Punjab

StateCommission

A/11/1033

Captain Gurjit Singh - Complainant(s)

Versus

Max New York Life Insurance Company - Opp.Party(s)

Sandeep Arora

02 Mar 2015

ORDER

First Additional Bench

 

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, PUNJAB,

DAKSHIN MARG, SECTOR 37-A, CHANDIGARH.

 

First Appeal No.1033 of 2011  

       Date of institution: 06.07.2011.

Date of Decision:   02.03.2015.

 

Captain Gurjit Singh son of Chanchal Singh resident of House No.136, Village Bal, Tehsil and District Gurdaspur.

                                                                  .….Appellant/Complainant.

                                      Versus

1. Max New York Life Insurance Company Ltd. Regd. Office Max House 1, Dr.Jha Marg, Okhla New Delhi 110020, through its Chairman.
2. Max New York Life Insurance Company Ltd., 11^th Floor, DLF Square, Jacaranda Marg, D.L.F.Phase II, Gurgaon-122002, (Haryana), through its Managing Director.
3. Max New York Life Insurance Company Ltd, Branch Office Y.P.Tower, Jail Road, Gurdaspur through its Manager.

       …..…Respondents/Opposite parties.

First Appeal against order dated 21.03.2011 of District Consumer Disputes Redressal Forum, Gurdaspur.

Before:-

                Shri J.S.Klar, Presiding Judicial Member

                Shri Vinod Kumar Gupta, Member.

 

Present:-

                For the appellant    :    Sh.Puneet Sharma, Advocate               

                For respondent            :      Ms.Jaimini Tiwari, advocate

Vinod Kumar Gupta, Member

                This appeal has been preferred by the appellant (complainant in the complaint) against the respondents of this appeal (‘opposite parties in  the complaint) under Section 15 of the Consumer Protection, 1986 (hereinafter referred to as the ‘Act’) against order dated 21.03.2011 of District Consumer Disputes Redressal Forum, Gurdaspur (hereinafter called the ‘District Forum’) in  Consumer Complaint No.516 of 2010, vide which, the complaint of the complainant was dismissed.

2.                The brief facts of the complaint are that Capt.Gurjit Singh (Retd.) complainant filed the complaint against the opposite parties on the averments that on the allurement of Kamal Rana, an agent/representative of Max New York Life Insurance Company Limited representing that the Unit Linked Investment Plan has good prospectus and will be beneficial in the long run, the complainant purchased a plan in the name of Smt.Gurmeet Kaur, his wife for Rs.90,000/-, for three years.  He paid Rs.30,000/- as first premium annually, but no receipt was given.  It was pleaded that the said agent/representative represented to him that the receipt alongwith the policy document would be sent within a month or so.  After waiting for a month or so, he met the Branch Manager and enquired about policy and receipt and then the same was sent to the complainant.  He was shocked to go through it that the name of the insurer was mentioned as Ms.Puneet Kaur, his grand daughter instead of Smt.Gurmeet Kaur, his wife.  Mode of payment was half yearly instead of annually.  He met the Bank Manager again and requested to cancel the plan/policy and issue afresh policy after making the necessary correction about the name of the insured and mode of payment of premium, but he did not listen to him.  It was further pleaded that he asked the opposite parties many times to cancel the policy and return the amount of installment, but of no avail.  Hence, he filed the complaint seeking direction to the opposite parties to cancel the policy of the complainant by refunding the premium amount of Rs.30,000/- and to make payment Rs.50,000/- as compensation on account of mental and physical harassment along with litigation expenses.

3.                The complaint was contested by opposite parties No.1,2 & 3 by filing written reply before the District Forum, raising preliminary objections that the complaint is frivolous, false, malicious in content and is malafide and the present complaint is not maintainable.  District Consumer Forum has no jurisdiction to entertain and try the complaint.  On merits, it was pleaded that the complainant after thoroughly understanding the terms and conditions of the scheme, his scope, prospectus, filled the proposal form to purchase the Unit Builder Unit Linked Investment Plan for Rs.6 Lacs.  He himself mentioned necessary details in it  Rs.60,000/- were payable as premium annually, but, he chose to pay it to half early installment of Rs.30,000/- each.  He paid Rs.30,000/- as first premium thereon.  It was further pleaded that the policy document, copy of proposal form and receipt were sent to the complainant through Speed Post on 08.10.2009 and he acknowledged it.  He was given free look period of 15 days to go through the terms and conditions of the plan and if it was not acceptable to him, then to make a request to cancel it and return the premium, but no such request was made by the complainant within the given period.  It was further pleaded that the second premium was not paid by the complainant on the due date.  Notice dated 07.03.2010 was issued to the complainant to pay the premium instead of paying the premium, he made a request to cancel the policy, which was beyond the free look period.  So, his request to cancel the policy was turned down.  He did not pay the second premium due on 07.03.2010, so his policy lapsed due to non-payment of premium.  Notice regarding this fact was issued on 13.5.2010 to the complainant.  On 24.06.2010, he called at the helpline of the company to know the status of the policy and he was told that the policy has been lapsed for the non-payment of premium.   On 03.06.2010, a request was made by the complainant to cancel the policy and to return the amount of premium, but his request was declined being not tenable and he was accordingly, informed about it by letter dated 03.07.2010.  A letter was written to him on 07.07.2010 intimating that the policy cannot be cancelled on 11.7.2010 and another notice qua this was given to the complainant.  The request of the complainant to cancel the policy and to refund the amount of premium was declined rightly and legally.  Other allegations in the complaint were denied.  It was alleged that there is no deficiency in service on the part of the opposite parties.  Dismissal of the complaint was prayed for by the opposite parties.

5.                The complainant tendered in evidence his affidavit Ex.C-1, copies of proposal form, visiting card of Kamal Rana, Ration Card and applications Ex.C-2 to Ex.C-6 and closed the evidence.  The opposite parties tendered in rebuttal evidence affidavit of Ritu Yadav, Deputy Manager (Customer Care) Ex.RW1/A, copies of proposal form and letters Ex.P1 to Ex.P9 and closed the evidence. On conclusion of evidence and arguments, the District Forum, Gurdaspur dismissed the complaint of the complainant.  Dissatisfied with the order of the District Forum, the instant appeal has been preferred by the complainant now appellant.

6.                We have heard learned counsel for the parties and have gone though the record of the case.

7.                As per the allegations made in para 3 of the complaint, the opposite parties/respondent  insured the life of grand daughter of the complainant Puneet Kaur instead of his wife Gurmeet Kaur, mode of payment shown as Semi Annual Mode in place of Annual Mode.  On the other hand, the opposite parties placed on record the proposal form vide Ex.OP1, which was filled in by the complainant himself.  We have perused the proposal form No.733460414 dated 17.09.2009  Ex.OP No.1,  which shows that the complainant purchased a “Unit Builder Unit Linked Investment Plan” in the name of Puneet Kaur for the sum assured Rs.6.00 Lacs for the payment of Rs.30,000/- half yearly installment on 17.09.2009.  The policy documents were sent to the complainant accompanied by a forwarding letter, in which, it was averred that if the policy holder was not satisfied with the policy terms & conditions, then he had 15 days free look period to cancel the policy, which is proved on record vide Ex.OP2.  The complainant paid only Rs.30,000/- as half yearly premium after that he had not paid any premium.  Renewal premium notice was sent to the complainant on 17.03.2010, but no premium was paid by the complainant.  The complainant sent an application to the Manager, Max New York Life Insurance Company Ltd., Gurgaon without any date, vide Ex.OP-4, which is admitted by the opposite parties in his reply in para 5 that the request of the complainant to cancel the policy on 06.05.2010.  Again on 13.5.2010, the opposite parties sent a policy lapse notice to the complainant since no premium was deposited by him, which is also proved on record vide Ex.OP5.  The opposite parties received another letter on 03.06.2010 from the complainant to cancel the policy, which is also proved on record vide Ex.OP-6.  On 03.07.2010, the opposite parties declined to cancel the policy and to refund the premium amount, which is also proved on record vide Ex.OP7.  The option was not exercised by the complainant within the free look period of 15 days after the receipt of the policy documents.  We have also perused the terms and conditions of the policy vide Ex.OP2 and relevant Clause 14.2 is reproduced as under :-

“14.2 Discontinuance of premiums within three years of inception of the policy

1.           If all the Annual Target Premiums have not been paid for at least 3 consecutive years from the effective date of coverage, the insurance cover under the policy shall cease immediately on expiry of the grace period and the Unit Account will be closed.
2.          We will give you an opportunity to revive the policy within the revival period as mentioned in Section 15.

On revival, the insurance cover as at the date of lapse will be restored and the Unit Account re-opened.  The amount of premium paid on revival, together with an amount equal to the fund value prevailing as on the date of lapse, less any Premium Allocation Charge Attributable to the premium paid on revival, and according to the ratio in which the premium should be allocated in various Funds, as specified by you, will be used to purchase Units at the Unit Price determined as on the date of revival.  An amount equal to the Policy Administration Charges falling due between the date of lapse and the date of revival will be levied on revival by cancelling Units in the Unit Account at their Unit Price.

(c) In case the policy is not revived during the revival period,   the policy will terminate and the surrender value as on the date of lapse, if any, shall be paid at the end of the third policy anniversary or at the end of the revival period, whichever is later.”

         

8.                From the perusal of above Clause 14.2 (c)  in case policy is not revived during revival period, the policy will terminate and the surrender value as on date of lapse, if any, shall be paid at the end of the third policy anniversary or at the end of the revival period, whichever, is later.

9.                Sequel to the above discussions, appeal filed by the appellant/complainant is partly allowed and the opposite parties are directed to pay the surrender value of the policy, as admissible under the policy document, if any, after the completion of the three years period and to further pay an amount of Rs.3000/- as litigation expenses to the complainant.  The order of the District Forum is set-aside to this extent in this appeal and complaint of the complainant is accepted protanto as discussed above.

10.              The arguments in this appeal were heard on 20.02.2015 and the order was reserved. Now the order be communicated to the parties.

11.              The appeal could not be decided within the statutory period due to heavy pendency of court cases.

 

                                                                               (J.S.Klar)

                                                                Presiding Judicial Member

 

March 2, 2015                                               (Vinod Kumar Gupta)

Lb/-                                                                               Member