DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

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Rup Chand Bhardwaj, H.No. 715A, MIG Super, Phase-11 (Sector 65), SAS Nagar (Mohali).

                                                                   ---Complainant

Vs

[1]     ICICI Prudential Life Insurance Co. Limited, through its Branch Manager, Vinod Silk Mills Compound, Chakravarthy, Ashok Nagar, Ashok Road, Kandivali (E), Mumbai – 400101.

[2]     Shri Avtar Singh (I.R. 689), ICICI Pru. LIC Ltd., Sector 9-D, Chandigarh, through its Branch Manager, SCO No. 9, 10, 11, Sector 9-D, Chandigarh.

---- Opposite Parties

BEFORE:          SH.LAKSHMAN SHARMA                  PRESIDENT

MRS.MADHU MUTNEJA                    MEMBER

                        SH.JASWINDER SINGH SIDHU          MEMBER

Argued By:      Complainant in person.

Sh. Gaurav Bhardwaj, Counsel for Opposite Party No.1.

Opposite Party No.2 ex-parte.

PER MADHU MUTNEJA, MEMBER

1.                Briefly stated, the Complainant purchased an insurance Policy No. 12023808 from the Opposite Parties, which was later changed to Policy No. 12075376. The Complainant had paid an initial premium of Rs.15,000/- on 05.06.2009 vide Cheque No. 261447, receipt of which is at Annexure A-1.  As per the Complainant, the officers of the Opposite Parties kept contacting him frequently and induced him to sign a proposal form and collected the premium from him.  When the insurance Policy No.12023808 was received, it was found that Rs.3567/- had been charged as “Medi Care” premium. The Complainant brought this deficiency to the notice of Mr. Avtar Singh, an officer of the Opposite Parties, who advised the Complainant to shift the policy to the policy in which medical premium was not involved. A sum of Rs.11,433/- was utilized in place of Rs.15,000/- paid by the Complainant and the Complainant has alleged that he was assured that Rs.3567/- taken as medical care premium in the earlier Policy No.12023808 would be returned to him.  The Complainant has been waiting for the refund, but the amount has not been received. 

                   The Complainant vide letter dated 07.12.2009 requested the Mohali Branch office of Opposite Parties that he was unable to pay premium due on 24.12.2009 and in future also.  The Opposite Parties vide letter dated 28.12.2009 (Annexure A-4) brought out the terms and conditions of the policy. When the Complainant studied the policy documents Annexure A-5 and A-7, he found that all assurances orally given to him were not part of the policy.

                   According to the Complainant, the medical care premium which had been assured to him free of cost had been charged at Rs.3567/-. The Opposite Parties were also charging policy administration charges which had not been told to him. When the amount of Rs.3567/- was not refunded to him, the Complainant wrote another letter dated 22.01.2010 (Annexure A-8) to the Opposite Parties and another letter dated 11.02.2010 (Annexure A-9), stressing upon the free look period and the terms & conditions of the policy, which were never made available to him before entering the policy. Moreover, the full amount has not been refunded even within the free look period.

                   The Complainant has thus, filed the instant complaint with allegations of fraud, cheating, misrepresentation etc. and has requested that the amount of Rs.15,000/- be ordered to be refunded to him, along with interest and compensation.

2.                After admission of the complaint, notices were sent to the Opposite Parties.

3.                Opposite Party No.1 in reply has taken the preliminary objection that the complaint is false, frivolous and vexatious, as the Complainant has not disclosed any cause of action to proceed against the Opposite Parties. He has alleged mis-selling, misrepresentation, forgery and cheating against particular individuals to which conversation the answering Opposite Party was not privy. Sh. Avtar Singh is not an employee of ICICI Prudential Life Insurance Co. Ltd., but an insurance advisor of the company. Such serious allegations of the Complainant require a proper trial by a civil/ criminal court and evidence has to be taken which is not possible in a summary trial. No consumer dispute has been raised by the Complainant. Further the Opposite Party No.1 had received the proposal form/ application form duly filled and signed by the Complainant for two plans on the life and health of his daughter Sushma Kumari. Along with the application, the Complainant submitted the first premium deposit for both the plans and a covering letter stating that he was taking combo policy (Life Stage RP and Hospital Care) for his daughter Sushma Kumari, out of love and affection (Annexure R-2).   After due verification, the Opposite Party issued Policy No. 12023808 on 12.6.2009 against Hospital Care Plan and on 30.6.2009, the Opposite Party issued the Complainant Policy No. 12075376 against Life Stage RP Plan to the Complainant. Opposite Party No.1 has further submitted that every policy document is accompanied by forwarding letter which clearly mentions that if the policy holder is not satisfied with the features or the terms and conditions of the policy, he may return the policy within 15 days under the free look period provision. The Complainant submitted the free look request form for Policy No. 12023808 on 7.7.2009. The Opposite Party duly processed the free look request and paid Rs.3487/- through ECS to Complainant’s State Bank of India bank account 10847808158 as per the free look request form, which fact has not been disclosed by the Complainant. The Complainant did not opt for free look period refund for Policy No. 12075376. The Complainant was unable to make payment of the next premium for Policy No. 12075376, which became due in Dec., 2009, due to which the said policy lapsed. The Complainant has himself admitted that he was unable to pay the premium. Hence, Opposite Parties are not liable to pay any compensation or amount to the Complainant.   

                   On merits, Opposite Party No.1 has contended that Policy No. 12023808 was not changed to Policy No. 12075376, as stated by the Complainant. They are two separate policies for which the Complainant had himself opted by taking a combo policy plan. The Complainant himself acknowledged the first policy within the free look period and the amount was refunded to him through ECS to his State Bank of India bank account. Opposite Party No.1 has further contended that they have not in any way manipulated the account or gone beyond the norms and guidelines of IRDA. Nor they have indulged in unfair trade practice or unlawful activity as alleged by the Complainant. They have also submitted that serious allegations of the Complainant require a proper trial by a civil/ criminal court and evidence has to be taken which is not possible in a summary trial and hence the complaint needs dismissal. 

4.                In the rejoinder to the reply filed by the Opposite Party No.1, the Complainant has reiterated the submissions made in the complaint. Besides, he has alleged deficiency in service by the Opposite Parties on three grounds. Firstly, according to him, the Opposite Parties have not taken action against their officers and agents, who have made unwarranted calls to him and exploited him on fake and false assurances to make investment in the company. Secondly, the Opposite Party has not provided information as requested by him vide his letters. Thirdly, they have not refunded Rs.3567/- despite repeated requests. He has demanded Rs.15,000/- paid by him to the Opposite Party along with interest which has not been refunded to him. According to him, the terms and conditions of policy can only be valid if they are disclosed and provided before entering into the proposal form for the policy. He was only interested in compound interest @16-17% and not for the life insurance policy. According to him it is manipulation of his signatures made in good faith as he had no interest in the policy, except the interest expected and given above.  Though the policy No. 12023808 was returned within the free look period, the amount has yet not been refunded. There is no such ECS entry in his account. Also, there are no other letters from the Opposite Party with regard to refund of payment. Therefore, the Complainant has reiterated that all averments made by the Opposite Party in reply are wrong and incorrect. The agents of the Opposite Party are playing illegal tactics for extracting investment from the innocent people, which amounts to deficiency in service and unfair trade practice. He has therefore, prayed that the complaint be allowed. 

5.                As none appeared on behalf of Opposite Party No.2, despite service, therefore, it was proceeded against exparte on 27.03.2012.

6.                Parties led evidence in support of their contentions.

7.                We have heard the learned counsel for the Complainant and Opposite Party No.1 and have perused the record.

8.                The gist of the matter can be brought out from the proposal form at Annexure R-1, placed on record by the Opposite Party No.1. The Complainant had applied for two policies in the name of his daughter Sushma Kumari for which he has paid a lump sum premium of Rs.15,000/-. The first plan was Life Stage RP with a premium of Rs.11,433/- and the second is Hospital Care where the premium is Rs. 3566/-. Both the policies have been received by the Complainant. He has made request to the Opposite Party for refund of the Hospital Care policy within the free look period. As per the Opposite Party, this amount has been refunded to him through ECS to his bank account in State Bank of India.

9.                The Complainant has placed on record Annexure         A-1 which is a copy of his savings bank pass book. Interestingly, only the dates have been given but no actual entries of amounts/ cheques deposited or withdrawn or the balance in the account is shown.  Hence, neither the ECS entry nor any other entry with regard to his account is available. The Opposite Party has also not given any proof regarding this payment/ refund to the Complainant.

10.              With regard to the request of the Complainant for refund of the premium for the other policy No. 12075376, it is the Complainant himself, who has stated that he requested for refund well beyond the free look period, because he was unable to make payment of the premium amount. The Opposite Party has refused to refund this amount and the policy has also lapsed due to non- payment of the premium amount. The Opposite Party has thus refused to refund this amount. Due to non-receipt of the two refunds, the Complainant has made allegations of cheating, forgery, misrepresentation, misstatement, false assurances etc. against the officers of the Opposite Parties. He has stated that he had deposited the money not for the insurance policy, but in expectation of a return of at least 16-17%, besides free insurance and free health care.

11.              The Complainant has placed on record self attested copy of policy No. 12075376, wherein he has himself given details of the break up of the premiums. As per the document, the policy acquires a surrender value after payment of full premium for the first policy year. As per the policy, the surrender value would be as under:-

“Mortality Charge:-      A mortality charge will be deducted on a monthly basis on the sum assured. These charges will be deducted by cancellation of units.”                  

The date of commencement of this policy is 24.6.2009. According to the terms and conditions of the policy, the policy can be surrendered on or after 24.6.2012 (3 years). It is evident that the Complainant has not seen this condition or even applied to the Opposite Parties for surrender of this policy, but has resorted to file the present complaint.

12.              It needs to be mentioned here that the Consumer Protection Act, 1986 is a social beneficial legislation for the benefit of consumers, but complaints with unnecessary allegations against the parties should not be permitted. The Complainant has himself filed and signed the proposal form in his own handwriting. Annexure R-2 is a document where he has declared that he has taken the combo policy in the name of his daughter out of love and affection. Hence, all the allegations against the Opposite Parties, as mentioned above, seem frivolous and misplaced.  

                   The Hon’ble State Consumer Disputes Redressal commission, U.T. Chandigarh, in First Appeal No. 297 of 2011, decided on 09.01.2012, titled as M/s Bajaj Allianz Life Insurance Co. Limited Vs. Bhupinder Singh and Others, has held that the allegations of forgery, fraud and cheating cannot be adjudicating by the consumer Forums. In this regard, they have relied on certain judgments of the Hon’ble National Commission. The relevant portion of the judgment is reproduced below: -

“In Oriental Insurance Company Ltd. Vs. Munimahesh Patel, 2006(2) CPC 668 (SC), Reliance Industries Ltd. Vs. United India Insurance Co. Ltd., I (1998) CPJ 13, a case decided by four member’s Bench of the National Consumer Commission and M/s Singhal Swaroop Ispat Limited Vs. United Commercial Bank 111 (1992) CPJ 50, a case decided by three member bench of the National Commission it was held that when there are allegations of forgery, fraud and cheating, adjudication whereof, requires elaborate evidence, the same cannot be decided by a Consumer Fora, proceedings before which, are summary in nature.”

                   As per the terms and conditions of the policy, the policy holder can apply for refund of amount paid within the free look period. The Complainant has availed of this option for the Hospital Care policy alone and with regard to the second policy, no request for refund has been made by the Complainant, within the required time period, and the policy has since lapsed. But he is still entitled to the surrender value as per the terms and conditions of the policy, after expiry of three years i.e. on or after 24.06.2012.

13.              Hence, in view of above discussion, we feel that the complaint is not maintainable at this stage. However, the Complainant is at liberty to apply to the Opposite Parties for surrendering his policy, after fulfilling the terms and conditions and paying surrender charges, as applicable as per the terms of the policy. The case is accordingly, disposed off. No costs.

14.              Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room.

Announced

31^st July, 2012.                                                                             

Sd/-

(LAKSHMAN SHARMA)

PRESIDENT

Sd/-

(MADHU MUTNEJA)

MEMBER

Sd/-

 (JASWINDER SINGH SIDHU)

MEMBER