: O R D E R :
MR. J.BAG, LD. MEMBER
This is an application under Section 12 read with Section 13 of the Consumer Protection Act 1986. The Complainant purchased the policy of Birla Sun Life Insurance Platinum Plus by paying a sum of Rs.25,00,000/- on 28th March 2008.Again , he purchased two such policies on payment of Rs.100000/- on 16th May 2008 and another one lakh on 16th April 2010. Later the Complainant was shocked when he saw that his investment had fallen down to Rs. 15,01895/- within a period of 3 and a half years and a number of units left with the Complainant’s Policy had declined from 2,40,000.00 to 1,37,379.00 . It came to the knowledge of the Complainant that the said Birla Insurance started deducting Rs.16,000/- per month by selling the remaining unit each month and it further appeared that Rs. 2,00,000/- was being deducted per year from the policy of the Complainant. It is also the case of the Complainant that a statement dated 28.03.2009 showed that only 189055 units were left, although the second installment of Rs. 1,00,000/- was paid on 22.4.2009 well within time. It was noticed that the policy was put into some discontinuance account for one month without the Complainant’s knowledge and the OP deleted another 40000 units from the Complainant’s account and it appears that by June 2009 , the Complainant had 160000 units when the NAV was Rs.7 only. It also appeared that the said Company illegally deducted excess amount of mortality charges . As per calculation the mortality charges have been Rs.5,25,940/- which actually should have been Rs.357.755 as per the policy. The OP overcharged the mortality rate by more than 1.6 lakhs over the last 3 years and the said charges have been illegally deducted from the Complainant’s account every month by selling of its units and the lowest NAV.
The cause of action arose on 28.10.2011 when the office of the Insurance Ombudsman expressed its inability to admit the complaint of the applicant . In the said circumstances the Complainant has come up with a prayer for direction to readjust the amount of Rs.27,00,000/- minus Rs. 15,01,890/- = Rs. 11,89,110/- with all insurance benefit as per policy dated March 2008 or to repay the principal amount of Rs. 27,00,000/- with 16 % interest till date of payment . Prayer for Rs.1,50,000/- on account of unfair trade practice and payment of Rs. 40,000/- for unnecessary litigation has also been placed.
The OP No.1 has contested, while names of OP 2 & 3 have been expunged vide Order No. 7 dated 11.09.2012 . The W.V. submitted by the OP No. 1 contends that the complaint is barred by limitation as the Complainant after 3 and a half years of purchase of the policy admittedly realizing the adverse position about the units in his account. There has been no allegation against the OP about deficiency in service or unfair trade practice. It has been stated that a Complainant submitted an application for Insurance bearing No. A891 7606 dated 31.03.2008 in his own name for Platinum plus Plan for sum of of Rs. 1,25,00,000/- on payment of premium of Rs. 25,00,000/-. The insured opted for annual payment of premium . The Policy document was sent to the policy holder . He paid premium for 3 years . The risk for the said policy was under written on 28.03.2008 and the aforesaid Policy documents were delivered immediately to the life assured. The life assured did not avail the free look option within the stipulated time mentioned in the said letter. The life assured never lodged any protest against the policy contract under the free look option of 15 days and it was only in the forth year that the Complainant started corresponding with the answering OP indicating withdrawal from the aforesaid policy . It has been denied that the Complainant was given any assurance about highest NAV over the period of 10 years with continuous growth as alleged . The Complainant opted for a high value insurance ( sum assured Rs. 1,25,00000/- ) with a benefit period of 10 years and paying period of 3 years . It has been specifically denied that the Complainant was unable to track policy details as alleged. It was also denied that the Complainant was entitled to stop the policy in the forth policy anniversary. The surrender request given by the Complainant was processed and the surrender value amounting to Rs. 14,51,307.73/- was paid to the Complainant which is an admitted fact. The Complainant can not be permitted to play speculative with the aforesaid fund. OP No.2 and 3 did not appear or contest the complaint.
Ld. Advocate appearing for the Complainant submitted that at the time of purchasing the policy he was assured that he would be paid the highest NAV and the amount of Rs.27,00,000/- in all speculation would not be reduced. It is from the statement of OP No. 1 that the Complainant came to know about the reduced value of Rs.14,51,307/- . This was a unfair trade an unfair trade practice on the part of the OP, which as per Section 2 ( r ) of the Consumer Protection Act 1986 means a trade practice which for the purpose of promoting the sell , use or supply of any goods or for the provision of any service , adopts any unfair method or unfair or deceptive practice. In the present case , the OP adopted the deceptive practice of alluring the Complainant to invest their hard earned money in their fund and later deceived by paying a lesser amount than assured.
Ld. Advocate appearing for the OP submitted that the Complainant took the policy after being well conversant about the terms and condition of the policy . It was repeatedly told that the policy was a Unit Linked Insurance Policy and the performance of the fund was directly related to the performance of the market and daily fluctuations of NAV i.e. Net Asset Value. Specific high light of the feateares was reflected in the premium quotation and illustration statement which the Complainant signed at the inception of the policy . In the said documents it was clearly mentioned that the assumed rates of return were not guaranteed and the same were not the upper or lower limits of what the Complainant might get back . Further the Complainant never expressed his dissatisfaction when he had an opportunity to do so during free look period. The OP had no deficiency in service and in no sense adopted any unfair trade practice.
The question that deserves consideration is whether the Complainant is a consumer or not.
Decision with Reasons
It is a fact that the Complainant availed the service of the OP by paying premium for return and the service of insurance at the same time. The Complainant is, therefore, a consumer as defined under Section 2 i(d) of the Consumer Protection Act.
Another question that deserves consideration is whether the Complainant is entitled to the relief as prayed for.
It is by his own admission vide Paragraph 6 of the petition of complaint that the Complainant ‘did not bother to track his policy details on regular basis’ , but he was shocked when he saw that his investment of Rs. 27,00,000/- had fallen down to Rs.15,01895/- within a period of 3 years and a half . This shows that the Complainant took it for sure that his investment would be growing in amount automatically and he would earn good return. His basic objective was to earn profit by investment and getting insurance service against the policy obtained was not of vital consideration for him. He did not bother to check how or whether his investment of a huge sum of Rs.27,00,000/- was growing or reducing . It was after long period of 3 years and half that he realized that his expectation was not at all fulfilled . In his e-mail message dated 25.08.2011 , he stated that he was completely misguided , cheated and swindled. Based on the misleading advertising for the product which promised a guaranteed highest NAV , he was made to believe that the investment was a very safe one. The Complainant, however, failed to produce any copy of the misleading advertisement from which it would be cleare what exactly the OP Insurance Company assured about their product.
It is indeed a fault on the part of the Complainant himself that he neglected to keep himself apprised with the fate of his invested amount.
On the other hand the OP sent policy document which contained a regulatory provision about free look option . If he felt dis-satisfied with the terms and conditions or the benefits of the policy , under such free look, the policy holder had the option to reconsider his decision and for cancellation of the policy within 15 days of receipt of the policy. The Complainant did not take opportunity or the option offered by the insurance company.
It was well known to the Complainant that the Unit Linked Insurance Plan was directly related to the performance of the market and daily fluctuations of NAV . Specific highlight of that particular feature was reflected in the Premium Quotation and illustration statement which the Complainant is said to have signed at the inception of the policy. It has never been agitated by the Complainant that he was not delivered the complete policy docket comprising of the terms and conditions of the policy contract and the illustrations as per IRDA Regulations. The Complainant again has not refuted or denied in any manner that as per his surrender request,the surrender value amounting to Rs.14,51,307.73/- was paid to him.
Going by the above discussion we are of the considered view that the Complainant was much more responsible for the alleged loss in respect of his invested amount and the OP Insurance Company had little to save the loss suffered by the Complainant . In fact , there appears to be no deficiency in service or negligence or unfair trade practice on the part of the OP Insurance Company. In such circumstances , we hold that the complaint does not succeed. Hence,
Ordered
that the complaint be and the same is dismissed on contest . There shall be no order as to costs.
Sd/- Sd/-
Sri Jagannath Bag Sri Debasis Bhattacharya
(Member) (Member)
