DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KOZHIKODE
PRESENT : Sri. P.C. PAULACHEN, M.Com, LLB : PRESIDENT
Smt. PRIYA.S, BAL, LLB, MBA (HRM) : MEMBER
Sri.V. BALAKRISHNAN, M Tech, MBA, LL.B, FIE: MEMBER
Wednesday the 30th day of November 2022
C.C. 07/2018
Complainant
Babu. K. K,
S/o Unnichandu,
Kinattumkarakandy,
Valappil House, Olavanna P.O,
Kozhikode – 673 025.
(By Adv. Sri. Thrivikraman Namboodiri )
Opposite Parties
- Max Life Insurance Policy,
11th Floor, DLF Square,
Jacarauda Merg, DLF City,
Phase – 11, Gurgaon – 122002,
Haryana
(By Adv. Smt. Shameena. A. K & Adv. Sri. Jalaludheen)
- Axis Bank Ltd.,
Represented by Manager,
Agent Max Life, Ground Floor,
Marina Mall, YMCA Cross Road,
Kozhikode – 673001.
(By Adv. Sri. P. S. Murali)
ORDER
By Sri. P.C. PAULACHEN – PRESIDENT.
This is a complaint filed under Section 12 of the Consumer Protection Act, 1986.
2. The case of the complainant, in brief, is as follows:
The complainant is an insured person under the first opposite party. The second opposite party is the agent of the first opposite party through whom the complainant got insured. While taking the policy, the opposite parties had assured that it would fetch high profit and the complainant would get the entire amount which he had paid as premium after the maturity period of 6 years even if he was unable to pay the remaining premiums and discontinued the policy. The policy was issued on 16/09/2012. The first premium paid was Rs. 1,02,542.17/-. The second instalment of Rs. 1,01,085.34/- was paid on 05/09/2013.
3. Thereafter, the complainant could not pay the remaining instalments from the year 2014 September onwards and the policy was lapsed. Thereupon, he approached the opposite parties for refund of the amount already paid as premium. He was assured that he would get back the amount on maturity of the policy which was on 05/09/2017. Hence on completion of the stipulated period, the complainant approached the opposite parties for that purpose. But they refused to pay the amount even after issuance of notice. Hence the complaint for refund of the premiums paid with interest along with compensation of Rs. 1,00,000/-.
4. The opposite parties resisted the complaint by filing separate written version wherein they have denied all the allegations and claims in the complaint.
5. According to the first opposite party, the complaint is barred by limitation. The complainant after completely understanding the terms and conditions of “ Max Life Life Gain Plus 20Yr 6 Pay” had voluntarily applied for a policy by filling up the proposal form. On the basis of the information furnished by the complainant, the policy was issued to him on 05/09/2012 for an annual premium of Rs. 99,041.59/- against the sum assured of Rs. 5,83,100/- for a premium paying term of 6 years. Thereafter the policy terms and conditions sent to him clearly stated that in case he had any objections with respect to any terms and conditions of the policy, he is entitled to request for cancellation of the policy within the free look period of 15 days. But no such objections were received and a legally valid contract was concluded between the parties. The complainant had paid an aggregate amount of Rs. 2,04, 691.34/- under the said policy. Thereafter he did not pay the renewal premium which was due on 05/09/2014. Due to non-payment of the renewal premium due on 05/09/2014, the policy lapsed and this was intimated to him and the policy was terminated. Since the complainant did not pay the renewal premium for 3 years, he is not entitled to receive any surrender value under the policy as per the terms and conditions of the policy. There was no deficiency of service on the part of the first opposite party. With the above contentions, the first opposite party prays for dismissal of the complaint.
6. The second opposite party has admitted that they are the agent of the first opposite party and the complainant had availed the policy through them. According to the second opposite party, there was no assurance given to the complainant that in case of default in paying the premium, the amount paid would be refunded after 6 years. No such assurance was given at any point of time. The policy containing full terms and conditions was sent to the complainant. Before issuing the policy, the officials of the first opposite party had apprised the terms and conditions to the complainant and it was only after full concurrence of the complainant that the policy was issued. As per the policy, the insured has to pay at least 3 yearly premium in order to become eligible for refund after 6 years, if the policy lapses. The complainant had paid only 2 premiums and thereafter the policy had become lapsed. The second opposite party has not committed any deficiency in service and they are not liable to pay any amount to the complainant. The complaint is devoid of merits and liable to be dismissed.
7. The points that arise for determination in this complaint are;
(1) Whether the complaint is barred by limitation?
(2). Whether there was any deficiency of service or unfair trade practice on the part of the opposite parties?
(3) Whether the prayer for refund of the premiums already paid is allowable?
(4). Reliefs and costs.
8. Evidence consists of the oral evidence of PW1 and Exts A1 to A4 on the side of the complainant. No oral evidence was let in by the first opposite party. Exts B1 to B4 were marked on their side. RW1 was examined on the side of the second opposite party. No document was marked on the side of the second opposite party.
9. We heard both sides. Brief argument note was filed by the first opposite party.
10. Point No. 1: The first opposite party has taken a contention in the written version that the complaint is barred by limitation. The contention is that the last premium was paid by the complainant on 05/09/2013 and hence the cause of action has arisen on 05/09/2013 and the complaint should have been filed within a period of 2 years from that date.
11. As per section 24 A of the Consumer Protection Act, 1986, a complaint is to be filed within a period of 2 years from the date on which the cause of action has arisen. Here the maturity period of the policy was 6 years. The policy was availed on 05/09/2012. The cause of action has to be calculated from the date of maturity. If that be so, the complaint filed on 04/01/2018 is well within time. The complaint is not barred by limitation.
12. Points 2 and 3: The complainant has approached this Commission claiming refund of the premiums paid by him for the policy which lapsed due to non-payment of the subsequent premiums. He also claims compensation to the tune of Rs. 1,00,000/- from the opposite parties.
13. The complainant has got himself examined as PW1, who has filed proof affidavit and deposed in terms of the averments in the complaint and in support of the claim. Exts A1 and A2 are insurance premium receipts dated 16/09/2012 and 04/09/2013 respectively, Ext A3 is the copy of the notice dated 09/10/2017 and Ext A4 is the letter dated 16/09/2012 issued by Max Life insurance to the complainant.
14. RW1 is the Branch Manager/Deputy Vice -President of the second opposite party. RW1 has filed proof affidavit and deposed reiterating the contentions in the written version. Ext B1 is the copy of the proposal form and policy document, Ext B2 is the copy of the notice dated 06/08/2014, Ext B3 is the copy of the policy lapse intimation letter dated 05/10/2014 and Ext B4 is the copy of the letter dated 07/06/2017.
15. The complainant had availed “Max Life Life Gain Plus 20Yr 6 Pay” policy of the first opposite party. The policy bearing number 873595847 was issued to him on 05/09/2012. The second opposite party is the agent through whom the complainant got insured. The maturity period of the policy was 6 years. The first premium paid the complainant was Rs. 1,02,542.17 and the second instalment of the premium amounting to Rs. 1,01,085.34 was paid by the complainant on 05/09/2013. Thereafter the complainant defaulted payment of the remaining premiums from 2014 September onwards and the policy was lapsed. There is no serious dispute on the above aspects.
16. The prayer of the complainant is for refund of the 2 instalments of premium paid by him as stated above. So the crucial point to be considered in this case is as to the entitlement of the complainant to get refund as claimed.
17. Ext. B1 contains the terms and conditions of the policy. It shows that an insured person has to pay at least 3 years premium in order to become eligible to get surrender value under the policy. The relevant clause of the policy contract reads as follows;
“Cash value.
Non guaranteed cash values as decided by the Appointed
Actuary. This policy will acquire cash value if it has been in force
for at least 3 years and provided all the premiums that have
fallen due have been paid. The guaranteed cash value in this
policy will be 30% of the Premium(s) (excluding the first year’s
Premium) received”
Thus there can be no dispute to the fact that as per the terms and conditions of the policy, the insured has to pay at least 3 years premium in order to become eligible for claiming cash value.
18. In this context, the case of the complainant is that the opposite parties had assured him that the premium paid would be refunded even if the remaining premiums were defaulted and the policy lapsed. But there is absolutely nothing in evidence to show that there was any such assurance from the part of the opposite parties. It cannot be believed that the opposite parties would give such an assurance contrary to the terms and conditions of the policy. The policy was issued on the basis of Ext B1 proposal form submitted by the complainant. According to the opposite parties, the terms and conditions were explained to him and he was satisfied with same and that is why he had signed the proposal form. In this context, it may be noted that even if he was not satisfied with the terms and conditions, he could have asked for cancellation of the policy within the free look period. Ext A4 letter dated 16/09/2012 which was produced by none other than the complainant shows that the policy terms and conditions were forwarded to the complainant as per Ext A4 and it was specifically stated that in the unlikely event of his not being completely satisfied with policy, he had the option to cancel the policy by returning the original policy with a request within 15 days from the receipt and in such case, the premium paid would be refunded to him. Thus the complainant had the free look period of 15 days for applying for cancellation if he was not satisfied with the terms and conditions of the policy. He is not an illiterate person. PW1 has deposed before this Commission in the cross-examination that he has studied only up to 10th class. But Ext B1 proposal form shows that he is a graduate. It is crystal clear that PW1 is suppressing the fact that he is a graduate who is able to read and understand the terms and conditions of the policy in order to suit the occasion. At no stretch of imagination, it can be said that the complainant was unaware of the terms and conditions of the policy.
19. The policy lapsed with effect from 05/09/2014 due to non- payment of the renewal premium due on 05/09/2014. The complainant failed to renew the policy within the stipulated time and consequently the policy was terminated. Ext B4 is the intimation of end of policy revival period issued to the complainant. He has paid premium for 2 years only and thereafter defaulted payment. Since he did not pay the renewal premium for 3 years, he is not entitled to get any surrender value under the policy as per the terms and conditions of the policy. That being the position, no unfair trade practice or deficiency of service can be attributed against the opposite parties. In the absence of any proof of unfair trade practice and deficiency of service, the opposite parties cannot be held liable. The complainant is neither entitled to get any surrender value under the policy nor any compensation from the opposite parties. For the aforesaid reasons, the complaint must fail.
20. Point No.4: In view of the finding on the above points, the complainant is not entitled to claim and get any relief;
In the result, the complaint is dismissed. However, no order as to costs.
Pronounced in open Commission on this, the 30th day of November, 2022.
Date of Filing: 04/01/2018.
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PRESIDENT
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MEMBER
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MEMBER
APPENDIX
Exhibits for the Complainant :
Ext. A1 – Insurance premium receipt dated 16/09/2012.
Ext. A2 – Insurance premium receipt dated 04/09/2013.
Ext. A3 – Copy of the notice dated 09/10/2017.
Ext. A4 – Letter dated 16/09/2012.
Exhibits for the Opposite Party
Ext. B1 - Copy of the proposal form and policy document.
Ext. B2 – Copy of the notice dated 06/08/2014.
Ext. B3 – Copy of the policy lapse intimation letter dated 05/10/2014.
Ext. B4 – Copy of the letter dated 07/06/2017.
Witnesses for the Complainant
PW1 – Babu. K. K. (Complainant)
Witnesses for the opposite parties
RW1 – Asok Kumar A. G.
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PRESIDENT
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MEMBER
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MEMBER
Forwarded/ By Order
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Assistant Registrar
