IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Thursday the 30th day of June, 2016
Filed on 6.1.2015
Present
1.Smt. Elizabeth George (President)
2.Sri. Antony Xavier (Member)
3.Smt.Jasmine.D. (Member)
in
C.C.No.1/2015
between
Complainant:- Opposite Party:-
Smt. Sumakumari. C. Aviva Life Insurance Co. India Ltd.
C/o Rajan.K. Head Office, Aviva Tower
Thattathezhathu Puthenveedu Sector Road, Oppo. Golf Course
Kallumala P.O., Mavelikara DLF – Phase V, Sector 43
(By Adv. Bijo Mathew) Gurgaon, Pin – 122 003
Represented by General Manager
(By Adv. Saji Isaac)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
The case of the complainant is as follows:-
The complainant is a policy holder of the opposite party the insurance company. She had been made to believe by the agent of the opposite party that after paying 3 installments by premium the total sum assured will be given to the complainant. Believing these words complainant paid 3 installments of Rs.1 lakh each on 22.8.2008, 12.10.2009, and 20.12.2010. Complainant is an illiterate lady who has no idea about these papers signed when the agent introduced the policy told to pay the premium amount. Now the complainant is in need of money and she approached the agent for cash withdrawal. At that time only she came to know that the policy is for the period of 10 years. She is not in a circumstance to pay the balance installments. Now she is in need of money, but the opposite party is not ready to pay the amount. Hence the complaint.
2. The version of the opposite party is as follows:-
The opposite party filed version challenging the maintainability of the complaint. According to the opposite party the complaint is barred by the law of limitation as the policy of the complainant was terminated on 26.7.2012 and the complaint is after period of 2 years. It is contended by the opposite party that the policy taken by the complainant is a unit linked policy and is a speculative investment with speculative gain and hence the complainant is not a consumer within the meaning of Consumer Protection Act. The allegation that without knowing the full details, complainant was made to sign the policy applications and she paid 3 installments defaulted the payment of subsequent premiums demanded by the opposite party. According to the conditions of the policy, if regular premium due is not received with the grace period of 30 days from the due date of the first unpaid installment of regular premium, then the policy will remain in force for a period of 2 years from the due date of the first unpaid installment of regular premium, and the charges as specified in the schedule will continue to be deducted. The policyholder may exercise any of the 3 options during the 2 year reinstatement period namely, reinstate the policy, surrender the policy or continue the policy beyond the reinstatement period without paying the regular premium, provided the Company receives a written notice from the policy holder within 60 days from the due date requesting to continue the policy. The complainant did not exercise any of the three options as provided under the policy conditions. The policy conditions stipulate that if the policy holder fails to exercise any of the options, then the policy with all available benefits shall automatically terminate at the expiry of the reinstatement period and the Company shall pay the surrender value to the policy holder. The policy of the complainant was automatically terminated at the expiry of the reinstatement period on 26.7.2012. The complainant was also sent the amount of Rs.1,00,000/- as the surrender value by cheque and an interest of Rs.99/- was also paid to the complainant. There is no deficiency in service on the part of the opposite party.
3. Complainant was examined as PW1. The documents produced were marked as Exts.A1 to A4. No oral evidence adduced from the side of the opposite party. One document produced by the opposite party was marked as Ext.B1. 4 . Complainant filed a petition for hearing about the maintainability of the complaint. After hearing both parties this Forum passed an order finding the complaint as maintainable. Against the said order, the opposite party filed revision petition before the Hon’ble State Commission, and Hon’ble State Commission dismissed the petition stating that the revision petitioner can raise this point regarding maintainability after the disposal of the complaint.
5. The next point is to be considered is whether there is any deficiency in service on the part of the opposite party. According to the complainant, she being a poor lady blindly believing the agents of the opposite party paid 3 installments of Rs.1 lakh each. While cross examining the complainant, she answered to the question of the opposite party that she is a ‘graduate’. But at the time of hearing, she stated that she did not understand the word meaning ‘graduate’ and deposed before the Forum that she was not even passed SSLC. According to the complainant she is in dire need of money, hence she approached the opposite party for the amount offered by the opposite party, and only after that she came to know that she should pay annual installments of Rs.1 lakh each in every year for getting the full payment. She again stated that there is a fraud on the part of the opposite party and she was deceived by the agents of the opposite party. While cross examining her she answered to the question, “... …...................................” There is no oral or documentary evidence produced by the opposite party to prove their contention that the policy having been taken by the complainant for investment of premium amount in share market which is for speculative gain. According to the opposite party the policy conditions stipulate that if the policy holder fails to exercise any of the options like reinstatement of the policy, surrender of the policy, or continue the policy beyond the reinstate period without paying regular premium, then the policy with all available benefits shall automatically terminate at the expiry of the reinstatement period. They further stated that the policy of the complainant was terminated and they sent an amount of Rs.1,00,000/- as the surrender value by cheque and an interest of Rs.99/- was also paid to the complainant. But the complainant stated before the Forum that she did not receive the cheque. Opposite party has not produced any document to prove that they have sent an amount of Rs.1,00,000/- to the complainant. “As per the IRDA (Treatment of Discontinued Linked Insurance Policies) regulation 2010, Regulation 7, obligation of an insurer upon discontinuance of a policy is stated. As sub clause of Regulation 7 the charge levied on the discontinuance, as a percent of one annual premium or fund value on the date of discontinuance and its limits are specified. After three years the maximum discontinuance charge for the policy having annualized premium above Rs.25,000/- is shown as lower of 3% (AP or FV) the maximum of Rs.4,000/-.” So the opposite party is eligible for the deduction of Rs.4,000/- only. In our view, as per the above Regulation, the complainant is entitled to get Rs.2,96,000/-. The failure on the part of the opposite party in refunding the amount, amounts to deficiency in service.
In the result, complaint is allowed. The opposite party is directed to refund an amount of Rs.2,96,000/- (Rupees two lakhs ninety six thousand only) along with 9% interest per annum from the date of filing the complaint till realization to the complainant. Since the primary relief is granted, there is no order as to compensation. The opposite party is further directed to pay an amount of Rs.3,000/- (Rupees three thousand only) towards costs of this proceedings to the complainant. The order shall be complied within one month from the date of receipt of this order.
Dictated to the Confidential Assistant transcribed by her corrected by me and pronounced in open Forum on this the day 30th day of June, 2016.
Sd/- Smt.Elizabeth George (President)
Sd/- Sri. Antony Xavier (Member)
Sd/- Smt.Jasmine.D. (Member)
Appendix:-
Evidence of the complainant:-
PW1 - Sumakumari (Witness)
Ext.A1 - Policy document
Ext.A2 - Renewal premium receipt for 22.8.2009
Ext.A3 - Pass book of the complainant
Ext.A4 - Copy of Policy Account Statement
Evidence of the opposite party:-
Ext.B1 - Brochure of Life Saver Plus Policy
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite parties/S.F.
Typed by:- pr/-
Compared by:-
