Dinesh Kumar complainant has filed the present complaint against the opposite parties U/S 12 of the Consumer Protection Act (for short, C.P.Act.) seeking necessary directions to the opposite parties to cancel the first policy bearing no.005585272 and second and third policies bearing nos. 006094175 and 006398335 and to refund the amount in his favour which the opposite parties have received from him in three installments alongwith interest @ 18% P.A. from the date of due till its actual realization and also to pay compensation alongwith litigation expenses, in the interest of justice.
2. The case of the complainant in brief is that on the allurement given by the employee of the opposite party, he had paid a sum of Rs.30,000/- as Annual Premium by cheque bearing no.503595 of Bank of Baroda dated 11.5.2012 and received the policy documents at his home address having policy no.005585272. As per the terms and conditions of the policy in dispute, the policy would be matured on 19.5.2069 and sum assured Rs.5,84,500/- Guaranteed Survival benefit was Rs.8,62,137.50 paise and guarantee survival benefit term was 26 years. Second premium of Rs.30,000/- has been paid in cash to the authorized official of the opposite party after proper receipt. He has next pleaded that on being convinced by the opposite parties he purchased new policy bearing no.006404706 with the product name Vision Life Income Plan having annual premium of Rs.30,000.13 for the sum assured of Rs.3,41,765, income benefit of Rs.17,088.25 and premium paying terms is of 15 years and policy matured on 24.2.2070 and he paid Rs.30,000/- vide cheque bearing no.000005 of Bank of Baroda dated 17.2.2014 as a first premium against the policy bearing no.006404706. He has also paid Rs.30,000/- an another amount vide cheque bearing no.000018 as a premium amount against the policy bearing no.005585272 then it appeared to him on 18th April, 2014 vide computer generated statement that his first policy was lapsed and it also shows that only a premium of Rs.29,998.03 for the May, 2012, whereas he has paid the premium regularly against this policy in dispute for the three times as he has paid 3 premiums of the said policy. But the act of the opposite parties to show that he has paid only first premium and thereafter the policy was lapsed is altogether wrong, illegal and same ultimately leads to the unfair trade malpractice on the part of the opposite parties. A letter in the form of Lapsation notice 1 dated 9.6.2014 has been received from the office of Birla Sunlife Insurance Company. On receipt of it, he visited the office of the opposite party no.1, the concerned official has provided a computer generated premium paid certificate dated 18 June, 2014 regarding the alleged policy bearing no.006094175 as per which premium received shown as Rs.28,552.39 Paise against the policy bearing no.006094175 issued on dated 29.4.2013. He has further pleaded that the authorized agent of the opposite party i.e. Mr.Mukesh Kapoor when took the amount of Rs.30,000/- in cash as a second premium against the original policy bearing no.005585272, he instead of depositing the said due second premium, the said Agent had in wrongful manner invested the said amount into a new policy product in his name about which he had no knowledge as the same was done by the Agent in a wrongful manner without his knowledge and consent. Hence this complaint.
3. Upon notice, the OP filed the written version reply through their counsel taking the preliminary objections that the present complaint was not maintainable as no cause of action ever arose in the complainant’s favor who has not come to the Forum with clean hands and has presented a false story to mislead the Forum by distorting the facts and circumstances of the case. Complainant had submitted to the opposite parties four proposals first dated 11.5.2012 for the purchase of BSLI Vision Plan, the proposal was accepted on the standard rates based on the information provided by the LA and consequently a policy was issued bearing policy no.005585272 dated 19.5.2012 and the same commenced on 19.5.2012. Thereafter, he submitted second proposal dated 20.4.2013 for the purchase of BSLI Vision Endowment Plan, the same was accepted and was issued policy no.006094175 dated 29.04.2013 and the same commenced on 29.4.2013. Thereafter, he submitted third proposal dated 7.02.2014 for the purchase of BSLI Vision Life Secure Plan, the same was accepted on the standard rates based on the information provided by the LA and consequently a policy was issued bearing no.006398335 dated 13.02.2014 and the same commenced on 13.02.2014. Finally he submitted fourth proposal dated 17.2.2014 for the purchase of BSLI Vision Life Income Plan, the same was accepted and policy was issued bearing no.006404706 dated 24.2.2014. The present complaint is an afterthought and has only been filed with the ulterior motive to harass and humiliate the opposite parties. Hence, the present complaint deserves to be dismissed with special costs; the Forum lacks the jurisdiction to put the present complaint on trial since no cause of action ever arose within its jurisdiction. The complainant has surrendered the fourth policy i.e. no.006404706 within 15 days free look period, therefore, the opposite parties refunded the amount of premium of Rs.30,000/-. It has been further contended that two policies i.e. policy no.005585272 dated 19.05.2012 and policy no.006094175 dated 29.04.2013 have already been lapsed and complainant has already taken all the benefit of the policies for the period for which he had paid the premium. The Life Assured had paid the initial premium of Rs.29,998.85/- by way of a cheque no.503595 dated 11.05.2012 for Rs.30,000/- in favour of Birla Sun Life Insurance Co.Ltd. with the signed proposal form dated 11.05.2012, second premium of Rs.28,552/- deposited in cash on 20.04.2013 alongwith the signed proposal form dated 20.04.2013 and third premium of Rs.27,000/- by way of cheque, i.e. cheque no.000018, dated 7.2.2014 alongwith the signed proposal form dated 7.2.2014 which clearly goes to indicate and establish that the complainant/Life Assured had full knowledge about the premiums, main features and plans of the policies. The Policy holder (and also the proposer) duly accepted and acknowledged the terms of the Policy upon purchase while signing the proposal form and have also enjoyed the insurance cover during all these years and thus there has been no deficiency in service on the OP’s part. Further, the insurance policy is not an investment scheme where the amount invested/paid is liable to be received back with interest etc. The risk covered is the main service (its benefit and purpose) and it is a paid service as well; the accrued benefits etc are the collaterals, only. The OPs have also quoted some Superior court verdicts in support of their objections/averments etc that the premiums cannot be refunded with interest etc as the insurance cover, the main service (benefits) already stood availed by the life assured. On merits, the OP have repeated the same objections/averments etc while denying and rebutting all the other pleadings/allegations made in the body of the complaint and lastly the complaint has been prayed to be dismissed with costs. The OP3 was served with the notice cum summons but it preferred to remain absent and thus were ordered to be proceeded against ex-parte vide order dated 25.11.2014.
4. Counsel for the complainant tendered into evidence affidavit of complainant Ex.C1, alongwith other documents Ex.C2 to Ex.C14 and closed the evidence.
5. Counsel for the opposite party no.1 and 2 tendered into evidence documents Ex.OP-1,2/1 to Ex.OP1-2/8 and closed the evidence.
6. We have examined all the documents/evidence produced on record and have also duly considered and perused the arguments duly put forth by the learned counsels for both the sides, while adjudicating the present complaint. We find that the OP insurers somehow did not produce the requisite deposition in support of its evidential defense in spite of availing five nos. of ‘requested’ adjournments as was judicially observed too by the honorable State Commission in its orders dated 18.05.2015 while dismissing their related appeal # 346 of 2015. The learned counsel has repeatedly put forth that the first 2 nos. of Policies (# 005585272 of 19.05.2012 & # 006094175 of 29.04.2013) stand lapsed but Policy # 006398335 of 13.02.2014 was alive & active whereas Policy # 006404706 of 24.02.2014 stood refunded (on 25.08.2014) through its surrender within the 15 day look in period by the complainant. No doubt, the OP insurers have attempted to establish their fair dealings but their conduct as apparently depicted through the available documents (on record) has failed them. The four Proposal Forms (Ex.OP1,2/3 to OP1,2/6) are at shocking variance. The ID proof in two are same but DOB (date of birth) are surprisingly different; whereas the two nos. are filled in at Gurdaspur and the later two at Patiala and Jalandhar. It is not understood as to why an individual will go to another far of city to purchase an insurance Policy when he knows well the local city Branch office and has already purchased Policy from there. Another person’s Photograph has been affixed on one proposal form whereas the other form is without any photograph. Somehow, the OP insurers have also not rebutted the complainant’s allegation of his ‘fake’ signatures on one proposal form. Further, the complainant has stated having not received the Second Policy issued out of the Second premium of the First Policy but the OP insurers have failed to produce any evidence of receipt or even dispatch of the same to the complainant who thus could not avail of his right to return the Policy within the 15 day look in period as prescribed by the IRDA. Further, we do find many such glaring instances of ‘deficiency in service’ on the part of the OP insurers that indicate profit maximization through employment of ‘unfair trade practices’. We, thus find that the complainant’s consumer rights have indeed been bruised through the unethical acts of the OP insurers and that holds them liable to an adverse award under the Consumer Protection Act’ 1986.
7. In the light of the all above, we partly allow the present complaint and thus ORDER the OP insurers to cancel the policies and refund/ repay back the aggregate amount (received as premium payments) to the complainant along with Rs.5,000/- as compensation for the undue harassment inflicted besides Rs. 3,000/- as cost of litigation; within 30 days of receipt of the copy of these orders, otherwise the entire awarded amount shall attract interest @ 9 % PA form the date of the orders till actually paid.
8. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.
(Naveen Puri)
President
ANNOUNCED: (Jagdeep Kaur)
October 06, 2015. Member
*MK*
