Haryana

Panchkula

CC/245/2016

VIJAY KUMAR ANAND - Complainant(s)

Versus

BAJAJ ALLIANZ LIFE INSURANCE COMPANY LTD. - Opp.Party(s)

ANIRUDH KUSH

25 Apr 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,  PANCHKULA.                                                            

Consumer Complaint No	:	245 of 2016
Date of Institution	:	08.09.2016
Date of Decision	:	25.04.2017

                                                                                          

Vijay Kumar Anand s/o Sh.Om Parkash Anand, R/o H.No.2692, Sector-21, Panchkula, Haryana.

                                                                                        ….Complainant

Versus

 

1.       Bajaj Allianz Life Insurance Company Ltd., West Hub, 2^nd Floor, Bajaj Finserve, Survey, # 208/1-B, Behind Weikfield IT Building, Viman Nagar Road, Pune, Maharashtra-411014, through its Managing Director.

2.       M/s Yes Bank Ltd., through its Manager, SCO No.29, Sector-11, Panchkula.

                                                                                        ….Opposite Parties

 

COMPLAINT UNDER SEC. 12 OF THE CONSUMER PROTECTION ACT, 1986.

 

Before:                 Mr.Dharam Pal, President.

Mrs.Anita Kapoor, Member.

 

For the Parties:     Mr.Anirudh Kush, Adv., for the complainant. 

                             Mr.Varun Chawla, Adv., for the Op No.1.

                             Op No.2 already ex-parte.

ORDER

(Dharam Pal, President)

1. The complainant-Vijay Kumar has filed this complaint against the Ops with the averments that he has saving bank account No.011093600002230 with the Op No.2 Branch and in the month of June, 2011, the complainant approached the bank to deposit money in the fixed deposit as the fix deposit earn higher rate of interest as compared to saving account interest. The official of Op NO.2 suggested the complainant that he should invest the money in the scheme launched by the OP no.1 and he would earn interest @ 11.5% per annum. He further assured that the money deposited by the complainant should be secured as the Op No.2 was master policy holder of the scheme of Op NO.1. On the advice of OP NO.2, the complainant invested the money in group seva plan NO.UIM73B01, Policy No.0225007732 and the complainant was also given membership No.0293101024. The plan was for the minimum term of five years and the complainant would withdraw the amount after expiry of three years without any surrender charges. But earlier, the Op No.1 wrongly mentioned the name of the complainant as Mr.Vijay Anani. Thereafter, the name of the complainant was corrected and correction certificate (Annexure C-5) to this effect was also issued by the OP No.1. On 07.06.2016, the complainant wrote a letter to OP No.2 requesting to make the payment of principal amount of Rs.2,00,000/- alongwith interest 11.5% per annum and to deposit the same in the saving bank account of the complainant. On 20.07.2016, the complainant visited the OP No.2 and came to know that the Op No.1 was not paying the interest @ 11.5% on the investment of the complainant and it was also told that the sundry charges would be deducted by the Op No.1. The complainant asked the Op NO.2 the reason for not paying to Op NO.1 and he told that the complainant should contact the OP No.1. The complainant wrote a letter to Op NO.1 but to no avail. This act of the opposite parties amounts to deficiency in service on their part. Hence, this complaint.
2. The Op No.1 appeared before this Forum and filed written statement by taking some preliminary objections and submitted that the complainant has never approached the Op No.1 for surrender of the policy. It is submitted that the contract of insurance was entered between the Op NO.2 and the OP NO.1 whereby the benefits were payable to the master policy holder. It is submitted that there is no privity of contract between the complainant and the Ops thus, the complainant is not a consumer under the Consumer Protection Act, 1986. It is submitted that the complainant being a prudent person himself opted to be enrolled as member of the “Super Secure-SP Group Master Policy bearing No.0225007732 administered by Yes Bank i.e. OP No.2 after understanding the features, benefits, risks, charges and other terms & conditions of the policy. It is submitted that the complainant was enrolled as a member of the said master policy with membership No.0293101024 and date of commencement was 23.01.2013 and membership term was 5 years and the basic sum assured was Rs.8,00,000/-. It is submitted that the single premium @ Rs.2,00,000/- was stipulated to be paid and paid by the insured member to enjoy the benefits under the policy. It is submitted that the certificate of insurance was accordingly issued to the complainant containing coverage details and other relevant terms and conditions of the membership which was duly received by him. It is submitted that the complainant neither disputed the terms & conditions of the Master Policy administered by Yes Bank i.e. Op No.2 nor he ever challenged the terms & conditions of the certificate of Insurance admittedly received by him. It is submitted that the complainant continued to enjoy the risk cover to the tune of Rs.8,00,000/- without ever disputing the terms & conditions of the policy without any coercion or force which indicated that he was fully satisfied with the terms of the membership. It is submitted that the terms of the cover/certificate of insurance and the amount was payable to the complainant as per terms and conditions of the policy on completion of the formalities. The relevant terms of the certificate of insurance are reproduced as under:-

“a)    On Death of an individual Member: On the occurrence of death of the member due to any cause subject to exclusion of suicide as mentioned hereinafter or upon the accidental permanent total/partial disability if opted, the sum assured, rider benefit, if opted plus the account value in the individual account as on date of death would become payable to the Nominee through the Policyholder for the benefit of the beneficiary.

b)      On Member reaching to Maturity Date: The account value, subject to minimum guaranteed maturity value in the individual account as on date of maturity would become payable to the Member through the Policyholder for the benefit of the beneficiary.

c)       Surrender of the Policy: On surrender of the Policy, account of all Members’ shall be closed and the account value, subject to the Market Value Adjustment as applicable on the date of such closure, less surrender penalty, if any, shall be paid.

5)      Surrender Value: After completion of one year of membership, any member may surrender his membership and the surrender value shall be the account value of the said member subject to market value adjustment as applicable on the date of such closure less surrender penalty if applicable, subject to minimum guaranteed surrender value. Surrender value would become payable to the Member through the policyholder for the benefit of the beneficiary.

The minimum guaranteed surrender value is 70% (Single Premium less scheme administration fees charged at inception of membership less life insurance premium and rider premium, if any deducted till the date of surrender. The surrender penalty as a percentage if single premium is as follows

No. of completed months from the date of membership	Surrender Penalty as % of Single Premium
12-35	3.00%
36+	0.00%

 

8) The Minimum tenure of the membership would be 5 years.

It is submitted that the Op no.1 has never authorized any person or agent to make any commitment beyond the terms and conditions of master policy or certificate of insurance which were as per the approvals of the IRDA. It is submitted that the agents are independent contractors who are duly licensed by the IRDA to act as agent for solicitation of insurance business for an insurance company. It is submitted that the Op No.1 is not responsible for the acts & omissions on the part of the agent as there is no Principal-Agency relationship between the agent and the Op. It is submitted that the Op No.1 has never authorized any person to make any commitment beyond the terms and conditions duly approved by the IRDA, therefore, the Op No.1 is not responsible or liable for any unauthorized commitment or promise made by an insurance agent. Thus, there is no deficiency in service on the part of Op No.1 and prayed for dismissal of complaint with costs.

3. Notice was issued to the Op No.2 through registered post but none has appeared on behalf of the OP NO.2. It is deemed to be served and the Op No.2 was proceeded ex-parte vide order dated 30.11.2016.
4. The complainant has tendered the evidence by way of affidavit Annexure C-A alongwith documents Annexure C-1 to C-8 and closed the evidence. On the other hand, the counsel for the Op No.1 has tendered into evidence by way of affidavits Annexure R1/A alongwith documents Annexure R1/1 to R1/7 and closed the evidence.
5. We have heard learned counsel for the parties and have also perused the record.
6. The complainant-Vijay Kumar enrolled as member of Super Secure SP group master policy bearing No.0225007732 administered by Yes Bank i.e. Op No.2. The membership No.0293101024 was issued to the complainant and the date of commencement was 23.01.2013. The membership was for 5 years for which basic sum assured was of Rs.8 lacs. The single premium @ Rs.2 lacs was paid by the complainant. The certificate of insurance (Annexure R-2) (page 16) was issued. The terms and conditions of the membership was issued and received by the complainant as per Annexure C-2) (page 13). The OP No.2 i.e. Yes Bank was holder of principal policy No.0225007732 which was commenced on 25.06.2011. The application for membership is as Annexure C-2 (page 14). From the perusal of the application, it reveals that the complainant deposited Rs.2 lacs vide cheque No.305389 dated 23.01.2013 drawn from HDFC Bank. The complainant vide his application dated 07.06.2016 requested to the Manager, Yes Bank, Sector-11, Panchkula (OP No.2) that the money deposited by him be refunded to him and payment of principal and interest @ 11.5% be made in account No.011093600002230 (SB A/c). In the abovesaid application, the complainant has clearly mentioned that he had completed 41 months of the policy taken by him. As per clauses 4  and 5 of the terms and conditions of the policy (Annexure C-2) (page 13), the benefit payable are as given below :-

“4.    The Benefits payable are as given below

a)      On Death of an individual Member: On the occurrence of death of the member due to any cause subject to exclusion of suicide as mentioned hereinafter or upon the accidental permanent total/partial disability if opted, the sum assured, rider benefit, if opted plus the account value in the individual account as on date of death would become payable to the Nominee through the Policyholder for the benefit of the beneficiary.

b)      On Member reaching to Maturity Date: The account value, subject to minimum guaranteed maturity value in the individual account as on date of maturity would become payable to the Member through the Policyholder for the benefit of the beneficiary.

c)       Surrender of the Policy: On surrender of the Policy, account of all Members’ shall be closed and the account value, subject to the Market Value Adjustment as applicable on the date of such closure, less surrender penalty, if any, shall be paid.

5)      Surrender Value: After completion of one year of membership, any member may surrender his membership and the surrender value shall be the account value of the said member subject to market value adjustment as applicable on the date of such closure less surrender penalty if applicable, subject to minimum guaranteed surrender value. Surrender value would become payable to the Member through the policyholder for the benefit of the beneficiary.

The minimum guaranteed surrender value is 70% (Single Premium less scheme administration fees charged at inception of membership less life insurance premium and rider premium, if any deducted till the date of surrender. The surrender penalty as a percentage if single premium is as follows

 

No. of completed months from the date of membership	Surrender Penalty as % of Single Premium
12-35	3.00%
36+	0.00%

 

As per the above terms and conditions, there is no surrender penalty of the policy after 36 months.

7. From the above, it is clear that the complainant has surrendered his policy after completion of 41 months and the Ops No.1 and 2 are liable to pay the complainant as per clause 5 of the terms and conditions without any penalty. The claim of the complainant that he is entitled to the interest @ 11.5% as assured by the Ops but on perusal of the documents, it reveals that the Op No.1 informed the complainant (Annexure C-4) that the last year gross of investment return of group seva plan is 11.5% and it was also made clear to the complainant that as per the plan the minimum terms is 5 years but he can withdraw his money after 3 years without any surrender charges. Hence the complainant is not entitled for the interest @ 11.5% per annum as claimed by him.
8. In view above, the complaint of the complainant deserves to be allowed and the same is allowed partly. The Ops are jointly and severally directed as under:-

a)       To make the payment to the complainant in view of the clause 5 of the terms and conditions of the policy within a period of 30 days failing which the Ops are further directed to pay interest @ 9% per annum from the date of filing of the present complaint i.e. 08.09.2016 till realization.

b)      To pay Rs.2000/- as compensation for harassment, mental agony and deficiency in service to the complainant.

c)       To pay Rs.2000/- as cost of litigation.

 

9. The Ops shall comply with this order within a period of one month from the date its communication to them comes about. A copy of this order be sent to the parties free of costs and file be consigned to the record room after due compliance.

 

 

 

Announced

25.04.2017 JAGMOHAN SINGH            ANITA KAPOOR             DHARAM PAL

                      MEMBER                   MEMBER                PRESIDENT

 

Note: Each and every page of this order has been duly signed by me.

 

 

                                          

                                                         DHARAM PAL

                                                          PRESIDENT