DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA

CC.No.552 of 13-12-2013

Decided on 19-05-2014

Nitesh Jain aged about 35 years S/o Dhan Raj Jain R/o Janta Motor Store, GT Road, Bathinda.

........Complainant

Versus

1.Birla Sun Life Insurance, Registered Office One Indiabulls Centre, Tower 1, 15th and 16th Jupiter Mill Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai-400013, through its CMD/MD/Chairman/President/GM.

2.Branch Manager/Branch Head, Birla Sun Life Insurance, 1st Floor, The Mall, Bathinda.

.......Opposite parties

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

QUORUM

Smt.Vikramjit Kaur Soni, President.

Smt.Sukhwinder Kaur, Member.

Sh.Jarnail Singh, Member.

Present:-

For the Complainant: Sh.Ashok Gupta, counsel for the complainant.

For Opposite parties: Sh.Varun Gupta, counsel for the opposite parties.

ORDER

VIKRAMJIT KAUR SONI, PRESIDENT:-

1. The instant complaint has been filed by the complainant 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 on the allurement of the agent of the opposite parties, the complainant purchased one insurance policy bearing No.00421581 for 3 years and paid the premium of Rs.1 lac on dated 28.6.2010. The complainant alleged that the opposite parties never sent him any terms and conditions of the abovesaid policy, rather the premium has been paid on the assurance of the opposite parties that the complainant would be given the refund with bonus immediately but they have not fulfilled their commitment. The complainant requested the opposite parties to refund the amount with bonus and interest, but they did not listen to him and told him that they would give him the full amount on the surrender of the abovesaid policy. The complainant surrendered the abovesaid policy and requested the opposite parties to make the payment with bonus, but they did not make him the payment. The complainant many times contacted the head office of the opposite parties on mobile and ultimately, he received the cheque No.909766 dated 1.8.2013 for Rs.42,248.19/-. The opposite parties swallowed the amount of Rs.57,752/- of the complainant, whereas at the time of selling of the abovesaid policy they were committed to give him hefty bonus of Rs.3 lacs and promised him that the dummy policy would be issued to him that would be encashed at anytime, but later on they paid only the amount of Rs.42,248.19/- to the complainant. Hence the present complaint filed by the complainant to seek the directions of this Forum to the opposite parties to refund the amount of Rs.57,752/- alongwith interest @ 18% per annum from 2.8.2013 till payment besides cost and compensation or to give him any other additional or alternative relief for which he may be found entitled to.

2. The opposite parties after appearing before this Forum have filed their joint written statement and pleaded that the complainant himself was willing to purchase their Life Insurance plan and for that he approached their adviser and got the entire information about all the insurance plans in vernacular language. Thereafter, after understanding all the terms and conditions and benefits of all the plans, the complainant opted to purchase 'BSLI Platinum Premier Plan Unit Linked Life Insurance Policy' of the opposite parties and filled the proposal form bearing No.A39052441 on 26.6.2010 and opted to pay the annual premium of Rs.1 lac with Sum Assured of Rs.5 lacs, policy term as 10 years and premium paying term as 10 years and premium allocation percentage 100 in maximiser and disclosed the opposite parties his annual income as Rs.2 lacs and payment method by direct bill i.e. cash, payment mode annually and paid the amount of Rs.1 lac to the opposite parties at the time of filling of the proposal form. The complainant has also signed the declaration before filling of the proposal form. After receiving the proposal form and going through the entire contents of the proposal form, the Underwriters of the abovesaid policy, had issued the insurance policy bearing No.004215981 and sent the policy documents alongwith its all terms and conditions to the complainant on the given address that has been received by him and are in his possession. The free look period option has been given to the complainant, in which he had an option to reconsider/cancel his policy within 15 days from the date of receipt of the policy if he was not satisfied with the terms & conditions of the policy, but he did not avail the free look period option, meaning thereby he was fully aware about the terms and conditions of the abovesaid policy. The complainant paid first premium against the abovesaid policy and has failed to pay the next due premium on 28.6.2011, so his policy lapsed due to the non-payment of the premium. The opposite parties have referred the Policy Premium and Premium Discontinuance:-a) During the first three policy years, if we do not receive the entire policy premium by the end of the grace period, this policy will be deemed lapsed and all insurance will cease immediately. You will then have two years from the lapse date to revive your policy'. The opposite parties further pleaded that the premium amount cannot be refunded and relied upon various authorities in this regard.

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. Admittedly, the complainant purchased one insurance policy bearing No.004215981 and paid the premium of Rs.1 lac on dated 28.6.2010 under the name 'BSLI Platinum Premier Plan Unit Linked Life Insurance Policy'. The complainant received the amount of Rs.42,248.19/- vide cheque No.909766 dated 1.8.2013.

6. The complainant submitted that he has been allured by the opposite parties that his amount would be refunded to him immediately on his request with bonus. The complainant requested the opposite parties to refund the amount with bonus and interest, but they did not listen to him and asked him to surrender the abovesaid policy and accordingly, he surrendered the same and requested them to make the payment with bonus, but they have paid him only the amount of Rs.42,248.19/- vide cheque No.909766 dated 1.8.2013 and withheld the amount of Rs.57,752/- with them, whereas at the time of selling of the abovesaid policy they were committed to give him the hefty bonus of Rs.3 lacs and also promised him to issue the dummy policy that can be encashed anytime.

7. On the other hand the submission of the opposite parties is that the complainant has filled the proposal form bearing No.A39052441 on 26.6.2010 and opted to pay the annual premium of Rs.1 lac with Sum Assured of Rs.5 lacs, policy term of 10 years and premium paying term of 10 years and premium allocation percentage 100 in maximiser and disclosed the opposite parties his annual income as Rs.2 lacs and payment method by direct bill i.e. cash, payment mode annually and paid the amount of Rs.1 lac to the opposite parties at the time of filling of the proposal form and also signed the declaration to this effect. The free look period option was given to the complainant, in which he had an option to reconsider/cancel his policy within 15 days from the date of receipt of the policy if he was not satisfied with the policy terms & conditions, but he did not avail the free look period option, meaning thereby he was fully satisfied with the policy terms and conditions. The complainant has paid the first year premium against the abovesaid policy and has failed to pay the next due premium on 28.6.2011, so his policy lapsed due to the non-payment of the premium. The opposite parties further submitted that the insurance is a contract and its terms and conditions are binding on the parties and have referred to the law laid down by the Hon'ble Supreme Court of India in case titled as Life Insurance Corporation Limited & Others Vs. Smt.S.Sindhu, decided on 4.5.2006 and have also referred to various authorities on other aspects of the matter.

8. The opposite parties have referred to Policy Premium; Premium Discontinuance, Revival and Non-Revival, which are reproduced hereunder:-

“Policy Premium:-Your policy details shows the annual policy premium, the premium paying mode, the installment premium and its due dates. Subject to the Premium Discontinuance provision, we must receive policy premiums when due in order for this contract to be valid and remain in effect. Premiums are payable without any obligation on the company to issue a notice for the same.

Premium Discontinuance:-If you are unable to pay the policy premium by the due date, you will be given a grace period of 30 days during which time all insurance under this policy will continue.

a) During the first three policy years: If we do not receive the entire policy premium by the end of the grace period, this policy will be deemed lapsed and all insurance will cease immediately. You will then have two years from the lapse date to revive your policy'.

Revival:-.......

Non-Revival:-If the policy is not revived by the end of the two year revival period, we will terminate this contract and pay the Surrender Value as of the lapse date to you at that time or at the end of the third policy year, whichever is later. The Surrender Value as of the lapse date will not vary based on the performance of the investment funds and will remain constant till the time it is paid to you. You cannot make partial withdrawals until the policy is revived or until the end of the third policy year, whichever is later. You may however request to surrender your policy after three completed policy years in which case we will immediately pay you the Surrender Value as of the lapse date.”

As per the version of the opposite parties, the complainant has failed to pay the second due premium on 28.6.2011. As per the clauses mentioned above

if the life assured failed to pay the next premium within the grace period of 30 days, the policy will deemed to be lapsed and all insurance cover will cease immediately, in that case the insured has two years period from the lapse date to revive his/her policy. In case the policy is not revived by the end of the two years of revival period, the contract will be terminated and Surrender Value will be paid as of the lapse date to the insured at that time or at the end of the third policy year, whichever is later. The Surrender Value as of the lapse date will not vary based on the performance of the investment funds and will remain constant till it will be paid to the insured. The Non-Revival Clause of the policy has already been reproduced in the aforementioned Paras. As mentioned in the Non-Revival Clause, the complainant/insured has to surrender his policy after three completed policy years, in that case the surrender value will be paid immediately to him as of the lapse date. Thus relying upon the Clauses mentioned in the written statement of the opposite parties we are of the considered opinion that the complainant has applied for the surrender of the abovesaid policy and on his request the amount of Rs.42,248.19/- has already been refunded to him vide cheque No.909766 dated 1.8.2013.

9. As discussed above the complainant has withdrawn from the policy contract as he has failed to pay the second due premium on 28.6.2011 and accordingly, the opposite parties have paid him the amount of Rs.42,248.19/- vide cheque No.909766 dated 1.8.2013, but they have failed to give any detail that how the surrender value to the tune of Rs.42,248.19/- has been calculated by them and how the amount of Rs.57,752/- has been deducted from the premium deposited by the complainant.

10. With utmost regard and humility to the authorities relied upon by the learned counsel of the opposite parties, have distinguishable facts and circumstances.

11. Therefore in view of what has been discussed above this complaint is partly accepted with Rs.3000/- as cost and compensation against the opposite parties. The opposite parties are directed to furnish a detail calculation sheet to show the deductions made from the premium amount of the complainant. In case the opposite parties find that any amount is still payable to the complainant, the same will be paid to him.

12. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.

13. 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:-

19-05-2014

(Vikramjit Kaur Soni)

President

(Sukhwinder Kaur)

Member

(Jarnail Singh) Member