1.       The present First Appeal (FA) has been filed by the Appellant against Respondent as detailed above, under section 19 of Consumer Protection Act 1986, against the order dated 03.03.2020 of the State Consumer Disputes Redressal Commission, West Bengal, Kolkata (hereinafter referred to as the ‘State Commission’), in Consumer Complaint (CC) No. 885/2018 inter alia praying for directing the OP to:-

(i)      produce the correct policy document with proper seal and signature of the issuing authority and stamped with adequate revenue.

(ii)     to produce a detailed description of the benefits and the charges to be deducted as stated and/or requested by the Appellant.

(iii)    to provide for due, adequate and exemplary compensation as this Commission deems fit.

2.       While the Appellant was Complainant and the Respondent was Opposite Party (OP) in the said CC No. 885/2018 before the State Commission. Notice was issued to the Respondent on 12.02.2021.  Parties filed Written Arguments/Synopsis on 15.03.2022 (Appellant) and 02.09.2022 (Respondent) respectively.

3.       Brief facts of the case, as emerged from the FA, Order of the State Commission and other case records are that:

1. The Appellant/complainant Mr. Harshvardhan Sancheti, purchase a Pension Plan termed as "Max Life Forever Young Pension Plan" in July 2016 with a single pay premium of Rs.27,99,712/-. After payment of the said single premium, the Appellant received some information about the policy number 403087067 and a computer generated unsigned copy instead of the properly sealed and signed original policy. The policy has been issued by Maxlife Insurance Co. Ltd. Lots of emails and correspondences took place between the Complainant and Max Life Insurance Co. Ltd. and it is still continuing, no suitable response has arrived and also the matter has been put before the senior management by Max Life team for Kolkata operations and complaint has been filed before IRDAI Ombudsman, Gachibowli, Hyderabad.

2. Before purchasing the policy a list of charges was stated to the Appellant, i) Premium Allocation Charge; ii) Fund Management Charge; iii) Policy Administration Charges; iv) Surrender/ Discontinuation Charge. But the purported computer generated policy copy provided in 2017 mentioned the another charge named "Mortality Charge". Vide letter dated 09.08.2017 the Respondent again added two new charges namely "Rider Charges" and "Miscellaneous Charges". After several complaints and enquiries, the Respondent informed the Appellant on 03.10.2017 that only "Policy Administration Charge" will be deducted. The Appellant sought clarification by way of confirmation that all other charges mentioned in the literature or in the letter dated 09.08.2017 are not to be levied on this product but such confirmation was not provided. In July 2016, the Appellant was informed at the time of payment that there will be no premium allocation charges if it was single payment and also there would be two kinds of fund management charges firstly, one at the rate of 1.25% per annum and secondly guarantee charges of either 0.20% per annum or 0.40% per annum depending on the choice or allocation of the fund. The Appellant was further told that he did not need any guaranteed benefits other than this 0.20% and 0.40% charge will not apply. In July 2016, the appellant informed the Respondent that he needs full details of the guaranteed benefits for which there is separate policy or addendum to be informed before we agree to this additional facility and if they do not wish the guaranteed benefits and thus the said charges should not apply but this aspect has not been clarified till date. The policy states that the Policy Administration Charges will be deducted starting from the first policy year on a monthly basis during the policy term but that single premium policy administration charges of 0.08% of the single premium per month and will increase by 4% per annum over 0.08% commencing from 2nd policy year with a maximum of Rs. 400/- per year. On several occasions, Appellant communicated with the Respondent for rectification of the draft policy or issuance of corrected original policy or communicating them about the dispute of the charges but the Respondent did not pay any heed to rectify the computer generated purported policy or take any action to intimate or explain the Appellant about the discrepancy of the charges. The copy of the policy is unsigned, incomplete, unsealed, without mentioning any date and no revenue stamp is affixed and also the coverage date is incorrect.  The addendums required to be filled up are left empty and blank. Hence, the Appellant/complainant filed complaint before the State Commission.

4.       Vide Order dated 03.03.2020, the State Commission has dismissed the complaint with the observation that “the Bench appeared to have hardly any opportunity to direct the OP to make changes in the policy as prayed for by the Complainant.  The prayer, therefore, was proven an untenable one and, as per our considered view, was liable to be rejected. Hence, that the complaint stands dismissed.”

5.       Appellant/complainant has challenged the Order dated 03.03.2020 of the State Commission mainly on following grounds:-

(i)      the Respondent has not provided the original policy document till date in spite of various requests and enquiries and only provided a computer generated policy without any proper seal and signature from the authority and stamped in accordance with the Laws of Government Revenue and Stamp. Before purchasing the policy the Appellant informed about only four types of charges but after purchasing the policy three separate additional charges, namely: Mortality Charges, Rider Charge and Miscellaneous Charges were proposed to be levied without providing prior intimation. The Respondent is not willing to clarify these issues nor did care to pay heed to the various communications for the purpose of rectification and/or quantum of the charges when asked. The computer generated copy of policy has been provided to the Appellant on 03.11.2016 after several requests without proper seal and  signature of the authority. When the Appellant came to  know that various other charges except mentioned at the time of discussion of buying the said policy, he made complaints and enquiries to the Respondent for a detail description of the benefits which should be incurred by charges. But the Respondent has failed to do so till date.

(ii) The Appellant has requested on various occasion to cancel the 'Policy Administration Charges' because this is not applicable for the customers who opt for paying the whole amount at one time. The charges are continuing to be deducted and all the requests made by the Appellant were in vain.

iii) The State Commission has dismissed the Complaint on the ground of lacking of documents of evidentiary value. The  State Commission has, in their Order dated 03.03.2020, dismissed the Complaint on the ground that the Appellant had not availed the facility of free look to review the policy terms prior to paying the one time premium of Rs. 27,99,712/. It is submitted that the question of opting for such a "free look" or review within the stipulated time period has not been a fact in issue raised by the Appellant in his complaint and thus cannot be deemed relevant in context of his Complaint or this Appeal. The Appellant has filed an RTI on 06/12/2016, 13/12/2016, 29/12/2016 and on 06/01/2017 to the Insurance Regulatory and Development Authority of India where there was query regarding the charges which proves that the Appellant has taken appropriate measures to answer the questions of Respondent and this could be made only when a person does not get proper response from the authority he expects to answer his queries or is not satisfied by the answers provided. It is clear from those letters that the Appellant has chose to move to the higher authority after many failed attempts to reach his grievance from the Respondent.   The Appellant is sending letters to the Respondent from 04/03/2017 and trying till date to get a copy of policy with proper seal and signature and deduction of proper charges as requested by the Appellant but no attempts from the part of the Respondent has been made which is purely a 'deficiency of service'.

6.       Heard counsels of both sides.  Contentions/pleas of the parties, on various issues raised in the FA, based on their FA/Reply, Written Arguments, and Oral Arguments advanced during the hearing, are summed up below.

6.1 In addition to the averments made in the Appeal and grounds the Appellant contended that the Policy Administration Charges apply only to such policies where the payment is periodically made during the term of the policy and there is neither annual nor monthly payment due for next thirty five years thus there cannot be any Policy Administration Charges at all for next thirty two years. No Policy Administration Charges should be levied since the single payment was made prior to the issuance of the policy, now onwards no premium is payable and total amount already paid stays constant for a period of next 32 years. The Respondent admitted at Page 44 under clause 17 in the very first line of the Policy that the Policy holder is a Consumer and may have grievances against the Company if any dispute arises.It is also evident from the Reply of the Respondent that the policy is a Unit Linked Pension Plan (ULPP) not a Unit Linked Insurance Plan (ULIP).The ULPP allows the policyholders to secure his post-retirement life.It does not offer life insurance offer.The ULIP plan gives the policyholders an opportunity of wealth creation while providing the security of a life cover.The working of ULPP is different from ULIP, in terms of investment.If it is a speculative investment therefore how can there be any guarantee charges be imposed to the Policy?The Policy was issued to the Policy holder based on the proposal form filled and signed by the policy holder where the policy holder has opted for Capital Unit Gain Size only with a regular mode and frequency selected as yearly, which was a market linked policy and the value of the policy was dependent on the unit prices.The Appellant has placed reliance on the judgment of this Commission in 2013 SCC Online NCDRC 910 (Harish Kumar Chadha Vs. Manager Bajaj Allianz Life Insurance Co. Ltd. and the judgment of Hon’ble Supreme Court in (2020) 3 SCC 455 (Canara Bank Vs. United India Insurance Co. Ltd. It is further contended that the Respondent states in their Reply that one Proposal Form was signed by the Appellant on 18.10.2016 but the proposal form itself is incomplete and not accompanied by a welcome letter which clearly mentioned about the “Free Look Cancellation period”.In the Annexure R-3 which is annexed to the Reply of the Respondent, a digital signature of Mr. Indeevar Krishna Dandigutta is present on behalf of Respondent, whose exact designation is not known, on the duplicate policy which is almost three years later of the issuance of the Policy.It is not known where is the original policy or its copy, when was it issued or who signed it. The policy period is stated to be for twenty years is due to mature on 28.10.2036. Therefore the original policy is suspected to have been issued on 28.10.2016. In the Reply of the Respondent the digital signature of Mr. Indeevar Krishna Dandigutta is seen with an endorsement that stamp duty of Rs. 560/- has been paid but no judicial stamp paper or the endorsement of the Collector of Stamps or the place of endorsement is available. The revenue stamp is also missing. The Respondent in its Reply has produced a proof of delivery where discloses neither the name of the courier company nor what document the package contained and also no name of the recipient can be seen. No such document was received by the Appellant on 03.12.2016. It is also a questionable fact that when the current address of the Appellant is provided as London in the proposal form which is annexed as Annexure R-1 to the Reply of the Opposite Party dated 20^th March, 2021, then why was the original policy document sent to Kolkata instead of London? The main dispute in this proceeding is the demand of Appellant for issuance of original policy. The Appellant is not seeking cancellation of the policy but issuance of original policy duly signed and validly stamped and clearly setting out the policy charges. The Respondent did not take any action to formally intimate or gave any explanation till date about the discrepancy of charges. The charges under the insurance policy were not duly explained to the appellant nor they are clarifying now. The Respondent has violated the guidelines issued by the Insurance Regulatory and Development Authority of India. It requires that the charges to be levied and also the rights of the Policy Holder against the Insurance Company should be transparent. There is Deficiency of Service' on the part of the Appellant. The Appellant has placed reliance on judgment reported in (2010)10 SCC 194 (Chandigarh Housing Board -vs- Avtar Singh & Ors.).

6.2 On the other hand the Respondent/Insurance Company contends that they received the duly filled and signed proposal form for issuance of the policy in question on 18.10.2016, precisely explained the standard terms and conditions including the charges applicable under the policy and handed over the application form along with standard terms and conditions and key features of the policy.It is also contended that the Appellant also signed a benefits illustration wherein the charges under the policy were explained. Every policy document sent by the Respondent/Insurance Company is accompanied with a copy of the proposal form signed by the applicant and a welcome letter.In the policy documents a freelook period of 15 days is provided to each and every policyholder giving them an option to review the policy and opt for cancellation in case they are not agreeable with the terms and conditions of the policy.The Appellant was provided an opportunity to approach the Insurance Company for freelook cancellation, however, the Complainant failed to approach the company with any grievance within the freelook period of 15 days from the date of receipt of the policy documents, which was delivered to the Appellant at the Appellant’smailing address on 01.12.2016 via M/s Secure Express Courier Service Pvt. Ltd. vide airway bill number 2807627. The Appellant first time approached the Company on 15.12.2016 for clarification regarding the charges under the policy and not for cancellation of policy or refund of the premium.One Mr. Kaushik Banerjee on behalf of the policy holder vide e-mail dated 19.12.2016 approached the Insurance Company and clarified that no Appeal with regard to the subject policy has been raised by the policy holder. Again on 09.03.2017, the Appellant raised a query regarding the charges under the policy which was replied vide letter dated 26.05.2017 sent through Speed Post.The Insurance Company received a complaint dated 01.08.2017 through IRDAI which was acknowledged vide letter dated 03.08.2017. The Insurance Company also received a complaint from Consumer Affairs Department IRDA dated 18.11.2017 submitted by the Appellant.A complaint was also received from Jago Grahak Jago alleging deficiency in services on the part of the Insurance Company, which was replied by the Insurance Company vide e-mail dated 21.05.2018 wherein the Respondent/Insurance Company relied upon the response sent to the Complainant through emails dated 08.09.2017, 17.09.2017, 19.09.2017, 22.09.2017, 26.09.2017, 28.09.2017 & letter dated 03.10.2017 as the final reply from the Company.Further, the Insurance Company received a letter dated 15.11.2018 from the Appellant for cancellation of the policy and refund of the premium.

The request for cancellation was declined being beyond the freelook period vide email dated 22.11.2018. The Appellant was informed that only Policy Administration charges will be deducted in the policy going forward.The Cash Surrender Value as on 28.03.2022 of the policy is Rs.44,10,530.41 which is more than the premium paid.The Respondent has placed reliance on the judgments passed by this Commission in Mohan Lal Benal Vs. ICICI Prudential Life Insurance Co. Ltd. (RP No. 2870/2012) decided on 16.10.2012 and Harish Kumar Chadha Vs. Bajaj Allianz Life Insurance Co. Ltd. (RP No. 3271 of 2013) decided on 07.10.2013 and Shrikant Murlidhar Apte Vs. Life Insurance Corporation of India (RP No. 634 of 2012) decided on 02.05.2013.It is also contended that the terms of the contract cannot be altered.In this context the Respondent/Insurance Company has relied upon the judgment of the Hon’ble Apex Court in the case of Suraj Mal Ram Niwas Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. [(2010) 10 SCC 567] and Reliance Life Insurance Co. Ltd. Vs. Madhavacharya (RP No. 211 of 2009) and has also placed reliance on some other judgments passed by this Commission and Hon’ble Supreme Court. It is also contended that this Commission does not have jurisdiction to entertain the present Appeal.In this context the Insurance Company has placed reliance upon the judgment passed by the State Commission, Chandigarh in Smt. Paramjit Kaur V. Aviva Life Insurance Co. Ltd. CC No. 96 of 2011, judgment passed by this Commission in Ram Aggarwal V. Bajaj Allianz Life Insurance Co. Ltd. & Anr. III 2013 CPJ 203 (NC) and the judgment passed by State Commission, Odisha in FA No. 162 of 2010 in the case of Smt. Abanti Kumari Sahoo Vs. Bajaj Allianz Life Insurance Company Ltd.In view of the above, the Respondent has prayed that the Appeal filed by the Appellant be dismissed with cost in the interest of equity and justice.

7.       We have carefully gone through the orders of the State Commission and other relevant records and rival contentions of the parties.  A perusal of the complaint shows that the only prayer in the complaint was to direct the Respondent Insurance Company to re-issue correct new policy.  In the complaint, it is mentioned that the policy has been wrongly issued by the Respondent thereby causing deficiency of service.  The complaint is quiet, vague and sketchy and does not contain any details of the defects in the policy and nature of deficiency of service.  In this regard the extract of relevant para of the order of the State Commission is reproduced below:-

“The record appeared to be lacked in documents of evidentiary value to substantiate the charges in the complaint brought against the OP Insurance Company. The policy appeared to have been issued on 03.11.2016. The Complainant, admittedly became aware of the controversial policy conditions through copy of the policy papers, when, as alleged, the original policy was retained by the OP Insurance Company.

The entire complaint, therefore, appeared to be based on the copy of the policy documents, allegedly received by the Complainant but the date of receipt of the said copy appeared to have not been divulged in any corner of the complaint.

The policy defined at para b, clause 9, a free-look which offered the Complainant a scope to review the terms and conditions of the policy within a period of 15 days (30 days if the policy is sourced through distance marketing modes). The record was seen silent about the first communication made to the OP Insurance Company necessitating change in the policy. Both the dated documents, had those been made available with the record, would have helped the Bench ascertain as to whether the Complainant took appropriate measure within the period specified under the provision of “freelook” to review the policy terms or to cancel the policy.

The existing policy was no less than a contract between the parties, terms and conditions of which were the binding force between them. In the instant complaint, the Bench could hardly derive any decision as to whether the Complainant could fulfil the steps for incorporation of the proposed correction in the existing policy filing such petition within the free-look period as per provisions envisaged in the policy.

Given the circumstances as above, the Bench appeared to have hardly any opportunity to direct the OP to make changes in the policy as prayed for by the Complainant. The prayer, therefore, was provenly an untenable one and, as per our considered view, was liable to be rejected.”

8.       While concluding the hearing on 26.10.2023, Respondent was directed to file authentic version of copy of insurance policy in question i.e. Max Life Forever Young Pension Plan.  In compliance of this order, the Respondent has submitted a copy of the policy document (with respect to the policy issued to the Petitioner herein) on 01.11.2023.  The policy in question was issued in 2016.  At this stage, no direction can be issued to the Respondent to change any terms & conditions of the said policy.  However, in the interest of justice, Registry is hereby directed to supply to the Petitioner herein a complete copy of the policy documents submitted by the Respondent herein in compliance of the order dated 26.10.2023 of this Commission (49 pages), within one week from today through Speed/Registered Post.

9.       As the Petitioner herein has contended in the Appeal that he got only a computer generated unsigned copy instead of the properly sealed and signed original policy, in the interest of justice, we hereby direct the Respondent/Insurance Company to issue, within three weeks from today, a duplicate copy of the entire policy documents, with all its annexures etc. corresponding to the policy sets submitted before this Commission in compliance of the order dated 26.10.2023, signed in original by an authorized officer of the Respondent company, along with covering letter, stating clearly in such covering letter that the duplicate/originally signed copy being sent is as good as the original signed copy supplied earlier by the Respondent/Insurance Company. This duplicate copy be sent by Respondent Insurance Company to the Petitioner herein through Speed Post/Registered Post only.

10.     First Appeal is disposed off with above observations/directions.

11.     The pending IAs in the case, if any, also stand disposed off.