Punjab

StateCommission

A/08/257

HDFC,LIC - Complainant(s)

Versus

Gagan Pandhi - Opp.Party(s)

H.P.S.Ghuman

04 Feb 2015

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,  PUNJAB  DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.

 

  First Appeal No.257 of 2008.                                                   

             Date of institution  :    25.03.2008

Date of decision     :    04.02.2015

 

HDFC, Standard Life Insurance Company Limited, SCO No.139-140, Sector 9-C, Madhya Marg, Chandigarh.

…….Appellant/Opposite Party No.1

Versus

Gagan Pandhi S/o Sh. Ashok Pandhi, R/o H.No.4370/2, Chhatta Nanu Mal, Patiala.

                                                          …Respondent/Complainant 

First Appeal against the order dated 10.01.2008 of the District Consumer Disputes Redressal Forum, Fatehgarh Sahib, Camp at Patiala.

Quorum:- 

 

          Hon’ble Mr. Justice Gurdev Singh, President.

                        Shri Baldev Singh Sekhon, Member.

                        Mrs. Surinder Pal Kaur, Member.

 

Present:-

 

          For the appellant       :   Shri Nitin Thatai, Advocate.

          For the respondent   :   Shri Labh Singh, Representative.

 

 

 

JUSTICE GURDEV SINGH,  PRESIDENT :

 

                   The appellant/opposite party No.1 has preferred this appeal against the order dated 10.01.2008 passed by District Consumer Disputes Redressal Forum, Fategarh Sahib, Camp at Patiala (in short, “District Forum”), vide which the complaint filed by Gagan Pandhi, respondent/complainant, under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as, “the Act”), was allowed and the opposite party was directed to make payment of Rs.1,00,000/- to him, along with interest @ 9% per annum from 10.01.2006 till the realization thereof; to pay Rs.10,000/-, as compensation for mental agony and harassment; and  Rs.500/- as cost of the complaint.

1. The complainant alleged, in his complaint, that Sh. Ashok Pandhi was his father, who had taken a life insurance policy under the name “HDFC Savings Assurance Policy” (in short, “the policy”), which commenced with effect from 09.01.2004 and was to mature after 10 years. The sum assured under the policy was Rs.1,00,000/- and monthly premiums of Rs.1,088/- were payable. Those premiums were being deposited by his father regularly. However, he died on 10.01.2006, leaving behind him, as the nominee under the policy and after his death, he became entitled to Rs.1,00,000/- as per the terms and conditions of the policy, along with attaching bonuses; as were mentioned in the policy under the head “Schedule of Benefits”. He approached the opposite parties many times for the payment of the said amount, but they kept on avoiding their liability; which amounts to deficiency in service on their part. Thereafter, he served legal notice dated 24.07.2006, through his counsel, upon the opposite parties, but no response was received from their side. On account of the deficiency in service on their part, he suffered mentally and was harassed physically; for which he is entitled to compensation of Rs.20,000/-.

2. The complaint was contested by the opposite parties, who filed joint written reply before the District Forum. They did not dispute that the policy was obtained by Ashok Pandhi, father of the complainant, and the complainant was appointed as a nominee under the policy and that the sum assured under the policy was Rs.1,00,000/- and the same was for a period of 10 years and monthly premiums payable were Rs.1,088/-. While denying the other allegations made in the complaint, they pleaded that as per clause (ii) of the policy, only a sum of Rs.28,857/- was payable as the claim and not Rs.1,00,000/-. The discharge voucher of that amount was sent to the complainant on 13.06.2006, which was received back. They are still ready to pay that amount. The complainant is not a consumer as per provisions of the Act. The complaint filed by the complainant is not maintainable in the present form before the District Forum. There was no deficiency in service on their part and, as such, they are not liable to pay any such compensation etc.

3. Both the sides produced evidence in support of their respective averments before the District Forum, which after going through the same and hearing learned counsel on their behalf, allowed the complaint, vide aforesaid order.

4. We have heard the learned counsel for the appellant/opposite party No.1 as well as the representative of the complainant and have carefully gone through the records of the case.

5. It has been submitted by the learned counsel for the appellant/opposite party No.1 that thewrong findings were recorded by the District Forum, by misinterpreting the terms and conditions of the policy; which was proved on record by the complainant himself, as Ex.C-2. As per conditions of that policy, in case of death of the insured after one year of the obtaining the policy, only the total of the premiums paid plus interest @ 6% per annum compounded on each of the premiums from the premium due date to the date of death, was payable. That amount comes to Rs.28,857/- and the same was sent to the complainant through discharge voucher; which he refused to accept. The opposite parties are still ready to pay that amount to him. He never became entitled to Rs.1,00,000/-, which amount was to become payable only after the maturity of the policy i.e. after 10 years. The District Forum wrongly placed reliance on Tata Chemicals Ltd. Vs. Skypak Couriers Pvt. Ltd. [(2002) (2) CLT 428], while recording a finding in favour of the complainant, that attention of the assured was not drawn towards condition No.1 (ii) of the Standard Policy Provisions, nor he was made aware of that condition and, as such, the same could not have been invoked. That condition formed part of the policy document itself and on the first page of the policy Ex.C-2, it was mentioned clearly that the basic benefits are detailed in the schedule and the payment thereof was governed by the “standard policy provisions”. In these circumstances, the findings recorded by the District Forum cannot be sustained and are liable to be set aside.

6. On the other hand, the representative of the complainant, while supporting the finding recorded by the District Forum, submitted that by virtue of the ratio of the above referred judgment, the insured/complainant could not have been made bound by those terms and conditions of the policy; which were never got signed from the insured, nor were brought to his notice at the time of issuing of the policy. The amount was payable under the policy as per the “Schedule of Benefits” and it is very much clear from that “Schedule of Benefits”, that in case of death of the insured, the sum assured i.e. Rs.1,00,000/- was to be paid. Therefore, there is no ground for upsetting the well reasoned order of the District Forum.

7. It was nowhere alleged by the complainant in his complaint that the attention of the insured was not drawn towards the terms and conditions of the policy, or that he had no knowledge about those terms and conditions. Rather, it was specifically alleged in Para Nos.6 & 7 that as per the terms and conditions of the policy, the complainant is entitled to the sum of Rs.1,00,000/- and the attaching bonuses. In these circumstances, it does not lie in the mouth of the complainant, to allege that he himself or the insured was not bound by the terms and conditions, as contained in the “Standard Policy Provisions”, which is part of Ex.C-2 and the same is coming from the possession of the complainant himself. This was the policy, which was given to the insured, and the benefits thereunder were mentioned on the front page and are being reproduced below:-

    

   “The Basic benefits, plus any attaching bonuses, are detailed in the Schedule titled “Schedule of Benefits” and are governed by the standard policy provisions.”

 

1.           The “Schedule of Benefits” given therein is as under:-

                           (1)                           (2)                             (3)                        (4)

               Basic Benefit(s)            Sum Assured               Premiums        Expiry/Maturity Date

                                                                                       Monthly

                                                                                  (Amounts in Rs.)   (dd/mm/yy)

   i)          HDFC Savings

               Assurance-Death           100,000.00                    1,088.00            09/01/2014

               Benefit

   ii)          HDFC Savings              100,000.00                     “                      09/01/2014

               Assurance-Maturity

               Benefit

    

2. The relevant benefits, as mentioned in the “standard policy provisions”; which is on the second page of the folder of the policy, is reproduced below:-

    

   “2 (ii) Benefits payable on Death before the Maturity Date:

   During the first year from the Date of Commencement or the Date of issue or Date of reinstatement of the policy, whichever is later, a basic benefit of 80% of premiums received is payable on the death of the Life Assured.

   After the first year, the amount payable on death is the lesser of: The sum assured stated against HDFC Savings Assurance – Death Benefit in the schedule of benefits plus any attaching bonuses; or The total of the premiums paid to date plus interest, at 6% per annum compounded, on each premium from the premium due date to the date of death.”

    

3. It becomes very much clear from the conjoint reading of the said reproduced portions of the policy, that Rs.1,00,000/-, as sum assured, was payable either in the case of death or maturity only on 09.01.2014 and in case of the death of the insured before the date of maturity, the benefits were payable as per clause 2 (ii).

4. The main question involved in Tata Chemicals Ltd.’s case (supra) was, whether the opposite parties could have bound the complainant with the terms of the consignment note, vide which it was liable to pay the maximum of US $ 100, where the consignment was international and Rs.1,000/-, where it was domestic? It was held by the Hon’ble National Commission that condition No.7, printed on the reverse side of the Credit Agreement Form limiting the liability of the opposite party, was inapplicable as the carriage of goods was only in India and secondly, it was nobody’s case that any attention of the complainant was drawn towards that condition and the same was in small and fine print. By no stretch of imagination, the ratio of this judgment can be applied to the facts of the present case.

5. It was held by the Constitutional Bench of the Hon’ble Supreme Court in (General Assurance Society Ltd. Vs. Chandumull Jain and another), AIR 1966 SC 1644, that in interpreting documents, relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties, because it is not the court to make a new contract, however reasonable, if the parties have not made it themselves. It was also held therein that these are the terms and conditions of the proposed policy, which would govern the case, where the contract of insurance is complete and it is immaterial, whether the policy is actually delivered or not. Even if no terms are specified, the terms contained in the policy, customarily issued, would apply.

6. It is very much clear from the policy Ex.C-2 itself, that the name of the product was HDFC Savings Assurance Policy, which was for a period of 10 years. It was not a life insurance policy and the assured amount was not to become due on the death of the policyholder. The death benefit of Rs.1,00,000/- was payable only on the date of maturity i.e. after 10 years. It, in fact, was a tax saving policy, which was regulated by the standard policy provisions. The complainant cannot take up the plea that he himself or the insured was not bound by those terms and conditions. By virtue of those terms and conditions, the amount of the premium, so paid by the insured, along with interest @ 6% per annum, compounded as per clause 2 (ii), was payable and that amount was correctly calculated by the opposite parties, as Rs.28,857/-. The evidence was produced before the District Forum by the opposite parties, that the discharge voucher of that amount was sent to the complainant, but he refused to receive the same. In these circumstances, it cannot be held that there was any deficiency in service on the part of the opposite parties and, as such, the complainant is not entitled to any such compensation. Wrong findings were recorded by the District Forum that the complainant is entitled to the total sum assured of Rs.1,00,000/- and Rs.10,000/- as damages. Such findings cannot be sustained and are set aside.

7. Accordingly, the appeal is partly allowed, the order of the District Forum is modified to the effect that the opposite parties are directed to pay a sum of Rs.28,857/- to the complainant, along with interest @ 6% per annum from the date of death of the insured till the date of payment. In addition to that, the opposite parties are directed to pay Rs.1,000/- as cost of the litigation.

8.           The appellant had deposited a sum of Rs.25,000/- at the time of filing of the appeal and another sum of Rs.41,125/- was deposited on 28.07.2008, as per directions of this Commission. The registry shall first calculate the interest on the amount of Rs.28,857/- @ 6% per annum with effect from 10.01.2006 till the date of this order and shall remit the amount of Rs.28,857/- along with interest and Rs.1,000/- to the complainant along with interest which has accrued on the total amount of Rs.66,125/-, if any, shall be remitted to the appellant/opposite party No.1

9.           The appeal could not be decided within the statutory period due to heavy pendency of court cases.

    

    

    

                                                           (JUSTICE GURDEV SINGH)

                                                                          PRESIDENT  

    

                                                            

    

    

                                                            (BALDEV SINGH SEKHON)        

                                                                             MEMBER

                                                            

    

    

                                                          (MRS. SURINDER PAL KAUR)

   February 04, 2015                                        MEMBER

   (Gurmeet S)