Chandigarh

DF-II

CC/303/2016

Sahil Bhatia - Complainant(s)

Versus

DHFL Pramerica Life Insurance Co. Limited - Opp.Party(s)

Varun Katyal Adv.

04 Sep 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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Consumer Complaint  No	:	303 of 2016
Date  of  Institution	:	05.05.2016
Date   of   Decision	:	04.09.2017

 

 

 

 

Sahil Bhatia, resident of House No.2441, Sector 19-C, Chandigarh and also resident of House No.1375, Sector 25, Panchkula. 

                               …..Complainant

Versus

1]  DHFL Pramerica Life Insurance Co. Limited, having Registered Office DLF Center, Sansad Marg New Delhi 110001 through its Managing Director.

2]  DHFL Pramerica Life Insurance Co. Limited, having its corporate office at 4^th Floor, Building 9, Tower B, Cyber City, Phase-3, Gurgaon, Haryana 122002

3]  DHFL Pramerica Life Insurance Co. Limited, SCO No.2941/2942, Sector 22-C, Chandigarh through its Branch Manager. 

                          ….. Opposite Parties

 

BEFORE:  SH.RAJAN DEWAN                 PRESIDENT

         MRS.PRITI MALHOTRA             MEMBER

                                SH.RAVINDER SINGH              MEMBER 

 

 

Argued by :     Sh.Varun Katyal, Advocate for complainant

                Sh.Karan Nehra, Advocate for OPs.

  

PER PRITI MALHOTRA, MEMBER

 

 

          Briefly stated, the complainant availed Policy NO.000003005 from Opposite Party on 4.4.2009, having premium of Rs.4500/- quarterly with maturity date as 3.4.2014 (Ann.C-1).  It is averred that the complainant paid the premium till 25.11.2010 and thereafter, due to some unavoidable reasons, he could not deposit the premium for some time.  However, later on he deposited a lump sum amount of Rs.36,000/- on 28.12.2012 and Rs.22,500/- on 22.2.2014 to the Opposite Party Company and the complainant was assured of all benefits of the policy.  It is also averred that in total; the complainant paid an amount of Rs.90,000/-  (Ann.C-2). 

         It is submitted that when the complainant sought withdrawal of amount from the said policy, the OPs refunded an amount of Rs.58,500/- only vide cheque dated 18.6.2014, which he accepted under protest (Ann.C-3 & C-4).  It is also submitted that the complainant requested the Opposite Party vide letter dated 5.3.2015 to refund the remaining amount of Rs.31,500/- but to no avail.  Hence, this complaint has been filed alleging deficiency in service on the part of the OPs.

 

2]       The OPs have filed joint reply and while admitting the factual matrix of the case, stated that the policy issued to the complainant was DLF Pramerica Wealth + Policy, which is a Unit Link Plan and is directly linked to share market.  It is stated that under the said policy, the complainant had to pay regular premium in quarterly mode of Rs.4500/- per quarter till the expiry of the policy, but he had stopped paying the premium towards the policy.  It is also stated that the reminders were sent to the complainant but still he did not make the payment of premium, hence the policy of the complainant had lapsed.   It is submitted that the policy in question was auto surrendered as per the terms of the policy and revival request towards the policy made by the complainant was received after the expiry of 9 months.  It is also submitted that the complainant has received a cheque of Rs.58,500/- towards the full and final payment as per fund value of the units and as per market price of unit which prevailed at that moment.  It is further submitted that the surrender value of units has been paid to the complainant as per Article 5 of the policy and the complainant accepted the cheque, got it encashed, as full and final value of the policy.  It is denied that any amount is due towards the company.  Pleading no deficiency in service and denying rest of the allegations, the Opposite Parties have prayed for dismissal of the complaint.

 

3]       Parties led evidence in support of their contentions.

4]       We have heard the ld.Counsel for the complainant and have also perused the entire record.

 

5]       It is admitted by the OPs that the complainant deposited an amount of Rs.4500/- as quarterly premium and was issued policy No.000003005, dated 4.4.2009 (Ann.C-1); thereafter continued paying quarterly premium amounting to Rs.4500/- till 24.11.2010.

 

6]       It is submitted by the OPs that due to non-payment of the premium thereafter, the policy of the complainant lapsed and claimed to have issued reminders informing about the lapse status of the policy and inviting the complainant to get the policy revived by completing certain formalities, as mentioned in the letters allegedly declaring/informing the lapsed status of the policy.

 

7]       The Opposite Parties claimed that despite of the letters issued to the complainant, the complainant failed to act as per the instructions. The OPs pleaded that the complainant only after a period of 1 year & 9 months on 28.12.2012 (from the date of lapsation of the policy) deposited an amount of Rs.36,000/- showing his intention to revive the policy, but did not comply with the requisite conditions as were required vide letters dated 3.2.2011 and 3.3.2011 respectively.  It is also admitted by the OPs that the complainant after the deposit of Rs.36000/- on 28.12.2012, again deposited an amount of Rs.22,500/- on 22.2.2014. The complainant demanded complete benefit of the policy from the OPs. 

 

8]       The OPs in their written reply in Para No.5 stated as under:-

“5.  That in reply to Para no-5 of the complaint, it is submitted that the complainant has received the cheque for Rs.58,500/- towards the full and final payment as per fund value of the units and as per market price of unit which prevail at that moment.  It is further submitted over here that the surrender value of units has been paid to the complainant as per Article 5 of the policy which was accepted by the complainant at the time of taking policy.  It is pertinent to mention here that the complainant has never made any protest regarding the surrender value of the policy and he has received the cheque from the answering respondent and the cheque was encashed by the complainant and accepted the amount as full and final value of the policy.  It is absolutely denied that any amount is due to towards the company.  Hence, the present complaint is liable to be dismissed on this ground alone.”

 

9]       Whereas, improving their earlier stand, the OPs in their affidavit filed, stated as under:-

“3.  That on account of non payment of premium the Opposite party sent repeated reminders to the complainant for the payment of the premium.  Therefore on account of the Terms and conditions of the policy, the policy issued to the Complainant was lapsed.  That vide letter dated 03.03.2011, the Complainant was informed that the Policy has lapsed and in case he wants to revive the same then he is required to follow the Requirements for revival as specified in the letter dated 03.02.2011. …. Letter dated 03.02.2011 is annexed as Annexure R-2 with the Reply filed by the Opposite party.  For the kind perusal of this Hon’ble Court the relevant extract of the requirement for revival as specified in the letter dated 03.02.2011 is reproduced below…………..

“Requirement for Revival:

Within 3 months    Total Amount due

3 6 Months         Declaration of the Good health form duly filled and signed by the Complainant   Total Amount due

6 Months          Medicals (if applicable) Declaration of the Good health form duly filled and signed by the Complainant  Total Amount due”

 

3.   That the complainant came approached the opposite party and deposited a sum of Rs.36,000/- vide receipt dated 28.12.2012 i.e. after a period of 1 year and 9 months, to show his intention to revive the policy but the complainant after making the deposit failed to comply with the other terms and conditions of the policy i.e. the complainant did not submit his Medical documents & Declaration of the Good health form duly filled and signed by the Complainant.

     Therefore the policy issued to the Complainant could not be revived and the amount of Rs.36,000/- deposited by complainant could not be adjusted towards the Policy earlier issued to the Complainant and as a consequence the original policy remained lapsed w.e.f. 03.02.2011.

     Therefore as per the terms and conditions of the Policy a refund of Rs.2559.24/- was issued to the Complainant on 14.10.2013 and the same was accepted by the Complainant without any protest and the same has been admitted by the Complainant in his letter dated 28.11.2014 (Annexure R-4).

4.   That even after having received the refund amount on account of surrender of the policy, the Complainant again approached the Opposite Party and deposited on his own a sum of Rs.22,500/- on 22.02.2014 i.e. after a period of 1 year 3 months from the date of previous deposit, towards the revival of the policy and again without complying with the Requirements for the revival of the Policy.  Thereafter the opposite parties while considering the facts and circumstances and after having already made a refund on account of the lapsed policy vide refund dated 14.10.2013, decided to refund the amounts deposited by the Complainant for the revival of the Policy, as the policy was already auto surrendered due to aforesaid reasons hence the policy could not be revived.  Therefore the refund cheque of Rs.58,500/- was handed over to the Complainant and the complainant received the same without any protest vide receiving dated 14.07.2014.

          A detailed summary of the payment deposited and refunded to the Complainant is herewith annexed as Annexure R-7.   

          Further from the perusal of the document annexed as Annexure R-4 & R-5, it is evident that the Complainant was fully aware and is now trying to mislead this Hon’ble Court.  It is humbly submitted that further from the statements of deposits and refunds it is abundantly clear that the Complainant is himself a deliberate defaulter in making the payment of premium to the Opposite parties and hence the Opposite parties have acted in accordance with the terms and conditions of the Policy.  Further once a refund of Rs.2559.24/- on 14.10.2013, had been accepted by the Complainant, then he has no cause of action to pursue the present complaint.  In view of the facts and circumstances as stated above the present Consumer Complaint is also beyond Limitation as the refund was made to complainant on 14.10.2013 and the present complaint has been filed beyond a period of two years.”  

 

10]      The submissions made in reply as well as contents mentioned in the affidavit, clearly reflects the contradictory stand taken by the OPs. It is observed that in nutshell in Para No.5 of its reply, the OPs claimed that they aid Rs.58,500/- to the complainant towards the full & final payment as per Fund Value of the Units and as per market price of the Units, which prevailed at that point of time and in their affidavit claimed that as per the terms & condemns of the policy, a refund of Rs.2459.24 was issued to the complainant on 14.10.2013. The amount of Rs.58,500/- which the OPs claimed to have refunded as full &final payment as per fund value of the units, is in actual is the sum total of the amount which the complainant had deposited in two installments amounting to Rs.36,000/- deposited on 28.12.2012 and Rs.22,500/- deposited on 22.2.2014.  Thus, this statement is baseless and has also been rectified in the affidavit filed by Mr.Parmal Singh, D.M.-Legal of DHFL Pramerica Life Insurance Company that it is the refund of the excess amount paid by the complainant since the policy was lapsed on 3.3.2011 due to non-payment of premium and then auto foreclosed on 14.10.2013. 

 

11]      It is apparent on record that the refund of the excess amount was made by the OPs on 14.7.2014 against the deposits of Rs.36,000/- and Rs.22,500/- made on 28.12.2012 & 22.2.2014 respectively. It is the claim of the OPs that after the lapsation of the policy on 3.2.2011, when the policy goes into auto-foreclose mode, they paid an amount of Rs.2559.24/- on 14.10.2013, but there is no documentary proof in this regard, thus not accepted as true.  In the given situation, it is made out that the Opposite Parties have acted unfairly by retaining the amount of Rs.36,000/- paid on 28.12.2012 while paying the alleged amount of Rs.2559.24 on 14.10.2013 as averred in their affidavit.

 

12]      It is observed that the Opposite Parties kept mum on the deposit of Rs.36,000/- and Rs.22,500/- till 14.7.2014. The further deposit of amount of Rs.22,500/- by the complainant on 22.2.2014 reflects that the complainant was never informed about the status of the policy. It is a deceitful act of the OPs, which proves their indulgence into unfair trade practice.  It was expected from the OPs to make refund of the amount of Rs.36,000/- and Rs.22,500/- to the complainant immediately once it was clear in their record that the policy against which the said amounts were deposited had already been foreclosed. 

 

13]      The plea of the Opposite Parties that they have sent coverage lapse notice and renewal billing notices (Ann.R-2) to the complainant, is not tenable in the absence of any cogent evidence in the shape of postal receipts with regard to dispatch of the alleged notices.  

 

14]      In view of the above findings, in the absence of any clear cut proof in regards to the status of the Policy, the complaint deserves to be allowed. Accordingly, the complaint is allowed against Opposite Parties with directions to refund the balance amount of Rs.31,500/-, as claimed by the complainant, along with an amount of Rs.20,000/- as compensation for the harassment suffered by the complainant on account of deficiency in service as well as unfair trade practice on the parts of Opposite Parties, within a period of 30 days from the date of receipt of copy of this order, failing which they shall also be liable to pay interest @9% per annum on the whole awarded amount from the date of filing this complaint till realization.

        Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

4^th September, 2017              

                                                                                      Sd/-

                                                                   (RAJAN DEWAN)

PRESIDENT

 

 

                                                Sd/-

 (PRITI MALHOTRA)

MEMBER

 

Sd/-

(RAVINDER SINGH)

MEMBER