BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM
VAZHUTHACAUD, THIRUVANANTHAPURAM.
PRESENT
SRI. P. SUDHIR : PRESIDENT
SMT. R. SATHI : MEMBER
SMT. LIJU B. NAIR : MEMBER
C.C. No. 49/2011 Filed on 17.02.2011
ORDER DATED: 21.12.2015
Complainant:
Shelly Kumari, D/o late Krishnan, Souparnika, Mukkalavattom, Vakkom P.O, Thiruvananthapuram.
(By adv. S. Krishnakumar)
Opposite parties:
- Bajaj Allianz Life Insurance Company Ltd., GE Plaza, Airport Road, Yerawada, Pune-411 006.
- Bajaj Allianz Life Insurance Company Ld., II Floor, SS Plaza, College Junction, Attingal, Thiruvananthapuram-695 101 represented by Manager.
(By Adv. Sreevaraham G. Satheesh)
This C.C having been heard on 17.06.2015, the Forum on 21.12.2015 delivered the following:
ORDER
SMT. LIJU B. NAIR: MEMBER
The case of the complainant is as follows: Complainant submitted a proposal form for life insurance to the 1st opposite party through 2nd opposite party for unit linked pension plan. She opted the frequency of premium as single and the said amount comes to Rs. 99,000/-. Opposite parties accepted the proposal and issued the policy certificate with No. 0076642548 dated 30.11.2007. On receiving the same she found that frequency of premium payment is noted as annual and the due date for payment is 28th November of every year. So she contacted the 2nd opposite party and they in turn asked her to return the policy certificate to rectify the mistake. Complainant frequently contacted the 2nd opposite party for the corrected policy certificate but they told her that the same was sent to the 1st opposite party’s branch at Thiruvananthapuram for rectification. That being so in November 2008 2nd opposite party issued revival notice to the complainant. She again contacted the opposite party and they directed the complainant to submit a request again to avoid the payment and to change annual premium scheme noted in the policy certificate to single premium and the corrected certificate will reach the complainant through registered post, but nothing happened. In 2009 also she received the revival letter. But now she got a revival intimation letter stating that she had to pay an outstanding premium of Rs. 1,98,000/- and policy stands lapsed due to non-payment of premium. As such life insurance is not available and the same will be reinstated only after the revival of the policy after clearing the premium dues. Immediately after getting the said letter she approached the opposite party’s branch at Thiruvananthapuram and enquired about the matter and there it was revealed that the 2nd opposite party did not send the certificate to their branch office at Thiruvananthapuram and no policy certificate was sent to the 1st opposite party for rectification through the Thiruvananthapuram branch. For the last 3 years the 2nd opposite party assured the complainant that error free policy certificate will be issued to the complainant from their head office, but nothing happened. So complainant found deficiency in service and unfair trade practice on the part of the opposite parties and she wants the opposite parties to issue revised policy certificate and pay the sum assured on maturity or in the alternate she prays to repay the amount already collected as premium from the complainant.
Opposite parties entered appearance and filed version contending as follows: It is true that the complainant has taken life insurance policy named “Unit Gain Easy Pension Plus R.P (M) Size 3” from them on 28.11.2007. Before taking the policy she approached the opposite party’s agent and she was detailed about the benefits of the policy. After knowing all these details she approached the 2nd opposite party and got herself convinced with the benefits of the policy after confirming the same. Further they had given the policy schedule and policy document after the remittance of the first premium for Rs. 99,000/-. She paid only the first premium. The policy period is for 15 years. Opposite parties never issued single premium policy to their customers. The said policy is drafted after the approval from the insurance Regulatory Development Authority. The complaint raised by the complainant is against the approved policy terms and there is no provision for rectification of policy. As such the opposite parties never told the complainant that they will rectify the policy certificate and to alter the frequency of premium payment from 15 times to single. Complainant never approached the 2nd opposite party or anybody else till 28.10.2010. To avoid these kinds of allegations a 15 days free look period is there for the policy holder which is an option to review the policy terms and if found not acceptable return the same calling for cancellation of policy and refund of premium amount as per the applicable provisions. Further the present complainant has at no point of time ever raised a grievance regarding the frequency of premium and only after the lapse of policy she is disputing the frequency and trying to make a case by alleging that she had already approached the opposite party. She was well aware of the fact that she had to pay premium consecutively for 3 years. In the proposal form given before the 2nd opposite party, complainant herself declares that her educational qualification is matriculation and she is doing net work marketing from which she earns Rs. 2,50,000/- yearly. So this statement itself shows that she is a literate lady and she is socially and economically forward. It is true that revival letters are sent to the complainant in the year 2008 & 2009. If at all she had any complaint regarding the frequency of premium she can file complaint before the opposite party on receipt of the same at that time. But she never filed any such complaint. She filed the complaint before the opposite party only after getting the intimation letter showing that policy revival period for her policy ends on 30th November 2010. Only after this, she raised the contentions against the opposite parties. Only through the letter dated 28.10.2010 opposite parties came to know about the case of the complainant. The complainant herself willfully defaulted the 2nd and 3rd premium amount thereby committing violation of policy conditions. For the sake of her part she suppressed all her faults and blamed the opposite parties without any bonafide. This is only a cooked up story just for the purpose of this complaint. Moreover the complaint is barred by limitation. The terms, conditions, benefits and the payment of premium and everything was clearly stated in the policy condition document which was given by the opposite parties before taking the policy. She was well aware of these facts and now by willful suppression approached this Forum with unclean hands for which opposite party is eligible for compensatory costs.
Issues:-
- Whether the allegation against the opposite parties is true?
- Reliefs and costs if any?
Issues (i) & (ii):- Complainant filed affidavit along with 3 documents which were marked as Exts. P1 to P3. She was examined as PW1. Opposite party also filed chief affidavit to substantiate their contentions in the version. Perused the documents and heard both sides. Complainant approached this Forum by stating that opposite party issued policy to the complainant in which premium payment mode is marked wrongly. To substantiate this she produced Ext. P1 copy of insurance certificate. This insurance certificate is issued based on proposal form. Copy of the proposal form is there in Ext. P1. Policy is issued based on the details given in the proposal form. The only question to be decided herein is which premium frequency is opted by the complainant. On going through the copy of the proposal form the premium frequency mode is marked as single. But the premium term is denoted as 15 years, benefit term 15 years and the age at vesting is 67 years. Copy of the proposal form is produced by the opposite party also, but it is not marked. On going through the document it is seen that all other entries except premium frequency mode is the same as that produced by the complainant. In this document the premium frequency mode is marked as annual. So there arose a doubt regarding entry. Moreover Ext. P1 copy of policy document dated 30.11.2007 clearly states that there is a free look period for 15 days from the date of receipt of this policy document in which the policy holder has the option to peruse the terms and conditions and return the policy if they disagree to any terms and conditions stating the reasons for their objection. Then they will be eligible to get refund as per the policy conditions. Here in this case complainant failed to avail this option. Throughout this complaint she alleges that she had made several complaints before the opposite parties regarding the correction in premium payment mode. But not even a scrap of paper is produced before this Forum to substantiate this argument. Complainant produced Ext. P3 letter addressed to the Manager regarding change in premium payment mode, but it is not signed by anybody and there is no evidence to show that it was given to the opposite parties. So on going through the facts and on careful verification of the circumstances, complainant failed miserably to establish her case. The only option left before us is to dismiss the complaint without cost.
In the result, complaint is dismissed.
A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room.
Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the Open Forum, this the 21st day of December 2015.
Sd/-
LIJU B. NAIR : MEMBER
Sd/-
P. SUDHIR : PRESIDENT
Sd/-
R. SATHI : MEMBER
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C.C. No. 49/2011
APPENDIX
I COMPLAINANT’S WITNESS:
PW1 - Shelly Kumari. K
II COMPLAINANT’S DOCUMENTS:
P1 - Copy of policy documents dated 30.11.2007.
P2 - Intimation letter
P3 - Letter dated 03.01.2008
III OPPOSITE PARTY’S WITNESS:
NIL
IV OPPOSITE PARTY’S DOCUMENTS:
NIL
Sd/-
PRESIDENT
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