DISTRICT CONSUMER DISPUTES REDRESSAL FOR`UM, BATHINDA.
CC.No. 347 of 24-07-2012
Decided on 19-10-2012
Paramjit Kaur wife of Harvinder Singh r/o # 116, Phase-2, Model Town, Bathinda.
........Complainant
Versus
HDFC Standard Life Insurance having its office at Walia Complex Guru Kanshi Marg, Bathinda.
.......Opposite party
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM
Smt. Vikramjit Kaur Soni, President.
Sh.Amarjeet Paul, Member.
Smt. Sukhwinder Kaur, Member.
Present:-
For the Complainant: Sh.Sanjay Goyal, counsel for the complainant.
For Opposite party: Sh.Vinod Garg, counsel for opposite party.
ORDER
VIKRAMJIT KAUR SONI, PRESIDENT:-
1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act'). The brief facts of the complaint are that the opposite party approached the complainant for selling the life insurance plan and stated that she has to make the payment of Rs.50,000/- for once and she will be insured for Rs.2,50,000/- and in case she want to get the refund of the amount then she will be given Rs.50,000/- alongwith interest @ 12% p.a and no charges shall be deducted and she can claim the refund of the amount anytime. The complainant has agreed to purchase the insurance policy vide No.13511753 and made the payment of Rs.50,000/- in the month of February 2010 and she was assured that she is not required to make any further payment as insurance amount is to be paid only once. Neither any cover note nor any separate terms and conditions were ever supplied to the complainant by the opposite party and even free look period was not provided to her. In the year 2011 the complainant went to the opposite party for seeking the refund of Rs.50,000/- but they have refused to refund any amount and told her that she has to make the payment of minimum two years otherwise she will not be entitled to get the refund as such she was forced to make the payment of further premium of Rs.50,000/- as such the total amount of Rs.1,00,000/- was paid to the opposite parties. Few days back the complainant requested the opposite party to refund Rs.1,00,000/- alongwith interest @ 12% p.a but they stated that she shall be given only Rs.73,000/- being the fund value. Hence the complainant has filed the present complaint for seeking the directions to the opposite party to refund the amount of Rs.1,00,000/- alongwith interest @ 12% per annum alongwith cost and compensation.
2. Notice was issued to the opposite party. The opposite party after appearing before this forum has filed its written statement and denied that they approached the complainant for selling the insurance plan and it was stated that she has to pay Rs.50,000/- once only or that she can get the refund of Rs.50,000/- with interest anytime. The complainant has purchased the policy voluntarily, of her own accord after fully understanding the terms and condition of the policy and after submitting duly signed proposal form and even signed a declaration to this effect. The complainant had understood & signed benefit of the illustrations. The opposite party denied that the complainant was ever assured that she is not required to make any further payment as premium in future. Rather, the complainant herself opted for the insurance policy with annual premium of Rs.50,000/- with sum assured of Rs.2,50,000/-. The opposite party further denied that no cover note or terms and conditions were supplied to the complainant, rather the policy documents were sent to her immediately after issuance of the policy alongwith copy of the proposal form and a letter with an option to get the policy cancelled within free look period. The policy was delivered to the complainant on 8.3.2010. The opposite party also denied that the complainant has ever approached them for seeking the refund of Rs.50,000/- in the year 2011 or she was informed that she had to pay the premium for minimum 2 years or she was forced to pay another premium of Rs.50,000/-. The complainant has paid the premium as per the terms and conditions of the policy agreed upon. The complainant has not paid the premium due in March, 2012 & policy is lying in lapsed status for non-payment of 3rd premium. The complainant has never requested the opposite party for the refund of Rs.1,00,000/-.
3. The parties have led their evidence in support of their respective pleadings.
4. Arguments heard. The record alongwith written submissions submitted by the parties perused.
5. Admittedly, the complainant had purchased the insurance policy vide No.13511753 and made the payment of Rs.50,000/- in the month of February 2010. Thereafter the complainant again paid the amount of Rs.50,000/- to the opposite party, in total he had paid Rs.1 lac as premium. The sum assured was Rs.2,50,000/-.
6. The submissions of the complainant are that the opposite party conveyed him that the said policy is a single premium policy as she has to pay Rs.50,000/- only once and she can get the refund of the amount alongwith interest without any deductions anytime. No cover note, separate terms and conditions or free look period option letter were ever provided to the complainant. In the year 2011, the complainant sought the refund of Rs.50,000/- but the opposite party refused to refund the amount on the pretext that she has to make the payment for minimum 2 years otherwise she will not be entitled to get the refund. As such under the force circumstances she has made the payment of Rs.50,000/- more and in total she has paid Rs.1,00,000/-. Again the complainant requested for the refund Rs.1,00,000/- alongwith interest @ 12% p.a but the opposite party conveyed that she shall be given only Rs.73,000/- as the fund value.
7. The submissions of the opposite party are that the complainant was never conveyed by them to pay Rs.50,000/ only once or she can get the refund of Rs.50,000/- with interest at anytime. The complainant has purchased the policy voluntarily after understanding the terms and condition of the policy and has duly signed the proposal form and has also signed a declaration to this effect. The complainant had not paid the premium due in March, 2012 & policy is lying in lapsed status for the non-payment of 3rd premium. The complainant has never requested the opposite party for the refund of Rs.1,00,000/-. The parties are bound by the terms and conditions of the policy.
8. The complainant has specifically alleged that no cover note, terms & conditions or free look period option letter has been provided to her. The opposite party in para No.3 of their reply on merits has replied that the policy documents were sent to the complainant immediately after issuance of the policy alongwith copy of the proposal form and a letter with an option to get the policy cancelled within free look period. The policy was also delivered to the complainant on 8.3.2010.
The opposite party has placed on file Ex.R4 through which they have pleaded that the policy documents have been sent to the complainant vide Ex.R4, a perusal of the same shows that the name of the person who has alleged to receive the policy documents is in the typed form. An effort has been made by the opposite party to show that one Ravinder Kumar has received the documents and he has duly signed this receipt but it is not understandable that how the name of the receiver has been typed in advance and the same was received by her on 8.3.2012 whereas vide Ex.R5 the policy documents are digitally signed by the Metilda Stanley on dated 9.3.2010 at 21:50:19, again this is not understandable that the documents which have been shown to be received on 8.3.2010 by the complainant its contents were generated on 9.3.2010 this clearly depicts that the policy documents alongwith cover note, terms & conditions and free look option letter have never been sent to her.
9. Thus from what has been the discussed above, it is proved that the opposite party has never sent the cover note, terms & conditions and free look option letter or any other policy documents to the complainant. The terms and conditions placed on file are not binding on the complainant, thus there is deficiency in service on the part of the opposite party as the terms & conditions Ex.R5 are not supplied to her.
10. As discussed above, when no terms and conditions were either supplied or communicated to the complainant, she is not bound by such terms and conditions. The opposite parties cannot garb the hard earned money of the consumer on false pleas/pretexts. In these circumstances, the complainant is entitled to get the refund as per the Insurance Regulatory and Development Authority (IRDA) which are applicable on all the insurance policies. The deduction under the Surrender Charges of IRDA (Insurance Regulatory and Development Authority) (Standardization of terms and conditions of ULIP products and treatment of lapsed policies) Regulations, 2010 can be done as under:-
“10.......The proceeds of the lapsed policies shall invariably be refunded to the policyholder after the expiry of the revival period or at any time after completion of 3 years terms as and when demanded by the policyholder. In case, there is no demand from the policyholder for refund, insurance company shall refund the amount on its own by means of a cheque/demand draft to be delivered to the insured/nominee at his last known address. However, Insurer may deduct charges on account of pre-closure and lapsation which should, in any case, not exceed the charges stated in regulation 8 above.
Regulation No.8 i.e. Surrender Charges of Insurance
Regulatory and Development Authority (Standardization of terms and
conditions of ULIP Products and treatment of lapsed policies) Regulations, 2010, is reproduced hereunder:-
“It is observed that insurers apply different surrender charges while paying the surrender value to the Insured. After due consideration of various practices, the Authority orders that the surrender charges (as percentage of fund value) shall not exceed the limits specified below:-
Year Policy Period
Less than 10 years More than 10 years
---------- ----------------------- ---------------------
1st Year 12.50% 15%
2nd year 10.00% 12.50%
3rd year 7.50% 10%
4th year 5.00% 7.50%
5th Year 2.50% 5%
6th year Nil 250%
7 year & onward Nil Nil.”
10. Therefore in view of what has been discussed above, the policy is for 11 years and the complainant has paid only 2 yearly premiums and has not paid 3rd year premium. The deduction on the premium paid will be made according to the abovementioned table. Hence this complaint is accepted with Rs.3000/- against the opposite parties as cost and compensation. The opposite party is directed to pay the amount of Rs.90,000/- after deducting 10% i.e. Rs. 10,000/- from Rs.1 lac (Rs.1,00,000 -10,000=Rs.90,000/-) to the complainant within 45 days from date of receipt of the copy of this order.
In case of non compliance the interest @ 9% per annum will yield on the amount of Rs.90,000/- since the date of institution of this complaint i.e. 24.7.2012 till realization.
11. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.
Pronounced in open Forum:-
19-10-2012 (Vikramjit Kaur Soni)
President
(Amarjeet Paul)
Member
(Sukhwinder Kaur)
Member
