DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA.

CC.No.446 of 06-09-2012

Decided on 21-12-2012

Maghar Singh, aged about 58 years s/o Sh.Niranjan Singh r/o # 27567 Lal Singh Basti St. No.22, Bathinda.

........Complainant

Versus

Bajaj Allianz Life Insurance company Ltd., through its Manager First Floor above ICICI Bank, Bibi Wala Road Bathinda.

.......Opposite party

Complaint under Section 12 of the Consumer Protection Act, 1986.

QUORUM

Smt. Vikramjit Kaur Soni, President.

Smt. Sukhwinder Kaur, Member.

Present:-

For the Complainant: Sh.Sanjay Goyal, counsel for complainant.

For Opposite party: Sh.M.L Bansal, counsel for opposite party.

ORDER

VIKRAMJIT KAUR SONI, PRESIDENT:-

1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act'). The brief facts of the complaint are that the opposite party approached the complainant for selling the life insurance plan and stated that he has to make the payment of Rs.1,10,000/- only once and he will be insured for Rs.2,20,000/- and in case he wants to get the refund of the amount then he will be given Rs.1,10,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and he can claim the refund of the amount anytime. The complainant purchased the insurance policy bearing No.0264809643 and paid Rs.1,10,000/- in the month of April 2012 and he was assured by the opposite party that he is not required to make any further payment as insurance amount is to be paid only once. The opposite party neither issued any cover note nor separate terms and conditions nor free look period option to the complainant. In May 2012 the complainant received a telephonic call from Head office of the opposite party to deposit Rs.1,10,000/- again in the next year also for which he clearly stated that he cannot afford to make the payment of Rs.1,10,000/- again as at the time of purchase of the insurance policy he was conveyed that he has to make the payment only once. The complainant approached the opposite party for seeking the refund of Rs.1,10,000/- and their officials who was present in the office obtained his signatures on some blank papers on the ground that some formalities are required to be completed for the payment of the refund and was conveyed by them he can collect the refund cheque after 10 days. When the complainant approached the opposite party after 10 days, they refused to refund any amount and conveyed him that he has to make the payment of minimum two years otherwise he will not be entitled to get the refund of any amount. Hence the complainant has filed the present complaint to seek the refund of Rs.1,10,000/- alongwith interest, bonus, cost and compensation.

2. Notice was sent to the opposite party. The opposite party after appearing before this Forum has filed its written statement and pleaded that the complainant after understanding the terms & conditions of the said policy has taken the traditional plan in which he has to make the annual payment for 2 years and he himself had opted for annual payment as such since he has the knowledge that he has taken the annual payment (traditional) plan for availing the benefits of 5 years term and for making the premium of two years, so he is required to pay atleast two premiums. After the issuance of the said policy, the complainant made a false complaint to the higher officials of the opposite party and during the enquiry, he himself gave in writing dated 8.8.2012 that he is satisfied with the terms & conditions of the said policy, but he has again filed the present complaint before this Forum by concealing the aforesaid facts against the documentary record. The complainant after fully understanding the features, benefits, terms and conditions of 'Bajaj Allianz Invest Gain-Economy' proposed for the said policy and submitted a proposal form for the insurance dated 11.4.2012 duly signed by him in English language. The proposal of the complainant was accepted as proposed by him and a policy bearing No.0264809643 was issued to him. The original policy bond containing express terms and conditions of the contract of the insurance was dispatched to the complainant at the address provided by him in the proposal form vide Speed Post No.EH457234009IN dated 30.4.2012 which was duly received by him. The complainant was offered 15 days Free Look Cancellation Period from the date of receipt of the policy bond to review the terms and conditions of the contract of the insurance as per the policyholders' Protections Regulation, 2002 and the said Free Clause has specifically mentioned in the Proposal for the insurance itself as a statutory provision to make him aware of the cancellation option available to him. If any of the promises made at the time of solicitation of the insurance were not the part of the policy document received by by him and the complainant should have raised the objection regarding that but he neither raised any objection with regard to the terms and conditions of the said policy nor ever disputed the contents of the policy document within the free look cancellation period. The complainant enjoyed the risk cover of Rs.2,20,000/- which clearly indicates that he was fully aware and satisfied with the terms of the said policy and the instant complaint has been filed as an afterthought to illegally withdraw the amount which was never agreed as per the contract of the insurance. No promise to the refund of the amount with interest @ 12% p.a was ever made by the opposite party and no such promise is the part of the said policy. The opposite party never authorized anyone to make any promise beyond the express terms and conditions as approved by the IRDA which were the part of the policy document received by the complainant. The complainant himself opted for the regular premium policy wherein he is required to pay the premiums for 2 years and the benefit terms of the said policy is 5 years. Since the said policy has not acquired any surrender value thus the question of refunding any amount does not arise.

3. The parties have led their evidence in support of their respective pleadings.

4. Arguments heard. The record alongwith written submissions submitted by the parties perused.

5. Admitted facts of the parties are that the complainant had purchased the insurance policy bearing No.0264809643 and paid Rs.1,10,000/- in the month of April 2012.

6. The submissions of the complainant are that he was conveyed by the opposite party that he has to make the payment of Rs.1,10,000/- only once and in case he wants to get the refund of the amount then he will be given Rs.1,10,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and he can claim the refund of the amount anytime. In May 2012 the complainant received a telephonic call from Head office to deposit the premium of Rs.1,10,000/- of the next year but being a retired employee and having pension as only source of income he is unable to deposit the amount of Rs.1,10,000/- again so he requested them that at the time of issuance of the said policy, he was assured only one time premium is payable and the amount of Rs.1,10,000/- that has already been towards the premium be refunded to him but the opposite party refused to accede to his request.

7. The submissions of the opposite party are that the complainant has purchased the traditional plan in which he has to make the annual payment for 2 years and he himself opted for the annual payment as such since it was in his knowledge that he has taken the annual payment (traditional) plan for availing the benefits of 5 years term and making the premium of two years, so he is required to pay atleast two premiums. Moreover the complainant himself gave in writing dated 8.8.2012 that he is satisfied with the terms & conditions of the said policy, but he again requested for the refund of the premium. The complainant after fully understanding the features, benefits, terms and conditions of 'Bajaj Allianz Invest Gain-Economy' proposed for the said policy and submitted a proposal form for the insurance dated 11.4.2012 duly signed by him in English language. The proposal of the complainant was accepted and a policy bearing No.0264809643 was issued to him. The original policy bond containing express terms and conditions of the contract of the insurance was dispatched to the complainant at the address provided by him in the proposal form vide Speed Post No.EH457234009IN dated 30.4.2012 which was duly received by him. The complainant was offered 15 days Free Look Cancellation Period from the date of receipt of the policy bond to review the terms and conditions of the contract of the insurance as per the policyholders' Protections Regulation, 2002 but he has not availed that period.

8. The opposite party has placed on file Ex.R6 policy document. In this the relevant portion of Clause 4 of Surrender Value is reproduced as under:-

“4) Surrender Value:

The policy can be surrendered provided three full years premiums have been paid. In case of premium payment of 2 and 3 years, the policy can be surrendered after 1 year from the date of commencement. For premium payment terms of 5 and 6 years, the policy can be surrendered after two full years premiums are paid. The Guaranteed Surrender Value (GSV) will be as per the table given below:-

Guaranteed Surrender Value Scale

As the case in hand is with regard to the traditional policy not with regard to the Unit Linked Policy. The complainant had paid Rs.1,10,000/- as one year premium and he was insured for Rs.2,20,000/-. The complainant has to pay this premium for 2 years and as per proposal form Ex.R2 page No.2 and the benefit term was 5 years.

Moreover vide Ex.R5 the complainant has given a satisfaction regarding the said policy on dated 8.8.2012. In this satisfaction he has fully mentioned that he is fully satisfied with all the terms and conditions of the said policy. Now at this stage he cannot challenge that the opposite party conveyed him that the premium was to be paid only once and he has not received the terms and conditions or not explained to him or has not been given 15 days free look cancellation period. The complainant has fully agreed with the terms and conditions supplied to him. But as he does not want to continue with the said policy Bajaj Allianz Invest Gain-Economy Clause 4 provides for the surrender value in the policy schedule wherein it has been specifically mentioned that in case of the premium payment term is of 2 and 3 years, the policy can be surrendered after 1 year from the date of commencement. The complainant has purchased the said policy in April 2012 and requested the opposite party in May 2012 for the refund of the premium but as per the policy conditions no premium can be refunded and the surrender value will be given that too according to the abovementioned table in Clause 4 of the surrender value of terms and conditions of the policy. It has been specifically mentioned in it:-

'Premium Term:-2 years, Surrender Value:-One year from commencement, Guaranteed Surrender Value:-60% of the paid premiums exclusive the premiums for all additional benefits and extra premium if any'

9. Therefore in view of what has been discussed above the complainant is entitled to get the surrender value as mentioned in Clause 4 of Ex.R6. Hence this complaint is accepted with cost of Rs.2000/- and the opposite party is directed to pay the surrender value as per Clause 4 of the said policy document Ex.R6. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.

In case of non-compliance the interest @ 9% per annum will yield on the amount of surrender value till realization.

10. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.

Pronounced in open Forum:-

21-12-2012

Vikramjit Kaur Soni

President

Sukhwinder Kaur

Member