West Bengal

Birbhum

CC/14/11

Ranjit Kr. Jaiswal, Vill. Kowa Mohal, - Complainant(s)

Versus

Br. Manager, Bajaj Allianz Life Ins. Co. Ltd., - Opp.Party(s)

Sanjit Acharya

18 Sep 2015

ORDER

This is a case u/s 12 of the Consumer Protection Act, 1986 (as amended up to date).

The case, in brief, is that Ranjit Kr. Jaiswal, the complainant purchased a policy from Bajaj Allianz Life Ins. Co. Ltd. (the O.P) bearing No. 0085221115 on 05/02/2008 and paid three annual premiums of Rs. 20,000 each. At the time of purchasing the policy he was informed by the Agent that he could get the policy amount after three years. Accordingly, the complainant asked his Agent for the payment of the policy amount but the Agent told him to wait up to 5½ years age of the policy. After that period the complainant was informed over telephone by Br. Manager of the O.P of Kolkata Office to renew the policy for revival after depositing two premiums as the policy became lapsed due to non payment of installment and he would get the policy amount after the age of 6years of the policy. The complainant paid two premium of Rs. 40,000 by cheque vide No. 033151 dated 12.03.2013 in favour of the O.P to renew his policy and delivered the cheque to the person who came to obtain the signature of the complainant for the revival of the aforesaid policy. After two months of such payment the complainant got a new policy vide No. 0297466718 which he never proposed. Being confused he rang the Br. Managers but they did not respond. The Agent of the O.P deprived the complainant and without his consent issued another policy instead of revival of the existing policy. The complainant visited the office of the O.P, rang to the person mentioned above but all were in vain. These activities of the O.P are amounting to deficiency in service as well as unfair trade practice. Hence, this case. The complainant has prayed for reliefs as per complaint.

The O.P contested the case by filing written version and denied all the allegations made against him. The O.P has stated that complainant paid premium for the policy No. 0085221115 for three years and after that the policy holder has not deposited any premium, even he has not revived the policy within two years from the date of first unpaid premium and as per terms and condition of the policy the complainant had no opportunity to make payment of premium under policy No. 0085221115 after expiry of that period. The O.P has also mentioned that the complainant in March 2013 again made a proposal for insurance and paid Rs. 40,000 to purchase a fresh policy and accordingly policy No. 0297466718 was issued to the complainant. The O.P has again mentioned that insurance agent against whom the allegation was made has not been impleaded as an O.P in the complaint and the complainant was provided 15days to review the terms and conditions for any reasons including for any misrepresentation but no grievance was raised by the complainant within 15 days after receipt of that policy document and the entire allegations are after thought and the petition be rejected with cost.

The Complainant has filed evidence-in-chief and some relevant documents. The O.P did not adduce any evidence. Written arguments have been filed by the concerned lawyers of both sides.

On appreciation of pleadings of both sides and verifying the documents on record the following points are necessary for discussion to determine the case.

POINTS FOR DETERMIATION

1. Is there any deficiency in service on the part of the O.P?
2. Is the complainant entitled to get relief or reliefs as prayed for?

DECISION WITH REASONS

Point No.s i) & ii):

            Both the points are taken up together for discussion as they are interrelated for the sake of convenience and brevity.

            It is admitted that the complainant had purchased the policy bearing No. 0085221115 from the O.P on 05.02.2008and had paid three annual premiums of Rs. 20,000/- each for that policy. It is also admitted that the complainant had again paid Rs. 40,000 in March 2013. Now, the complainant has claimed that he had deposited Rs. 40,000 to revive the aforesaid policy but the O.P has issued a new policy being No. 0297466718 instead of revival of the existing policy whereas the O.P has stated that the complainant has not paid any premium for policy No. 0085221115  after first 3 years and even the complainant had not revived that policy within two years from the date of first unpaid premium and as per terms and condition of the policy the complainant had no opportunity to deposit any premium after that period under the policy in question. The O.P again has claimed that the complainant had made a proposal for new policy and had deposited Rs. 40,000 for that purpose and accordingly a new policy has been issued and the complainant has not raised any objection within 15 days after receiving that policy document.

            We have carefully gone through the terms and condition provided in the policy document of policy No. 0085221115 filed by the complainant. Apparently Sec. 34 of the policy document speaks that this policy may be revived with the consent of the company within two years from the due date of the

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last unpaid premium subject to receipt by the company the following;

1. A written application for revival,
2. All due unpaid regular premiums,
3. Production of evidence of insurability satisfactory to the Company.

The complainant in his complaint neither mentioned about any written application sent to the O.P Company for revival of the policy nor he adduced any such documents before us.

Moreover, as per the due date of the premium of the policy paper and as per written version of the O.P the complainant paid last regular premium on February 2010 and again he deposited Rs. 40,000 on 12.03.2013 i.e. after 3 years of last regular premium. But as per Sec.12(C) of terms and condition of policy document the complainant had opportunity to revive the policy within 2 years of last regular premium. So, the allegation of the complainant that he had deposited Rs. 40,000 for revival of the said policy is not acceptable. Besides that, complainant has said that the Agent of the Insurance Company deprived him but he has neither impleaded that Agent as an O.P in this case nor he examined the Agent as witness. There is no other cogent evidence for the complainant to prove his allegation that he had deposited Rs. 40,000 for revival of the existing policy.

However, it is admitted that the complainant deposited 3 premiums of Rs. 20,000 each i.e. total sum of Rs. 60,000. After that the complainant discontinued the payment of regular premium and as per the written statement of the O.P the policy holder did not opt to continue the policy after the revival period of two years, rather, he has proposed for the new policy. Therefore, as per Sec. 12(c )(ii) of the terms and conditions of the policy documents the policy shall be terminated by paying the fund value. But we are unable to calculate the current fund value of the policy as neither the complainant nor the O.P has submitted the current account statement regarding the policy in question before this Forum. Hence, we have decided to settle the claim of the complainant as per Regulation 2010 of Insurance Regulatory and Development Authority which were notified by notification dated 01.07.2010 i.e much before the cause of action accrued to the complainant in the year 2013. As per Regulation 7, IRDA Regulation 2010 where the policy is discontinued during the policy year three, maximum discontinuation charges for policies having annualized premium above Rs. 25,000 will be lower of 3% of annualized premium or fund value on the date of discontinuation subject to maximum of Rs. 4,000 and the O.P could not charge any other charges except those mentioned above. Since the complainant paid a sum of Rs. 60,000 for the policy in question as premium for three years to the O.P, according to the regulation extracted above she is entitled to get Rs. 58,200[ 60,000-(3% of 60,000)]. But in the written argument the O.P has denied to pay any amount to the complainant taking plea of lapsed Policy.​ Such type of activity is illegal in the eyes of law. We find deficiency in service on the part of the O.P. In view of the above, the case stands in part. Point No. i) & ii), thus, stands in favour of the complainant.

 

Proper fees have been paid.

            Hence, 

O R D E R E D                                        

that C.F Case No. 11/2014 be and the same is allowed on contest against O.P in part.

The O.P is directed to pay Rs. 58,200 to the complainant to settle the insurance claim for the policy No. 0085221115 with interest @ 10% P.A. from the date of filing this case i.e. on and from 22.01.2014 till the date of realization. The O.P also directed to pay Rs. 3,000 as litigation cost to the complainant. All such payment shall be made within one month from the date of this order failing which the complainant shall be at liberty to put this order for execution as per law and procedure.

Copies of this order be supplied to the parties each free of cost immediately.