Date of Filing : 30/03/2016

Order No.  17  dt.  16/01/2018

          The case of the complainant in brief is that the complainant is a policy holder of o.p insurance company being policy no.785041377. The complainant used to visit Axis Bank for transaction. The agent of o.ps. approached the complainant to purchase at least one policy for the educational benefit for the complainant’s grandson. The complainant on good faith without going through the application of the policy put her signature. After purchasing the policy the complainant paid the premium for 3 years i.e. 2010, 2011 and 2012 within the allured grace period of 30 days or before, but on 11.8.13 o.ps. sent the termination letter of determining the policy  and the said date was a holiday and on the next day was ed-dulfetar day and the premium was due on 9.8.13. That being the holidays for continuous 3 days o.ps. all on a sudden terminated the policy, even though there was 30 days grace period, but o.ps. did not wait for the grace period. After termination of policy o.ps. wrote to the complainant to keep the money in her bank account for ECS. This letter contradicts the termination letter. Even after the termination of the policy o.ps. accepted the premium on 9.10.14. The complainant wrote several letters against the illegal termination of policy. The complainant thereafter visited the Kolkata office of o.ps. and pointed out a hidden clause in the policy documents to misguide the customer and misrepresentation o.ps. may sell their policy to the customer with the only object of earning maximum profit. On the basis of the said fact the complainant filed this case  prayed for direction upon the o.ps. to refund the amount paid by the complainant of Rs.1,20,000/- as well as compensation of Rs.5 lakhs and litigation cost of Rs.20,000/-.

                The o.ps. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the complainant is an educated woman and she after understanding the nature and character of the policy wanted to invest money by putting her signature on the proposal form. The complainant paid a sum of Rs.30,000/- as initial premium and thereby accepting the terms of the contract. The paying terms of the policy was for 11 years. It was stated that according to the terms and conditions of o.p. nos.1 and 2 available any customer is dissatisfied, they have the option to cancel the policy by returning original policy with a written request within 15 days i.e. within free look period she could have sought for cancellation of the policy. The complainant further paid 2 renewal premiums. Thereafter when the ECS system was sent on 8.8.13 for the 4^th installment it got bounced on 16.8.13 due to insufficient balance. Once the ECS got bounced and auto generated letter was triggered and sent to the customer. The complainant deliberately and intentionally failed to pay the 4^th premium. The policy got terminated post expiry of the grace period in Aug. 2013 and one ATP i.e. Rs.30,000/- refunded to the complainant in view of the terms and conditions of the policy. When the said premium was transferred to o.ps. by the Axis Bank it was found that the policy already stands terminated. The o.ps. vide cheque no.181534 refunded the  4^th premium amounting to Rs.30,000/- which had been wrongly accepted by local branch of Axis Bank. The complainant alleged that there was mis selling of policy, but the agent has not been made a party to this case, therefore the question of mis selling does not arise. On the basis of the said fact it was specifically stated that out of the total amount paid by the complainant an amount of Rs.30,000/-was already refunded to the complainant. The o.ps. also refunded the amount equal to Rs.60,000/- to the complainant out of the alleged payment made by the complainant of Rs.1,20,000/-. There was no deficiency in service or unfair trade practice on the part of o.ps. and thereby o.ps. prayed for dismissal of the case.

                On the basis of the pleadings of parties the following points are to be decided:

1. Whether the complainant had the policy with o.ps.?
2. Whether due to non payment of premium the policy was terminated?
3. Whether the amount subsequently paid by the complainant was justifiable one?
4. Whether there was any deficiency in service or unfair trade practice on the part of o.ps.?
5. Whether the complainant will be entitled to get the relief as prayed for?

Decision with reasons:

                All the points are taken up together for the sake of brevity and avoidance of repetition of facts.

                Ld. lawyer for the complainant argued that the complainant is a policy holder of o.p insurance company being policy no.785041377. The complainant used to visit Axis Bank for transaction. The agent of o.ps. approached the complainant to purchase at least one policy for the educational benefit for the complainant’s grandson. The complainant on good faith without going through the application of the policy put her signature. After purchasing the policy the complainant paid the premium for 3 years i.e. 2010, 2011 and 2012 within the allured grace period of 30 days or before, but on 11.8.13 o.ps. sent the termination letter of determining the policy  and the said date was a holiday and on the next day was Edulfetar day and the premium was due on 9.8.13. That being the holidays for continuous 3 days o.ps. all on a sudden terminated the policy, even though there was 30 days grace period, but o.ps. did not wait for the grace period. After termination of policy o.ps. wrote to the complainant to keep the money in her bank account for ECS. This letter contradicts the termination letter. Even after the termination of the policy o.ps. accepted the premium on 9.10.14. The complainant wrote several letters against the illegal termination of policy. The complainant thereafter visited the Kolkata office of o.ps. and pointed out a hidden clause in the policy documents to misguide the customer and misrepresentation o.ps. may sell their policy to the customer with the only object of earning maximum profit. On the basis of the said fact the complainant filed this case  prayed for direction upon the o.ps. to refund the amount paid by the complainant of Rs.1,20,000/- as well as other reliefs.

                Ld. lawyer for the o.ps. argued that the complainant is an educated woman and she after understanding the nature and character of the policy wanted to invest money by putting her signature on the proposal form. The complainant paid a sum of Rs.30,000/- as initial premium and thereby accepting the terms of the contract. The paying terms of the policy was for 11 years. It was stated that according to the terms and conditions of o.p. nos.1 and 2 available any customer is dissatisfied, they have the option to cancel the policy by returning original policy with a written request within 15 days i.e. within free look period she could have sought for cancellation of the policy. The complainant further paid 2 renewal premiums. Thereafter when the ECS system was sent on 8.8.13 for the 4^th installment it got bounced on 16.8.13 due to insufficient balance. Once the ECS got bounced and auto generated letter was triggered and sent to the customer. The complainant deliberately and intentionally failed to pay the 4^th premium. The policy got terminated post expiry of the grace period in Aug. 2013 and one ATP i.e. Rs.30,000/- refunded to the complainant in view of the terms and conditions of the policy. When the said premium was transferred to o.ps. by the Axis Bank it was found that the policy already stands terminated. The o.ps. vide cheque no.181534 refunded the  4^th premium amounting to Rs.30,000/- which had been wrongly accepted by local branch of Axis Bank. The complainant alleged that there was mis selling of policy, but the agent has not been made a party to this case, therefore the question of mis selling does not arise. On the basis of the said fact it was specifically stated that out of the total amount paid by the complainant an amount of Rs.30,000/-was already refunded to the complainant. The o.ps. also refunded the amount equal to Rs.60,000/- to the complainant out of the alleged payment made by the complainant of Rs.1,20,000/-. There was no deficiency in service or unfair trade practice on the part of o.ps. and thereby o.ps. prayed for dismissal of the case.

                Considering the submissions of the respective parties it is an admitted fact that the complainant had the policy with o.ps. and during continuance of the policy the complainant paid the premium. Subsequently at the time of payment of 4^th premium it was found that due to intervention of holidays the complainant could not pay the premium for which o.ps. terminated the policy and refunded the amount as per proportion of the amount paid by the complainant. The complainant has alleged that the complainant purchased the said policy for the purpose of education of her grandson and she paid the amount @ Rs,.30,000/- per annum and continued the said premium by paying for 3 annual premiums. At the time of payment of 4^th premium since there was some intervention of holidays because of Ed-ulfetar, Saturday, Sunday, etc. the complainant could not pay the amount. Subsequently she deposited the amount at Axis Bank, Uttarpara Branch which was accepted by the bank. Thereafter o.ps. detected that the policy had already been terminated and thereby the said premium amount was returned to the complainant. The complainant thereafter demanded the amount paid by her but the said amount was not sent, only a portion of the amount was paid to the complainant. Considering the facts and circumstances of the case it appears that o.ps. did not allow the complainant to continue with the policy which the complainant had the sentimental value for which she invested the amount for the purpose of education of her grandson. Since o.ps. did not allow the complainant to continue with the policy and whenever the complainant asked for the refund of the policy amount the said amount was not paid, only a portion of the said amount was paid which created a gross deficiency in service as well as unfair trade practice on the part of o.ps. Therefore we hold that the complainant has been able to substantiate her allegation against the o.ps. and as such, the complainant will be entitled to get refund of the amount. From the facts and circumstances it appears that out of the total amount paid by the complainant the o.ps. already refunded the amount of Rs.60,000/-, thereby o.ps. should be given direction for refund of the rest am\unt of Rs.60,000/-. Thus all the points are disposed of accordingly.

                Hence, ordered,

                That the CC No.135/2016 is allowed on contest with cost against the o.ps. The o.ps. are jointly and/or severally directed to refund the amount of Rs.60,000/- (Rupees sixty thousand) only to the complainant along with compensation of Rs.10,000/- (Rupees ten thousand) only for harassment and mental agony and litigation cost of Rs.5000/- (Rupees five thousand) only within 30 days from the date of communication of this order, i.d. an interest @ 8% p.a. shall accrue over the entire sum due to the credit of the complainant till full realization.                

                Supply certified copy of this order to the parties free of cost.