BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION AT BANGALORE (URBAN)

DATED 02^ND DAY OF AUGUST 2022

ORDER

SRI.K.S.BILAGI, PRESIDENT

1. This  complaint is filed against the Opposite parties for the following reliefs

1. To Direct the OP to refund the payment of Rs.4,00,000/- charged by the OP, towards surrender of policy no.03140203.
2. Direct the OP to pay an amount of Rs.2,00,000/- towards harassment and mental agony and hardship,
3. Direct the OP to reimburse costs of this proceedings and pay an amount of Rs.50,000/- towards cost of litigation and  such other reliefs as this Hon’ble Forum deems fit.

2.  The case of the complainant in brief is as follows:

The complainant being the NRI opened an account and  taken a policy for period of 30 years and premium payment was for a period  of 10 years. One Ms.Kavitha Joshi, assigned as Relationship Manager of OP following the  complainant. Accordingly, he transmitted a yearly premium. The complainant  to pay 1^st 5 years and in the even cannot pay after 03 years he was assured benefit under the claim.

It is further case of the complainant that  he came back India for short time and that time   he wanted soft copy of the policy. The information furnished  by Ms.Kavitha Joshi that  policy was sent to the present address of the complainant which delivered on 10.02.2015, but no soft copy was furnished. Soft copy not furnished after  repeated requests.

It is further case of the complainant that he relocated in India 2018 along with his family. He met Indiranagar Branch Manager in the year 2018, but there was vague reply. Even he had paid 04 installments of Rs.2,00,000/- every year, but branch manager told agent misguided him. He also clarified the manager that he never received the documents and  due to indifferent  attitude of the OP, he approached Ombudsman in the year 2019, who rejected his claim. The  complainant received only Rs.4,00,000/- against Rs.8,00,000/- and OPs are liable to refund balance amount of Rs.4,00,000/- and compensation of Rs.2,00,000/-. The act of the OP amounts to deficiency of service.

3. After receipt of   notice, the OP appeared through  counsel and filed version. The complainant had approached Ombudsman office who  passed  award dt.17.01.2020. The cause of action for filing this complaint arose in the year 2015 and complaint is barred by limitation. The complainant being  the policy holder  had an option to cancel within 15 days. The policy was also sent to present address of the complainant, which came to be delivered in the respective address of the complainant. Only in case of payment five years the policy holder will be liable to receive 50%, the complainant failed to exercises his option to take benefit free look period. There is no deficiency of service as complainant  failed to take benefit free look provision. Therefore, the complainant is not entitled to any amount. The proposal form was not signed by the complainant, but he failed to withdraw policy within 15days. There is no deficiency of service. The OP requests to dismiss the complaint.

4. The complainant filed his affidavit evidence and relies on  22 documents annexed to the complaint. OP has filed affidavit evidence  and relies on 08 documents.

5.          Heard the arguments,  Perused records.

6. The following points arise for our consideration are as under:-

1. Whether there is deficiency in service on the part of the OP?
2. Whether the complainant is entitled for the reliefs as sought for?
3. What order?

7. Our answer to the above points are as under:

       Point No.1:- Negative

      Point no.2:- Negative

      Point No.3:-As per the final order.

REASONS

8. Point Nos.1 and 2:.The OP by contending that  policy was taken in the year 2015 and complaint filed in the year 2020 is  barred by limitation.

9. It is further contended that  the complainant took the policy of 30 years in the year 2015 from the OP. The grievance of the complainant is that he was mis-guided by the agent. The complainant was liable to pay 03 years premium to get the surrendered value. If 03 years is only taken into consideration upto  January 2017. Admittedly, the complainant paid premium for 04 years namely i.e. January 2015, January-2016, January-2017 and January-2018. Later on the complainant had approached ombudsman  by filing complaint in the year 2019. According to the Ombudsman order, the policy commenced 02.02.2015, the date of repudiation is 25.05.2019. This complaint came to be filed on 10.08.2020. The  complaint is filed within 02 years from 25.05.2019. Therefore, OP  is not right in saying that the complaint is barred by limitation. The complainant never made any request for refund of premium between 2015 to 2018. He made only request for refund 04 years premium of Rs.8,00,000/- in 2019 and OP repudiated this claim on 25.05.2019.

10. The allegations made in the complaint and version are being spoken by both the parties.

11. At the 1^st instance, we would like to refer 22 documents relied by the complainant. Document no.1 is proposal form submitted by the complainant. Wherein, specifically mentioned that the premium payment term is 10 years and policy term is  30 years with sum assured Rs.20,00,000/- and yearly premium of Rs.2,00,000/-. It is true that during February 2015 the complainant caused  demand for soft copy of the policy from the OP, but OP took time to furnish the soft copy of the policy. It is specification of the OP that the policy dt.06.02.2015 was sent to the present address of the complainant at Bengaluru and same has been received on 10.02.2015. The complainant has produced the policy dt.06.02.2015 with schedule, it clearly indicates that the policy was sent to the permanent address of the complainant at Bengaluru. The clause-5 of this policy speaks about surrender value. It indicates that the policy holder gets 50% in case of the surrender between 4^th to 10^th year. Admittedly, the complainant has surrendered his policy in the year 2019 and received Rs.4,00,000/-. This complaint is for refund of balance amount of  Rs.4,00,000/- out of Rs.8,00,000/-. The complainant himself admits in the complaint and in the affidavit evidence that he along with his family relocated to India in the 2018 and he opened hard copy of the policy and looking to the contents he was shocked.  When the complainant opened the policy in the year 2018, OP was right in saying that the hard copy of the policy reached present address of the complainant at  Bengaluru on 10.01.2015. The complainant could have made enquiry with  his family members at Bengaluru about receipt of the policy and  asked the family members at Bengaluru to sent scanned copy of the policy. The complainant remained silent till 2018 without asking his family to send hard copy of the policy to U.K. and not requested his family members  at Bengaluru to send  either scanned copy of the policy or copy of the policy  by WhatsApp. This inaction of the complainant cannot be taken as acceptable explanation.

12. According to the complainant, the insurance agent misguided him that complainant was to pay premium for 03 years to get the full reimbursement. The complainant has  not disclosed name of the insurance agent and insurance agent not made as party to this proceedings to take action against  the OP,  due to the alleged conduct/misconduct of the insurance agent. More over  non sending of the soft copy of the policy does not help the complainant that he was given undertaking that he was liable to pay only 03 years premium to get full surrender value. When he opened the hard copy of the policy in the year 2018 and met the Branch manager of Indiranagar in  January 2018, we fail to understand why immediately he has not filed his protest petition against the act of the agent of the OP and act of the officer of the OP. It is not the case of the complainant that the original hard copy of the policy was not sent to his home address at Bengaluru only in the year 2015. He has not made any reference in the complaint that on enquiry his family members at Bengaluru told that they have not received hard copy of the policy. The complainant slept over for three years from the date of taking of policy and now claiming balance of Rs.4,00,000/-. This act of  complainant  cannot be appreciated.

13. It is true  that between January 2019 to October 2019 the complainant made correspondence with OP.  He no where whispered the hard copy never reached his  home address in Bengaluru in the years 2015. Later on, he approached the Ombudsman, who has rejected the claim of the complainant. The Ombudsman categorically held as per terms conditions of the policy payment of Rs.4,00,000/- surrendered value was correct. As per clause-5 of the policy, the complainant was entitled to 50% of the surrender value between 4^th to 10^th year. When the complainant made annual installment in all Rs.8,00,000/-, the payment of Rs.4,00,000/- only  surrender value is correct. Under such circumstances, the complainant is not entitled for claim another Rs.4,00,000/- surrender value from the OP.

14. The OP relies on 8 documents. Document no.1 is order of Ombudsman which has been referred while referring documents of the complainant. The document no.2 is proposal form, which has been also produced by the complainant as document no.1.  Document no.3 produced by the complainant, covering letter with policy produced by the OP are one and the same.  There is no need to through in detail about document no.3. Document no.4 is the letter of the OP that full payment of premium for 03 years has received and policy should be in force till January 2019 liable for payment of  surrendered value. Document no.5 application of complainant  dt. 07.02.2019. OP relying on clause-5 of the policy as paid Rs.4,00,000/- to the complainant and complainant accepted the same. Letter of complainant is silent about raising  finger making allegations against agent. Other documents are correspondence between the complainant and OP.

15. The complainant has made all allegations against agent of the OP without making agent as OP in this case. The complainant  has not whispered the name of the agent who alleged to have  misguided him. The complainant has not filed any police complaint  against the agent  who  alleged by and made him to suffer of Rs.4,00,000/-. Under such circumstances, there is no deficiency of service on the part of OP. Accordingly, the complainant is not entitled for any of the reliefs.

16. Point no.3:-.  In view of the discussions in point no.1 & 2, complaint requires to be dismissed. Accordingly, we proceed to pass the following 

O R D E R

1. The complaint is dismissed without costs.
2. Furnish the copy of this order to both the parties.

(Dictated to the Stenographer, got it transcribed and corrected, pronounced in the Open Commission on this 02^th  day of August, 2022)

Documents produced by the Complainant-P.W.1 are as follows:

Documents produced by the representative of opposite party – R.W.1 :