Order by:
Sh.Amrinder Singh Sidhu, President
- The complainant has filed the instant complaint under section 12 of the Consumer Protection Act, 1986 (as amended upto date) on the allegations that she took policy bearing No. 133106635 dated 18.03.2010 against the premium of Rs.One Lakh from the Opposite Party. The Complainant alleges that as per the policy, three installments of Rs.1 lakh each of every year have been paid regularly within the specified dates and in this way, the Opposite Party received Rs.3 lakhs as per the policy and due date of the policy was fixed 31.03.2018. The original policy has already been handed over to the Opposite Party and that is in their possession. Further alleges that as per the policy, the Complainant tendered the policy document after completing the five years to get the amount of the policy, but the Complainant received Rs.2,14,228/- on 21.04.2018 in her Saving Bank Account which is maintained in Punjab National Bank, G.T.Road, Moga. After receiving the amount, the Complainant approached the Opposite Party and sought the details of the policy and also informed that as per the IRDA notification, the Opposite Party can not deduct the amount after the completion of the five years, rather liable to pay the amount alongwith all its benefits bonus etc., but the Opposite Party has deducted the amount without any explanation and detail and in this way, he Opposite Party has deducted Rs.85,772/- alongwith other benefits of the policy wrongly against IRDA rules. Thereafter, the Complainant also served legal notice on 08.06.2018 to the Opposite Party which was duly acknowledged by them on 20.06.2018, but to no affect. Moreover, no policy bound has ever been returned to the Complainant as alleged in their reply dated 20.06.2018, hence it is clear cut deficiency in service on the part of the Opposite Party and the Opposite Party is liable to pay the entire amount without the alleged deduction against the policy in question. Due to the aforesaid acts and conduct and deficiency in service on the part of the Opposite Party, the Complainant has suffered mental tension, harassment as well as financial loss. Vide instant complaint, the complainant has sought the following reliefs.
- The Opposite Party may be directed to make the claim amount of Rs.2,35,772/- alongwith interest @ 12% per annum alongwith bonus and other benefits of the policy dated 18.03.2010 issued by the Opposite Party alongwith further interest thereon at the rate of 18% per annum till its realization.
2. Upon notice, Opposite Party appeared through counsel and contested the complaint by filing written reply taking certain preliminary objections therein inter alia that the complaint is not maintainable and is liable to be dismissed as there is no deficiency in service rendered by the Opposite Party. Actually, the Complainant took an Insurance policy N o. 133106635 with date of commencement 31.03.2010 for a sum assured of Rs.5 lakhs under Table Term 801-8(3) Wealth Plus Plan which is a Unit Linked Endowment Plan with limited premium paying term. The life assured had paid three annual premiums @ Rs.1 lakh each and was allotted 8530.070 units on 31.03.2010, 9593.718 units on 23.03.2011 and 9546.148 units on 30.11.2012 and the policy was revived on 30.11.2012. As per the terms and conditions of the policy allocation charges @ 12% during the first year and @ 2.50% during the subsequent years are to be deducted. Apart from allocation charges, the following charges are also leviable, (i) Mortality charge (life cover)- As this policy is with life cover, morality charges were being taken every month by cancelling appropriate number of units out of the policy holders fund value as per NAV rate applicable. (ii) Accident benefit charges- As the life assured opted for DAB for Rs.5 lakhs, charges of 0.50 paisa per 1000 sum assured per policy year was being charged, (iii) Policy administration charges- A charge of Rs.60/- per month during the first year and @ Rs.25/- per month during the second year and thereafter from the third year onwards throughout the end of policy term of policy Rs.25/- per month escalating at 3% per annum is being charged by cancelling appropriate number of units out of policy holders fund value on monthly basis and (iv) Service Tax charges- A service charges are being levied on the charge mortality, accident benefit by cancelling appropriate number of units out of the policy holders fund value on monthly basis as and when above charges are deduced. During the financial year 2009-10 rate was 10.30% (10% service tax + 3% educational cess on service tax). With effect from 01.10.2010 service tax is being levied on policy administration, mortality, accident benefit, premium allocation, fund management, switching and alteration charges. On the policy holder surviving the date of maturity an amount equal to the value of units held in the policy holders fund is payable as maturity claim. For this purpose the bid value as on date of maturity will be based on the highest NAV over the first seven years of the policy or the NAV as applicable at the end of the policy term, whichever is higher. On the maturity i.e. 31.03.2018, the total number of the units in the account of the Complainant were 13855.189 and the NAV was 15.4619 and the maturity has been paid at NAV Rs.15.4619 amounting to Rs.2,14,228/- on 19.04.2018 as per the terms and conditions of the policy. After the maturity free risk cover for sum assured Rs.5 lakhs is available on the life of the life assured for next two years from the date of maturity, thus the claim amount has been correctly paid to the Complainant and nothing is due towards the Opposite Party. On merits, the Opposite Party took all most same and similar pleas as taken up by them in the preliminary objections and hence, there is no deficiency in service on the part of the Opposite Party. All other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with special costs has been made.
3. In order to prove her case, complainant placed on record her affidavit Ex.C1, alongwith copies of documents Ex.C2 to Ex.C6.
4. On the other hand, to rebut the evidence of the complainant, Opposite Party placed on record the affidavit of Sh.R.K.Verma, Marketing Manager Ex.R1 alongwith copies of documents Ex.R2 to Ex.R6.
5. We have heard the ld. counsel for the parties, perused the written arguments of the Complainant and have carefully gone through the evidence on record.
6. Ld.counsel for the complainant has reiterated the averments as narrated in the complaint and contended that the Complainant took policy bearing No. 133106635 dated 18.03.2010 against the premium of Rs.One Lakh from the Opposite Party. Further contended that as per the policy, three installments of Rs.1 lakh each of every year have been paid regularly within the specified dates and in this way, the Opposite Party received Rs.3 lakhs as per the policy and due date of the policy was fixed 31.03.2018. The original policy has already been handed over to the Opposite Party and that is in their possession. Further alleges that as per the policy, the Complainant tendered the policy document after completing the five years to get the amount of the policy, but the Complainant received Rs.2,14,228/- on 21.04.2018 in her Saving Bank Account which is maintained in Punjab National Bank, G.T.Road, Moga. After receiving the amount, the Complainant approached the Opposite Party and sought the details of the policy and also informed that as per the IRDA notification, the Opposite Party can not deduct the amount after the completion of the five years, rather liable to pay the amount alongwith all its benefits bonus etc., but the Opposite Party has deducted the amount without any explanation and detail and in this way, he Opposite Party has deducted Rs.85,772/- alongwith other benefits of the policy wrongly against IRDA rules. Thereafter, the Complainant also served legal notice on 08.06.2018 to the Opposite Party which was duly acknowledged by them on 20.06.2018, but to no affect. Moreover, no policy bound has ever been returned to the Complainant as alleged in their reply dated 20.06.2018, hence it is clear cut deficiency in service on the part of the Opposite Party.
7. On the other hand, ld.counsel for the Opposite Party has repelled the aforesaid contention of the ld.counsel for the Complainant on the ground that in fact, the Complainant took an Insurance policy No. 133106635 with date of commencement 31.03.2010 for a sum assured of Rs.5 lakhs under Table Term 801-8(3) Wealth Plus Plan which is a Unit Linked Endowment Plan with limited premium paying term. The life assured had paid three annual premiums @ Rs.1 lakh each and was allotted 8530.070 units on 31.03.2010, 9593.718 units on 23.03.2011 and 9546.148 units on 30.11.2012 and the policy was revived on 30.11.2012. As per the terms and conditions of the policy allocation charges @ 12% during the first year and @ 2.50% during the subsequent years are to be deducted. Apart from allocation charges, the following charges are also leviable, (i) Mortality charge (life cover)- As this policy is with life cover, morality charges were being taken every month by cancelling appropriate number of units out of the policy holders fund value as per NAV rate applicable. (ii) Accident benefit charges- As the life assured opted for DAB for Rs.5 lakhs, charges of 0.50 paisa per 1000 sum assured per policy year was being charged, (iii) Policy administration charges- A charge of Rs.60/- per month during the first year and @ Rs.25/- per month during the second year and thereafter from the third year onwards throughout the end of policy term of policy Rs.25/- per month escalating at 3% per annum is being charged by cancelling appropriate number of units out of policy holders fund value on monthly basis and (iv) Service Tax charges- A service charges are being levied on the charge mortality, accident benefit by cancelling appropriate number of units out of the policy holders fund value on monthly basis as and when above charges are deduced. During the financial year 2009-10 rate was 10.30% (10% service tax + 3% educational cess on service tax). With effect from 01.10.2010 service tax is being levied on policy administration, mortality, accident benefit, premium allocation, fund management, switching and alteration charges. On the policy holder surviving the date of maturity an amount equal to the value of units held in the policy holders fund is payable as maturity claim. For this purpose the bid value as on date of maturity will be based on the highest NAV over the first seven years of the policy or the NAV as applicable at the end of the policy term, whichever is higher. On the maturity i.e. 31.03.2018, the total number of the units in the account of the Complainant were 13855.189 and the NAV was 15.4619 and the maturity has been paid at NAV Rs.15.4619 amounting to Rs.2,14,228/- on 19.04.2018 as per the terms and conditions of the policy. After the maturity free risk cover for sum assured Rs.5 lakhs is available on the life of the life assured for next two years from the date of maturity, thus the claim amount has been correctly paid to the Complainant and nothing is due towards the Opposite Party and hence, there is no deficiency in service on the part of the Opposite Party.
8. Perusal of the contention of the ld.counsel for the shows the policy bearing No.133106635 with date of commencement 31.03.2010 for a sum assured of Rs.5 lakhs under Table Term 801-8(3) Wealth Plus Plan which is a Unit Linked Endowment Plan with limited premium paying term. The life assured had paid three annual premiums @ Rs.1 lakh each and was allotted 8530.070 units on 31.03.2010, 9593.718 units on 23.03.2011 and 9546.148 units on 30.11.2012 and the policy was revived on 30.11.2012. In the proposal form Ex.R5 duly signed by the policy holder/ Complainant it is clearly mentioned that it is LIC’s Wealth Plus ULIP plan. Ex.R6 is the LIC’s Wealth Plus-Plan 801 regarding Unit Linked Endowment Plan with Limited Premium Paying Term. In this regard, ld.counsel for the Opposite Party relied upon the documents produced and proved on record by the Opposite Party i.e. proposal form in which the complainant herself has opted the investment of her entire premium amount in Moderator i.e. in the form of moderator shares in open market. In the declaration for Unit Linked Products signed by the complainant, the complainant has admitted that she fully understood that investment in this product is subject to market risks and the actual rate of return may be higher or lower than what has been illustrated. Same fact has been mentioned in Benefit Illustration where the complainant has directed the Opposite Party for investment of her funds in open market in the form of, it has been admitted by the complainant that earnings will increase or outpace inflation. In the terms and conditions of the policy document So, all these documents fully prove that the policy obtained by the complainant is United Linked Insurance Policy and the complainant himself has opted to invest her entire premium amount 100% in the moderator share in the open market in order to earn profit. It has been held by Hon’ble National Commission in Revision Petition No.658 of 2012 titled as Ram Lal Aggarwalla Vs. Bajaj Allianz Life Insurance Company Limited and others decided on 23.04.2013 that where the investment made by the petitioner/ complainant in Unit Linked Insurance Policies to gain the profit, it was invested for commercial purposes and therefore, the petitioner/ complainant is not a consumer of the Opposite Party. Hon’ble State Commission, Orisha in First Appeal No.162 of 2010 in case Smt.Abanti Kumari Sahoo Vs. Bajaj Allianz Life Insurance Company Limited have held that the money of the petitioner/ complainant invested in the share market is no doubt a speculative gain and the speculative investment matter does not come under the Consumer Protection Act and accordingly, the Hon’ble State Commission, dismissed the appeal. Similar are the facts of the present case as the complainant has directed the Opposite Party to invest her amount of premium in the share market to gain profit. Investment in the share market is no doubt a speculative gain and the speculative investment matter does not come under the Consumer Protection Act.
9. Resultantly, we hold that the instant complaint is not maintainable before this District Consumer Commission and the same stands dismissed. However, the complainant is at liberty to file the same before the appropriate court/ authority having proper jurisdiction in accordance with law for the Redressal of her grievances. In doing so, if limitation comes in root, he can take advantage of decision of Hon’ble Supreme Court of India in case of Laxmi Engineering Works Vs. P.S.G.Industrial Institute II (1995) CPJ 1. Keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the orders be supplied to the parties free of costs and thereafter, the file is ordered to be consigned to the record room.
10. Reason for delay in deciding the complaint.
This complaint could not be decided within the prescribed period because the government has not appointed any of the Whole Time Members in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.
Announced in Open Commission.
Dated: 26.10.2021.
(Aparana Kundi) (Mohinder Singh Brar) (Amrinder Singh Sidhu)
Member Member President
