Haryana

Karnal

CC/126/2022

Ravinder Munjal - Complainant(s)

Versus

Canara HSBC Oriental Bank Of Commerce Life Insurance Company Limited - Opp.Party(s)

Manjeet Kamboj

06 Feb 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                          Complaint No. 126 of 2022

                                                          Date of instt.11.03.2022

                                                          Date of Decision 06.02.2023

 

Ravinder Munjal son of Ram Dayal Munjal, resident of House no.1277, Sector-13, Karnal-132001 age 56 years.

 

                                                 …….Complainant.

                                              Versus

 

1.     Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited Corporate office at 2^nd floor, Orchid Business park, Sector-48, Sohna road, Gurugram-122018, Haryana through its Manager/authorized person.

 

2.     Canara HSBC Oriental Bank of Commerce Life Insurance Co. Ltd. branch office at –SCO-93 1^st floor, Sector-7, Karnal Haryana -132001.

                                                                    …..Opposite Parties.

 

      Complaint u/s 35 of the Consumer Protection Act, 2019

 

Before   Sh. Jaswant Singh……President.       

      Sh.Vineet Kaushik ………..Member

      Dr. Rekha Chaudhary…..Member

 

 Argued by: Shri Manjeet Kamboj, counsel for the complainant.

                    Shri Dheeraj Sachdeva, counsel for the OPs.

 

                        (Jaswant Singh President)

 

ORDER:                    

 

                        The complainant has filed the present complaint u/s 35 of the Consumer Protection Act, 2019 against the opposite parties (hereinafter referred to as ‘OPs’) on the averments that the agent of the OPs met with complainant and allured to purchase a term plan for a period of 27 years. On the advice of agent of OPs, complainant purchased a term plan policy from the OPs. For purchase of the said policy, complainant has to undergo various medical tests like BP, diabetes tests as well as CBC, HIV, TMT etc at the hospital of OPs’ company i.e. Chaudhary Maternity Hospital Sector-13 Karnal and after getting all the satisfactory test reports, the OPs issued a policy namely Canara HSBC Oriental Bank of Commerce Life Insurance Select Term Plan vide policy no.0089835517. The monthly premium of the policy was Rs.2486.86/-. The risk coverage was of Rs.80,00,000/-. The OPs’ company assured that in case of the death of the insured during the period of insurance, the nominee/legal heirs of the insured would be entitled to receive the sum assured amount. The complainant started paying premium of the policy on 18.03.2019 and complainant requested to the agent as well as to the OPs to provide policy documents, but the OPs did not provide any policy document and just provided some detail of policy i.e. the policy number, the premium amount and the period of insurance and sum assured. The complainant was regularly paying the premium of insurance. In the month of 2020, the agent of the OPs again met with the complainant and introduced another insurance plan of the OPs to be very beneficial for the complainant. The complainant again agreed to purchase another insurance from the OPs’s company and again as per the instruction of the OPs, complainant conducted the various medical tests. After tests conducted upon the complainant, it was told to the complainant that a PMT test of complainant has failed and the report of the said test is not favorable and refused to provide the insurance plan. Being a bonafide insured person, complainant not insisted to the OPs to provide another insurance policy and withdrawn the proposal for the said new insurance plan. It is further averred that after the said PMT test, the OPs asked to complainant, the current policy of the complainant i.e.  policy no.0089835517 would be cancelled by the company for the reason that the test of complainant has conducted in the year 2020 has been failed and in case, the complainant desires to continue the validity of policy, the complainant has to provide the OPs all the tests reports pass and favorable in the year 2019 at the time of issuance of the policy. OPs refused to accept the premium of the policy and asked the complainant that the premium would only be accepted after the re-medical examination and after positive result of PMT medical examination. The complainant was surprised that when a policy has already been issued to the complainant and during the continuation of the policy, the OP company is demanding once again to get all tests conducted and to provide with all the tests report favorable. The complainant contacted the OPs and requested that once the policy has been issued after getting full satisfaction of tests, then the OPs’ company cannot cancel the policy on the ground of afterward test reports. Complainant visited the office of OPs so many times and requested to accept the premium amount, but of no use. During all these circumstances, an unprecedented situation of covid-19 faced by the country, the complainant was unable to contact the OPs. After the pandemic lockdown, the complainant once again approached to the OPs in 2021 and requested not to cancel the policy and requested to accept the premium amount but OPs did not pay any heed to the request of complainant. Complainant visited the office of OPs to know about the status of the policy, but OPs only kept on demanding the pass test reports and threatened the complainant that in case, the said pass/favorable test reports not provided, the policy in question would stand cancelled. The complainant again shocked to know that the OPs would arbitrarily and illegally turned the policy as lapsed and now the OPs are demanding the tests reports for revival of policy despite of the fact that the test reports have been not favorable. In this way there is deficiency in service and unfair trade practice on the part of the OPs. Hence this complaint.

2.             On notice, OPs appeared and filed its written version raising preliminary objections with regard to maintainability; jurisdiction and concealment of true and material facts. On merits, it is pleaded that complainant after understanding the terms and conditions  of the policy “Canara HSBC Oriental Bank of Commerce Lie Insurance Select Term Plan” for a sum assured of Rs.80,00,000/- and monthly installment  premium of Rs.2484.86. The complainant opted for a policy term of 27 years and premium paying term of 27 years, vide proposal form bearing no.7000088928 dated 27.12.2018 and provided all the relevant details and information in the said proposal form. Upon receipt of the duly signed proposal form and Addendum and believing the information provided by the complainant to be true and correct, alongwith the initial premium, OPs evaluated and processed the proposal form and issued the policy bearing no.0089835517 with risk commence date of 18.03.2019. The policy documents were duly dispatched to the address of the complainant, vide speed post with AWB no.EH564586865IN on 20.03.2019. As per terms and conditions of the policy, the complainant was provided a freelook period of 15 days from the date of receipt of the policy to cancel the policy in case there is any discrepancies in the policy, OPs gave an opportunity to review/cancel the policy within freelook period but complainant failed to approached the within freelook period with respect to the proposal form or the terms of the policy. It is further pleaded that complainant was required to pay the premium monthly for a period of 27 years, however, he paid the premium only till January, 2020. The next premium fell due on 18.02.2020 and the company tried to debit the premium from the account of complainant, however, the same could not be debited due to insufficient fund and same was informed to the complainant, vide letter dated 19.02.2020. The company also sent a renewal premium overdue notice dated 26.02.2020 to the complainant reminding him to pay the premium. However, the same was not paid by the complainant. Despite receipt of the dishonour letter and premium overdue notice the complainant failed to pay the renewal premium thus, the policy lapsed on 18.02.2020 and same was informed to the complainant, vide letter dated 17.03.2020.  Subsequently, on 20.04.2020 the company was in receipt of revival request from complainant. On receipt of the said request, the company requested the complainant to undergo fresh medical checkup to ascertain the health of the complainant, however, the complainant refused to undergo the same for the reasons best known to him. Therefore, the policy could not be reinstated and the premium paid for reinstatement was refunded to the complainant and the policy was discontinued. This was duly communicated to the complainant, vide letter dated 11.05.2020. There is no deficiency in service and unfair trade practice on the part of the OPs. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of policy schedule Ex.C1, copy of welcome letter dated 19.03.2019 Ex.C2, copy of letter to OPs by complainant Ex.C3, copy of letter dated 24.12.2021 sent by OPs to complainant through email Ex.C4 and closed the evidence on 20.07.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Arindam Mishra, Senior Manager-Legal Ex.RW1/A, copy of welcome letter Ex.OP1, copy of letter dated 19.02.2020 regarding payment dishonour intimation Ex.OP2, copy of policy lapse notice dated 17.03.2020 Ex.OP3, copy of rejection towards revival letter dated 11.05.2020 Ex.OP4 and closed the evidence on 11.11.2022 by suffering separate statement.

6.             We have heard the learned counsel for the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for the complainant, while reiterating the contents of the complaint, has vehemently argued that complainant purchased a term plan policy from the OPs. For purchase of the said policy, complainant has to undergo various medical tests and after getting all the satisfactory test reports, the OPs issued a policy in question. On the advice of agent of the OPs, complainant wants to purchase another insurance policy and for this complainant conducted the various medical tests. In the said tests PMT test of complainant is failed.  After the said PMT test failure, OPs cancelled the policy in question whereas all the tests reports were passed and favorable in the year 2019 at the time of issuance of the policy. When a policy has already been issued to the complainant and during the continuation of the policy, the OPs are demanding once again to get all tests conducted. Complainant visited the office of OPs so many times and requested to accept the premium amount, but of no use. He further argued that during all these circumstances, an unprecedented situation of covid-19 faced by the country, the complainant was unable to contact the OPs. After the pandemic lockdown, the complainant approached the OPs and requested not to cancel the policy and requested to accept the premium amount but OPs did not pay any heed to the request of complainant. He further argued that now complainant does not want to continue the policy in question as he lost the faith on the OPs and he wants to take the refund the premium deposited by him and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OPs, while reiterating the contents of written version, has vehemently argued that the complainant purchased a term policy from the OPs and premium paying term of 27 years. The risk commence date is of 18.03.2019. Complainant paid the premium only till January, 2020 and the next premium due on 18.02.2020 could not be debited due to insufficient fund and same was informed to the complainant, vide letter dated 19.02.2020. The company also sent a renewal premium overdue notice dated 26.02.2020 to the complainant, despite receipt of said notice, the complainant failed to pay the renewal premium thus, the policy lapsed on 18.02.2020 and same was informed to the complainant, vide letter dated 17.03.2020.  On 20.04.2020 OPs received a of revival request from complainant. On receipt of the said request, the company requested the complainant to undergo fresh medical checkup to ascertain the health of the complainant, however, the complainant refused to undergo the same. Thus, the policy could not be reinstated and the premium paid for reinstatement was refunded to the complainant and the policy was discontinued. This was duly communicated to the complainant, vide letter dated 11.05.2020 and lastly prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, complainant purchased a term policy namely Canara HSBC Oriental Bank of Commerce Life Insurance Select Term Plan from the OPs. It is also admitted that complainant paid the premium of Rs.27,346/- till January, 2020.

11.           The OPs have taken a plea that complainant paid the premium till January, 2020 and the premium due on 18.02.2020 has not been paid by the complainant and in this regard OPs have sent a renewal premium overdue notice dated 26.02.2020 to the complainant, despite receipt of said notice, the complainant failed to pay the renewal premium thus, the policy lapsed on 18.02.2020 and same was informed to the complainant, vide letter dated 17.03.2020. On the other hand, complainant said that he has not received any letters from OPs. The onus to prove its version lies upon the OPs but OPs have failed to prove the same by leading any cogent and convincing evidence. OPs have failed to place on file any postal receipt, receipt issued by the complainant with regard to the delivery of the said letters. Furthermore, if it is presumed that OPs sent a letter dated 17.03.2020 regarding cancellation of the policy to the complainant. During this period due to spread of Novel Coronavirus (COVID-19) lockdown was imposed by the Government and due to lockdown complainant could not be paid remaining premium amount. After opening of the lockdown, on 20.04.2020, complainant approached the OPs for revival of the policy but OPs refused to revive the policy in question on the medical ground.

12.           It is evident from the letter Ex.OP4 dated 11.05.2020, OPs were ready to refund the amount of Rs.8796.42 but till date no refund has been made by the OPs. Complainant paid Rs.27,346/- but OPs were ready to pay only Rs.8796/-. OPs have failed to explain as to why they  have refunded only Rs.8796/- inspite of Rs.27346/-. In view of the above, we are of the considered view that complainant is entitled for the refund the premium amount which was deposited by him.

13.           Admittedly, complainant paid Rs.27346/- to the complainant. Thus, he is entitled for the said amount alongwith compensation for mental agony, harassment and towards litigation expenses.

14.           Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OPs to pay 27,346/- (Rs. twenty seven thousand three hundred forty six only) to the complainant. We further direct the OPs to pay Rs.5,000/- to the complainant on account of mental agony, harassment and towards litigation expenses. This order shall be complied with within 45 days from the receipt of copy of this order. It is made clear if the awarded amount not paid within stipulated period then interest @ 9% per annum shall be charged on the awarded amount from the date of announcement of order till its realization.  The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Dated:06.02.2023     

                                                               

                                                                  President,

                                                     District Consumer Disputes

                                                     Redressal Commission, Karnal.

 

(Vineet Kaushik)        (Dr. Rekha Chaudhary)

                           Member                          Member