1. Mr. Debashis Sanyual,

Mayfair Eternity F102 Block-B,

256, Netaji Subhas Chandra Bose Road,

Atlas More,Kolkata-700145._________ Complainant

____Versus____

1. HDFC Standard Life Insurance Co. Ltd.

Eureka Towers, 5^th Floor,

Mindspace Complex, Link Road,

Malad (West), Mumbai-400064.

2. HDFC Standard Life Insurance Co. Ltd.

Ground Floor, Menaka Estate,

3, Red Cross Place, Red Road,

Kolkata-1, West Bengal.

3. Branch Manager,

HDFC Standard Life Insurance Co. Ltd.

Gariahat Shopping Complex Mol,

Kolkata-29, West Bengal, P.S. Gariahat.

4. Ranjan Kumar (Branch Manager)

Union Bank of India,

Machuatoli Branch, Machuatoli Arya

Kumar Road, Patna-800004.________ Opposite Parties

Present :           Sri Sambhunath Chatterjee, Hon’ble President

                          Dr. Subir Kumar Chaudhuri, Member.

                        Smt.  Samiksha Bhattacharya, Member

Order No.   24    Dated   11/08/2016.

       The case of the complainant in brief is that he invested Rs.10 lakhs as 1^st premium in the insurance policy of the o.ps. and paid service charges. O.p. no.4 is an agent of HDFC Standard Live Insurance Co. and approached the complainant to invest in the mutual fund with added insurance policy of HDFC and pressed the complainant to invest the Unit Link Pension to be extend of rs.10 lakhs as premium. O.p. no.4 representing himself as authorized agent of o.p. no.1 made to convince the complainant that by investing the said policy there would be good return by using a mixture of equity and hidden investment. O.p. no.1 also assured the complainant that the said amount would be invested in the market port folios like a hidden investment so the effective charge is lot less than and it is close to the mutual fund. Complainant would pay Rs.10 lakhs per annum or reduced amount of Rs.10,000/- only to continue his policy. On the basis of the said assurance from o.p. no.4, the complainant invested the sum of Rs.10 lakhs and a policy certificate was issued. After receiving the certificate it was found that the several charges were deducted. Thereafter he contacted with o.p. no.4 who told the complainant that if he is not agreeable to any of the provisions in the said policy he has the option of returning the policy to the issuing office.

            After receiving the said policy complainant made contact with o.p. nos.2 and 3 and wanted to get back the premium paid by him. Subsequently, the complainant shifted his family to Kolkata and as per advice of branch office of o.p. no.1 he further deposited Rs.2,50,000/- per annum. Complainant received a letter on 17.2.11 from o.p. no.1 that his premium payment for the aforesaid policy has been discontinued since 30.1.11 and he was informed that his current fund value of the policy as on 15.2.11 was Rs.10,61,365/-. Complainant requested the o.ps. to reduce the premium at Rs.10,000/-, but o.ps. did not accept the same.

            It was stated by the complainant that although the 1^st premium of the policy was Rs.10 lakhs but remaining premium may be only for Rs.10,000/- as per letter dt.4.12.08 written by o.p. no.4. But o.ps. did not allow the complainant to pay such amount. If the complainant would have been allowed to pay Rs.10,000/- per annum then the complainant could have paid Rs.1.10 lakhs during residual period of eleven years whereas the complainant has paid Rs.5 lakhs in two years at the instruction of HDFC SLIC.

            Complainant further stated that o.ps. refused to refund the amount of premium with interest and hence fraud practiced upon the complainant the adopted unfair means of trade practice to earn money by illegal means.

            On the basis of the said fact the complainant demanding the said amount sent the information to o.ps. praying for the amount paid by him along with interest but he same the refused for which complainant had to file this case.

            O.ps. contested the case by filing w/v whereby o.ps. denied all the material allegations of the complaint. O.ps. disputed that this Forum has the jurisdiction to entertain the case. It was specifically stated that in or about 2008 complainant approached through its agent expressed his willingness to avail of life insurance policy and he understanding and being satisfied with the same applied for a HDFC Unit Link Pension Plus. Complainant paid Rs.10 lakhs annual premium. The said policy was for a term of twelve years. In the policy as per the guidelines of IRDA there is an option to return the policy, if the policy holder is not satisfied within its free look period i.e. 15 days. Complainant did not opt for the option or return of the policy within its free look period.

            Since the complainant failed to pay the premium which fell due in Jan 2009 as a result of which the policy lapsed. Thereafter in the month of July prayed to the o.ps. for reduction of the premium and accordingly, the premium was reduced from Rs.10 lakhs to Rs.2,50,000/-. O.ps. accepted the request of complainant and reduced the premium to Rs.2,50,000/-. After reduction of premium the complainant paid the premium for the years 2009 and 2010, but again failed and neglected to the premium which fell due in Jan 2011. O.ps. duly sent the premium payment notice but the complainant did not turn up to pay the premium. As per the clause 5 III (A) of the policy terms and conditions provided as follows: “If any payment remains unpaid after the 1^st three years of the policy the policy will be made paid up; the unutilized fund will continue to be invested; all charges will continue to be rejected and the policy holder will not be entitled to all policy servicing”.

            As per the terms of the said policy if the value of the units in a paid up policy falls below the minimum fund value as specified in the policy schedule, the policy will be cancelled. The amount payable on cancellation would be unutilized fund value arrived at after deduction of the surrendered charge as specified in the schedule of charges. Complainant did not pay the renewal premium. The policy reached to paid up status. In the letter issued to the complainant at the time of opening the policy it was clearly mentioned that risk cover will continue and regular charges will be recovered as per the terms of the policy schedule.

            The complainant did not turn up to pay the renewal premium and wrote a letter praying for reducing premium to Rs.10,000/- which was not accepted by o.ps. and informed the complainant that the policy has already been cancelled and fund value at the time of cancellation was Rs.9,97,246.81 and forwarded the cheque to the complainant and the cheque was encashed by the complainant. Thereafter the complainant has filed this case on the basis of the false and frivolous ground. As such, o.ps. prayed for dismissal of the case.

            On the basis of the materials on record the following points are to be decided:

1. Has this Forum jurisdiction to entertain the case.
2. Was the complainant availed of the policy which Unit Link Pension Plus.
3. Was there any deficiency in service on the part of the o.ps.
4. Will the complainant entitled to get the relief as prayed for.

Decision with reasons:

            All the points are taken up together for the sake of brevity and avoidance of repeatition of facts.

            It is an admitted fact as argued by ld. lawyer for the complainant that the complainant hired the services of o.ps. by investing Rs.10 lakhs as 1^st premium of the insurance policy. The said policy was opened on the advice of the Branch Manager of Union Bank of India where the complainant had an account where agent of the bank convinced the complainant to invest in mutual fund that added insurance policy of HDFC Standard Life Insurance Co. Ltd. and accordingly complainant invested the sum of Rs.10 lakhs as premium. It was also assured by o.p. no.4 that if the complainant paid Rs.10,000/- per annum he can continue with the said policy. After knowing the said fact and since the complainant had the capacity to pay Rs.10,000/- towards annual premium for continuation of the said policy agreed to invest in the said policy. Whenever it was found after having discussions with o.p. nos.1 to 3 that there is no scope for him to pay only Rs.10,000/- towards premium for continuation of the policy. The complainant requested the Branch Manager and the premium was reduced to Rs.2,50,000/- and he paid Rs.5 lakhs in two installments. In such a manner complainant paid Rs.15 lakhs and he continued the policy for three years and he had no idea that the said policy was the Unit Link Pension Plus and the said fact was never disclosed to the complainant by o.p. no.4. Whenever complainant came to know that he cannot continue with the policy he wanted to get back the said amount invested by him. But it is curious enough that the o.ps. returned him with the amount of Rs.9,97,246.81. It cannot be even imagined by complainant that he will get lesser amount then that of the amount invested by him. Complainant was never apprised of the object of the said policy otherwise he would not have invested the said amount.

            So far as the jurisdiction is concerned ld. lawyer for the complainant argued that during the three years of continuation of the policy two cheques were issued from Kolkata and thus cheques were received in Kolkata for which the jurisdiction of this Forum is well established and as such, this case cannot be dismissed on the ground of not having jurisdiction of this Forum.

            Ld. lawyer for the complainant argued that the policy was acknowledged by complainant and to his utter dismay it was found that the same was legally worded terms and conditions arbitrarily incorporated therein which appeared to be beyond the offer / promises made by o.p. no.4. Complainant whenever found that the o.p. insurance company remitted a sum of Rs.9,97,446/- after deducting sum of Rs.5,02,754/- out of Rs.15 lakhs towards surrendered value of the said policy he lodged complaint with the insurance company and with the insurance ombudsmen but no fruitful result was achieved.

            Ld. lawyer for the complainant emphasized that the principle of insurance is a contract based on good faith and forbid either party from non disclosing the facts which the parties know. The insurance company is vicariously liable for acts of their agents. O.ps. obtained the signature of the complainant on a blank pages and KYC of the complainant was not obtained. Ld. lawyer also brought to our notice that it would be evident from the document annexure at page 37 that the current gross total income from all sources is Rs.5 lakhs per annum while policy issued to the complainant wherein the annual premium of Rs.10 lakhs. Thus it is patent and manifest that to achieve their target business accepted the alleged proposal in the name of the complainant without scrutinizing the same in its proper perspective, specifically financial position of the proposer.

            In support of such contention ld. lawyer for the complainant relied on a decision as reported in 2015(2) CPR 720 (NC). Ld. lawyer for the complainant also relied on another decision as reported in 2012(3) CPR 19 (NC).

            On the basis of the facts and circumstances of the case ld. lawyer for the complainant argued that the case as filed by complainant has got the merit and he will be entitled to get the relief as prayed for.

            Ld. lawyer for the o.p. nos.1 to 3 argued that in or about 2008 complainant approached the o.ps. to avail a life insurance and after understood and being satisfied with the same complainant duly applied for a HDFC Unit Link Pension Plus and to avail of that policy the complainant put his signature on the documents. The conditions of the said policy was for term of twelve years with an annual premium of rs.10 lakhs. After opening of the policy complainant was given 15 days free look period wherein he could have exercised his right for not accepting the policy but he did not avail of that opportunity and he was satisfied with the terms and conditions. Since the policy got lapsed and with the reducing the premium from Rs.10 lakhs to Rs.2,50,000/- for re-installment of the policy and o.ps. accepted the request of the complainant and complainant paid premium for the years 2009 and2010 and again he failed to pay the payment and as per the clause 5(3)(A) of the policy terms and conditions the amount payable on cancellation of the unutilized fund value arrived at further reduction of the surrendered charge and complainant was provided with a cheque of rs.9,97,248.81.

            The Ld. Lawyer for the o.p. nos.1 to 3 argued that annex-A is the Unit Link Proposal Form, the caption of the form itself says that the policy was unit link proposal form and after knowing the fact the complainant put his signature on the said form. Annex-B discloses that the complainant was offered the option to return the policy but he did not avail of that offer. Apart from those documents and other documents the guideline of the unit link clear mentioned as to the amount to be payable to the policy holder in case of premium unpaid in the 1^st three years of the policy and after observing all terms and conditions, rules and regulations the amount was given to the complainant. Therefore the complainant cannot have any say that he had no idea regarding the reduction of the amount premium paid by him and as such, complainant will not be entitled to get any relief as prayed for.

            Considering the submissions of the respective parties it is admitted fact that complainant had a policy and he continued the policy for three years. Initially complainant paid Rs.10 lakhs and subsequently  he paid Rs.2,50,000/- for the year 2009-2010 and he discontinued the policy and as per the terms and conditions of the policy the amount was deducted from the total premium paid by the complainant and accordingly cheque of Rs.9,97,246.81 was paid to the complainant. Complainant encashed the cheque. Complainant has given blame upon the o.p. no.4 who is a fictitious person and he did not contest the case and the case has proceeded exparte against him. It is also an admitted fact that after acceptance of the proposal of the insurance policy the complainant was informed that in case he was not agreeable to any of the provisions stated in the policy and the details in the proposal form he may have the option for returning the policy to the o.ps. within 15 days from the receipt of the policy and complainant was given the option to arrange for refund of the premium paid by him. But in spite of receiving the letter dt.12.2.08 complainant did not raise any objection regarding the said policy and subsequently though he claimed that o.p. no.4 gave him the assurance that he can continue with the policy by passing Rs.10,000/- per annum but the same was not accepted by o.ps. and he was given the scope for continuation of the said policy and for that purpose the premium amount was reduced to Rs.2,50,000/-. This clearly shows that the cooperation rendered by contesting o.ps. Therefore it cannot be said that the complainant misunderstood the conditions of the said policy or the o.ps. by making unfair trade practice committed any mischief to the complainant.

            In this respect we can also rely on a decision as reported in 2015(1) CPR 204 (NC) wherein it was held that unfair trade practice, deficiency in service and negligence and plea of not having opportunity of free look period does not hold good and it was also held by the Hon’ble National Commission that it is common practice that policy paper together with relevant documents are sent to the policy holder at the time of policy. The complainant is an educated person and he would suddenly exercised due caution and diligent as also ensure that he will inform benefits and terms and conditions before taking such a policy for Rs.10 lakhs.

            Considering the facts and circumstances of the case and materials on record we hold that the complainant has tried to make out a case without having any substantive materials for which we can hold that there was any deficiency in service or unfair trade practice was made by the contesting o.ps. Thus all the points are disposed of accordingly and we hold that the case has got no substance and the complainant will not be entitled to get any relief as prayed for.

            Hence, it is ordered,

            That the C.C. No.259/2013 is dismissed on contest without cost against the o.ps.            

            Supply certified copy of this order to the parties free of cost.