Date of Filing: 16/05/2011

        Date of Order: 11/07/2011

BEFORE THE I ADDITIONAL DISTRICT CONSUMER DISPUTES REDRESSAL FORUM SESHADRIPURAM BANGALORE -  20

Dated:  11^th DAY OF JULY 2011

PRESENT

SRI.H.V.RAMACHANDRA RAO,B.SC.,B.L., PRESIDENT

SRI.KESHAV RAO PATIL, B.COM., M.A., LL.B., PGDPR, MEMBER

SMT.NIVEDITHA .J, B.SC.,LLB., MEMBER

COMPLAINT NO. 933 OF 2011

Mr. Tanveer Ahmed,

Aged About 38 years,

R/at: No.3660, 9^th Main,

2^nd Cross, Cauvery Nagar,

B.S.K. 3^rd Stage,

Bangalore-560 085.                                                            ….  Complainant.

V/s

1) Bajaj Allianz Life Insurance

Company Limited,

Represented by the Manager/Concerned Officer,

G.E. Plaza, Ground Floor,

Airport Road, Yerawada,

PUNE-411 006.

2) Bajaj Allianz Life Insurance

Company Limited,

Represented by its Manager,

No.26, Akshaya Commercial Complex,

Victoria Road-Near Hyderabad Biryani,

BANGALORE-560 047.

(Policy Issuing Branch Office)                                          …. Opposite Parties.

BY SRI. H.V.RAMACHANDRA RAO, PRESIDENT

-: ORDER:-

The brief antecedents that lead to the filing of the complainant U/s 12 of the Consumer Protection Act seeking direction to the Opposite Parties to pay Rs.30,000/-, are necessary:-

          Being influenced by the advertisement of the opposite parties regarding the policy called as “new unit gain” the complainant has paid Rs.18,000/- to the first opposite party during first week of January-2008 towards first year premium.  The opposite parties assured that the terms of the policy and the policy will reach within 10 days.  Even though the opposite parties have realized the cheque has not issued the complete policy.  The complainant contacted the opposite parties several times.  During the second week of August-2009 the complainant had contacted second opposite party and requested to furnish the policy bond, but they are postponing the event.  Even under the insurance law free look period is there, even that has not been given.  Hence the complainant has issued the notices to the opposite parties on 19.03.2011 as it has not complied with this complaint has been filed seeking refund of Rs.18,000/- and compensation of Rs.12,000/-.

2.       In brief the version of the opposite parties are:-

          The complaint is not maintainable, it is barred by time.  It is malicious.  The entire policy has been issued and is not incomplete.  Under the policy terms and conditions as the complainant has not paid the subsequent premiums it has lapsed.  The complainant has intentionally suppressed the facts.  The complainant has come to this Forum with malafide intentions.  Hence the complaint may be dismissed.

3.       To substantiate their respective cases the opposite parties had filed a Memo stating its version be read as its evidence.  The complainant did not turn up at all after filing the complaint.  Hence the arguments of the opposite parties were heard.

4.       The points that arise for our consideration are:-

:- POINTS:-

1. Whether the complaint is barred by time?
2. Whether there is any deficiency in service?
3. What Order?

5.       Our findings are:-

Point (A)        :           In the Positive.

Point (B)        :           In the Negative.

Point (C)        :           As per the final Order

                                      for the following:- 

-:REASONS:-

Point A to C :-

6.       Reading the pleadings in conjunction with the documents produced by the complainant himself it is an admitted fact that the complainant had paid Rs.18,000/- towards first premium of policy No.0084464553 on 28.01.2008 as per the first premium receipt.  According to which the sum assured is Rs.3,60,000/- and premium is Rs.18,000/- per year which has to be paid and the risk between 28.01.2008 and 28.01.2028.  Along with the said receipt the opposite party has written to the complainant on 31.01.2008 thus:-

“We also offer you a 15 days Free Look Period, which commences from the date of receipt of this Policy Document.  During this period, you have the option to peruse the terms and conditions and should you disagree with any of the terms and conditions, you are entitled to a Free Look refund.”

The said letter and the enclosures reads thus:-

These are the documents produced by the complainant himself.  Here the complainant has been sent with the terms and conditions of the policy as per the schedule and also stated that free look period of 15 days is given and if the complainant is not willing to this said terms and conditions he can cancel the policy and he is entitled to take refund of the amount.  As such if the complainant was not satisfied with these terms and conditions that has been offered in the letter dated: 31.01.2008 he could have cancelled the policy and sought refund of the money which would have been paid to him.  As he has not exercised that option he cannot turn round and say that the complete policy documents or terms and conditions of the policy are not supplied to him. 

7.       In any event when the opposite parties had given an option to the complainant on 31.01.2008 itself the cause of action for the complainant arose on 31.01.2008 and he should have filed the complaint for any deficiency in service within 31.01.2010.  But this complaint is filed on 16.05.2011 long after one year after the period of limitation ended.  Hence it is hopelessly barred by time.  Merely the complainant has issued a notice to the opposite parties on 19.03.2011 this will not enlarge the limitation or curtail the limitation.  Even this notice is issued long after two years after the period of limitation.  Hence the complaint is barred by time as rightly contended.

8.       The terms and conditions of the policy are:-

If the policy holder has failed to make a payment of Regular Premium due by the due date as specified in the Schedule, the Company shall give a grace period of 30 days (15 days, if the frequency of payment is monthly).  If the life Assured’s death occurs during the grace period, the full death benefit as per Section 9 shall be payable.

If the unpaid Regular Premium was due during the first three policy years, and the policy holder has failed to make the payment before the expiry of the aforesaid grace period:-

i) The Policy shall immediately lapse for the Insurance cover including the rider cover.  However, during the period of lapsation, the Policy shall continue to participate in the investment performance of the underlying Fund(s), subject to deduction of all charges except Moratality Charge and Rider Premium Charges, if any,

ii) The policy holder may revive the policy within a revival period of two years from the due date of first unpaid Regular Premium and recovery of any due but unrecovered Charges except Mortality charge and any Rider Premium Charge, since due date of first unpaid Regular Premium, failing which the Policy shall be terminated and the Surrender Value as on date of termination shall be paid at the end of the third policy year or at the expiry of the revival period, whichever is later.

If the first unpaid Regular Premium was due after the first three policy years, and the policy holder has failed to make the payment before the expiry of the aforesaid grace period:-

ci) Provided that the Policy holder has paid all Regular Premium due during the first three policy years, the Policy holder will be given an opportunity to revive the Policy, within two years from the date of first unpaid Regular Premium.  During this Limited period of revival, all the charges will continue to be deducted and the Policy shall continue for full Sum Assured and with additional Rider Benefits, if any, (except UL Waiver of Premium Rider benefit, if opted) till the Regular Premium Fund Value less surrender charge, if any, does not fall to an amount equivalent to one Annual Premium (NAV) across all the funds.

cii) If the Policy holder has failed to revive the Policy within the revival period of two years, the Policy shall continue for full Sum Assured and with additional Rider Benefits, if any, (expect UL Waiver of Premium Rider benefit, if opted) at the option of the Policy holder subject to deduction of all the Charges, till the Regular Premium Fund value less surrender charge, if any, does not fall to an amount equivalent to one Annual Premium (NAV) across all the funds.

ciii) When the Regular Premium Fund value less surrender charge, if any falls to an amount equivalent to one annual premium or the Policy holder does not opt to continue the policy after the revival period, the contract shall be terminated by paying, the Regular Premium Fund value less surrender charge, if any, plus the Top Up Premium Fund Value, if any, as on date of termination.”

Accordingly the policy has lapsed, the policy is not in force at all.  As the complainant had not paid the subsequent premiums i.e., the premium as on 31.01.2009, the premium as on 31.01.2010 the premium as on 31.01.2011 it has lapsed.  Hence he cannot seek refund of the amount, i.e, the first premium paid by him. 

9.       There is a clause for revival of the policy.  If complainant is interested he can utilize the clause by paying the subsequent premiums with penalty and get the policy revived, for which this order will not come in the way.  Here there is no deficiency in service.  The complainant himself is responsible for this complaint and not the opposite parties.  There is no deficiency in service also.  Hence we hold the above points accordingly and proceed to pass the following:-

-: ORDER:-

1. The Complaint is Dismissed.
2. Return the extra sets filed by the parties to the concerned as under Regulation 20(3) of the Consumer’s Protection Regulation 2005.
3. Send a copy of this order to both parties free of costs, immediately.

(Dictated to the Stenographer, transcribed and typed by him, corrected and then pronounced by us in the Open Forum on this the 11^th Day of July 2011)

MEMBER                                    MEMBER                              PRESIDENT