IN THE CONSUMER DISPUTES REDRESSAL FORUM, KOTTAYAM
Dated this the 29th day of July, 2020
Present: Sri. Manulal.V.S, President
Smt..Bindhu.R, Member
Sri. K.M. Anto, Member
CC No. 191/18(Filed on 14/9/18)
Complainant : Aleyamma Joy
C-03, Sanghamitra CGHS
Sector-4, Plot No.20, Dwaraka
New Delhi-78 Now residing Green Court
Apts 14C,S.H Mount Po, Kumaranelloor,
Kottayam-686006
(Adv. Shyni Gopi)
Vs
Opposite parties : 1) Birla Sun Life Insurance Co.Ltd.,
G Corp Tech Park, 6th Floor Kasar
Wadavalli, Ghodbunder Road,
Thane-400601
2) Birla Sun Life Insurance Co.Ltd.,
2nd Floor, C.K.G Tower, K.K Road,
Kanjikuzhy, Kottayam-686004
(Adv. Robin K.N)
O R D E R
Sri. Manulal.V.S, President
This complaint is filed under Section 12 of the Consumer Protection Act 1986.
The case of the complainant is as follows:
The complainant is a policy holder of Birla Sun Life Insurance Police vide policy No.005587929 Vision Plan. The opposite party persuaded the petitioner to purchase the policy by assuring that she could redeem it after her retirement on attaining 60 years. The petitioner had paid Rs. 35,000/- vide cheque No.831450. When the petitioner approached the opposite party after her retirement to refund the money then the opposite party informed the petitioner to pay another sum of Rs. 35,000/- for another 16 years and the initial amount cannot be paid back if the policy was not continued by paying Rs.35,000/- every year for 16 years. Now the petitioner who is a senior citizen and not in a position to pay the said amount for another 16 years and there is only a mere chance that the petitioner may claim it after 16 years. The petitioner was forced by the representative of the opposite party to take the policy and falsely promised and misrepresented the facts regarding the policy. The petitioner discontinued the policy and informed the opposite party but the opposite party told the petitioner to pay for the full term. The opposite party has made the complaint take their policy by misrepresenting the facts which is against unfair trade practice from the side of the opposite party. The opposite party received consideration from the petitioner but has failed to provide proper service to the petitioner and these amounts to deficiency in service from the side of opposite party. Hence this complaint.
Upon notice from this forum opposite parties appeared before this forum and filed their version as follows.
The complainant opted for BSLI vision plan by filing proposal form and on receipt of mandatory documents, OP issued policy bearing No.005587929 on 31-05-2012. The said policy document was despatched to the complainant on the registered address on 4/6/12. The complainant did not approach the opposite party during the free look period and thereby the complainant was agreeable to the policy terms and conditions. The opposite parties acted as per mandate given by the complainant in proposal form and issued the insurance policy which is a concluded contract between the complainant and opposite party. On 19/6/2012 when the opposite party contacted the complainant over telephone, the complainant never raised any objection or query about the policy term, pay term and features of the policy were communicated to the complainant by proposal form and also by telephonic conversation. The said policy has pay term of 16 years whereas the complainant has paid only initial payment of Rs. 3330.74. As per the terms and conditions of the policy, the policy lapsed for non receipt of renewal premium on 31-5-2013 and further the policy was terminated on 31-5-2015. The opposite party has acted strictly as per the proposal from and terms and conditions of the policy documents. There is no deficiency in service on the part of the opposite parties.
The complainant filed proof affidavit in lieu of her chief examination. Exts A1 to A3 were marked from the side of the complainant. No oral or documentary evidence adduced from the side of the opposite party.
On the evaluation of complaint, version and evidence on record we would like to consider the following points.
- Whether the complaint is maintainable or not?
- Whether there is any deficiency in service or unfair trade practice on the side of the opposite parties?
- If so what are the reliefs and costs?
Point No.1
It is admitted by both parties that the complainant had availed an insurance policy from the 1st opposite party vide Ext.A1 policy certificate on 31/5/12. The specific case of the complainant that she had took the insurance policy from the opposite party by believing the words of the opposite party that she could redeem the insurance policy after her retirement on attaining 60 years of age. The complainant further pleaded that after her retirement when she approached the opposite party for the insured amount. The opposite party rejected her plea for the amount stating that she would have to pay premium for another period of 16 years. From the perusal of Ext.A1 policy certificate we can see that the policy was issued on 31/5/12 and the maturity date of the policy is stated as 31/5/2053. On perusal of Ext.A1 policy certificate we can see that annual premium for the policy is 33,307.74 and the sum assured is Rs.310,715/-. The opposite parties defended the case of the complainant by contending that the complainant had not availed the free look period, that the period which is provided for the complainant in accordance with the IRDA regulations to withdraw from the policy, if in case the complainant is not satisfied with the terms and conditions of the policy for which she has filed proposal form. The opposite party has relied on the decision of the Hon’ble National Commission in
Aditya Prasad Roy Vs. Suresh Mahalingam and 3 Ors, the Hon’ble National Commission vide its judgment dated 6-1-2015 has stated that “ It is quite clear from the reading of the records on the file that petitioner is a highly educated person who has availed of the TATA AIG Life Invest Assure Flexi Plan Policy. It is presumed that such a well-educated person would exercise due caution and diligence as also ensure that he is well informed of the benefits and terms and conditions before taking such a policy for Rs.10 lakh and before paying fourteen quarterly premiums. His plea is that he could see the policy papers as he had left for China. This cannot give the right and option to cancel the policy three and a half years after the receipt of the policy and expiry of the free look period of 15 days. He has admittedly paid 14 numbers of premiums and only objected to the terms and conditions after he was refused a loan as it is not permitted under this policy. To see a man of prudence would have seen the terms and conditions of the policy to see whether he was entitled and eligible for taking a loan under the said policy.
The opposite party further contented that the complainant has paid only the initial premium of Rs.33,307.74/- and she had defaulted the further annual premium. On perusal of page No.2 of Ext.A1 it is stated in the head of premium discontinuance as follows;
If you are unable to pay the installment premium by the due date, you will be given a grace period of 30 days during which time all benefits under the policy will continue.
a)Untill 3 full year installment premiums are paid:
If we do not receive the entire installment premium by the end of the grace period, this policy will be deemed lapsed and all benefits will cease immediately.The lapse date is the date the unpaid premium was due.You will be given two years from the lapse date to reinstate your policy.
(b)Once 3 fully year installment premiums have been paid:
If we do not receive the entire installment premium by the end of the grace period, the policy will be deemed paid-up and benefits will continue as per the Policy Paid-Up provision. The paid-up date is the date the unpaid premium was due. You will be given two years from the paid-up date to reinstate the policy for its full benefits.
To reinstate the policy, you must pay all unpaid installment premiums due till date plus interest thereon and repay any outstanding policy loan balance plus interest thereon. The interest we will charge is at a rate declared by us from time to time at our sole discretion. In addition, you must provide us with evidence of insurability satisfactory to us with respect to the life insured. The effective date of reinstatement is when these requirements are met and approved by us, at our sole discretion”.
On perusal of Ext.A1 we can see that the surrender benefit of the policy will acquire only after the completion of three policy years with all due premiums paid for at least three policy years. Thus, the policy holder can claim the surrender benefit of the policy as per the terms and conditions of the policy if she is paying the annual premium without any default for the three consecutive years. Here in case on hand admittedly the complainant had paid only the initial premium and discontinued the payment of further annual premium.
Admittedly the complainant had availed the service of the opposite parties by availing a life insurance policy from the opposite party while she was working at New Delhi. On perusal of Ext.A1 the address of the complainant is shown as Mrs.Aleyamma Joy,C-03, Sangamitra Appart, Sector-4, Plot No.20, Dwarka-110079. On perusal of Ext.A2 which is a complaint launched by the complainant to the opposite party regarding the payment of the sum assured as per the terms and conditions and policy conditions. We can see that this also launched before the office of the opposite parties at New Delhi. On going through the recitals of Ext.A2 we can infer that the complainant had availed the insurance policy from the 1st opposite party at New Delhi. Ext.A3 is the reply letter of Ext.A2 dated 7/10/16 is also addressed to the complainant at her address New Delhi.
Section 11(2) of Consumer Protection Act deals with the territorial jurisdiction of the District Forum and the same read as under “(1) Subject to the other provisions of this Act, the DistrictForum shall have jurisdiction to entertain complaints where the value of the goods or services and the compensation, if any, claimed does not exceed rupees twenty lakhs.
(2) A complaint shall be instituted in a District Forum within the local limits of whose jurisdiction,—
(a)the opposite party or each of the opposite parties, where there are more than one, at the time of the institution of the complaint, actually and voluntarily resides or carries on business or has a branch office or personally works for gain, or
(b) any of the opposite parties, where there are more than one, at the time of the institution of the complaint, actually and voluntarily resides, or carries on business or has a branch office, or personally works for gain, provided that in such case either the permission of the District Forum is given, or the opposite parties who do not reside, or carry on business or have a branch office, or personally work for gain, as the case may be, acquiesce in such institution; or
(c) the cause of action, wholly or in part, arises.
In the case of Sonic Surgical Vs. National Insurance Co.Ltd(2010 1 SCC 135, IV 2009 CPJ 40SC) The Hon’ble Supreme Court held that if the contention of the learned counsel of appellant is accepted, it will mean that even if a cause of action has arisen at Ambala, then, the complainant can file a claim petition in Tamil Nadu or Guwahati or any were India where branch office of the insurance company is situated. It was further contented that it will lead to absurd consequences and lead to bench hunting.
In New India Assurance Co,.Ltd Vs. Gopal Gupta decided by the Hon’ble National Commission as per order dated 3/9/13, it was held that merely because the insurance company has a branch office in Chandigarh, this by itself does not give the State Commission UT, Chandigarh the territorial jurisdiction to entertain the complaint. In the said case the insured premises was situated at Kaithal, and the insurance policy was also issued at Kaithal.
In the light of the above said decisions and evidence on record we are of the opinion that mere including branch office of the 1st opposite party as 2nd opposite party in the complaint does not attract the territorial jurisdiction of this Forum to entertain this complaint.
As discussed above the complainant has defaulted the payment of annual premium after the initial payment of first premium in the year 2012. The policy has become lapse on 31/5/15 due to no renewal of premium as per the terms and conditions of the policy. If the complainant defaulted the payment of annual premium for the continuous three years she is not entitled to claim the surrender value of the premium. Therefore we are in the opinion that the complainant has not succeeded to prove any deficiency in service or unfair trade practice from the side of the opposite party and the complaint is liable to be dismissed.
In these circumstances the complaint is dismissed without any cost.
Pronounced in the Open Forum on this the 29th day of July 2020.
Sri. Manulal.V.S, President Sd/-
Smt..Bindhu.R, Member Sd/-
Sri. K.M. Anto, Member Sd/-
Appendix
Exhibits marked on the side of complainant.
A1-Policy
A2-Copy of letter dtd 26/9/16
A3-Reply letter dtd 7/10/16
By Order,
Senior Superintendent.
