On call, learned counsel Sri Binod Kumar Bariar on behalf of the complainant appeared. Though no one appeared on behalf of the opposite party. This case is now being disposed of after hearing, the learned lawyer on behalf of complainant as well as on account of the facts available on record.
Complainant has filed petition before the Commission against the opposite parties with a prayer for return of the whole premium amount which was deposited total Rupees 1,20000/- (one lac twenty thousand only) from 22.12.2007 to 11.10.2010 during the insurance policy taken by the complainant in the year of 2007.
The main facts for adjudication in case after perusal of the complainant and written statement of the opposite parties, it appears that administrative charges which was deducted in every month by the insurance company beyond the terms and conditions as mentioned in policy document before purchasing the policy.
On 15.12.2017, complainant filled up & singed a proposal of policy form bearing no. 605521145 for a Policy named “Max Amsure Secure Returns Builder” giving all relevant details and information in the prescribed form, for an assured sum of Rs. 3,00,000/- (Rupees Three Lac Only). Under the said policy, an annual target premium of Rs. 30,000/- (Rupees Thirty Thousand only) was to be paid annually on account of sum assured. On the basis of proposal form, Insurance Company issued ULIP plan policy document on 26th Dec 2007.
Complainant submitted that the deduction of administrative charge from the premium amount in every month is against the terms and conditions as laid down in the policy proposal form before purchasing the policy. He further stated that it is clear from the terms and conditions of the policy form that allocation charge would be deducted 20 % of the Annual target Premium (ATP) and 3% of all renewal ATP in once in a year not in every month.
Learned Counsel on behalf of the opposite party submitted that the relationship between the complainant and opposite party is regulated by the IRDA rules and terms of conditions of the Policy and Complainant has also given a declaration in the proposal form that he has fully understood the meaning and scope of Proposal form. Further stated that it is specifically mentioned in Policy document under Policy Review Period that if complainant does not agree with terms and conditions of the Policy, he can submit a written request for cancellation of the policy within fifteen days from the date of receipt of the Policy. In such an event, premium paid, adjusted for any adverse movement in Fund Value less charges incurred on medical examination and on account of stamp duty, will be refunded without interest.
After considering the submissions as well as the document placed on the record and also after taking into account the facts pleaded on behalf of both the sides, we find that undoubtedly there is no denial relating to administrative charge have been deducted by Insurance Company.
In policy document, it is mentioned about policy administration charge that in 1st and 2nd year of Policy, a charge @ 0.42% of the Sum Assured will be charged every month and from 3rd year to the end of policy term a charge @ 0.07% of the Sum Assured will be charged every month, subject to a maximum of Rs. 100 per month. But so far, as the issue on context is that opposite party has deducted the administrative charge excessive than the due. We see that complainant has signed the proposal form on 15.12.2007 but it is not mentioned that how much administrative charges would be payable and whether it would be monthly deducted or annually. After considering all, we have no hesitation to observe that why proposal form was obtained by the opposite party singed by the complainant dated 15.12.2007 then why not it was mentioned specifically regarding the deduction of the administrative charges. But the same is said to have been developed after 11 days in policy document (Date of Policy issued-26.12.2007). Here it becomes relevant that such policy document is developed based upon such proposal form which was executed on date 15.12.2007. Opposite party has deducted administrative charges more than 0.42% of the Sum Assured per month for the period of 2 years i.e., for 24 months which is apparent on policy statement.
Therefore, new development relating to deduction of administrative charges from the proposal form makes liable to the opposite party and to such extent. Opposite party may be directed to compensate in a manner which is mentioned here under.
Policy statement annexed from period of 26 Dec 2007 to 11 Oct 2010 shows that in 1st and 2nd year of policy, even a charge more than @ 0.42% of the Sum Assured is charged every month and from 3rd year to the end of policy term even a charge more than @ 0.07% of the Sum Assured (more than 100 Rs.) is charged every month which breaches itself the term and condition of Policy Document.
From the facts as above, entire responsibility of the deduction of administrative charge cannot be shifted upon the head of opposite party only. But after going through the pros and cons and comparative study of 1st form of agreement and subsequent form of agreement and taking into the account the action and response taken by both the side, the complainant also cannot be allowed to escape from the liability of administrative charge. Therefore, the fault of the complainant is also considered in this regard to some extent.
Accordingly, this complainant stands allowed to the extent that we direct the opposite party to pay altogether Rs. 29,000/- (Twenty-Nine Thousand Only) along with 6% interest thereon, from the date of filing of this case i.e., 13.09.2011 to the complainant connecting to the deduction of the excessive administrative charges within two months of this order. In case of non-compliance, the complainant shall be entitled to recover the amount in due course of law. In the result, this complaint case stands allowed to the extent as above.
