the abovesaid policy, the opposite party assured the complainant that she has to make the payment of Rs.20,000/- for 5 years and would be insured for Rs.5 lacs and after the completion of 5 years, she would be paid Rs.1 lac plus bonus. After the retirement as the complainant was in need of money, she approached the opposite party to seek the refund of the amount of Rs.1 lac plus bonus but the opposite party refused to refund her any amount.
7. On the other hand the submission of the opposite party is that the present complaint is barred by limitation under section 24 A of 'Act' as the cause of action arose in March 2007 and the complainant has filed the present complaint in April 2012 and has referred various authorities to this effect. On merits, the opposite party submitted that the complainant has purchased the 'Pension Plus Unit Linked' plan, filled and signed the proposal form bearing No.NNU12079851 dated 7.3.2008 for the proposed premium amounting to Rs.20,000/- which has to be paid annually for 5 years and on maturity, she will get the fund value (units pertaining to regular premiums/single premium and top up premiums and additional regular premium) to purchase an immediate annuity, at rates prevailing at the time of vesting and the below two choices will be given:-
“To take up to one third of the fund value as lump sum and use the balance to purchase an annuity from Aviva.
To buy an annuity from any other life insurance company. Aviva will apply no charges for this facility.”
The complainant has duly filled the proposal form and the policy bearing No.APG1904855 was issued to her. The policy in question commenced from 10.3.2008. The policy documents has been dispatched to the mailing address of the complainant through overnite courier AWB No.560722063 and the same was delivered/received by her on 20.3.2008. It is clearly mentioned in the policy schedule that the abovesaid policy is a Pension Plus Unit Linked policy. The abovesaid policy also contains a Free Look Period option of 15 days, wherein the complainant has the option to cancel her abovesaid policy within the period of 15 days from the date of receipt of the policy documents, if she was not satisfied with the abovesaid policy, she had the option to avail free look period but she has not done so. Now at the time of maturity, she is entitled for Maturity Benefit as per Article 3(B) of the terms and conditions of the abovesaid policy.
8. The opposite party has taken the objection that this complaint is barred by limitation, is not tenable as the opposite party has mentioned in its written statement as well as written arguments that cause of action arose in March 2007 when the abovesaid policy was issued to the complainant, whereas she has filed the present complaint in April, 2012. From the perusal of file, we find that, the plea taken by the opposite party is wrong as the policy was issued to the complainant in the year 2008, as per Para No.12(iii) of the written statement of the opposite party, in preliminary objection and submission, the opposite party has specifically mentioned that the complainant has filled the proposal form bearing No.NNU12079851 on dated 7.3.2008 for the proposed premium amounting to Rs.20,000/- and accordingly, the policy bearing No.APG1904855, commenced from 10.3.2008, has been issued to her (as mentioned in para No.12 (iii) of the written statement of the opposite party). In the preliminary objections and submissions, the opposite party has wrongly mentioned the date of commencement of the policy and institution of the complaint, as the complainant has filed the present complaint on 26.8.2013. A further perusal of file reveals that the complainant has paid 5 premiums i.e. upto March, 2012 and her request to refund the amount of the abovesaid policy has been declined in the month of March, 2012, thus the cause of action has arisen to her in the year 2012. As per 'Act' the complainant can file the consumer complaint within the period of 2 years from the date of cause of action, thus the present complaint is well within the limitation.
9. A perusal of record placed on file shows that the complainant has paid 5 premiums vide Ex.C2 to Ex.C6. In the proposal form, Ex.OP1/2, it is mentioned in the column No.4.1, name of plan:-'Pension Plus'; column No.4.2, term of the plan in years:-05; column No.4.3, premium paying term in years:-05; column No.4.4, annual premium:-Rs.20,000/-; column No.4.6, premium frequency:-yearly; column No.4.7, premium as per frequency (in Rs.):-Rs.20,000/- and column No.4.10, type of fund:-Unit Linked Fund. The opposite party has placed on file Ex.OP1/3 containing 2 pages, but these 2 pages do not belong to the complainant as no policy number and the name of the complainant is mentioned in these documents. Ex.OP1/4, shows that the maturity benefit available in the pension policy to the complainant wherein the complainant has to give her option:-
“1/3rd and 2/3rd -The customer can withdraw 1/3rd amount and reinvest the 2/3rd of the amount in the annuity either from AVIVA or any other insurance company as per his wish.
100%-The customer can reinvest 100% of the amount in the annuity either from AVIVA or any other insurance company as per his wish.
In the light of the above stated facts, we wish to inform you that we will not be able to accept your request for full refund of maturity value in this policy.”
Ex.OP1/5, does not pertain to the complainant as this is issued in the name of Mr.Chandra Bali Prasad, Gram-Dangharia, Post-Khochwa, Mirzamurad, Varanasi, Uttar Pradesh. Ex.OP1/6 and Ex.OP1/7 also do not belong to the complainant as the same has no connection with the policy of the complainant. Moreover the insurance policy is an individual contract between the complainant and the opposite party. Ex.OP1/4, is the only document that shows the policy bearing No.APG1904855 is issued to the complainant.
10. As discussed above the maturity benefit is available in the pension policy, under this benefit the complainant has to give her option. Sh.Watan Kumar Bhajanka, Assistant Manager of Aviva Life Insurance Co.Ltd., Gurgaon in his affidavit has deposed:-'The said policy documents were dispatched to the mailing address of the complainant through overnite courier AWB No.560722063 and same was delivered on 20.3.2008 and same was received'. Nothing has been mentioned in the written statement as well as affidavit given by Sh.Watan Kumar Bhajanka, by whom the policy documents has been received. Moreover the policy documents those have been placed on file vide Ex.OP1/5 to Ex.OP1/7 do not pertain to the complainant. The opposite party has itself failed to place on file the policy documents, meaning thereby the version of the complainant is true that the policy documents has not been supplied to her till date. Thus the terms and conditions of the abovesaid policy are not binding on the complainant. As discussed above the proposal form, Ex.OP1/2 has been placed on file by the opposite party, wherein the plan is mentioned as 'Pension Plus'; term of the plan:-5 years and premium paying term:-5 years. Accordingly, the complainant has paid the annual premium of Rs.20,000/- each for 5 years. No separate terms and conditions has been supplied to the complainant, thus are not binding on her, but the complainant has signed the proposal form, declaration and authorization, this shows that she after fully understanding the contents of the proposal form, has signed the same and opted the Pension Policy. Thus as mentioned in Ex.OP1/4, maturity benefit is available in the pension policy which is already produced in foregoing paras, the complainant is entitled to withdraw 1/3rd amount and reinvest 2/3rd amount in the annuity either from AVIVA or any other insurance company as per her wish.
11. Therefore in view of what has been discussed above there is deficiency in service on the part of the opposite party. Hence this complaint is accepted with Rs.5000/- as cost and compensation against the opposite party. The opposite party is directed to pay 1/3rd amount immediately on the receipt of the copy of this order and take the option of the complainant regarding 2/3 amount if the complainant wants to invest the same in annuity or wants its refund to invest the same in any other insurance company. If the complainant has given the option to seek the refund of 2/3rd amount also, the same will be given to her immediately.
12. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.
13. In case of non-compliance the amount of Rs.1 lac will carry interest @9% per annum till realization.
14. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.
Pronounced in open Forum
27-11-2013
(Vikramjit Kaur Soni)
President
(Amarjeet Paul)
Member
(Sukhwinder Kaur)
Member
