Haryana

Ambala

CC/5/2013

BHAGWAN DASS GERA - Complainant(s)

Versus

MAX NEW YORK LIFE INSS. - Opp.Party(s)

In Person

25 May 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

             Complaint Case No.      : 5 of 2013

Date of Institution         : 03-01-2013

           Date of Decision            : 25.05.2017

 

 

Bhagwan Dass Gera son of Sh. Jodha Ram, R/o # 429 (old) New 569, Prem Nagar, Ambala City.

          ……Complainant.

Versus

 

1.       The Manager/Managing Director/CEO, Max Newyork Life Insurance Company Ltd. 90-A, Udyog Vihar, Sector 18, Gurgaon (Haryana)  

2.       The Manager, Max Newyork Life Insurance Company Ltd, Panna lal Building of Bangali Mohalla, Nichalson road, Ambala Cantt.

 

                                                                   ……Opposite Parties.

 

Complaint Under Section 12 of the Consumer Protection Act

 

BEFORE:   SH. D.N. ARORA,  PRESIDENT.

                   SH. PUSHPENDER KUMAR, MEMBER.

                   MS. ANAMIKA GUPTA, MEMBER.        

                  

Present:       Sh. Sanjay Aggarwal, counsel for complainant.

                   Sh. I.S. Gill for opposite parties.  

 

ORDER.

 

                    In nutshell, brief facts of the complaint are that the complainant is holding a policy no. 498102730, dated 04-09-2008 of the opposite parties on the assurance that the money will be safe and increase day by day and also assured for minimum 10 % increment in the same and amount will be paid to the company, remain safe as all the transaction between the parties would be according to the terms and conditions laid down by the Govt. of India. On the above said assurance, complainant has agreed to pay Rs. 20,000/- as annual premium.  The complainant continuously paid three annual instalments to the opposite parties against the valid receipts issued by the office of opposite party No. 2 and thus total amount of Rs. 60,000/- paid to the opposite parties. The complainant had inquired about the status of above policy on 04-09-2011 and surprised to find that the amount deposited with the opposite parties decreased in place of increase and when the complainant had the conversation with the employees of opposite parties they told the complainant that his deposited amount decreased just due to his old age and thus tried to make fool of complainant. Thereafter, complainant stopped the further premium for some time on the instruction of Area Sale manager namely Mr. Manmohan and the same application was also written by him on 02-11-2011 as per rules of policy. Thereafter, complainant inquired about the status of the policy from the office of opposite parties and they assured the complainant that his policy was updating but not supply any written information in this regard so the complainant gave a letter dated 18-06-2012 through registered post to know about the policy status and the status of the application dated 02-11-2011 and the status of the amount of the complainant deposited with the OPs but no reply was ever given by them. Thereafter, complainant personally inquired about the status of policy in the third week of August and was shocked about knowing that the policy was terminated by the opposite parties, without prior information to the complainant and thereafter, the complainant also issued a legal notice dated 25-08-2012 to the opposite parties but they are hopelessly failed to reply the same. As such, the complainant has prayed that the act & conduct of OPs amounts to deficiency in service and prayed for acceptance of the complaint as per relief clause.

2.                Upon notice, OPs appeared through counsel and filed written statement raising preliminary objections qua maintainability of complaint and suppression of material facts. It has been submitted that the complainant after fully understanding & deliberating upon the terms and conditions of ‘Smart Assure (unit linked investment plan)’ submitted the duly signed proposal form No. 498102730 dated 30-08-2008 pursuant to which an insurance policy was issued and sent to the complainant on 04^th Sept. 2008 for a sum assured of Rs. 2,00,000/-. Under the said policy, a premium of Rs. 20,000/- is to be paid annually. On 20-07-2009, OP sent the unit statement to the complainant, on 21-04-2010 OP sent unit statement to the complainant on the request of the complainant.  On 12-06-2010, the complainant deposited his premium in the branch office of the OP. On 05-09-2010, the OP sent an account statement to the complainant. On 22-12-2010, the complainant visited the branch office to enquire about the policy details and the same was duly informed to the complainant. On 24-06-2011, complainant again visited the branch office to enquire about the fund value of the policy and the same was duly informed to him. It is further submitted that the policy term as chosen by the complainant on the proposal form was 10 years and this being a ULIP policy, returns would never been guaranteed as specific amount as quoted in the complaint. Due to the old age of the complainant the charges were high which was already explained to the complainant. It is further submitted that the agent who sold the policy to the complainant is the granddaughter of the complainant who was very well aware of the policy and was also trained as per the IRDA guidelines. The opposite parties never received any legal notice. On 10-02-2013, the OP sent a termination letter to the complainant where it was stated that the OP has terminated the policy as per terms and conditions of the policy contract.

13. Termination of policy

          This policy will terminate immediately upon the earlier of the following events:

1. The date upon which we received your surrender request under Section 4.1.
2. On payment of maturity benefit
3. On death of insured.
4. If at any time, after the third policy anniversary, the fund value equals to or is less than one ATP, the policy will terminate and we will pay the surrender value (if any).  

 

. As such, the OPs have prayed that the complaint is liable to be dismissed with costs.

3.                To prove his version, complainant tendered affidavit as Annexure CX alongwith documents as annexure C-1 to C-4 and closed his evidence on 18.08.2015.  On the other hand, counsel for OPs tendered affidavit of Anand Siongh as Annexure R1 alongwith documents R2 to R8 and closed the evidence.

4.                We have heard learned counsel for the parties and gone through the case file very carefully. Counsel for the complainant has argued that the complainant paid three annual instalments against the policy in question and thus total amount of Rs. 60,000/- paid to the opposite parties. He further argued that he had inquired about the status of above policy on 04-09-2011 and surprised to find that the amount deposited with the opposite parties decreased in place of increase. Thereafter, complainant stopped further premium for some time on the instruction of Area Sale manager namely Mr. Manmohan and an application also written by him on 02-11-2011 as per rules of policy. Thereafter, on inquiry complainant came to know that the policy was terminated by the opposite parties.  

                   On the other hand counsel for the opposite parties has argued that the policy term as chosen by the complainant on the proposal form was 10 years and this being a ULIP policy, returns would never been guaranteed as specific amount as quoted in the complaint. Due to the old age of the complainant the charges were high which was already explained to the complainant. It is further argued that the agent who sold the policy to the complainant is the granddaughter of the complainant who was very well aware of the policy and was also trained as per the IRDA guidelines. He further argued that on 10-02-2013, the OP sent a termination letter to the complainant as per terms and conditions of the policy contract. 

                   At the time of arguments, on 22-05-2017 opposite party has given a cheque bearing No. 353179 dated 06-04-2017 amounting to Rs. 21,686.17/- to the complainant and in this regard complainant has made a statement that he has received the above said cheque as part payment and requested that balance amount as well as interest be got recovered from the OPs.

          Counsel for the opposite parties has further produced statement of account/calculation sheet of fund value, vide which an amount of Rs. 25,577.57/- to be shown as closing balance. In view of the aforesaid document, calculation shown to be correct and the complainant is entitled for an amount of Rs. 25,577.57/-. But OPs have only paid Rs. 21,686.17/- to the complainant on 22-05-2017 during the pendency of the complaint, which is less than the payable amount and balance amount of Rs. 25,577.57/- minus Rs. 21,686.17/- = 3891.4/- which is payable to the complainant.  

5.                After hearing the counsel for the parties and going through the case file, we are of the considered view that the complainant is entitled to Rs. 25,577.57/- from the date of termination of policy i.e. 03-11-2011 as per statement of account/calculation sheet and Rs. 21,686.17/- has already received by the complainant by way of cheque No. 353179 dated 06-04-2017 from the opposite parties on 22-05-2017.

6.                In view of the above discussion, we allow the present complaint with costs and direct the OPs to comply the following directions within a period of thirty days from receipt of copy of the order:-

1. To pay a sum of Rs.3891.4/- to the complainant alongwith interest @ 9% per annum from the date of receiving of Rs. 21686.17/- i.e. 22-05-2017 till its realization and pay interest @ 9 % on the sum of Rs. 25,577.57/- from the date of filing of the complaint till 22-05-2017.
2. Also to pay a sum of Rs. 3000/- as litigation expenses.

                   Copies of the order be sent to the parties, free of costs, as per rules.  File be consigned to the record room after due compliance.

 

ANNOUNCED ON: 25-05-2017                               (D.N. ARORA)

                            PRESIDENT                 

 

 

(PUSHPENDER KUMAR)

                                                                                      MEMBER

                  

                                                         

                                                                             (ANAMIKA GUPTA)

                                                                                      MEMBER