This complaint is filed by the complainant u/S. 12 of the C.P. Act, 1986 alleging deficiency in service and unfair trade practice against the Ops as the Ops have foreclosed his insurance policy without giving any prior intimation and after foreclosure the entire benefit has not been given to him.

The brief fact of the case of the complainant is that he was an insured under the policy of Life Stage Pension with the Ops for the period of 10 years

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issued by the OP-1. The policy was commenced on and from 28.3.2008 and the date of cessation of the policy was 28.3.2018. The mode of payment of premium was annually and the amount of the premium was of Rs. 25,000=00 per year. The wife of the complainant was the nominee of the said policy. The complainant has been paying the premium amount of Rs. 25,000=00 per year within due date to the OP-1. The complainant deposited Rs. 25,000=00 towards 3^rd premium in the ICICI Prudential office at Chittaranjan branch and Officer-in-Charge of the ICICI Prudential office at Chittaranjan branch had received Rs. 25,000=00 towards 3^rd premium and acknowledged a receipt on 30.6.2011. The complainant was also deposited Rs.25, 000=00 towards the 4^th premium before the said office by cash which also acknowledged the money receipt on 29.7.20011. Very surprisingly the complainant received a letter dated 29.3.2012 along with an A/c payee cheque of Rs. 23,739.49 from the Ops stating that the said insurance policy of the complainant has been foreclosed with effect from 28.3.2012 as per the terms and the conditions of the policy. It was also stated by the Ops that the value of units for the above-mentioned policy of the complainant as on 28.3.20112 was of Rs. 59,555.56 paisa and so the Ops have issued the cheque of Rs. 23,739.49 paisa drawn on ICICI bank to the complainant and requested to deposit in the bank of the complainant for clearance within three months from the date of that cheque. It is pertinent to mention that in the said letter the Ops never made any explanation why the policy was foreclosed by the Ops with effect from 28.3.2012. After receipt of the letter dated 29.3.2012 the complainant sent a letter dated 03.5.2012 to the OP-1 stating that the complainant deposited 3^rd and 4^th premium of Rs. 25,000=00 each on 30.6.2011 & 29.7.2011 accordingly in the office of the ICICI Prudential, Chittaranjan branch and got money receipt issued by the said office. Therefore the complainant has deposited Rs. 1, 00,000=00 for his running policy and hence there was no question for foreclosure of the policy of the complainant. So the complainant requested the OP-1 to look into the matter earnestly. On 04.5.2012 the Op-1 received the letter from the complainant and after received the same the OPs sent a reply to the complainant through letter dated 07.5.2012 stating that the Ops had received a grievance pertaining to

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complainant’s Life Stage Pension policy at their touch point on 04.5.2012 and they would revered to the complainant within 10 business days from the date of receipt of the grievance letter of the complainant. Thereafter the Ops sent a letter dated 17.5.2012 to the complainant stating that upon investigation of the above-mentioned matter it has been learnt as per records that the company did not receive the premium amount of Rs. 50,000=00 in total towards 3^rd  and 4^th  premium dated 30.6.2011 & 29.7.2011 paid by the complainant in cash to the sales personnel. It was also stated by the Ops that the company has no bearing towards any cash transaction which has been allegedly done by and between the complainant and the sales personnel and also the payment receipt shared by the complainant is not a valid receipt and for this reason the Ops are unable to comply with the request of the complainant in making refund of that amount of Rs. 50,000=00 to him against the policy. The complainant requested the Ops on several times to look into the matter seriously as  early as possible because he has already made payment Rs. 50,000=00 towards premium amount in respect of the policy in the office of the OP-3 and OP-3 issued acknowledgment receipt with seal, signature and date. But inspite of knowing the said fact the Ops did not take any proper steps till today which indicates deficiency in service and unfair trade practice on the part of the Ops. So finding no other alternative to get relief the complainant being compelled has filed this complaint before this ld. Forum praying for direction upon the Ops to refund Rs. 1, 00,000=00 as deposited by him towards the premium of the policy along with 12% interest from the commencement of the policy in the year 2008, compensation to the tune of Rs. 1, 00,000=00 due to mental pain agony and harassment and litigation cost of Rs. 30,000=00.

The petition of complaint has been contested by the Ops by filing written version wherein it is contended that this Ld. Forum has no jurisdiction to entertain the present complaint as he has failed to demonstrate any deficiency in service on the part of the Ops. In view of the definition of deficiency as per C.P. Act must be any fault, imperfection, shortcoming or inadequacy in quality, nature

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and manner of performance; which is required to be maintained in pursuance of a contract. In the present case the Ops have never received any amount towards premium nor issued any policy, so the complainant is not a policy holder of the Ops and simultaneously he cannot be termed a consumer as per definition of consumer given in the C.P. Act. So the complaint should be dismissed on that score. It is contended by the Ops that being company the Ops are carrying on business for providing insurance service in accordance with relevant and applicable laws. In or about March 2008 the complainant approached the Ops through its agent and expressed his willingness to avail of a policy. The agent of the Ops furnished details about several policies. After understanding the same the complainant purchased U-49 Life Stage Pension Policy for himself and he has signed in the duly filled application. Thereafter one policy was issued in his favour which was for the term of 10 years with annual premium of Rs. 25,000=00 payable for 10 years. The original policy document was duly dispatched on 15.4.2008 and the same was received by the complainant. The complainant paid first two premiums i.e. for the years of 2008 & 2009 and failed or neglected to pay further premium. Payment of premium in due time is an obligation on the part of insured and not any liability on the part of the company to issue premium payment notice. As per the Clause 4.1 of the terms and the conditions of the said policy it is clearly mentioned that premiums are payable without any obligation of the company to issue notice for the same, if the policy holder suspends payment of premium for any reason whatever, the company shall not be held liable and the benefits, if any will be available only in accordance to the policy conditions. As the complainant failed or neglected to pay the subsequent premiums, the policy got the status of lapse and thereafter the company has to foreclose the said policy as per the Clause no. 9 and 2.2 of the terms and conditions of the policy. Clause no. 9 speaks that if full premium for the first three policy years is not paid and the policy is not revived within a period of two years from the due date of the first unpaid premium, then surrender value as described in Clause 2.2 will be paid at the end of the third policy year or at the end of the re-instatement period, whichever is earlier. Clause 2.2 provides that the policy acquires a surrender value

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after the payment for the first policy year. However, the surrender value would be payable only after the completion of three policy years or whenever the policy is surrendered thereafter. In the said clause it is further mentioned that in case of making payment of premium for one year then during surrender 75% will be deducted and in respect of making payment of two premiums deduction will be 60%. As the policy got foreclosed the Ops as per the terms and the conditions set the foreclosure amount of Rs. 23,739.49 through the cheque dated 28.03.2012 along with a forwarding letter dated 29.3.2012 and the same was duly received by the complainant. After receipt of the cheque the complainant issued letter on 03.5.2012 which was received by the company on 4.5.2012 as alleging thereby that he paid the third and fourth premium of Rs. 25,000=00 each in cash on 30.6.2011 & 29.7.2011 respectively to the sales person Mr. Avijit Chowdhury. The Ops through their reply dated 07.5.2012 communicated that the grievance of the complainant has been registered and enquiry would be done into the matter. The Ops duly made investigation and intimated the complainant by issuing letter dated 17.5.2012 that the premium of Rs. 50,000=00 as alleged by the complainant has been paid in cash was not received by them. Moreover the payment receipt relied upon by the complainant is not valid receipt. The Ops further directed the complainant to initiate proceeding against the concerned person to whom the payment in cash of Rs. 50,000=00 was made. It is pertinent to mention here that the Ops always request the customers for making payment directly to the counter of the company, if the payment is made in cash, as cash payment made to individual cannot be traced out. The company has no bearing towards such cash transaction and moreover the purported receipt as relied upon by the complainant in no manner reflects the premium was deposited with the company and the said receipts are not valid. As the Ops have all along acted in strict compliance of the terms and the conditions of the policy and there was no deficiency in service and unfair trade practice on behalf of the Ops hence the complainant is not entitled to get any relief from the this ld. Forum through this complaint accordingly prayer has made by the Ops for dismissal of the complaint.

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We have carefully perused the entire record and documents filed by the parties and heard argument at length from the ld. Counsel for the parties. Admittedly, the complainant obtained one policy namely Life Stage Pension for the period of 10 years issued by the ICICI Prudential Life Insurance Co. Ltd. through the Op-1 which was commenced on and form 28.3.2008 and the date of cessation of the policy was 28.3.2018. Further admitted fact is that mode of payment of the premium was annually and the amount of premium Rs. 25,000=00 per year, the wife of the complainant was declared as nominee of the said policy, the complainant is to pay premium within due  date to the OP-1. According to the complainant he paid 4 yearly premiums of Rs. 25,000=00 per year to the OP-1 but the Ops have alleged that the complainant did not pay 4 premiums and instead of paying the same he paid only 2 premiums. It is evident from the complaint that he deposited Rs. 25,000=00 towards third premium in the office of ICICI Prudential office at Chittaranjan branch and accordingly receipt was issued on 30.6.2011  and in the same way he paid Rs. 25,000=00 towards 4^th premium in the said office and one money receipt was issued against such payment on 29.7.2011. The allegation of the complainant is that all on a sudden he received one letter dated 29.3.2012 along with an A/c payee cheque of Rs. 23,739.49 from the Ops stating that the Ops being compelled to foreclose his policy with effect from 28.3.2012 as per  terms and the conditions of the policy. The ld. Counsel for the Ops has submitted that as per clause no. 2.2 the Ops have made payment @60% against payment of the complainant by issuing cheque. It is evident from the record that on 28.02.2012 the value of the units for the above-mentioned policy of the complainant was Rs. 59,555.56 paisa. In respect of such argument one question cropped our mind why the Ops have deducted the fund value at 60% where the complainant paid 4 due premiums within due dates and never requested the Ops to foreclose his policy. Therefore question of deduction does not arise. During argument the ld. Counsel for the ops have further argued that as the complainant accepting the cheque has encashed the same he is estoppels to claim any amount as well as file any complaint before the Consumer Forum. In this respect we have noticed that immediately after accepting the cheque the complainant started to

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correspond with the Ops through written correspondences and when he did not get any favourable or positive answer from the Ops hence being compelled  he has filed this complaint. The Ops did not produce any document before us that the complainant received the said cheque amounting to Rs. 23,739.49 paisa towards full and final settlement from Ops. So in our opinion there is no bar for filing complaint before the ld. Forum by the complainant. It has been further been stated by the Ops that the value of units for the above-mentioned policy of the complainant was on 28.3.2012 was Rs. 59,555.56 and so the Ops sent one A/c payee cheque amounting to Rs. 23,739.49 to the complainant and requested to deposit the same for clearance within three months. Further allegation of the complainant is that in the said letter no explanation was given by the Ops as to why the policy was foreclosed by the company. Upon receipt of the said letter and cheque the complainant started to make correspondence with the Ops in writing stating that he paid third and fourth premium at the branch office of the Ops and as he paid Rs. 1, 00,000=00 in total he is entitled to refund the entire value of the units if it is foreclosed otherwise he did not make any correspondence with the Ops to foreclose the policy. Request was made to the Ops to investigate the matter earnestly. Along with the written correspondence the complainant sent two premium receipts issued by the Ops in respect of payment of 3^rd and 4^th premium. In reply the Ops intimated the complainant by issuing letter after investigation that as per records the company did not receive any amount from the complainant in respect of 3^rd and 4^th premium. It has been further mentioned by the Ops that the company has no bearing towards any cash transaction which has been allegedly done by and between the complainant and the sales personnel and not only that the money receipts which were annexed with the correspondence according to the Ops the same were not valid receipts  and for this reason the Ops were unable to comply with the request of the complainant to refund amount of Rs. Rs. 50,000=00 towards balance  payment as claimed by him against the policy. The contention of the Ops is that as the complainant did not make payment of the 3^rd and 4^th premium within due period as per the terms and the conditions of the policy being compelled the policy has

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been foreclosed by them and in view of the terms and the conditions of the policy the company has refund the amount to the complainant by issuing A/c payee cheque. In this respect we are to say that from the documents filed by the complainant it is seen by us that on 30.6.2011 one acknowledgement receipt was issued by the company towards the payment of the 3^rd premium amount, which was paid by the complainant at the branch office of the Ops in cash. The Annex-C2 reflects that the said acknowledgment was issued by the Ops with seal and signature of the recipient. The Annex-C3 similarly reflects similar picture that on 29.7.2011 the complainant paid Rs. 25,000=00 in cash before the office of the Ops towards 4^th premium. But the Ops are reluctant to give any weightage or importance to these receipts and stated that the said receipts are not valid at all. If we accept such contentions of the Ops one question is cropped up our in mind that if the Annex - C2 & C3 are not valid, why the Ops did not take any steps against such two documents by referring such documents before the hand writing expert or stating that at that point of time no such person was in service at their branch office. Without doing the same the Ops are simply denied the statement of the complainant of course on affidavit. Be it mentioned that the complainant has filed the complaint on affidavit also. From the said Annexures it is clear to us that the complainant paid four yearly premiums towards the said policy and there is no scrap of document before  us that the complainant has failed to make payment 3^rd and 4^th premium or if any premium which he was required to pay during that period. Secondly, it is an admitted fact that in case of non-payment of any premium amount the Ops has no liability to remind the same by issuing letter to the complainant, but the Ops have no authority to foreclose any policy issued by them without intimating the insured through written correspondence. If the complainant intended to foreclose the policy then only the Ops were at liberty to foreclose the same but otherwise not, as per the terms and the conditions of the policy.  In the terms and the conditions of the policy there is no such whisper that to whom premium amount would be given. During hearing the ld. Counsel for the Ops has mentioned that the complainant did not make payment of the premium amount  at  the  proper  place.   In  this  regard  we  are  to  say  that  when  the

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complainant made payment premiums before the branch office of the Ops and who acknowledging the same issued money receipt then what prompted the Ops for coming to the conclusion that the complainant did not pay 3^rd and 4^th premium in respect of his policy and for this reason the policy was foreclosed by them. In our view as the complainant paid 4 yearly premiums, then it was not proper to foreclose the policy by the Ops arbitrarily going beyond their terms and the conditions of the policy. During hearing the ld. Counsel for the complainant has argued that he is intending to continue with the policy but as the Ops have foreclosed the same then the Ops are liable to make payment of the balance amount (Rs. 1,00,000 - 23739.49) i.e. Rs.76,260.51 paisa to the complainant forthwith through A/c payee cheque. Admittedly such action of the Ops clearly shows deficiency in service as well as their highhandedness as they foreclosed the policy in an arbitrary manner without giving any prior intimation to the complainant and moreover where the complainant did not make any request in this respect. For such deficiency in service the complainant had to face mental agony and harassment for a prolonged period and his grievance has not been directed by the Ops out of court under compelling situation he had to approach before this ld. Forum by making this complaint. So according to us the complainant is entitled to get some amount towards compensation from the Ops as in our view if we direct the Ops for making payment of Rs. 10,000=00 towards compensation to the complainant it will meet justice. Further by initiating this complaint the complainant had to incur some litigation cost and he is also entitled to get some litigation cost from the Ops and according to us the Ops shall pay litigation cost of Rs. 3,000=00 to the complainant.

Going by the foregoing discussion, hence, it is, ordered, that the complaint is allowed on contest with cost. The Ops are directed to make payment either jointly or severally of Rs. 76,261=00 towards balance amount within 45 days from the date of passing of this order, in default, the amount shall carry penal interest @10% per annum for the default period. The Ops are further directed to make

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payment either jointly or severally compensation to the tune of Rs. 10,000=00 due to harassment and mental agony and litigation cost of Rs. 3,000=00 within 45 days from the from the date of passing of this order, in default, the complainant will be at liberty to put the entire decree into execution as per provisions of law. With the above-mentioned observation the complaint is thus disposed of accordingly.

Dictated and corrected by me.