BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SAS NAGAR, MOHALI

                                  Consumer Complaint No.256 of 2014

                                 Date of institution:          16.04.2014

                                                 Date of Decision:            08.06.2015

Ms. Savinder Kaur Randhawa, resident of House No.2693-B, Sector 70, Mohali.

    ……..Complainant

                                        Versus

1.     ICICI Prudential Life Insurance Company Limited through its Senior Manager Sales, Vinod Silk Mills Compound, Chakravarthy Ashok Road, Ashok Nagar, Kandiwal (E), Mumbai.

2.     ICICI Prudential Life Insurance Company Limited through its Grievance Redressal Officer, Vinod Silk Mills Compound, Chakravarthy Ashok Road, Ashok Nagar, Kandiwal (E), Mumbai.

3.     ICICI Prudential Life Insurance Company Limited through  Manager Sales, SCF No.91, 3^rd Floor,  Phase-XI, Mohali.

4.     Ms. Neeru Verma, ICICI Prudential Life Insurance Company Limited through  Manager Sales, SCF No.91, 3^rd Floor,  Phase-XI, Mohali.

        Second Address:

        Ms. Neeru Verma, presently working at Aviva Life Insurance, Sector 9, Madhya Marg, Chandigarh.

………. Opposite Parties

Complaint under Section 12 of the

Consumer Protection Act, 1986.

CORAM

Mrs. Madhu. P. Singh, President.

Shri Amrinder Singh, Member

Mrs. R.K. Aulakh, Member.

Present:    Complainant in person with Counsel Capt. Arun Kumar.

Shri P.S. Bhangu, counsel for OP No.1 to 3.

None for OP No.4.

(Mrs. Madhu P. Singh, President)

ORDER

                The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 for issuance of following directions to the Opposite Parties (for short ‘the OPs’):

1. to refund her  the amount of policies alongwith interest.

(b)    to pay compensation of Rs.1,50,000/- for mental agony and harassment.

        (c)    to pay litigation expenses of Rs.11,000/-.

(d)    refund the premiums paid towards policies No.15601229  and No.15879560 with interest.

                The complainant’s case is that she has retired from the Armed Forces. The complainant got her family members insured through OP No.4 under the following policies:

                Sr.No.      Policy No.        Amount (Rs.)

                1.             15601229            29,600.00

                2.             16106674            50,000.00

                3.             16106882            50,000.00

                4.             15707116            12,000.00

                5.             15879560         1,00,000.00

                The duplicate of these policies were received by the complainant on 23.11.2012. OP No.4 advised the complainant that policy No.5 is like a fix deposit which will yield 24% interest yearly without payment of any further premium.  Later on OP No.4 told the complainant that if all the premiums under the policies are paid at one time, the complainant could withdraw all the money after one year.  Under this, the complainant started paying money in cash to OP No.4.  From the cheques of the complainant OP No.4 made 8 new policies of her own without the knowledge and consent of the complainant and appended the forged signatures of the complainant on the application forms. The address for receiving the policies was given of the bank office and OP No.4 gave her mobile number instead of the complainant which was later on corrected by one Ms. Nivedita an employee of OP No.3 on 23.11.2012 as the complainant came to know of the new policies only on 23.11.2012 and on the same day she submitted a complaint against OP No.4 to Manish Kumar Manager of the OPs. Then policy No.16411428 was received by the complainant on 07.10.2013 and policy No.14174847 has yet to be received. Indemnity bond and bank fine was submitted on 01.04.2014.  These two policies were not reflected on the computer on 23.11.2012.  The following is the detail of 8 policies with the date of receipt of duplicate policies:

                The originals of the above policies were never received by the complainant as the address for receiving the policies was of the bank office. On receipt of these policies, the complainant approached Mr. Manish Kumar and Mr. Pathania Bank Managers for refund of the money but Mr. Manish Kumar told that the policies were 6 months old and the amount cannot be refunded.  The complainant also approached Bank Manager of the OPs in Sector 9 who also did not help her.  The complainant also filed a complaint with Economic Offence Wing of the police but after some time it was informed that they are unable to take any action.  OP No.4 stole the original 5 policies  from the house of the complainant and the diary containing policy information.  Later on the diary was found but the pages containing information of the policies were torn.  OP No.4 increased the premium of the original five policies from 3 to 5 years, 7 years and 10 years. Policy No.15601229 was to mature in February, 2012 but it was released to the complainant that on maturity the money will go to the person insured as the complainant was shown as a payer and not a proposer. OP No.4 also increased the premium paying period of this policy to 7 years w.e.f. 2011.  OP No.4 also willfully deleted all the messages of the complainant’s mobile having passed by OP Nos.1 to 3 to the complainant. OP No.4 also falsely charged for training clarification of Mrs. Akwinder Kaur daughter-in-law of the complainant to appoint her as an insurance agent with ICICI Prudential Life Insurance as Rs.3500/- five times and Rs.65,000/-  for similar training to her son whereas no training was given to him. The complainant had also approached Ombudsman, Chandigarh and IRDA Chandigarh  by way of complaints but no action has been taken till date.  Thus, with these allegations the complainant has filed the present complaint.

2.             OP No.1 to 3 in the written statement have pleaded  in the preliminary objections that the complainant has made the allegations against OP No.4, Manish Kumar and one Mr. Pathania but has failed to disclose the correct facts and has not impleaded the agents/advisors as necessary party.  The policies were sourced by Kamalpreet Kaur, Neha Pasricha, Robi Thakur, Monika Bhardwaj and Gurwinder Kaur who have not been impleaded party in the complaint.  This Forum has no jurisdiction to entertain the present complaint as the complainant has alleged forgery, fabrication, misspelling and misdeeds which require a proper trial by a civil/criminal forum.  The allegation of theft has already been investigated by the police and cannot be adjudicated by this Forum.  The complainant has enjoyed the benefit of the policies of insurance and now wants to wriggle out of the same and even claimed back the premium against the same.  The complainant has stated that she retired as a Brigadier and these being an educated person have applied for all the policies after properly understanding the policy terms and conditions.  The Unit Linked Insurance Policies are not the subject matter of Consumer forum as held  by the Hon’ble National Commission in Ram Lal Aggarwala Vs. Bajaj Alliance Life Insurance.  The OPs have received 13 application forms duly filled and signed from the complainant and based on the information and declaration, the policies were issued to the complainant which were dispatched to the complainant and received by her.  Alongwith the policy documents, a copy of the proposal form were also sent. The complainant retained the policy documents and did not approach the OPs with any discrepancy regarding premium payment, benefits, foreclosure, surrender and the policy terms and conditions during the free look period thereby implying that she had agreed to all the terms and conditions of the policies. The complainant also signed benefit illustration after fully understanding the terms and conditions.  As per Clause 6 (2) of Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations 2002 every policy document sent is accompanied by a forwarding letter which clearly mentions that in case policy holder is not satisfied with the features or the terms and conditions of the policies he can withdraw/return the policy within 15 days i.e. under the Free Look Period.  The complainant very well knew about the terms and conditions of the policies she had purchased.  The fund value of policy No.15879560, 16106674 and 16106882 was credited to the discontinued policy fund and the proceeds shall be paid at the end of lock in period of the policies.  The policy Nos. 15601229 and 15707116 are in a lapsed status and the surrender of these policies can be done only if the premiums for three full years have been paid.  For the remaining policies the complainant was required to pay the premium on yearly mode.  The legal notice dated 03.07.2013 and 04.07.2013 sent by the complainant were duly replied by the OPs vide letters dated 29.08.2013.  Thus, denying any deficiency in service on their part, the OP Nos.1 to 3 have sought dismissal of the complaint.

3.             OP No.4 in her separate reply pleaded that she has no role with respect to the policies and denied any deficiency in service on her part.  Thus denying the averments made in the complaint, she prayed for dismissal of the complaint against her.

4.             Evidence of the complainant consists of her affidavit Ex.CW-1/1; copies of documents Ex.C-1 to C-15.

5.             Evidence of OP No.1 to 3 consists of affidavit of Gurjeet Singh and Rohit Thakur, their Manager Ex.OP-1/1 and Ex.OP-1/2 and document Ex.OP-1 to Ex.OP-19.

6.             After filing reply on 11.06.2014, none appeared for OP No.4 nor was any evidence tendered on her behalf.

7.             We have heard the learned counsel for parties and have gone through the written arguments filed by them. However, neither any written arguments filed by OP No.4 nor anyone appeared on her behalf for addressing the oral arguments.

8.             During the course or proceedings the complainant vide separate application dated 04.05.2015 stated that out of the 13 policies, 6 policies are not unit linked and 7 policies are unit linked policies, therefore, she prayed that unit linked policies be not adjudicated by this Forum in the light of Ram Lal Aggarwal’s case (supra) and prays for deciding the issue relating to other non unit linked policies. Therefore, we confine ourselves to adjudicate the issues relating to 6 non unit linked policies which are as under:

                For remaining 7 unit linked policies, the complainant is at liberty to avail legal remedy before the appropriate Forum/authority.

9.             Admittedly the purchase of above mentioned policies is not disputed. Admittedly the above policies are non unit linked policies.  Admittedly in all the policies the complainant has paid only one premium except in policy No.15601229 where three premiums are paid and the policy is in currency. Admittedly, all the remaining policies are lapsed or discontinued due to non payment of subsequent premiums due as the premium is annual. The question remains for determination is whether the policies which are lapsed/discontinued can the OPs withhold or forfeit the premium deposited at the time of purchase of the policies.

10.           In this regard the counsel for the OPs has drawn our attention to clause-5 of terms and conditions of the policy No.15601229 and 15707116 that the surrender of the policy can be done only if the premium for three full years has been paid. In the present complaint, the complainant has not paid premium for three full years and, therefore, she cannot surrender the policies and in that eventuality no benefit is available to the complainant.  The contention of the OPs in this regard is in correct because as per OPs own admission in Para No.1 on merits, the status of policy No.15601229 is shown as ‘in force’ and perusal of the table shown under the heading facts of the case in the reply, the total premium has been shown as Rs.73,800/- against the said policy and the last premium paid has been shown as 11.06.2014.  Thus, the stand of the OPs regarding conditions governing the surrender of the said policy is quite contradictory. The OPs cannot come from their own admission regarding status of the policy i.e. ‘in force’. 

11.           So far as policy No. 16307241, 16510984, 16411428 are concerned, the stand of the Ops regarding the surrender conditions applicable , the OPs have relied upon IRDA regulations 2002 wherein upon nonpayment of the premium or policy being lapsed, the OPs have sent notices to the complainant and still the complainant has not revived the policies by making further premiums. Therefore, the complainant is not entitled to any benefits of the policies.

12.           In order to counter the contentions of the OPs, the counsel for the complainant has drawn our attention to IRDA Notification dated 16.02.2013 on the subject wherein all the IRDA regulations including IRDA Regulations 2002 issued prior said to notification have been superseded.  As per new guidelines in the event of default of payment of premiums in the following years and the policy being discontinued/lapsed, the OPs are to refund the first premium deposited minus some administrative charges as per following table: 

13.           Therefore, withholding of money deposited by the complainant and not releasing the same after deduction of administrative charges as per table above with regard to policy No.1641234 (premium paid Rs.49,200/-); policy No.16307241 (premium paid Rs.49,200/-); policy No.15707116 (premium paid Rs.12,000/-); policy No.16510984 (premium paid Rs.1,00,000/-) and policy No.1641428 (premium paid Rs.49,200/-) is an act of deficiency in service and unfair trade practice on the part of the OPs for which the complaint deserves to be allowed and the complainant deserves to be compensated.

14.           So far as policy No.15601229 is concerned, it is admitted position that the policy is in force as the complainant has paid total three premiums of Rs.73,800/- as on 11.06.2014. The perusal of policy documents shows that it is an EOG guaranteed saving insurance plan, the complainant is at liberty to continue the same or get the surrender value after submission of the relevant documents to the concerned quarters.

15.           In view of above discussion, the complaint is allowed and OPs are directed as follows:

(a)    to calculate the amount of the premium deposited against all the above policies mentioned in  Para No.13 above after deduction of administrative charges as per table given in Para 12 above.

2. and pay the amounts so calculated as at (a) above alongwith interest @ 12% per annum w.e.f. the respective dates of deposit till realization.

(c)    to pay a lump sum compensation of Rs. 25,000/-            (Rs. Twenty five thousand only) for harassment, mental agony and costs of litigation.

                Compliance of this order be made within a period of thirty days from the date of receipt of a certified copy of this order. Certified copies of the order be furnished to the parties forthwith free of cost and thereafter the file be consigned to the record room.

Pronounced.                           

June 08, 2015.    

                                                                    (Mrs. Madhu P. Singh)

                                                                        President

                                                (Amrinder Singh)

Member

(Mrs. R.K. Aulakh)

Member