DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA.

CC.No.376 of 07-08-2012

Decided on 21-01-2013

Rajinder Bansal aged about 59 years s/o Chiranji Lal Bansal r/o H.No.117, Model Town, Near T.V Tower, Bathinda,

........Complainant

Versus

1.Max New York Life Insurance Co.Ltd., Regd. Office Max House 3^rd Floor, 1 Dr.Jha Marg, Okhla, New Delhi-110020, through its Managing Director.

2.Max New York Life Insurance Co.Ltd., 2047 AB, Mall Road, Near Bahia Fort, Bathinda; through its Branch Manager.

3.M/s Shree Ganesh Corporate Services Ltd., SCO 46, NAC Mani Majra, Chandigarh; through its Prop./Partner.

.......Opposite parties

Complaint under Section 12 of the Consumer Protection Act, 1986.

QUORUM

Smt. Vikramjit Kaur Soni, President.

Sh.Amarjeet Paul, Member.

Smt. Sukhwinder Kaur, Member.

Present:-

For the Complainant: Sh.Balkaran Singh, counsel for complainant.

For Opposite parties: Sh.N.K Batta, counsel for opposite party Nos.1 and 2.

Opposite party No.3 ex-parte.

ORDER

VIKRAMJIT KAUR SONI, PRESIDENT:-

1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act'). The brief facts of the complaint are that on the assurance of the opposite party Nos.1 and 2, the complainant has purchased the insurance policy bearing No.471656629 on 24.7.2008 and as per the terms of the said policy, he is required to deposit the premium of Rs.21,000/- per annum. The complainant has already deposited a sum of Rs.63,000/- with the opposite party Nos.1 & 2 i.e. Rs.21,000/- per annum upto 1.8.2010. At the time of purchasing of the said policy, the officials of the opposite parties told the complainant that as per the terms & conditions he can withdraw the amount at any stage, after the completion of the period of 3 years and after depositing three annual premiums of Rs.21,000/- and also told him that the total amount shall be refunded to him alongwith all other benefits. The officials of the opposite parties never told the complainant regarding the deduction of any charges in case he will seek the refund of the amount deposited by him before the completion of the term of the said policy. In the month of July 2010, the officials of the opposite party Nos.2 & 3 called the complainant to their office at Bathinda and induced him to purchase the more policies on the pretext that the opposite party No.1 has launched the new policy of one time installment and assured him that he shall receive the quarterly bonus on the said policies and he can get the refund of the total amount after the completion of the period of one year. The complainant further alleged that at that time, the friend of the complainant namely Sh.S.K Garg s/o Ved Parkash Garg r/o 165, Model Town, Bathinda was also present with him in the office of the opposite party No.2. On the assurance of the opposite party Nos.2 & 3, the complainant has purchased five more policies from the opposite parties i.e. three policies in his own name and two policies in the name of his wife, as detailed below:-

The complainant further alleged that he was allured to pay the premium one time only. After purchasing the abovesaid policies, the complainant never received any bonus from the opposite parties and after passing the period of about 4 months from the date of purchase of the second policy dated 16.7.2010, he approached the opposite party No.2 to enquire about the bonus amount on the said policies but they have been putting the matter off on one or the other false pretext and did not make any payment of the bonus to him. The complainant alleged that later on he came to know that the officials of the opposite party Nos.2 and 3 have sold him 5 policies to achieve their target and the same are also not under one time installment rather he is required to deposit the regular premium amount of the said amounts each and every year. Thus the complainant alleged that the opposite parties sold him 5 more policies while misrepresenting the facts. The complainant repeatedly requested the opposite parties to refund the total amount including Rs.63,000/- alongwith upto date interest and other benefits on account of the policy No.471656629 date 24.7.2008 in which he had already deposited 3 annual premiums with the opposite party Nos.1 and 2. The complainant has also sent many letters to the opposite parties to refund the total amount deposited by him with them but they did not pay any heed to his requests. Hence the complainant has filed the present complaint to seek the directions to the opposite parties to refund all the total amount deposited by him with them in all the abovesaid six policies alongwith upto date interest, cost and compensation.

2. Notice was sent to the opposite parties. The opposite party Nos.1 & 2 after appearing before this Forum have filed their joint written statement and pleaded that the complainant after being satisfied with the first policy voluntarily applied for 5 more policies. The opposite parties received duly filled and signed proposal form on the basis of which the policies were issued. The policy documents comprising all the terms & conditions of the policy contract were sent to the complainant. The complainant being an educated person was well aware of all the terms & conditions. The opposite parties are unable to entertain the request of the complainant to refund the entire amount as the policies are outside the free look period. The opposite parties in order to support their version have referred the various authorities. The said policies were issued upon the receipt of the proposal forms and the first premium under the respective policies. In policy No.1, on 1.8.2008, the policy document was sent to the channel partner office Shree Ganesh to be further handed over to the complainant; on 29.7.2009, the complainant called on the toll free to inquire about the fund value and was informed appropriately; on 30.7.2009, an account statement was sent to the complainant; on 8.9.2009, the complainant paid the renewal amount of Rs.21,000/- vide cash; on 13.9.2009, the opposite parties sent a premium receipt to the complainant; on 13.11.2009, the complainant called on the toll free to inquire about the policy details and was informed appropriately; on 14.7.2010, the complainant paid renewal due for the year 2010 vide cheque No.644303; on 30.7.2010, an account statement was sent to the complainant. On 31.7.2010, the opposite parties sent a premium receipt to the complainant; on 30.6.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.7.2011, an account statement was sent to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies being mis-sold; on 11.11.2011, a representative called the complainant and said his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that the policyholder should write a letter to the opposite parties; on 5.1.2012, as the complainant had stopped paying the premium after year 2010, fund value of the policy depreciated and a devaluation of the fund value letter was sent to him.

In policy No.2 on 21.7.2010, the policy document was sent to the complainant vide first flight courier airway bill No.020158114; on 14.12.2010, the opposite parties sent a renewal premium notice to the complainant; on 18.1.2011, as the opposite parties did not receive renewal premium the policy got lapsed and lapse letter was sent to the complainant; on 13.2.2011, the opposite parties again sent the lapse intimation to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and said his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 16.1.2012, the opposite parties received a complainant letter claiming mis-selling; on 27.1.2012, a letter was sent to the complainant declining his request as the policy was outside the free look period.

In policy No.3 the policy document was received by the complainant's wife Nidhi sent by first flight courier airway bill No.018246632 on November 13, 2010; on 13.9.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.11.2011, as the opposite parties did not receive renewal premium the policy got lapsed and lapse letter was sent to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties.

In policy No.4 on 10.12.2010, the opposite parties received a complainant letter regarding plan change from life gain to life partner plus; on 13.12.2010, the policy document was sent by the first flight courier airway bill No.ZO0205949; on 23.10.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 22.12.2011, as the opposite parties did not receive the renewal premium the policy got lapsed and lapse letter was sent to the complainant.

In policy No.5 on 6.8.2010, the policy document was sent by the first flight courier airway bill No.020469940; on 30.12.2010, the opposite parties sent a renewal premium notice to the complainant; on 3.2.2011, the opposite parties sent a renewal reminder to the complainant; on 28.2.2011, the opposite parties sent lapse letter to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties.

In policy No.6 on 28.10.2012, the policy document was sent by first flight courier airway bill No.O18164464; on 13.9.2011, the opposite parties sent a renewal premium notice to the complainant; On 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and said his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 13.11.2011, the opposite parties did not receive the renewal premium the policy got lapsed and lapse letter was sent to the complainant.

The opposite parties never told the complainant that he can withdraw the amount anytime and get the full refund. The policy document had the details of all the surrender charges and calculation and terms of the policy was 15 years and after 3 years the complainant had the option of surrendering the policy with all the applicable charges. The opposite parties did not receive any surrender request in the year 2010 for the policy. The complainant being satisfied with the earlier policy applied for the more policies. The opposite parties received duly filled and signed proposal form bearing Nos.815834759, 829204718, 832182414, 815834775 and 808833420. The opposite parties have received the following amount towards 5 policies:-

The bonus is declared only after the completion of 3 years and also the policy should be active at the time which means that the premium should be regularly paid by the complainant. In this case the policies are lapsed. The lapse intimation was sent to the complainant in respect of the said policies. As per the terms & conditions, the complainant has an option to return the policy within the free look period of 15 days from the date of receipt of the policy. In this case the policy is outside the free look period hence the opposite parties are unable to return the premium amount. The opposite parties received an e-mail from the complainant's son. The letter was received from the complainant in the year 2012 and it was duly replied by the opposite parties.

3. The opposite party No.3 despite service of summons has failed to appear before this Forum. Hence ex-parte proceedings are taken against the opposite party No.3.

4. The parties have led their evidence in support of their respective pleadings.

5. Arguments heard. The record alongwith written submissions submitted by the parties perused.

6. Admitted facts of the parties are that the complainant has purchased the insurance policy bearing No.471656629 on dated 24.7.2008 and had paid 3 annual premiums and in total he had paid Rs.63,000/-. Thereafter he has purchased 5 more policies and the details of the same are given as under:-

7. The disputed facts between the parties are that the complainant has not been issued the terms & conditions of the said policies and the opposite parties have not refund the amount of Rs.63,000/- in policy bearing No.471656629 dated 24.7.2008 alongwith interest and other benefits and sold the other 5 policies while misrepresenting the facts to him.

8. On the other hand the submissions of the opposite parties are that the complainant being satisfied with the policy bearing No.471656629 dated 24.7.2008, has purchased 5 more policies from them and the said policies document have been sent to him and a complete details have been given by them with regard to policies document sent to him. In policy No.1, on 1.8.2008, the policy document was sent to the channel partner office Shree Ganesh to be further handed over to the complainant; on 29.7.2009, the complainant called on the toll free to inquire about the fund value and was informed appropriately; on 30.7.2009, an account statement was sent to the complainant; on 8.9.2009, the complainant paid the renewal amount of Rs.21,000/- vide cash; on 13.9.2009, the opposite parties sent a premium receipt to the complainant; on 13.11.2009, the complainant called on the toll free to inquire about the policy details and was informed appropriately; on 14.7.2010, the complainant paid renewal due for the year 2010 vide cheque No.644303; on 30.7.2010, an account statement was sent to the complainant. On 31.7.2010, the opposite parties sent a premium receipt to the complainant; on 30.6.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.7.2011, an account statement was sent to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies being mis-sold; on 11.11.2011, a representative called the complainant and conveyed him that his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that the policyholder should write a letter to the opposite parties; on 5.1.2012, as the complainant had stopped paying the premium after year 2010 fund value of the policy depreciated and a devaluation of the fund value letter was sent to him.

In policy No.2 on 21.7.2010, the policy document was sent to the complainant vide first flight courier airway bill No.020158114; on 14.12.2010, the opposite parties sent a renewal premium notice to the complainant; on 18.1.2011, as the opposite parties did not receive renewal premium the policy got lapsed and lapse letter was sent to the complainant; on 13.2.2011, the opposite parties again sent the lapse intimation to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and conveyed him that his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 16.1.2012, the opposite parties received a letter from complainant claiming mis-selling; on 27.1.2012, a letter was sent to the complainant declining his request as the policy was outside the free look period.

In policy No.3 the policy document was received by the complainant's wife Nidhi sent by first flight courier airway bill No.018246632 on November 13, 2010; on 13.9.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.11.2011, as the opposite parties did not receive renewal premium the policy got lapsed and lapse letter was sent to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told him that e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties.

In policy No.4 on 10.12.2010, the opposite parties received a complainant letter regarding plan change from life gain to life partner plus; on 13.12.2010, the policy document was sent by the first flight courier airway bill No.ZO0205949; on 23.10.2011, the opposite parties sent a renewal premium notice to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told that his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 22.12.2011, as the opposite parties did not receive the renewal premium the policy got lapsed and lapse letter was sent to the complainant.

In policy No.5 on 6.8.2010, the policy document was sent by the first flight courier airway bill No.020469940; on 30.12.2010, the opposite parties sent a renewal premium notice to the complainant; on 3.2.2011, the opposite parties sent a renewal reminder to the complainant; on 28.2.2011, the opposite parties sent lapse letter to the complainant; on 31.10.2011, the opposite parties received an e-mail from the complainant's son about the policies mis-sold; on 11.11.2011, a representative called the complainant and told that his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties.

In policy No.6 on 28.10.2012, the policy document was sent by first flight courier airway bill No.O18164464; on 13.9.2011, the opposite parties sent a renewal premium notice to the complainant; On 31.10.2011, the opposite parties received an e-mail from the complainant's son about the mis-selling of policies; on 11.11.2011, a representative called the complainant and conveyed him that his e-mail Id is not registered and in case he wants to know any details he should visit the branch office and also suggested that policyholder should write a letter to the opposite parties; on 13.11.2011, the opposite parties did not receive the renewal premium the policy got lapsed and lapse letter was sent to the complainant.

The opposite parties received duly filled and signed proposal form in policies bearing Nos.815834759, 829204718, 832182414, 815834775 and 808833420 and the details of the said policies are given already given in aforementioned paras.

9. The submission of the complainant is that in the next 5 policies, the premium was to be paid only once but no such document has been placed on file by the complainant to show that in these policies the premium is to be paid only once. The details of all the policies have been duly given by the opposite parties. Moreover the complainant was well aware of the terms and conditions of the first policy as well as other 5 policies and had paid 3 premium in the first policy. Hence the allegations of the complainant that the opposite parties have mis-sold him other five policies by misrepresenting the facts that only one time premium is payable and no policy document have been supplied to him are not tenable. With regard to the policy bearing No.471656629 dated 24.7.2008 again it is not believable that the opposite parties have sent the terms & conditions to the complainant and in all other policies and he has not received the terms & conditions in this policy and kept on paying the premium for 3 years and he without going through the terms & conditions has purchased 5 more policies meaning thereby he was fully aware of the terms & conditions of the policy bearing No.471656629 dated 24.7.2008 At this stage the complainant cannot state that no terms & conditions were given to him or the other 5 policies were mis-sold to him. The complainant has already paid 3 premiums in the first policy at the most, he can seek the surrender value of the said policy but he has not applied for the same with the opposite parties. As per the terms & conditions, the complainant is entitled to get the amount in policy bearing No.471656629 dated 24.7.2008 as per Clause 4 of Ex.R2. The relevant portion of Clause 4 is reproduced as under:-

“Year Surrender Charge (As a % of annual target premium)

1 *100%

2 50%

3 42%

4 40%

5 35%

6 30%

7 25%

8 20%

9 15%

10 10%

11 & onwards 0%

* In year one, surrender charge shall be levied at the rate of 100% of one ATP or Fund Value at the time of surrender, which is lower.”

10. As discussed above, the complainant has purchased the policy bearing No.471656629 dated 24.7.2008 and paid 3 premiums of Rs.21,000/- per year, as such the complainant has paid the total amount of Rs.63,000/-, he has filed the present complaint on 7.8.2012 hence the said policy is in the 5th year of its inception, as per the aforementioned table the deductions to be done on the total amount as per terms & conditions of the policy. The complainant is not entitled to get either refund of the premium or other benefit in other 5 policies in question as the complainant has paid only one premium and the policies have lapsed due to the non-receipt of the second premium. Even if the complainant wants to get the surrender value in these policies he can get the same after applying with the insurance company i.e. opposite parties and can get the surrender value as per the terms and conditions of the respective policies. Hence no direction can be given regarding the remaining 5 policies that have been purchased by him in year 2010.

11. Therefore in view of what has been discussed above, this complaint is partly accepted with Rs.5000/- as cost and compensation against the opposite parties and the opposite parties are directed to pay the amount of Rs.63,000/- after deducting 35%(Rs.63,000-Rs.22,050/-) i.e. Rs.40,950/- in the policy bearing No.471656629 dated 24.7.2008, to the complainant. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.

In case of non-compliance the interest @ 9% per annum will yield on the amount of Rs.40,950/- till realization.

12. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.

Pronounced in open Forum:-

21-1-2013

Vikramjit Kaur Soni

President

Amarjeet Paul

Member

Sukhwinder Kaur

Member