Punjab

StateCommission

A/11/671

Lalit Goyal - Complainant(s)

Versus

ICICI Prudential Life Insurance Company Ltd. - Opp.Party(s)

Tribhawan Singla

06 Feb 2015

ORDER

                                                               FIRST ADDITIONAL BENCH

 

STATE  CONSUMER  DISPUTES  REDRESSAL  COMMISSION,     PUNJAB

          SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.

                                     

                   First Appeal No.671 OF 2011

 

                                                          Date of Institution:20.04.2011  

                                                          Date of Decision : 06.02.2015

 

Lalit Goyal son of Sh.Krishan Goyal, resident of Gobind Colony, Gali No.1, Lucky Gate Wali Gali, Opposite House No.1266, Tehsil and District Barnala.

 

                                                          …..Appellant/Complainant.

         

                                      Versus

 

1.       ICICI Prudential Life Insurance Company Ltd., College Road, Ist          Floor, HDFC Bank Building, Barnala, through its Branch Manager.

 

2.       ICICI Prudential Life Insurance Company Ltd., ICICI Prulife Towers,    1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025 through its Managing Director.

 

                                                          ….Respondents/Opposite Parties.

 

         

First Appeal against order dated 09.03.2011 passed by the District Consumer Disputes Redressal Forum, Barnala.

Quorum:-

 

          Shri J. S. Klar, Presiding Judicial Member.

          Shri Vinod Kumar Gupta, Member.  

Present:-

 

          For the appellant              :         Sh.Tribhawan Singla, Advocate

          For the respondents        :         Sh.K.S Cheema, Advocate

 

          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

                            

J. S. KLAR, PRESIDING JUDICIAL MEMBER:-

                                     

           The appellant (the complainant in the complaint) has directed this appeal against the respondents of this appeal (the OPs in the complaint) challenging the order dated 09.03.2011 of District Forum Barnala.

2.      The appellant/complainant has filed the complaint U/s 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the OPs on the allegations that OP No.3 is agent of the OP No.1 and 2. The OP No.3 approached the complainant and intimated him about the benefits of the insurance policy namely "Premier Life Gold" issued by OP No.1 and 2.  It was assured by OP No.3 to complainant that in case complainant purchased the said policy and paid the premium of Rs.1,00,000/- for three years for each year, then complainant would be insured for ten years period for Rs.10,00,000/- i.e Rs.5,00,000/- for Premier Life Gold and Rs.5,00,000/- for accident and disability benefits. In case, the complainant did not pay the premium for three years continuously, then benefits of the insurance would not be given to him and policy would be cancelled and amount of premium received would be refunded accordingly. Believing  OP No.3, the complainant purchased the said policy from OPs by paying the premium of Rs.1,00,000/- on 10.10.2007. The OPs released the said policy bearing no.06293159 dated 10.10.2007, which did not contain any terms and conditions. The complainant asked the OPs for supply of the terms and conditions of the policy and he was informed that there were no terms and conditions in black and white and policy was just oral one. The complainant could not pay other installments due to unavoidable circumstances. On the completion of three years, the complainant asked for refund of the premium deposited by him, whereupon the OPs sent a letter dated 13.10.2010 to the complainant alleging that value of the units under the said policy is Rs.1,02,927.47 on 11.10.2010 and cheque of Rs.25731.87 dated 12.10.2010 bearing no.891273 of ICICI Bank was enclosed with the said letter to the complainant. The complainant did not accept the said cheque and raised objections that terms and conditions thereof were not supplied to him by the OPs. The complainant visited the OPs many times, but to no effect. The complainant has accordingly filed the complaint directing the OPs to refund the amount of Rs.1,00,000/- to the complainant along with interest @18% p.a from the date of payment of premium till realization besides cost of litigation of Rs.25,000/-.

3.      Upon notice, OPs filed written reply, raising preliminary objections that the complaint is false and frivolous and is only an abuse of process of the Forum. That complainant has not approached the Consumer Forum with clean hands and filed complaint on the false, frivolous and vexatious grounds.  It was further averred that the OPs sent welcome kit to its policyholders containing policy documents with terms and conditions along with the policy certificate forming part of it. The complainant earlier had a policy bearing no.00974467 with the OPs, which was surrendered by him as per policy terms and conditions and thereafter he took another policy bearing no. 06293151 from the OPs/company. The complainant failed to pay the premium on due date due to his own fault and he allowed the policy to be foreclosed. Clause 4.1 of the policy deals with the payment of premiums which indicates that the premiums are payable without any obligation on the company to issue a notice for the same. The policy of the complainant was foreclosed as per the terms and conditions under Clause 9  and cheque bearing no.A891230 amounting to Rs.25,731.87 drawn on ICICI Bank was sent to the complainant, which was received by him. That as per Clasue 9 of the policy, if policy is not revived within a period of two years without making payment of full premium from the due date, then the surrender value would be described as per Clause 2.2 at the end of third policy year. The policy documents in original was dispatched to the complainant and same was duly received by the complainant. The complainant submitted application for surrender of the policy bearing no. 00974467 and requested the OPs on 27.09.2007 to transfer the fund amounting to Rs.1,00,000/- under the policy vide application no.LL09198300 i.e Premier Life Gold Plan and requested to refund the excess amount. As per request of the complainant, the OPs transferred a sum of Rs.1,00,000/- to new application as referred to above and excess amount of Rs.9346.21 after surrender of the policy was refunded to the complainant, vide cheque bearing no.633316  on 30.09.2007, which was duly encashed by the complainant on 29.10.2007. The complainant has not returned the policy within free look period and thereby he implicitly agreed to the terms and conditions of the policy as well. The OPs controverted the averments of the complainant as pleaded in the complaint and, thus, prayed for dismissal of the complaint.

4.      The complainant tendered in evidence, policy document  Ex.C-1, letter dated 13.10.2009 is Ex.C-2  letter dated 13.10.2009,  copy of cheque  Ex.C-3, affidavit of Lalit Goyal, complainant as Ex.C-4. As against it, the opposite parties tendered in evidence  affidavit of Ms.Sudha Sharma, Legal Manager Ex.R-1, copy of proposal form Ex.R-2, copy of request letter for transfer of funds as Ex.R-3, copy of policy documents as Ex.R-4, copy of policy documents Premier Life Gold as Ex.R-5 and closed the evidence. On conclusion of evidence and arguments, the District Forum, Barnala dismissed the complaint of the complainant. Dissatisfied with the order of the District Forum, the complainant has come up in this appeal against the same.

5.       We have heard Ld.Counsel for the parties and have gone through the record of the case.

6.       The order of the District Forum has been assailed by the appellant contending that the onus probandi was upon insurance company/Op to prove that they have sent the terms and conditions of the policy to the appellant and the District Forum shifted this onus erroneously on the complainant. It was further argued that the fund value of the payment  was to be refunded to the appellant after completion of three years of the policy, hence, the amount of Rs.75,000/- has been deducted from the fund value unnecessarily by the OPs. It was further submitted that the appellant has not encashed Rs.25,731.87, therefore, it cannot be said that the appellant has received the money without any protest.

7.       We have examined the above-referred contentions raised by appellant before us coupled with evidence adduced on the record by the parties in this case. Ex.C-1 is the Premium Life Gold Policy, premium paying term three years and assured sum of rupees five lacs. Ex.C-2 is letter dated 13.10.2010 regarding foreclosure of the premier life gold policy with effect from 11.10.2010. Affidavit of Lalit Goyal Ex.C-4 is on the record. To counter this evidence, OP relied upon affidavit of Ms.Sudha Sharma, Senior Legal Manager Ex.R-1 on the record stating,  same facts in this affidavit as taken in the written reply by the OP. Ex.R-2 is copy of the policy, Ex.R-3 is the application for surrender of the policy by the complainant and Ex.R-5 is terms and conditions thereof.

8.       Undisputedly, the complainant discontinued the policy after payment of the first premium on 10.10.2007 and failed to deposit the second premium which was due by him in this case, therefore, policy stood lapsed. From perusal of Clause 9 of this policy document Ex.R-5, it is evident that if full premium for the first three years policy is not paid and the policy is not revived within period of two years from the due date of the first unpaid premium, then surrender value as described in Clause 2.2 thereof would be paid at the end of third policy year or at the end of the reinstatement period whichever is later. On the basis of Clause 9 of the policy, the surrender value as described in Clause 2.2. would be paid at the end of the third policy year or at the end of the reinstatement period, whichever is later. Clause 2.2 thereof deals with the surrender value and the surrender value would be payable after completion of three policy years whenever the policy is surrendered thereafter. The surrender value payable is the fund value after deducting the surrender charges mentioned therein, if premium payments are discontinued within the first three policy years, all benefits thereof after expiry of days of grace would cease. There was free look period of 15 days with the complainant to return the policy. We find no substance in the argument raised by the appellant that the terms and conditions of the policy were not supplied to him. The complainant has not complained at any time to the OPs for non-supply of the terms and conditions of the policy. The complainant earlier took the policy no. 00974467 and was duly aware of the terms and conditions thereof and he cannot be said to be ignorant about it. The complainant has also not filed any complaint to challenge the amount of Rs. 25,731.87, which was sent to him and it was duly received by him. The parties are bound by the terms and conditions of the policy document, which is a contract between them.  We do not find any deficiency in service on the part of OPs on account of own default of the complainant in not paying the premium. We find that the policy would acquire the surrender value only after payment of full premium for first policy year and same was to become payable after completion of three years of the policy only. Surrender charges are applicable in this case as policy was not revived within two years from the date of first unpaid premium. On this point, we are also fortified by the view of our own Commission in case titled as ICICI Prudential Life Insurance Company Limited & ors  Vs… Inderjit Kaur Mela in First Appeal No.1321 of 2011, decided on 04.08.2014.

9.       In the light of our above discussion, we find no merit in the appeal and same is hereby dismissed.

10      Arguments in this appeal were heard on 05.02.2015 and the order was reserved. Now the order be communicated to the parties.

11      The appeal could not be decided within the statutory period due to heavy pendency of court cases.

 

                                                                          (J. S. KLAR)

                                                             PRESIDING JUDICIAL MEMBER

                       

                                                                   (VINOD KUMAR GUPTA)

                                                                          MEMBER

 

February,06  2015.                                                                  

(ravi)