Haryana

Ambala

CC/210/2018

Piyush Goel - Complainant(s)

Versus

Bajaj Allianz Life Insurance Co Ltd. - Opp.Party(s)

28 Nov 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

                                                          Complaint case No.: 210 of 2018.

                                                          Date of Institution           :  04.07.2018.

                                                          Date of decision    :  28.11.2019.

 

Piyush Goel age 29 years S/o Shri Parveen Kumar Goel, R/o H.No.544, B.C.Bazzar, Ambala Cantt.  

          ……. Complainant.

                                                    Versus

 

1. Bajaj Allianz Life Insurance Company Ltd., Parry Hotel, 1^st Floor, Opp GPO Staff Road, Ambala Cantt, through its Branch Manager.
2. Bajaj Allianz Life Insurance Company Ltd., GE Plaza, Ground Floor, Airport Road, Verawada, Pune-411006, Maharashtra through its MD cum CEO Shri Tarun Chug.
3. Shri Indrajit Dutta-Head, Policy Servicing, Bajaj Allianz Life Insurance Company Ltd, Policy Serviciing Department, 3^rd Floor, Bajaj Finserv Building, Survey No.208/1-B, Behinid Weikfield IT Park, Viman Nagar, Pune-411014.

                                                                           ….…. Opposite Parties.

 

Before:        Smt. Neena Sandhu, President.

                   Smt. Ruby Sharma, Member.

Shri Vinod Kumar Sharma, Member.         

                            

Present:       Shri Arvind Goel, Advocate, counsel for the complainant.

Shri Rajiv Sachdeva, Advocate, counsel for the OPs.

 

Order:        Smt. Neena Sandhu, President

Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) praying for issuance of following directions to them:-

1. To pay the Maturity amount of Rs.25,000/- alongwith all benefits like bonus etc. & alongwith interest @ 24% per annum from the date of maturity of said policy till the date of realization of above maturity amount.  
2. To pay Rs.30,000/- as compensation for the mental agony and physical harassment suffered by him.
382.  

                   Any other relief which this Hon’ble Forum may deem fit.

 

Brief facts of the case are that the complainant on 28.04.2013, took Insurance Policy SARVE SHAKTI SURAKSHA POLICY, bearing membership No.0300336060, under policy No.0198061380 in his name from OP No.1 for a premium of Rs.5,000/- per annum for 5 years, having maturity date 28.04.2018. He deposited Rs.5,000/- per annum for 5 years continuously well in time every year. The above said policy was already matured on 28.04.2018 & on 30.04.2018, he along with his father visited the office of OP No.1 & asked the maturity payment cheque but the official of the branch told to him that the payment of this policy is to be made by the head office directly by way of cheque. The concerned official after checking the status of the policy in question and informed that cheque no.2108014 has already been issued and same would be delivered to him shortly. However, he did not receive the same and after waiting for 10 days, his father again visited the office of OP No.1 & enquired about the payment cheque. The concerned official had shown his helplessness and told him to contact at the company head office toll free number 1800037272. On 15.05.2018, complainant had a talk with Mr. David, the company customer care executive who told him to send the scanned documents such as copy of policy, copy of Aadhar, Copy of Pan Number. Copy of cross cancelled cheque of complainant etc. He immediately scanned all the documents and sent the same to the customer care @ Bajaj Allianz via E-mail, the above said mail was received by the company on 15.05.2018 at 17.15 P.M. under SRN No.72747497. The concerned official told that maturity payment of the policy in question will be credited in his account through NEFT at the earliest. No payment was received till date by complainant despite all efforts. He submitted all the relevant papers to OPs, which was demanded by OPs. Even after receiving all the papers, the OPs did not pay the maturity amount. He had served a legal notice dated 26.05.2018, upon the OPs, but of no avail. Thereafter, on 11.06.2018, he received a letter dated 31.03.2018, from the head of the Policy Servicing Department of the company i.e. OP No.3, stating therein that the cheque No.210804 dated 27.04.2018 of Rs.23,149/- was sent to him. Whereas, the said cheque has not been received by him till date. No proof of sending of the above said cheque by the OPs to him has been produced by the OPs. Had the OPs sent the said cheque to him, why they had demanded the copy of policy, pan number, cross blank cheque from complaint through Scanned/E-mail on 15.05.2018 for giving the credit of maturity amount through NEFT. Even otherwise how the OPs can send the cheque dated 27.04.2018 on 31.03.2018, whereas the policy was to be matured on 28.04.2018. By not paying the maturity amount, the OPs have committed deficiency in service. Hence, the present complaint.

2.                Upon notice, OPs appeared through counsel and filed written version, raising preliminary objections regarding maintainability; cause of action & not coming to this Forum with clean hands. On merits, it is stated that the policy in question matured on 28.04.2018 & an amount of Rs.23,606/- vide cheque No.476965 dated 23.08.2018 was sent to complainant and the said cheque has already been encashed by him. The complainant as per the terms & conditions of the policy the complainant was only entitled to the account value as on date followed by the closure of the individual account. The minimum maturity guarantee is the total net premiums paid till maturity date less sum of scheme administration fee deducted till maturity date, provided all due premiums have been paid by you for respective member. The complainant is not entitled to pay amount of the claim, damages or compensation. No legal notice was ever served on the OPs. In this connection, it is further stated that mere serving the legal notice does not entitle the complainant to recover the insurance amount against the terms and conditions of the policy. Terms & conditions of the policy are binding upon both the parties i.e insurer, insured and their legal representatives.  There is no deficiency in service on the part of OPs and prayer has been made for dismissal of the present complaint with costs.

3.                The ld. counsel for the complainant tendered affidavit of complainant as Annexure CA along with documents as Annexure C-1 to C-12 and closed the evidence on behalf of complainant. On the other hand, learned counsel for OPs tendered affidavit of Shri Yogesh Dalmiya, Executive Legal, Bajaj Allianz Life Insurance Company Ltd. Delhi as Annexure OP/A alongwith documents Annexure OP1 to OP6B and closed the evidence on behalf of OPs.

4.                We have heard the learned counsel of the parties and have carefully gone through the case file.

5.                 Admittedly, complainant had taken SARVE SHAKTI SURAKSHA INSURANCE POLICY from the OPs on 28.04.2013, for a premium of Rs.5,000/- p.a. for 5 years having maturity date 24.04.2018. The complainant has pleaded that he paid the premium of Rs.5,000/- per annum continuously for five years. As such he was entitled to get maturity amount of Rs.25,000/- along with all benefits like bonus etc. but the OPs paid only Rs.23,149/- without giving any reason. Thus they be directed to pay the remaining amount as per the terms and conditions of the insurance policy. They be also directed to compensate the complainant for the mental agony and physical harassment caused to him alongwith litigation expenses.

                   On the contrary Ld. counsel for the OPs vehemently argued that the OPs have already paid the maturity amount to the complainant as per the terms and conditions of the policy. Thus there is no deficiency on their part. Prayer has been made for dismissal of the present complaint with heavy costs.

6.                Admittedly, on 28.04.2013, the complainant had taken the policy in question from the OPs and the same got matured on 28.04.2018. Certainly, the complainant is entitled to get the maturity amount. It may be stated here that parties are bound by the terms and conditions of the policy. In the back page of certificate of insurance Annexure C-12 in term no. 2 Benefits under the Group Insurance Scheme at point ‘B’ Maturity Benefits, it is stated that “on the individual member being alive on the maturity date and surviving the entire term of the Membership under group insurance scheme, the individual account value of the individual Members as on the date of Maturity shall be paid. The minimum maturity guarantee is the total Net Premium paid till Maturity date less sum of Scheme Administration Fee deducted till maturity date, provided all due premiums have been paid for the respective Member.

          Net Premium means Premium less Life Insurance Premium i.e. the amount payable in respect of the Member on each Premium Due date to continue the life insurance cover on the life of the individual Member, which is deductible up front from the Premium”. Under the heading Scheme Administrative Fee, it is stated Scheme Administration fee is to be charged as mentioned below:-

(A)    25% of the net premium in the first year of the membership and 6% of the net premium in subsequent years, as and when premium is paid.

(B)     1.25% of account value at the end of each financial year after adjusting the account value for the investment returns.

          Admittedly, complainant paid premium of Rs.5,000/- per year for years, in total Rs.25,000/- till maturity date. As per term No.2-B, referred to above the complainant was entitled to get maturity amount equivalent to total net premium less sum of scheme administrative fee deducted till maturity date. In the letter dated 31.03.2018 (Annexure C-13), it is stated that the maturity claim was processed under the policy and released the amount of Rs.23,149/-. In the reply dated 04.09.2018, to the legal notice served upon the OPs by the complainant, it is mentioned that the OPs delivered the cheque No.476965 dated 22.08.2018 of Rs.23,606/- towards maturity benefits and the same was received by the complainant on 01.09.2018. This fact was not refuted by the Ld. counsel of the complainant. It may be stated here that the OPs have paid the maturity benefits to the complainant on 01.09.2018, after the filing of the present complaint i.e., 04.07.2018. Had the OPs paid the said amount to the complainant well in time, then there was no occasion for the complainant to file the present complaint and he would not have suffered from any mental agony and physical harassment. Since, the maturity benefits has been paid to the complainant after filing of the present complaint, therefore the complainant is certainly entitled to get compensation for the mental agony and physical harassment suffered by him alongwith litigation expense.

7.                In view of the aforesaid discussion, we hereby partly allow the present complaint and direct the OPs to pay Rs.5,000/- as compensation for mental agony and physical harassment suffered by the complainant, inclusive of litigation expenses. The OPs are further directed to comply with the aforesaid direction, within the period of 30 days from the date of receipt of the certified copy of this order. Certified copies of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced on :28.11.2019.

                        (Vinod Kumar Sharma)            (Ruby Sharma)     (Neena Sandhu)              Member                                      Member             President