BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION AT BANGALORE (URBAN)

DATED 30^thDAY OF NOVEMBER 2024

SMT. SUMA ANILKUMAR, MEMBER

1. The Complaint filed under section 35 of the Consumer Protection Act 2019, complainant seeking direction towards OPs for following reliefs.

2.Complainant request the Hon’ble Court to compensate the loss sustained to the complainant to the tune of Rs.2,09,000/- along with interest, cost and mental agony.

3. Brief facts of this case are as follows:-

The complainant submits that he had purchased Life Insurance policy NO.10469210 in his name from OP and continued for 2^nd year. Details below.

4. Policy No.10469210 paid Rs.1,04,500/- on 08/09/2021 policy No.10469210 paid Rs.1,04,500/- on 10/10/2022.

5. The complainant made many phone calls to OP Company as he did not receive any communication reply from the OP. The OP has sent proposal form through voice email on 26/10/2023 from customer care centre, wherein it was mentioned that the lock-inperiod for refund is 2 years,therefore the complainant to get refund made a second installment of premium. On not receiving any communication in writing from the OP, the complainant sentRegistered Post Acknowledgement Letter on 20/11/2023,but there was no reply to the said registered post from OP office. Hence the complainant decided to close the policy and get the refund of all the amount paid along with interest and sent the legal notice on 19/01/2024. Notice returned with a remarks “company address not found”. Left with no choice, the complainant filed this complaint. Hence this complaint.

6. On issue of notice to OP, OP appeared before this commission and filed its version along with 4 documents.

7. In the version of OP, OP submits that the complainant approached OP to obtain the insurance policy and had submitted proposal on 16/09/2021. Complainant had instructed that he would go for policy called “AVIVA NEW WEALTH BUILDER”,upon his instructions the OP insurance company had provided the general brief about the policy. The OP had precisely explained standard terms, conditions and key features of the insurance policy. On request and proposal of the complainant, the OP issued the said “policy bearing No.10469210”. The details of the policy are as stated below.

8.The complainant has paid the last premium on 10/10/2022 and the next premium was due on 25.09.2023 to continue the insurance policy. Since the complainant had not paid any premium afterthe second premium, the policy got converted into paid up policy. As per the terms and conditions mentioned in the policy bond.

“In case you stop paying premiums after the first 2 years, the policy becomes paid up which means – Only reduced insurance benefits will be payable. – ADB cover under Add-on benefit would also cease (if opted) – Maturity Benefit will be as per the Maturity Benefit factor applicable (excluding extra premium and taxes, if any). – In case of death before maturity or survival till maturity, the paid up sum assured shall be payable in respect of a paid-up policy.”

9. The complainant had paid first premium amount on Rs.1,00,000/- together with applicable taxes of Rs.4,500/- on 08/09/2021 and accordingly, as informed by the insured, the electronic copy of the insurance policy was sent through the official Email of the OP to the Email ID of the complainant as shared by him. The second premium amount of Rs.1,00,000/- was together paid with applicable taxes of Rs.2,250/- on 10/10/2022. The OP further submits that the complainant has misrepresentedthe facts that the OP has not communicated or replied to the complainant’s communications,but the OP has attended the calls and replied within the reasonable time frame. They received letters from the complainant due to incorrect address or any technical reasons thereof.The registered office address of the OP is updated in their website and also communicated to the complainant when asked, over official email of the complainant.Furthermore, the lock-in period that the customer has mentioned in the complaint does not guarantee refund but it is the minimum period for which the premiums need to be paid so as to stop the policy from going into lapse status and to generate reduced maturitybenefit amount proportionate to the number of premiums paid subject to charges if any. OP submits that there is no deficiency of service or cause of action to claim to refund of the premium paid by the complainant against the OP and hence the said complaint is liable to be dismissed.

10. The complainant files affidavit evidence along with this documents marked as Ex.P.1 to Ex.P.6. The OP fails to file their affidavit evidence and written arguments. The complainant files written arguments.

11. On the basis of above pleadings for our consideration are as follows:-

i) Whether the complainant has proved the deficiency of service on the part of OP?

ii) Whether complainant is entitled for the relief?

iii) What order?

12. Our answers to the above points are as follows:-

                        Point No.1:-Affirmative.

                        Point No.2:- Partly affirmative.

                        Point No.3:- As per the final order.

REASONS

13. Point No.1 and 2: These points are inter-connected to each other and for the sake of convenience, to avoid repetition of facts, these points are taken up together for common discussion.

14. On perusal of the documents submitted by the complainant in the Ex.P.12 which is the bank statement of the complainant, we observe that the complainant has made payment in favour of OP an amount of Rs.1,04,500/- on 08/09/2021, Rs.50,295/- and Rs.52,840/- on 10/10/2022, in total an amount of Rs.2,07,635/-. It is true that the complainant has taken Life Insurance policy from OP and the same is admitted by OP in their version. The OP in their contention have filed the policy and its terms and conditions. On perusal of the Ex.R.2, we observe that in case of emergency the surrender of the policy as “If you decided to surrender (withdraw) the policy, the payout will be made after deduction of surrender penalty. The payout would be less than the total of all premiums paid, in most cases surrender is allowed only after you have paid premiums for at least 2 years.”

15. The above said condition clearly indicates that the surrender or withdrawal of the policy can be made after the payment of 2 premium, the complainant has made 2 premiums. Considering the above terms and conditions, the complainant has waited and made payment of 2 premiums, so that he can surrender on the payment of 2^nd premium and collect his amount from the OP, but the OP fail to respond to his request. This shows deficiency in service and unfair trade practice on the part of OP.The Complainant has patiently waited and made the payment of 2^nd premium amount so that on payment of 2^nd premium,he can surrender (withdraw) the policy, but OP has failed to respond,and consider the request of the complainant. The OP has also failed to reply to the two legal notice issued by the complainant dated:03/01/2024 and 19/01/2024. This clearly shows the deficiency in service & unfair trade practice of the OP.

16. Hence the OP is liable to pay after deduction surrender penalty amount of Rs.89,283.05 with an interest of 10% from the date of insurance taken i.e, 08/09/2021 till realization. The OP has shown deficiency in service by not responding to the complainants claim. Hence the OP is liable to pay compensation of Rs.1,00,000/- and litigation charges of Rs.10,000/-.

17. Point No.3: In view of the discussion referred above, we proceed to pass the following:-

:ORDER:

1. The complaint filed under section 35 of consumer protection act 2019, is allowed in part.
2. The OP is directed to repay the amount as per the terms of the policy i.e, after deduction of surrender penalty of Rs.89,283.05/- with an interest of 10% from 08/09/2021 till realization.
3. The OP is directed to pay compensation of Rs.1,00,000/- and litigation charges of Rs.10,000/-.
4. The OP is directed to pay entire award amount within 45 days from the date of order failing which shall pay an interest of 12% from the date of such default till realization.
5. Furnish the copy of this order and return the extra pleadings and documents to the parties with no cost.

(Dictated to the Stenographer, got it transcribed and corrected, pronounced in the Open Commission on this 30^THday of NOVEMBER 2024)

Documents produced by the Complainant-P.W.1 are as follows: