| ORDER | DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA.
C.C. No.378 of 08-08-2012 Decided on 19-12-2012
Sandeep Garg aged about 39 years S/o Sh. Madan Lal Garg R/o Cozy Home, St. No.6, Nai Basti Bathinda. ........Complainant Versus Kotak Mahindra Life Insurance Company Ltd., The Mall, Bathinda, through its Branch Manager. Kotak Mahindra Old Mutual Life Insurance Company Ltd., Registered Office: 9th Floor, Godrej Coliseum, Behind Everard Nagar, Sion (E), Mumbai-400022, through its M.D/C.E.O.
.......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. Present For the Complainant : Sh.Vikas Singla, counsel for complainant. For Opposite parties : Sh.Vinod Garg, counsel for 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'). Briefly stated, the case of the complainant is that in the year 2008, the adviser of the opposite parties approached the complainant at his house and allured him to purchase their Kotak Smart Advantage Life Insurance policy. He further allured the complainant that as per the above said insurance policy, the complainant have to pay the premiums minimum for 3 years and thereafter he can withdraw his entire amount with interest @ 18% p.a alongwith other benefits. Accordingly, on the allurement of the adviser of the opposite parties, the complainant agreed to purchase the Kotak Smart Advantage Life Insurance policy and paid first premium of Rs.20,000/- through cheque No.163645 dated 28.7.2008 drawn on Oriental Bank of Commerce to the opposite parties. The opposite parties issued policy bearing No. 01178682 with sum assured of Rs. 1,00,000/- commencing from 31.7.2008, to the complainant. The complainant paid total three premiums of Rs.20,000/- each to the opposite parties i.e. total sum of Rs. 60,000/-. In the month of June 2012, the complainant was in dire need of money, so he approached the opposite party No.1 and asked their officials to close his said policy and give his entire policy amount i.e. Rs.60,000/- with interest @ 18% p.a from the date of deposit of all insurance premiums alongwith other benefits. The officials of the opposite party No.1 asked the complainant that the term of his policy is 10 years, so he has to pay the premiums for 10 years regularly, and refused to accept the surrender request of the said policy. Hence the complainant has filed the present complaint seeking directions to the opposite parties to refund Rs.60,000/- alongwith interest and pay him cost and compensation. The opposite parties filed their joint written statement and pleaded that the complainant proposed for an insurance policy, named Kotak Smart Advantage, by filling the proposal form duly executed and signed by him on 28.7.2008. The complainant had paid a sum of Rs.20,000/- towards this insurance policy through cheque dated 28.7.2008 bearing No.163645 drawn on Oriental Bank of Commerce. The opposite parties issued a Proposal Deposit Receipt against this payment. After duly understanding, the complainant had duly signed Benefit Illustrations dated 28.7.2008. The complainant was issued policy document containing all terms & conditions applicable thereto. The details of the said policy are :-
Policy No. | 1178682 |
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Name of Plan | Kotak Smart Advantage | Policyholder | Sandeep Garg | Life Insured | Sandeep Garg | Date of Commencement | 31.7.2008 | Policy Term | 10 years | Premium Payment Term | Annual |
The complainant upon receipt of the policy document has not raised any objection, within the free look period of 15 days mentioned therein. The complainant has paid three premiums of Rs.20,000/- each till date. Due to non-payment of the premium on 31.7.2011, the said policy has entered ACM (Auto Cover Maintenance) Mode on 4.9.2011. As per the terms and conditions of the said policy, it shall remain in the ACM Mode for a period of 2 years in total. As per the terms and conditions of the policy; the policy may be surrendered by the policyholder upon completion of 3 policy years. The opposite parties have further pleaded that under Clause 6 at page No.10 of the policy document, the said policy can be surrendered and the value upon surrender shall be as prescribed under the said clause. Therefore as per the said policy, the complainant cannot receive the entire amount of the premium paid. The various charges being deducted from the premium amount paid are primarily on account of the risk coverage given to the complainant from the date of policy commencement and which continues till date. 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 submission of the learned counsel for the complainant is that at the time of insurance of the policy in question, the opposite parties conveyed him that he has to pay only three premium and thereafter he can get the whole amount of premium refunded with interest, but now the opposite parties have refused to cancel the policy and refund the premium as per commitment. On the other hand the learned counsel for the opposite parties submitted that the complainant cannot seek refund beyond terms and conditions of the policy. Since the complainant has not paid 4th premium due on 31-07-2011, the policy is in Auto Cover Maintenance Mode from 4-9-011 and shall remain in the AMC for a period of two years and within this time, the policy can be revived by payment of premium due. Otherwise he cannot seek refund of premium other than surrender value as per Clause 6 on page 10 of policy. These are undisputed facts between the parties that the complainant purchased Insurance policy bearing No. 01178682 with sum assured of Rs. 1,00,000/- commencing from 31.7.2008, Plan - Kotak Smart Advantage. He paid three annual premium of Rs. 20,000/- each and now he seeks refund of the premium. The complainant has admitted in para No. 3 of his complaint that policy in question has been issued to him and he produced on file photocopy of policy as Ex. C-3 i.e. page 2 of 20 meaning thereby that the complete policy alongwith terms and conditions is in his possession. Clause 6 of the Terms and Conditions of the policy is reproduced hereunder :- “ 6. Surrender The policy can be surrendered only after completion of three policy years and three annual basic premiums are paid. The surrender value applicable will be the then fund value in Main and Top Up accounts (based on unit price) less a surrender charge (refer clause 14). The Top up accounts will also be surrendered together with the Main account and there will be no option to surrender these two accounts viz. The Main and the Top up accounts separately. The surrender value of the Top up accounts will be the fund value in the Top up accounts. Needless to say that in case of surrender, the policy shall stand terminated and no further death benefit or maturity benefit is provided.” A perusal of Clause 14, referred to above, reveals that no doubt this clause relates to charges but it does not clarify the exact amount to be deducted from the fund value of the complainant. At page 24 of Terms and Conditions of the policy, produced before this Forum by the parties during arguments, a complete chart has been made by the opposite parties themselves regarding Fund Value, Death Benefit and Surrender Value. It is the admitted fact that complainant has paid three annual premiums of Rs. 20,000/- each. According to this chart and keeping in view the plan of the complainant, the fund value available in the fourth year of the policy is Rs. 65,127/- and surrender value is Rs. 62,522/-. Hence, the complainant is entitled to the surrender value to the tune of Rs. 62,522/-. Therefore in view of what has been discussed above, this complaint is accepted against the opposite parties with cost and compensation of Rs 5,000/-. The opposite parties are directed to pay an amount of Rs. 62,522/- to the complainant.
The compliance of this order be done within 45 days from the date of receipt of the copy of this order. In case of non-compliance the interest @ 9% per annum will yield on the amount of Rs. 62,522/-. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.
Pronounced 19-12-2012 Vikramjit Kaur Soni President
Amarjeet Paul Member
Sukhwinder Kaur Member
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