| ORDER | DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
C.C. No. 526 of 15-10-2012 Decided on 23-01-2013
Rakesh Kumar, aged about 38 years S/o Sh. Pawan Kumar, R/o # 21736, Opposite Power House, Power House Road, Civil Station, Bathinda. ........Complainant Versus
ICICI Prudential Life Insurance Company Limited, through its Chairman/Managing Director, ICICI Prulife Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400 025. Branch Manager, ICICI Prudential Life Insurance Company Limited, Opposite Dr. Mohan Lal Garg, The Mall, Bathinda.
.......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM Smt. Vikramjit Kaur Soni, President. Sh.Amarjeet Paul, Member. Smt. Sukhwinder Kaur, Member. For the Complainant : Sh. N P Singh, counsel for complainant. For the opposite parties : Sh. Ashok Bharti, counsel for the opposite parties.
O R D E R
VIKRAMJIT KAUR SONI, PRESIDENT:-
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'). In brief, the case of the complainant is that the opposite parties through their agent induced him to obtain their policy by making false assurances to provide various benefits on the said policy including life insurance, interest and repayment of money in case of any need at any time. On the allurement of the opposite parties, the complainant purchased their Life Time Super Policy and deposited an amount of Rs. 20,000/ vide cheque No. 001882 dated 18-10-2007. The complainant alleged that the agent of the opposite parties obtained his signatures on various printed forms/blank papers/documents under bonafide impression and he did not disclosed/read over and explained the contents/terms of the said forms. The agent of the opposite parties assured the complainant that he will fill the forms and supply the photocopies of the filled forms later on to him. After few days, the opposite parties sent the policy in the regard to the complainant vide policy No. 06481429 dated 22-10-2007 alongwith first premium receipt No. 35540942 dated 22-10-2007 of Rs. 20,000/-, but did not supply the photocopies of the said printed forms duly filled, to him. Thereafter none of the officials or agent of the opposite parties came to the complainant for any installment nor they issued any letter or notice to him at any time in this regard whereas he had keen desire to continue the said policy. The complainant further alleged that he never surrendered the said policy to the opposite parties nor he requested them for foreclosure of the policy at any time. The opposite parties issued letter dated 25-10-2010 in connection with the policy in question to the complainant informing him that the value of the Units under his policy as on October 22,2010 is Rs. 19,169.83 and foreclosed the policy and sent cheque No. 000588 dated 23-10-2010 for Rs. 4792.45 to the complainant. The complainant received the said cheque under protest and asked about the short and invalid amount of the policy to opposite party No. 2 and also to the concerned agent of the opposite parties who induced him to obtain the policy of the opposite parties and will talk to their higher officials, but he did not respond to the request of the complainant. The complainant informed the opposite parties through registered letter dated 13-10-2011 regarding receipt of said amount under protest and demanded the balance amount. The complainant alleged that the opposite parties illegally deducted the amount of Rs. 15,207.55 without any intimation and criteria whereas they have admitted vide their letter dated 25-10-2010 that on 22-10-2010 value of unit under the policy was Rs. 19,169.83. The opposite parties of their agent never disclosed the complainant at any time to make any deduction from the principal amount nor they have any right to deduct the same. Hence, the complainant has filed the present complaint seeking directions to the opposite parties to pay Rs. 15,207.55 being the balance amount alongwith interest besides compensation and cost. The opposite parties filed their joint written statement and pleaded that the policy in question has been foreclosed due to complainant's own omission and commission as he failed to make the premium on due date. The complainant paid only two premiums (infact single premium) and thereafter failed to pay the subsequent premiums and he failed to revive his policy within the stipulated time, accordingly the policy was foreclosed. On foreclosure of the policy, an amount was paid to him through cheque which he received and got encashed. The detail of the policy in question of the complainant has been given as under :- Life assured Rakesh Kumar Policy No. 06481429 Type of Plan U39 LifeTime Super Proposals signed by the 22-10-2007 Life Assured Proposal Received Date 22-10-2007 Sum Assured 2,00,000.00 Premium frequency Half Yearly Premium Installment 20,000.00 Total premium paid till date 20,000.00 Risk Commencement date 22-10-2007 Policy issue date 23-10-2007 Policy Status Foreclosed Policy Dispatch date 26-10-2007 The opposite parties have pleaded that they have received the duly filled proposal form and has issued the policy namely Life Time Super. They dispatched the policy documents to the complainant and the same has been admittedly received by the complainant. The complainant after receipt of the policy documents has preferred to remain silent since he was agreed with the terms and conditions of the policy. In accordance to Clause 6(2) of the Insurance Regulatory and Development Authority (Protection of Policy Holder's Interest) Regulations, 2002 every policy document sent by it is accompanied by a forwarding letter which clearly mentions that in case of policy holder is not satisfied with the features or the terms and conditions of the policy, he can withdraw/return the policy within 15 days i.e. under the 'Free Look Period' provision. The complainant has not approached the opposite parties during the free look period or even after that with any of his grievance regarding the policy or its terms and conditions. The opposite parties have denied that the complainant signed any blank papers. It has been pleaded that no prudent person ever signs blank papers. The SMS was sent on the registered mobile of the complainant for renewal of payment. Since the complainant did not revive his policy within the stipulated period, accordingly as per clause 9 of the policy terms, the policy was foreclosed. The policy acquires surrender value only after the payment of full premium for the first policy year and would be payable only after the completion of three policy years. If the policy is not revived within two years from the due date of first unpaid premium than the surrender value as per clause 2.2 will be paid only after the end of third policy year. The parties have led their evidence in support of their respective pleadings. Arguments heard. The record alongwith written submissions submitted by the parties perused. The allegations of the complainant is that the agent of the opposite parties got signed blank documents such as proposal forms etc., at the time of effecting the insurance and did not disclose him the terms and conditions of the policy. His further allegation is that the opposite parties have foreclosed his aforesaid policy without any notice and illegally deducted the amount of Rs. 15,207.55 of the complainant without any intimation and criteria whereas they have admitted vide their letter dated 25-10-2010 that on 22-10-2010 value of unit under the policy was Rs. 19,169.83. On the other hand, the submission of the learned counsel for the opposite parties is that since the complainant has failed to make the payment of premiums on due dates and even under the grace period, to get the policy renewed, accordingly as per terms and conditions of the policy in question, the policy was foreclosed under clause 9 read with clause 2.2. and a cheque amounting to Rs. 4,792.45 was sent to the complainant which he received and got encashed. So, no benefit can be claimed by the complainant under the said subject policy and the complainant is not entitled for any amount. A perusal of Ex. C-2 Life Time Super policy in question of the complainant reveals that periodicity of payment is mentioned as 'Yearly' and alongwith this policy, terms and conditions of the policy documents were also enclosed and sent to the complainant. Moreover, according to clause 4.1 (ii), the premiums are payable without any obligation on the company to issue a notice for the same. Hence the contention of the complainant that none of the officials or agent of the opposite parties came to the complainant for any installment, is not tenable. Clause 9 of the policy reads as under :- Clause 9 “If the full premium for the first three policy years is not paid and the policy is not revived within the period of 2 years from the due date of the first unpaid premiums, then the surrender value as described in clause 2.2. will be paid at the end of third policy year or at the end of the reinstatement period, which ever is later. Clause 2.2 “The policy acquires a Surrender value after the payment of full premium for the first policy years. However, the surrender value would be payable only after completion of three policy years of whenever the policy is surrendered thereafter. The surrender value payable is the Fund value after deducting the following surrender charges : a. Applicable surrender charges where three full years premiums have not been paid :- Complete Policy years for Surrender charges as a % of the Fund which premiums have been paid value -------------------------------------- ------------------------------------- Less than one year 100% One Year 75% Two Years 60%
Keeping in view the facts, circumstances and the evidence placed on file by the parties, this Forum is of the considered opinion that since the complainant did not revive his policy within the stipulated period, accordingly, as per clause 9 of the policy terms, the policy in question was foreclosed and foreclosure amount which was payable under the aforesaid clause was paid to him. The Insurance is a contract between the policyholders and both the parties are governed by the terms and conditions mentioned in the policy document and all the benefits are payable as per the said policy terms and conditions. Hence, there is no deficiency in service on the part of the opposite parties on this account. The complainant has alleged that the agent of the opposite parties got signed blank documents i.e. proposal form etc., from him without disclosing any contents thereof. Ex. C-9 is the affidavit of Sh. Rajesh Kumar, who has deposed that he is the agent of the opposite parties and his agent code Number is 00049103. He has further deposed in para No. 3 of his affidavit that :- “3. That the blank insurance papers/forms duly signed by the complainant were filled by the officials of the opposite party No. 2 at Bathinda and they did not supply the photocopies of the documents to the deponent so that deponent was/is unable to supply the photocopies of the documents to the complainant.” The complainant has proved that the agent of the opposite parties got signed blank insurance papers/forms from the complainant which were filled by the officials of the opposite party No. 2 later on. Hence, such a practice on the part of the opposite parties amounts to unfair trade practice as their agents without disclosing the contents to the general public get the blank documents signed and later on, the agents/officials of the Insurance Companies fill the said documents according to their suitability by keeping the innocent public in dark. Thus, complainant is required to be compensated for such illegal practice adopted by the agent of the opposite parties while effecting the insurance, which the opposite parties may recover from their agent and issue the special guidelines to the agents not to adopt such type of practice and misguide the general public. In view of what has been discussed above, this complaint is accepted with compensation and cost of Rs. 5,000/-. The opposite parties are directed to pay Rs. 5,000/- being compensation and cost to the complainant, within 30 days from the date of receipt of copy of this order. A copy of this order be sent to the parties concerned free of cost and the file be consigned to record.
Pronounced :
23-01-2013
(Vikramjit Kaur Soni) President (Amarjeet Paul) Member
(Sukhwinder Kaur) Member
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