BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SIRSA.
Consumer Complaint no. 168 of 2018
Date of Institution : 24.05.2018
Date of Decision : 25.07.2019.
Poonam (aged about 25 years) wife of Sh. Jagdish Kumar, resident of Dabwali Road, Village Khai Shergarh, P.O. Panniwala Mota, Tehsil and District Sirsa.
……Complainant.
Versus.
- Max New York Life Insurance Co. Ltd., Regional Office: 11th Floor, DLF Square, Jacaranda Marg, DLF Phase II, Gurgaon- 122002 through its Regional Manager/ Authorized Signatory.
- Max New York Life Insurance Co. Ltd., Regd. Office: Max House, 3rd Floor, 1 Dr. Jha Marg, Okhla, New Delhi 110020 through its Managing Director/ Authorized Signatory.
...…Opposite parties.
Complaint under Section 12 of the Consumer Protection Act,1986.
Before: SH. R.L.AHUJA…………………………PRESIDENT
SH. ISSAM SINGH SAGWAL …… MEMBER.
SMT. SUKHDEEP KAUR………….MEMBER
Present: Sh. Vijay Sharma, Advocate for the complainant.
Sh. H.S. Raghav, Advocate for opposite parties.
ORDER
The case of the complainant in brief is that complainant purchased one life insurance policy of opposite parties i.e. Life Gain Plus 20 participating plan bearing policy No.866466691 on 15.6.2012 and its annual premium is of Rs.29100.31 and the duration of the policy is 20 years and the premium amount is payable for 10 years. It is further submitted that said policy was purchased by the complainant from the branch office of the ops situated at Sirsa and the premium of the policy was also paid at Sirsa office. The complainant has deposited four installments of premium. It is further averred that in the year 2016, when the complainant went to Sirsa to deposit premium of her aforesaid policy in the aforesaid office of the ops at Sirsa, it came to the knowledge of complainant that the said office has been closed, but the complainant could not get information regarding new address of office of ops at Sirsa and the complainant had made several efforts to find out new address of the office of ops at Sirsa, but she could not get the information in this regard. Hence, the premium for the year 2016 till date could not be deposited by the complainant due to aforesaid reason and thus there was no fault of complainant for non payment of premium within time. It is further averred that thereafter in the month of April 2018, the complainant came to know that the ops have their branch office at Bathinda and the complainant went to the office of the ops at Bathinda and asked the officials to get the due premium, but the officials told the complainant that as per status of the policy, it has been closed/ lapsed. The complainant disclosed the above said reason to the officials for non payment and also showed her readiness and willingness to deposit the whole due premiums to continue the policy, but the officials of the ops stated that policy cannot be restarted and even the amount deposited by her also cannot be given to her at any cost. It is further averred that after closing the office of the ops at Sirsa, no information was supplied by the ops to the complainant and even the ops never contacted the complainant to deposit her due premiums and regarding closing of the policy. That the ops have intentionally closed the policy of the complainant just to usurp the amount deposited by complainant. That the complainant approached the ops on many occasions and requested to continue her policy or to refund the amount deposited by the complainant alongwith interest thereon, but on every occasion, the ops have refused to admit the claim of complainant. That such act and conduct of the ops amounts to gross deficiency in service and they have caused mental harassment to the complainant. Hence, this complaint.
2. On notice, opposite parties appeared and filed written statement taking certain preliminary objections that complaint is totally false and frivolous based on misrepresentation of facts and is not maintainable as per law and that this Forum has no jurisdiction to entertain, try and decide the present complaint as the Tribunal to settle such kind of dispute are being located in India. The Insurance Regulatory & Development Authority of India has appointed Insurance Ombudsman in order to resolve such kind of disputes but the complainant has failed to approach the Ombudsman and that complainant has no locus standi and cause of action to file and maintain the present complaint. It is further submitted that complainant has not approached to this Forum with clean hands and has concealed the true and material facts. The true and material facts of the case are that complainant paid the premium up to 2014 and has not deposited the premium for the year 2015, due to which the policy was lapsed and in this regard, intimation was sent through letter dated 21.1.2015 and thereafter the ECS bounce letter was sent through post on 3.3.2015 and then revival letter dated 14.12.2015 was sent to the complainant. Thereafter, again the policy revival letter was sent through post on 21.9.2017 and the SMS/ mail was also sent on mobile number directing the complainant that the revival period for her policy ends on 15.12.2017. So, complainant was directed to pay Rs.1,06,817.93 at the earliest to avoid policy termination on dated 17.9.2017 through SMS but inspite of this, the complainant has failed to revive the policy of insurance. It is further submitted that answering ops were/are ready to revive the policy of insurance on an exception basis and in this regard, the ops spoke to the complainant but she asked to call later but did not pick up the phone. At present, the policy can be revived subject to payment of Rs.1,73,011.26 alongwith furnishing the health declaration form. The complainant was directed to pay the said amount alongwith said form but the complainant has failed to do so. It is further submitted that complaint is barred by limitation. With these averments, dismissal of complaint prayed for.
3. The parties then led their respective evidence.
4. We have heard learned counsel for the parties and have perused the case file carefully.
5. The complainant in order to prove her complaint has furnished her affidavit Ex.C1 wherein she has reiterated all the averments made in the complaint. She has also produced policy documents Ex.C2 to Ex.C11 and copy of her adhar card Ex.C12. On the other hand, ops produced affidavit of Ms. Pallavi Sharma, Assistant Manager as Ex.R1 wherein she has reiterated all the averments made in the written statement and ops have produced emails Ex.R2 to Ex.R5, synopsis of the complaint Ex.R6, copy of mail Ex.R7, copy of policy surrender form Ex.R8, policy lapse intimation Ex.R9 and email Ex.R10.
6. It is an admitted fact on record that complainant had purchased Life Gain Plus 20 Participating Plan bearing policy No.866466691 on 15.6.2012 from the opposite parties against the annual premium of Rs.29100.31 which was payable for 10 years and the duration of the policy is 20 years. The policy was purchased from the ops from Sirsa office. As per allegations of complainant, when she went to deposit the premium of aforesaid policy in the year 2016 to the ops at their Sirsa branch, it came to her knowledge that said office has been closed and complainant could not get any further information about location of the office of the ops as a result of which she could not continue the policy and could not get the same revived. On the other hand, there is specific pleadings of the ops that complainant did not continue with the policy despite calling upon the complainant through number of letters to get policy revived but complainant did not turn up as a result of which policy was cancelled/ lapsed.
7. The perusal of the written reply of ops reveals that ops are still ready to revive the policy and according to them the policy can be revived subject to payment of Rs.1,73,011.26 alongwith furnishing health declaration form. During the course of arguments, learned counsel for complainant has stated at bar that complainant is ready to pay the premiums amount to the ops without any interest and penalty as it is fault of the ops that ops did not inform the complainant about shifting of their office from Sirsa.
8. In view of above discussion and in the interest of justice, the present complaint is partly allowed and ops are directed to revive the policy of the complainant subject to submitting the health declaration form as well as deposit of due premiums amount with 7% per annum simple interest from due date of premium till its deposit by the complainant. The ops are directed to revive the policy within 30 days from the date of receipt of the payment and after getting health declaration form from the complainant. However, no order as to costs. A copy of this order be supplied to the parties free of costs. File be consigned to the record room.
Announced in open Forum. Member Member President,
Dated:25.07.2019. District Consumer Disputes
Redressal Forum, Sirsa.
