Kerala

Idukki

CC/85/2021

Biju T George - Complainant(s)

Versus

edelweiss Tokio life insurance co. - Opp.Party(s)

28 Feb 2024

ORDER

DATE OF FILING :16.7.2021

IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, IDUKKI

Dated this the   28^th   day of  February,  2024

Present :

SRI. C. SURESHKUMAR PRESIDENT

SRI. AMPADY K.S. MEMBER

CC NO.85/2021

Between

Complainant     :      Biju T. George,

Thoppil House,

Kaliyar P.O.,

Vannappuram, Thodupuzha – 685582.

          (By Adv: K.M. Sanu)

And

Opposite Parties     : 1.  Edelweiss Tokio Life Insurance Co. Ltd.,

Represented by its Manager,

Mathewsons Centre Point, 4^th Floor,

Mamangalam, Kochi – 682025.

      2.  The Manager,

Edelweiss Tokio Life Insurance Co. Ltd.,

Mathewsons Centre Point, 4^th Floor,

Mamangalam, Kochi – 682025.

     3.  The Manager,

Edelweiss Tokio Life Insurance Co. Ltd.,

Wing B, Kohinoor City Mall,

Kohinoor City, Kirol Road,

Kurli (W), Mumbai – 400070.

           (All by Adv: George Vinci Jose)

      4. The Manager,

Catholic Syrian Bank Ltd.,

Vannappuram Branch,

Vannappuram P.O.

 

O R D E R

 

SRI. C. SURESHKUMAR, PRESIDENT

 

1. This case originates from a complaint filed under Section 35 of the Consumer Protection Act of 2019 (the Act, for short).  Case of the complainant is briefly discussed hereunder :

 

Complainant is a customer of 4^th opposite party bank, namely, Catholic Syrian Bank, represented by its Vannappuram branch manager.  1^st opposite party is an insurance company, namely, Edelweiss Tokio Life Insurance Co. Ltd., which is represented by its Kochi branch manager.  2^nd opposite party is the branch itself represented by its manager.  3^rd opposite party is Mumbai office of the same insurance company, represented by the manager there.   Complainant had taken an insurance policy of opposite parties 1 to 3 after paying a premium of Rs.26,776/-.  This policy was made available to the customers of the 4^th opposite party bank as a joint move with opposite parties 1 to 3.  Complainant had joined the policy on 27.5.2014.  It had a maturity period of 15 years, for which complainant had to pay premium for 10 years.  Policy had death and critical illness coverage.  It also had maturity and surrender values.  Complainant had paid only the first premium.  Complainant is entitled for surrender factor and guaranteed additions under the policy.  After the commencement of policy, opposite parties 1 to 3 have stopped their operations in the locality.  When contacted over phone, they were not giving any meaningful response to complainant.  To the knowledge of complainant, opposite parties 1 to 3 had collected premium from  public  and left the place.  Even 4^th opposite party was unable to give a satisfactory response to complainant.  There is gross deficiency in service and unfair trade practice from the side of opposite parties.  Complainant is entitled to get surrender value as mentioned in the policy or in the alternate return of premium amount with 12% interest.  Despite repeated contacts over phone and finally by a letter, there was no response from opposite parties.  Complainant prays for return of policy amount of Rs.26,776/- with 12% interest along with a compensation of Rs.50,000/- for deficiency in service and litigation cost of Rs.5000/- from opposite parties.  

 

2.  4^th opposite party has not appeared despite receipt of notice.  Though 3^rdopposite party also had not initially appeared, later on written version was filed by it along with opposite parties 1 and 2.  Their contentions are briefly discussed hereunder :

 

According to opposite parties 1 to 3, complainant is not maintainable in law or upon facts.  Complainant has concealed material facts from this Commission.  Complainant had submitted a proposal for taking the insurance policy.  Proposal and policy  as well contain free look provisions which are clauses 4.1 and 6.2 of IRDA (Protection of Policy Holder’s Interest) Regulations 2002.  As per free look provision, policy holder has a 15 days free look in period from the date of receipt of policy documents to review the terms and conditions of policy.  In the event of policy holder disagreeing with any of the terms and conditions therein, he had an option to return the policy to the Company stating the reasons for his objections.  This provision is clearly mentioned in the brochure, proposal form, welcome letter of policy document and in the general terms and conditions of policy document.   Policy was issued on 27.5.2014 and was delivered to the complainant at his address mentioned in the proposal form.  After receipt of policy documents, complainant has not objected to the terms and conditions of policy within the free look period.  He had thus, bound himself to the terms and conditions of the policy as a subscriber.  Written version contains several quotes from the decision of National Consumer Disputes Redressal Commission which we are not requoting  herein for the sake of brevity.  As per policy terms, complainant has to pay annual premium for a period of 10 years.  However, complainant has paid only 2 premiums.  Renewal premium which was due on 27.5.2016 remained unpaid despite receipt of remainder letter dated 2.5.2016 by complainant.  Since renewal premium was not paid, despite reminder, policy had entered paid up status.  As per premium discontinuance provision, benefits will be paid to complainant only as per reduced paid up provisions vide the terms and conditions.  Complainant also had an option to surrender the policy, which he had not availed.  Upon surrender, surrender value will be paid as per terms of policy and it will be terminated.  It is further contended that the policy evidences a legal contract between the policy holder and insurance company.  There are extracts from decisions of Hon’ble Supreme Court and National Commission in the later portions of the written version also, which we again are not requoting for the sake of brevity.  Suffice to say,  that settled position, that both  insurer and insured are bound by the policy terms and conditions, has been repeatedly propounded in the written version.  It is contended that complainant had not given any oral or written request for surrender of the policy either to 4^th opposite party or to opposite parties 1 to 3.  He had with malafide and dishonest intention twisted and distorted  facts to suit his convenience  to mislead this Commission.  It is incorrect to say that opposite parties had failed to provide proper service to complainant or are guilty of unfair trade practice.  As per the terms of policy, complainant is entitled for surrender value upon submitting a surrender request.  Since he is not submitted any surrender request, opposite parties 1 to 3 are not able to treat the policy as surrendered and thereby terminated.  Hence they cannot pay surrender value also to complainant.  He is not entitled for the reliefs prayed for.  Complaint is to be dismissed with costs.

 

3.  After filing of written version, case was posted for steps and then for evidence.  despite availing repeated opportunities, complainant has not given any oral evidence.  Documents produced by him were marked as Exts.P1 to P3.  Ext.P1 is photocopy of receipt evidencing payment of first premium.  Ext.P2 is photocopy of policy schedule and Ext.P3 is an extract of terms and conditions which describe various benefits such as surrender benefit, surrender value of the policy and payment of premium and discontinuance of premium payment etc.  Evidence of complainant was closed after marking of Exts.P1 to P3.  Though an affidavit is seen filed along with the written version, the deponent was not available for cross examination at the time of evidence.  We notice that argument notes were also filed by the learned counsel.  Copy of the same was given to the learned counsel for complainant.  He was heard in reply.  Now the points which arise for consideration are :

1)  Whether there is any deficiency in service or unfair trade practice from the side of opposite parties ?

2)  Whether complainant is entitled for the reliefs prayed for ?

3)  Final order and costs ?

 

4.  Point No.1 :

 

We have gone through the rival pleadings and evidence on record and argument notes filed on behalf of opposite parties 1 to 3.  Contentions of the argument notes are identical to pleadings addressed in written version itself though under different captions.  We also notice that written version is seen filed on behalf of opposite parties 1 to 3, by Mr. Sagnik Ganguly, who is shown to be ‘DVP – Legal and Compliance of the Company’in the vakalath executed by him.  He has also filed an affidavit, describing himself in such capacity, verifying the pleadings.  However,  no authorization from the Company authorizing said designatory, Mr. Sagnik Ganguly to appear and address pleadings in this case on behalf of opposite parties 1 to 3 is submitted from the side of opposite parties.  However, we notice that  the case projected by opposite parties is that there were no objections during free look period and therefore policy being accepted, complainant is bound by it’s terms and conditions.  This is a settled position and therefore we do not think that any pleadings in this case are necessary from the side of opposite parties.  Complainant has a case that despite repeated requests, there was no response from opposite parties 1 to 3 about surrender value payable.  However, complainant has not produced copy of any communication addressed by him to opposite parties 1 to 4 demanding payment of surrender value of the policy.  There is no evidence from his side to prove that there were requests from his side for payment of surrender value either.  Ext.P3 is the extract of policy terms and conditions produced by complainant himself.  It is mentioned therein, under a head ‘surrender benefit’, that the policy holder is free to surrender the policy at any point of time during its tenor.  That the policy will accrue surrender value if atleast 2 years full premium has been paid.  That upon surrender, policy shall be terminated and all the benefits under the policy shall cease to apply.  It is further stated that upon receipt of a written request for surrender from the policy holder, company will pay  higher of guaranteed surrender value as sufficient surrender value.

 

In this case though the complainant has stated that he has paid premium only for one year, there is evidence in the form of affidavit from the side of opposite parties with regard to the contentions in written version by an employee of the Company that in fact premium for first two years was paid.  That being so, complainant will be entitled for  surrender value of the policy in accordance with its terms.  Admittedly, there was discontinuance of policy which appears to be after the initial 2 years.  There is no proof that any written request was given for surrender of the policy as mentioned in the terms and conditions.  Therefore non-payment of surrender value which was not preceded by a request for surrender in writing, cannot be termed as deficiency in service or practice of unfair methods by opposite parties. It is upto the complainant to make a written request for surrender and if he does so, we find no reason for opposite party to accept and act upon same if such request is in accordance with terms and conditions of policy as applicable on the date of surrender. Reverting back we find that surrender value could not be paid as the complainant has not abided by the terms and conditions of policy.  He had failed to give a written request for surrendering the policy.  That being so, we further find that complainant has not proved that there was any deficiency in service or unfair trade practice from the side of opposite parties 1 to 3.  Cause of action as such has not been proved.  Complainant is not entitled for the reliefs prayed for.  Point Nos.1 and 2 are answered accordingly.

 

5.  Point No.3 :

 

In the result, this complaint is dismissed, under the circumstances, without costs. Parties shall take back extra copies without delay.

 

     Pronounced by this Commission on this the   28^th  day of February, 2024

 

   Sd/-

       SRI. C. SURESHKUMAR, PRESIDENT

   Sd/-

    SRI. AMPADY K.S., MEMBER

 

 

 

 

APPENDIX

 

Depositions :

Nil.

Exhibits :

On the side of the Complainant :

Ext.P1     -   Photocopy of receipt evidencing payment of first premium.  

Ext.P2     -  Photocopy of policy schedule.

Ext.P3     -  An extract of terms and conditions which describe various benefits.

On the side of the Opposite Party :

Nil.

 

 

Forwarded by Order,

 

 

 

     ASSISTANT REGISTRAR