| Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA CC.No.404 of 04-07-2016 Decided on 23-05-2017 Pushpa Devi aged about 65 years W/o Raghunanadan Lal R/o Darziawala Mohalla, Rampura Phul, Tehsil Phul, District Bathinda. ........Complainant Versus 1.Bajaj Allianz Life Insurance Co. Ltd., Branch Office Near DAV College, Bibiwala Road, Bathinda, through its Branch Manager. 2.Bajaj Allianz Life Insurance Co. Ltd., GE Plaza, Airport Road, Yerwada, Pune-4110066. .......Opposite parties Complaint under Section 12 of the Consumer Protection Act, 1986 QUORUM Sh.M.P Singh Pahwa, President. Sh.Jarnail Singh, Member. Present:- For the complainant: Sh.Navneet Kataria, Advocate. For opposite parties: Sh.M.L Bansal, Advocate. ORDER M.P Singh Pahwa, President The complainant Pushpa Devi (here-in-after referred to as complainant) has filed this complaint U/s 12 of Consumer Protection Act, 1986 against opposite parties Bajaj Allianz Life Insurance Co. Ltd. and Other (here-in-after referred to as opposite parties). Briefly stated, the case of the complainant is that the insurance adviser of opposite parties approached her and induced her to purchase their insurance policy. It was disclosed that as per the terms of the policy, the complainant shall be required to deposit premium of Rs.2500/- after every six months (half yearly premium) for the term of 10 years. At the end of the policy, the policy holder shall be entitled to get total amount alongwith other statutory benefits besides the insurance claim. The complainant was also assured that she shall be entitled to withdraw the amount at any stage after completion of 3 years from the date of purchase of the policy i.e. after payment of 6 regular half yearly premiums of Rs.2500/-, without any deductions and in case of seeking the refund before the expiry of 3 years, the amount shall be refunded after deducting the service charges. It is alleged that being allured by the tall claims of opposite parties, the complainant agreed to purchase the policy from them. The insurance adviser obtained the signatures of the complainant on the proposal form and other blank signed papers, but contents of the same were not read over and explained to the complainant. Later on, she received the policy No.0095369276 from opposite parties. It is further alleged that the complainant deposited 6 premiums of Rs.2500/- after every 6 months for a continuous period of 3 years i.e. total Rs.15,000/- with opposite parties. Thereafter she visited the office of opposite party No.1 with the request for the refund of the amount of Rs.15,000/- deposited by her alongwith upto date interest and other incidental charges, but their officials proclaimed that she will be entitled to seek the refund only after 5 years from the date of purchase of the policy and no amount shall be deduced as she has already deposited the amount of 6 regular premiums of Rs.2500/- for 3 years. In the year 2015, she again visited the office of opposite party No.1 and requested it to refund the total amount of Rs.15,000/- alognwith up to date interest and other benefits. Opposite parties assured the complainant to refund the amount to her at the earliest possible, but they have been putting off the matter on one or other pretext. Ultimately, they have issued the cheque No.624186 dated 4.2.2016 for Rs.5073/- to the complainant against the total amount of Rs.15,000/-. After receiving this cheque, she accepted it under protest. She visited the office of opposite party No.1 for payment of the balance amount alongwith interest and other benefits, but to no effect. Opposite parties have refused to refund any further amount to the complainant and proclaimed that the fund value of the policy is only Rs.5073/- for which she has been issued cheque. She is not entitled to any further amount. On this backdrop of facts, the complainant has alleged deficiency in service and unfair trade practice on the part of opposite parties. She has claimed refund of remaining amount approximately Rs.10,000/- with interest and other benefits and compensation to the tune of Rs.10,000/- on account of mental tension, botheration and harassment etc. in addition to Rs.3300/- as cost of litigation. Hence, this complaint. Upon notice, opposite parties appeared through their counsel and contested the complaint by filing the written version. In the joint written version, opposite parties have raised the preliminary objections that no cause-of-action has arisen in favour of the complainant. The contract under the policy stands already terminated due to non-payment of regular premiums due on 28.3.2012 and onwards.Since the fund value in the unit account of the policy became equal to one yearly premium due to discontinuance of the premium payment by the complainant,the permissible fund value amounting to Rs.5073/- was admittedly paid to the complainant vide cheque No.624186 dated 4.2.2016, which was admittedly received by her without any protest. She has concocted a false story after expiry of more than 7 years of the commencement of the policy to derive illegal financial gains, contrary to the terms of the contract. The complaint is not legally maintainable as the payment of permissible fund value amounting to Rs.5073/- stand already made by opposite parties towards full and final settlement of all the claims under the policy strictly in accordance with the terms and conditions of the policy upon termination of the contract of insurance. The complainant is not 'consumer' as defined under 'Act'. She has purchased 'Unit Linked Policy' to earn the profit. She has not approached this Forum with clean hands and she has filed this complaint just to derive illegal financial gains contrary to express terms of the policy. The complaint is bad for non-joinder and mis-joinder of all the necessary parties. It is without any cause-of-action. It is further mentioned that the complainant being a very prudent person admittedly proposed for the regular premium unit linked 'New Family Gain' policy after fully understanding the feature, benefits, investment risks, charges and terms and conditions of the policy. She filled up a proposal form duly signed by her. Consequently, the policy bearing No.0095369276 was issued to the complainant with commencement date of 28.3.2008 for sum assured of Rs.50,000/-. The original policy bond containing express terms and conditions of the contract has been dispatched to the complainant, which has been received by her. She never challenged the receipt of the express terms and conditions of the contract of insurance. The complaint at this belated stage is barred by limitation. There is no deficiency in service on the part of opposite parties. The complainant is estopped from filing of this complaint by her own act and conduct. Opposite parties have also quoted some terms and conditions, reproduction of them is not necessary at this stage. Further preliminary objections are that the complainant has concocted the false story regarding signatures on the blank papers. It is further mentioned that she is estopped to file this complaint due to her own act and conduct as she was given 15 days free look cancellation period from the date of receipt of the policy bond by her to review the terms and conditions of the contract as per the Policy Holders' Protections Regulation, 2002. The reliefs claimed by the complainant is contrary to contract of insurance. The complaint is not maintainable as opposite parties have acted strictly in accordance with the terms and conditions of the policy. This Forum has no territorial jurisdiction to try and entertain the complaint. The contract of insurance does not provide for payment of interest on the money due under the policy. On merits, opposite parties have controverted all the material averments and reiterated their stand as taken in the preliminary objections and detailed above. In the end, they have prayed for dismissal of complaint. Parties were asked to produce evidence. In support of her claim, the complainant has tendered into evidence photocopies of payment receipts, (Ex.C1 and Ex.C7); her affidavit dated 27.1.2017, (Ex.C8) and closed the evidence. To rebut the claim of the complainant, opposite parties have tendered into evidence affidavit of Sandeep Kumar Jindal dated 4.11.2016, (Ex.OP1/1); photocopy of policy detail, (Ex.OP1/2); photocopy of letter, (Ex.OP1/3); photocopy of policy schedule, (Ex.OP1/4); photocopy of first premium receipt, (Ex.OP1/5); photocopy of compliance of IRDA, (Ex.OP1/6); photocopy of policy documents, (Ex.OP1/7); photocopy of account statement, (Ex.OP1/8) and closed the evidence. We have heard learned counsel for parties and gone through the file carefully. Learned counsel for parties have reiterated their stand as taken up in their respective pleadings and detailed above. We have given careful consideration to these rival submissions. The complainant has admitted that she has received the policy bearing No.0095369276 from opposite parties. In these circumstances, the controversy is to be decided as per terms and conditions mentioned in the policy documents. As per complainant herself, she has paid premiums for 6 half yearly installments i.e. 3 years and no premium has been paid thereafter. Copy of policy documents is on file as Ex.OP1/7. Clause 12 of the policy document deals with non-payment of regular premium and forfeiture and its sub-clause 3 is relevant to solve the controversy. For sake of convenience, this Clause is reproduced as under:- “c) If the unpaid regular premium due after the first three policy years and policyholder has failed to make the payment before the expiry of the grace period:- i) The policyholder will be given an opportunity to revive the policy within 2 years from the first unpaid premium, subject always to Section 34 below. During this limited period for revival, the policy shall be continued levying all appropriate charges as per Section 25 until the fund value falls below an amount eqivalent to one annual premium (NAV) across all the funds. At the end of two years i.e. period for revival, if the policy is not revived, the policyholder can opt to continue the policy subject to deduction of all charges as per Section 25 until the fund value falls below an amount equivalent to one annual premium (NAV) across all the funds. ii) If the policyholder does not opt to continue the policy after the revival period, the policy shall be terminated by paying the fund value. iii) When the fund value in respect of regular premium falls below an amount equivalent to one annual premium, the policyholder will be intimated about this in writing and policy shall be terminated by paying the fund value.” A perusal of above mentioned condition reveals that when the complainant has failed to make the payment after first 3 policy years and she has also not got the policy revived for further stipulated period of 2 years from first unpaid premium,the policy remained continue until the fund value falls below equivalent to one annual premium (NAV) across all the funds. In this case, the annual premium was Rs.5000/- (Rs.2500/- half yearly). Therefore, opposite parties continued the policy till fund value remained up to premium of one year and thereafter they have refunded the amount. In these circumstances, no deficiency can be attributed to opposite parties. For the reasons recorded above, the complaint is without merits and it stands dismissed without any order as to cost. The complaint could not be decided within the statutory period due to heavy pendency of cases. Copy of order be sent to the parties concerned free of cost and file be consigned to the record. Announced:- 23-05-2017 (M.P Singh Pahwa) President (Jarnail Singh) Member
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