Punjab

Ludhiana

CC/15/557

Mr.Sukhdev Singh - Complainant(s)

Versus

DLF Prmerica Life Ins.Co.Ltd. - Opp.Party(s)

M.S.Sethi Adv.

07 Feb 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

 

Consumer Complaint No. of  557 of 18.09.2015

Date of Decision          :   07.02.2017

Mr.Sukhdev Singh s/o Ramrakha Singh r/o 2A, Lal Bagh, Tehsil-Ludhiana West, Village Tharike, Distt. Ludhiana.

……Complainant

                                                    Versus          

1.DLF Pramerica Life Insurance Company Limited, 4^th Floor, Building No.9, Tower B, Cyber City, DLF City, Phase-11, Gurgaon-122002 through authorized signatory.

2.DLF Pramerica Life Insurance Company Limited, 5^th Floor, Kunal Towers, The Mall, Ludhiana through authorized signatory.

3.Mr Varun Chopra, Code-SE00013488 C/o DLF Pramerica Life Insurance Company Limited, 4^th Floor, Building No.9, Tower B, Cyber City, DLF City, Phase-11, Gurgaon-122002.                                                                                                                                                        ……...Opposite Parties

 

 

 (COMPLAINT U/S 12 OF THE CONSUMER PROTECTION ACT, 1986)

 

 

QUORUM:

SH.G.K.DHIR, PRESIDENT

SH.PARAM JIT SINGH BEWLI, MEMBER

 

COUNSEL FOR THE PARTIES:

For Complainant                     :       Sh.M.S.Sethi, Advocate

For OPs                         :       Sh.Surinder Kashyap, Advocate

 

PER G.K DHIR, PRESIDENT

 

1.                Complaint under Section 12 of the Consumer Protection Act, 1986(hereinafter referred to as the ‘Act’) filed by the complainant against OP by claiming that on 07.09.2012, the complainant approached OP3 agent of Op1 and OP2. Being impressed by the schemes and promises made by the agent that he is liable to pay one time investment and will get amount of his investment with bonus in 3/2013, complainant signed the blank two proposal forms and also submitted his income returns for the year 2012-13 and paid a sum of Rs. 96,150/- for two policies from his saving of the previous years. Thereafter, the complainant received the policies having Nos. 000170055 and 000170054 dated 17.9.2012 and 17.11.2012 in his name being policy holder and in the name of her daughter namely Darvinder Kaur Sidhu being life assured. On receiving the policy No. 000170055, the complainant acknowledged the facts that promise as made by the agent of the OPs was not fulfilled and that they succeeded in getting the amount from the complainant by way of mis-representation because as per the policy, the complainant was liable to pay premium of Rs. 96,150/- per year for a period of 10 years against the policy tenure of 20 years. It was not             possible for the complainant to pay yearly premium of Rs. 96,150/- because the annual income of the complainant was less than Rs. 3 lacs. However, the Ops failed to give  proper response and they postponed the matter on various    excuses and ultimately the complainant lodged its protest in writing on 7.5.2013 stating that the signatures of her daughter were forged on the policy documents as his daughter was not present at the time of signing the documents.    On10.5.2013, OP2 refused to cancel the policy. By pleading deficiency in service and adoption of unfair trade practice on the part of Ops and  by                 claiming that they have not followed the notification of the IRDA dated 1.7.2010 and has not paid the fund value according to the notification, prayer made for issuing direction against Ops to cancel the policy No. 000170055 dated 17.9.2012 and refund the basic premium of Rs. 96,150/- after deducting the charges as per the notification dated 1.7.2010 along with interest @ 9% p.a.. Compensation for mental harassment of Rs.50,000/- and Rs. 11,000/- as litigation expenses more claimed.

2.                In written statement filed by OP1 to OP3 jointly, they took preliminary objections that the complaint is false, malicious, incorrect and malafide to the knowledge of the complainant and the same is liable to be dismissed under Section 26 of the Act; the complainant had not approached the Forum with clean hands; there was no cause of action for the complainant to file the complaint; the proceedings before the Forum are summary in nature    whereas the allegations of fraud and forgery were levelled by the complainant, which required examination, cross-examination of the parties, therefore, the matter be relegated to the Civil Court; there was no negligence or deficiency in services on the part of the OPs; the complainant had opted for Tatkal Suraksha Gold, which was duly approved by the IRDA and after receipt of the policy document, the complainant had 15 days free look period and in case the terms and conditions of the policy were not suitable to him, he had a right to cancel the same, but he did not opt to cancel it within the free look period and now the parties to be governed by the terms and conditions of the policy. The   complainant after duly calculating and understanding the terms and conditions of Tatkal Suraksha Gold filled in application form Nos. OT 001123097 & OT 001123096 dated 7.9.2012 for purchasing policy for sum assured of Rs. 10 lacs for both the policies and premium was of sum of Rs. 97,635/- and Rs.98,092/-, respectively to be paid annually for a period of 15 years. At the time of filling the form, he had submitted the copies of PAN Card and Income Tax Returns. In case, complainant did not cancel the policies within the free look period, then presumption can be raised against the complainant that he was satisfied with the terms and conditions of the policy. For the first time on 7.5.2013, the OPs received the complaint with respect to the tampering, corrections, forgery of proposal or related papers. The Ops conducted a detailed investigation and after that letter dated 30.5.2013 was sent to the complainant stating that the policy was issued on the basis of duly signed application form received by the OP along with other required documents and they also received the important KYC document. On merits, it is submitted that the complainant Mr. Sukhdev Singh is Assistant Professor in Lovely Professional University, therefore, highly educated person. He clearly understood all the terms and conditions of the policy and did not cancel the same within free look period and now the parties are governed by the terms and conditions of the policy. The complainant did not deposit further premiums after deposit of the first premium, therefore, the policy of the complainant had lapsed. By denying allegations of adoption of unfair trade practice or of any deficiency in services on the part     of Ops, each and every other allegations of the complaint denied with prayer for dismissal of complaint, being false and frivolous in nature.

3.                Complainant tendered in evidence his affidavit Ex. C1 along with documents i.e. letters of Op Ex. C-1, premium receipt Ex. C-2, last page of proposal form Ex. C-3, letter dated 7.5.13 Ex. C-4, letter of Op Ex. C-5 and thereafter, counsel for the complainant closed the evidence on 20.12.2013.

4.                On the other hand, counsel for OPs tendered into evidence affidavit Ex.RA of Ms.Sujata SVP-Corporate Affairs and General Counsel along with documents Ex.R1 and Ex.R2 i.e. proposal forms and then closed the evidence on 13.2.2014.

5.                After hearing arguments, complaint was earlier dismissed vide order dated 26.3.2014 passed by this Forum by holding that no cause of action has accrued at Ludhiana and as such, this Fora has no jurisdiction to decide the complaint.

6.                However, on appeal being preferred before the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh, the said order was set aside by holding that this Forum has jurisdiction because proposal form was filled at Ludhiana as obvious from the document Ex.C3 and as such, this Forum was directed to dispose of the complaint on merits. Complaint was remanded back to this Forum by the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh vide order dated 12.8.2015 passed in FA No.1077 of 2014 titled as Mr.Sukhdev Singh vs. DLF Pramerica Life Insurance Company Limited and others.

7.                After remand of the case to this Forum, both counsel for the parties suffered statement that they are not to lead any more evidence except the already produced evidence before remand. After record of that statements of 6.5.2016, case was posted for arguments.

8.                Written arguments in this case were submitted by OP1 and OP2 on 26.3.2014 and even written arguments by complainant was submitted on 25.3.2014. No written arguments submitted after remand of the case. Oral arguments of counsel for parties heard and records gone through minutely.

9.                Proposal forms for purchase of the policies in question were submitted as Ex.R1 and Ex.R2 by the complainant. The insured are Sh.Balwinder Singh s/o complainant Sh.Sukhdev Singh and Darvinder Kaur d/o of complainant Sukhdev Singh. In Ex.R1 and Ex.R2 each educational qualification of Sukhdev Singh complainant is mentioned as Graduate and besides it is mentioned that he is a retired employee and is pensioner. However, educational qualification of insured Balwinder Singh mentioned as Post Graduate in Ex.R1, but that of Darwinder Kaur also mentioned as Post Graduate in Ex.R2. Sh.Balwinder Singh is shown as Computer Engineer in Ex.R1, whereas Darwinder Kaur is shown as Assistant Professor in Ex.R2. So, from this documentary evidence available on record, it is proved that not only the complainant (proposer/nominee), but even the insured are educated persons. These proposal forms bear the signatures of insured as well as complainant Sukhdev Singh each and they are of date 7.9.2012 each. So, in view of this contention of counsel for complainant not believable that proposal forms Ex.R1 and Ex.R2 were not signed by Balwinder Singh and Darwinder Kaur. Had these proposal forms been not signed by Balwinder Singh and Darwinder Kaur, then their affidavits should have been produced in evidence in support of that contention, but no affidavit of these Balwinder Singh and Darwinder Kaur produced and as such, complainant failed to establish that proposal forms Ex.R1 and Ex.R2 were not signed by Balwinder Singh and Darwinder Kaur.

10.              Contents of Ex.R1 leads to the inference that proof of age school/college certificate was provided and even the mobile numbers were provided. Contents of Ex.R2 establishes that copy of Pan Card in support of proof      of age of Darwinder Kaur was submitted and even mobile number was provided. Production of Pan Card and school certificate at the time of signing of proposal forms Ex.R1 and Ex.R2 leads to the only conclusion that actually the contents of proposal forms were explained to the insured and that is why they submitted the proof. Income of Balwinder Singh and Darwinder Kaur mentioned as Rs.3 lac and Rs.4 lac in Ex.R1 and Ex.R2 respectively. Even the name of organization, in which, Balwinder Singh and Darwinder Kaur were working mentioned as LG Electronics, Ludhiana and Lovely Professional University, Jalanadhar, Punjab respectively in Ex.R1 and Ex.R2. No insurance agent could have known these particulars unless disclosed to him by the person signing the documents and as such, these circumstances lead to the only irresistible conclusion that actually on submission of Pan Card copy and record of school certificate, the policies in question were issued after issue of premium receipt Ex.C2 with respect to both the policies.

11.              In premium receipt Ex.C2, date of commencement of the policy mentioned as 17.9.2012 with term of 15 years. Frequency of payment of premium mentioned as annual in Ex.C2. Complainant through letter Ex.C5 of date 17.9.2012 was disclosed that he can review the attached policy document and copy of application form. Further, through this letter Ex.C5 of date 17.9.2012 itself, the complainant was disclosed that in case, he is not satisfied with any aspect of any policy, then he can return the same within 15 days of receipt  and for Unit Link Products, the amount will be refunded after cancellation, but after deduction of certain charges. Receipt of this letter Ex.C5 by the complainant is established by the contents of Ex.C4 also, which is a letter dated 7.5.2013 written by the complainant to the Manager of DLF Pramerica Life Insurance Company Limited, Ludhiana. Through Ex.C4, complainant expressed inability to pay the annual premium amount by claiming that he being pensioner in age of 65 years not in a position to pay the same. Request for discontinuance of the policies was submitted through Ex.C4 by claiming that signature of son and daughter of the complainant on policies are forged. However, proof of that forgery is not at all adduced by examining any expert or producing Balwinder Singh and Darwinder Kaur as witnesses or by submission of their affidavits even.

12.              As contents of Welcome letter and premium receipt Ex.C5 and Ex.C2 came to the notice of the complainant on 17.9.2012 and as such, he could have exercised the option of cancellation of policies within 15 days of receipt of the policy documents. These policy documents were attached with letter        Ex.C5 is a fact borne from the contents of Ex.C5 itself. As cancellation of policies permissible by exercise of an option in that respect within 15 days from the receipt of policy documents as per contents of Ex.C5, but that option not exercised and as such certainly submissions advanced by counsel for Ops has force that the complainant bound by the terms and conditions of the policy.

13.              Contract of insurance binding on the parties. Nothing can be added or subtracted to the terms and conditions of the insurance policy. In holding this view, we are fortified by law laid down in cases titled as Ind Swift Limited vs. New India Assurance Co.ltd and others-IV(2012)CPJ-148(N.C.); Usha Sharma and others vs. New India Assurance Co.Ltd and others-I(2012)CPJ-488(N.C.); United India Insurance co.Ltd. vs. Harchand Rai Chandan Lal-IV(2004)CPJ-15(S.C.) and Deokar Exports Private Limited vs. New India Assurance co.Ltd-I(2009)CPJ-6(S.C.). As terms and conditions of the policies are binding on the complainant and as such, he cannot wriggle out of the terms and conditions of the policies now. These policies issued are Unit Link Products as per mention made in letter Ex.C5 and as such, Insurance Regulatory and Development Authority (Linked Insurance Products) Regulations, 2013 as notified in The Gazette of India : Extraordinary Part III through notification No.F.No./IRDA/Reg./15/73/2013 published on 16.2.2013 to govern the case.

14.              Regulation 1.A(d) of the above said regulations provides that date of payment of premium means the date on which premium payment is received by the insurer. Further, as per Regulation 1.A(f) of above said regulations, discontinuance means the state of a policy that could arise on account of surrender of policy or non-payment of the contractual premium due before the expiry of the notice period provided for stipulated in sub regulation (i) of Regulation 13(a) of these regulations. As the premium is payable annually and as such, on account of commencement of the policies w.e.f.17.9.2012 onwards, the next date for payment of premium was around 17.9.2013. That premium not paid and as such certainly the policies in question went in state of a discontinuance as per Regulation 1.A(f) of above pointed regulations.

15.              Regulation 1.A(o) of above said regulations of 2013 provides that lock in period means the period of five consecutive years from the date of commencement of the policy, during which period the proceeds of the discontinued policies cannot be paid by the insurer to the policyholder or to the insured, as the case may be, except in the case of death or upon the happening of any other contingency covered under the policy. Present case is not a case of discontinuance on account of death or on account of happening of any contingency covered under the policy, but it is a case of discontinuance of the policies due to non-payment of contractual premium due on after year i.e. on 17.9.2013 and as such, in view of provision of lock in period of 5 years, certainly the complainant not entitled for the refund of any amount until 17.9.2017, when the lock in period of 5 years will elapse.

16.              Even as per Regulation 7 contained in Chapter IV of the above said regulations, the minimum policy term for individual products shall be at least five years and as such, in view of this regulation and in view of stipulation of lock in period of 5 years from the date of inception of the policy through regulation 11 of the above said regulation, complainant not entitled to balance amount after deductions of discontinuance charges until 17.9.17.

17.              As per Regulation 15 of above said regulations, where the policyholder does not exercise the option available in terms of proviso to sub regulation (i) of Regulations 13 (a), the fund value/policy account value of the policy shall be credited to the discontinued policy fund/policy account value. Further, as per this Regulation 15(a) of the above said regulations, the proceeds of the discontinued policy shall be refunded only upon the completion of the lock in period. So, in view of this regulation 15(a) and in view of non exercise of option of discontinuance of the policy, complainant entitled to the fund value/policy account value as per scale prescribed by regulation 13 of above said regulations only.

18.              Even as per Regulation 2(i)(vi) of Insurance Regulatory and Development Authority(Treatment of Discontinued Linked Insurance Policies) Regulations, 2010 published in Government of India Gazette in III Part on 1.7.2010, situation of discontinuance of the policy to arise on account of non-payment of the contracted premium due before the expiry of the notice period provided by sub regulation (1) of 5 of these regulations. Lock in period of 5 years from the date of commencement of the policy is envisaged by regulation 2(i)(viii) of above said regulations of 2010 bearing notification No.F.No.IRDA/Reg./2/52/2010.

19.              As per Regulation 6 of these regulations 2010, the fund value of the policy to be credited to the discontinued policy fund after lapse of period of 5 years i.e. lock in period, but after deductions of discontinuance charges etc as provided by Regulation 7 of these regulations 2010. So, complainant is not at all entitled to the refund of the value of discontinued policy till 17.9.2017 and as such, complaint being pre-mature is not maintainable. However, entitlement of the complainant for withdrawal from the policies will remain as per IRDA Regulations after expiry of lock in period of 5 years commencing from the      date of issue of policies and as such, order passed accordingly.

20.              As a sequel of above discussion, complaint disposed of in terms that entitlement of the complainant for withdrawal from the policy will be as per IRDA Regulations after expiry of lock in period of 5 years commencing from the date of issue of policy. No order as to compensation and litigation costs is passed. Copies of order be supplied to parties free of costs as per rules

21.                        File be indexed and consigned to record room.

 

                             (Param Jit Singh Bewli)                       (G.K.Dhir)

                                          Member                                                         President

Announced in Open Forum

Dated:07.02.2017

Gurpreet Sharma.