Punjab

Moga

CC/17/60

Chamkaur Singh - Complainant(s)

Versus

Max Life Insurance Co. Ltd. - Opp.Party(s)

Sh.G.S.Dhaliwal

06 Dec 2017

ORDER

`THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.

 

 

                                                                                      CC No. 60 of 2017

                                                                                      Instituted on: 14.06.2017

                                                                                      Decided on: 06.12.2017

 

Chamkaur Singh, aged about 42 years son of Surjit Singh, resident of Village: Wadda Ghar, Tehsil: Bagha Purana, District Moga.

                                                                                ……… Complainant

 

Versus

1.       Max Life Insurance Co. Ltd., 11^th Floor, DLF Square, Jacaranda Marg, DLF Phase II, Gurgaon 122022, through its Authorized Signatory.

 

2.       Max Life Insurance Co. Ltd. Regd. Office: Max House, 3^rd Floor, 1 Dr. Jha Marg, Okhla, New Delhi 110 020, through its Authorized Signatory.

 

3.       AXIS Bank Ltd., Branch Bagha Purana (Agent-393679) Mudki Road, Bagha Purana, Tehsil: Bagha Purana, District Moga, through its Manager/Authorized Signatory.  

 

                                                                           ……….. Opposite Parties

 

 

Complaint U/s 12 of the Consumer Protection Act, 1986.

 

 

Quorum:    Sh. Ajit Aggarwal,  President

                   Smt. Vinod Bala, Member

                   Smt. Bhupinder Kaur, Member

 

Present:       Sh. Gurmeet Singh Dhaliwal, Advocate Cl. for complainant.

                   Sh. Vishal Jain, Advocate Cl. for opposite party nos.1 & 2.

                   Sh. Jasvinder Singh, Advocate Cl. for opposite party no.3.

 

 

ORDER :

(Per Ajit Aggarwal,  President)

 

1.                Complainant has filed the instant complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as the "Act") against Max Life Insurance Co. Ltd., 11^th Floor, DLF Square, Jacaranda Marg, DLF Phase II, Gurgaon 122022, through its Authorized Signatory and others (hereinafter referred to as the opposite parties) directing them to pay a sum of Rs.25,000/- with regard to policy no.876421389. Further they may be directed to pay Rs.50,000/- on account of compensation, damages, mental tension and harassment suffered by complainant or any other relief which this Forum may deem fit and proper be granted to complainant.

2.                Briefly stated the facts of the case are that in the month of January, 2013 one agent of insurance company i.e. opposite party nos.1 & 2 authorized by opposite party no.3 came to the house of complainant and told him regarding the insurance policy schemes of insurance company. On the assurance of agent of the company and goodwill of company complainant purchased insurance policy bearing no.876421389 dated 10.02.2013. At the time of making this policy officials of the company told to complainant that this policy is for five years and he can get the complete amount after five years i.e. on maturity alongwith interest @ 9% on the total amount and agent of insurance company told that if any complication will occurred and complainant will not able to deposit installments, then opposite parties will return the deposited amount to complainant within a week from the request of complainant at any time during the time period of insurance policy. The complainant deposited Rs.25,000/- on 10.02.2013 against receipt no.876421389/2012-13/01 with opposite parties as was settled between opposite parties and complainant. Thereafter, the financial condition of the complainant became too weak due to the business loss and his health was also not good and he suffered depression and due to this reason complainant could not deposit the installments with opposite parties. Thereafter, the complainant approached to opposite party no.3 and disclosed the facts and requested to return the said amount, opposite party no.3 told to complainant that they will not return the said amount before completion of five years. Then the complainant told to opposite party no.3 that they assured the complainant that he can get the amount within a weak after the request, on it opposite party no.3 directed the complainant to visit after two days. But when the complainant visited to opposite party no.3, they told that insurance company has changed the rules and according to new rules he cannot take money before five years and his money has been invested in share market by the insurance company and opposite party no.3 openly refused to make any payment and directed the complainant to contact opposite party nos.1 & 2, but being illiterate person, the complainant was unable to make any contact with opposite party nos.1 & 2. The complainant again approached to opposite party no.3 with respectables of the society and one relative, but to no effect. The complainant visited the office of opposite party no.3 a number of times, but they refused to pay any amount to complainant. Complainant also served a legal notice upon opposite parties, but all in vain. The aforesaid act of opposite parties amounts to deficiency in service and unfair trade practice on their part and due to the act and conduct of the opposite parties, the complainant has suffered mental tension, agony, harassment and financial loss. Hence this complaint.

3.                Upon notice, opposite parties appeared through counsel and filed their separate written replies. Opposite party nos.1 & 2 filed written reply taking certain preliminary objections that at the very outset the answering opposite parties denies all the averments and contentions made by the complainant in the complaint except those, which are specifically adverted to an admitted herein. The answering opposite parties further seeks the leave of this Forum to refer and rely upon the proposal, policy documents with annexure, the correspondence exchanged between the complainant and the opposite parties alongwith all forms and declarations submitted by the complainant at the time of inception of the policy and any other relevant documents; that contrary to the stand taken by the complainant of non-performance/deficiency in service, the answering opposite parties stated that the complainant had submitted its duly signed proposal form after fully understanding and deliberating upon the terms and conditions of the policy concerned. The terms and conditions of the policy are in strict adherence to norms set by IRDA and were duly communicated to the complainant. The opposite parties have taken all the necessary precautions and has kept the complainant adequately informed of her policy terms and obligations; that no cause of action arisen in favour of the complainant to file the present case. The complaint has been filed by the complainant with the mala-fide intention and further to grab the public money; that complainant does not fall under the definition of Consumer as per the Consumer Protection Act; that this Forum has no jurisdiction to try and decide the present complaint and the complaint of the complainant is time barred; that the relief sought in the present complaint is in violation of the terms and conditions contained in the policy; that the complainant has approached to this Forum with unclean hands by not disclosing and misrepresenting material facts; that the present complaint is false, frivolous, misconceived and vexatious in nature and has been filed with sole intentions of harassing the opposite parties. The complainant has knowingly and intentionally concealed the true and material facts from this Forum. The present complaint is a gross abuse of the process of law and misuse of the legal process; that the complainant has no locus standi and cause of action to file the present complaint; that the complaint is time barred. The complainant had purchased the insurance policy in question in 2013 and the complainant had any issue with regard to the insurance policy, he should have to file the complaint within 2 years. However, the complainant is filing the present complaint after the lapse of many years with the motive to harass the answering opposite parties and further with intention to grab the money from the answering opposite parties. It has been further submitted that on 01.02.2013, the answering opposite parties had received the Proposal Form duly filled and signed by the complainant for the policy no.876421389. On 01.02.2013 the policy was issued and documents were sent to complainant on the address provided by him. On 11.02.2014 the ECS Bounce letter sent. On 26.02.2014 ECS Bounce letter again sent. On 3.3.2014 policy lapse intimation sent. On 10.04.2014 ECS bounce letter sent. On 24.06.2014 policy lapse intimation sent. On 25.06.2014 ECS bounce letter sent again. On 03.11.2016 intimation of end of the policy Revival Periods sent.

          On merits, it has been submitted that the policy holder namely Chamkaur Singh himself approached the answering opposite parties with the motive to purchase an insurance policy of the Max New York Life Insurance Company, where different insurance plan were explain to him by the authorize representative of the insurance company. After going through the terms and conditions of the different insurance plans and as per her own sweet will, the complainant opted for Max Life Gain Plus 20 Year 6 Pay, wherein the total sum assured was Rs.175110/- and the annual target premium was Rs.24,199/-. The policy was in enforced on 01.02.2013 on the basis of the proposal form and only one premium was paid till date and the status of the policy at present is lapsed due to non payment of the premium under the policy. Further submitted that on receiving the dully signed proposal form from the complainant, the answering opposite parties issued the policy to complainant vide policy no.876421389. The policy documents were also sent to the complainant by the answering opposite parties vide speed post AWB  on 18.02.2013 and welcome call was also done before issuance of the policy, where policy premium payment terms were confirmed. But the complainant never submitted the required premium after the first year of the policy and as such the policy become lapse as per terms and conditions of the policy and same was intimated to complainant. Further submitted that the terms and conditions of the policy have paramount importance and same has to be applicable in the strict sense. The insurance contact is a special contact which is based on certain terms and conditions of the policy, upon which both the parties are bound to comply the same and none of the party can go beyond the same by claiming any amount which is beyond the scope of the agreed terms and conditions of the policy. Any claim/payment under the policy is subject to terms and conditions of the policy upon which both the parties agreed at the time of inception of the policy. There is no deficiency in service and there is no any illegal act and conduct on the part of answering opposite parties. The complainant is not entitled for any amount as the policy of the complainant is in lapse mode due to non payment of the premium under the policy. All other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with costs has been made.

4.                Opposite party no.3 filed written reply taking certain preliminary objections that the complaint is not maintainable. At the outset, it is submitted that opposite party no.3 Axis Bank Ltd is not carrying on Insurance Business as per the provisions of the Banking Regulation Act, 1949 and hence does not offer insurance products. The policy that forms the subject matter of this complaint was issued by opposite party nos.1 & 2 and hence the complaint cannot be maintainable nor relief sought by the complainant be ordered against opposite party no.3; that the role of opposite party no.3 has acted only as facilitator/referral agent and the actual insurance was issued by insurance company i.e. opposite party nos.1 & 2 and as such the complaint cannot be filed against opposite party no.3 in their proposal names; that there exists no privity of contact between the complainant and the opposite party no.3 to claim the insurance from opposite party no.3. It is settled principle of law u/s 230 of Indian Contract Act that an agent can neither sue or be sued except under the special circumstances mentioned therein. On this sole ground alone the complaint is liable to be dismissed; that opposite party no.3 has been wrongly joined as party to complaint as the contract of insurance is between Max Life Insurance Co. Ltd. and the complainant. The complainant may be directed to seek redressal of his grievances from opposite party nos.1 & 2 without involving opposite party no.3 that no deficiency in service has been attributed to answering opposite parties and from the allegations in the complaint no deficiency in service is made out; that the complaint is absolutely false and frivolous; that complicated question of law and facts are involved in the present complaint. Moreover lengthy examination-in-chief and cross examination of the parties/witnesses are required in the complaint. So, the complaint is required to be decided by civil court and as such this Forum has got no jurisdiction to entertain, try and dispose off the complaint; that the complainant has not approached to this Forum with clean hands rather he has wilfully concealed the material and patent facts from this Forum while filing the present complaint which ipso-facto disentitles the complainant to seek any relief against the answering opposite party.  On merits, all other allegations made in the complaint have been denied and a prayer for dismissal of the complaint with special costs has been made.

5.                In order to prove the case, complainant tendered in evidence his duly sworn affidavit as Ex. C1 and copies of documents Ex.C-2 to Ex.C-4 and closed the evidence. 

6.                On the other hand, opposite party nos.1 & 2 tendered in evidence duly sworn affidavit of Sh.Dhiraj Malik, Deputy Manager Legal as Ex.OP-1
& 2/1 and copies of documents Ex.OP-1 & 2/2 to Ex.OP-1 & 2/11 and closed the evidence. Whereas, opposite party no.3 tendered in evidence affidavit of Sh.Tejinder Singh, Branch Head, Axis Bank Ltd. as Ex.OP-3/1 and closed the evidence.

7.                We have heard ld. counsel for the parties and have very carefully gone through record placed on file.

8.                Ld. counsel for complainant argued that agent of the opposite party nos.1 & 2 authorized by opposite party no.3 approached to the complainant and insisted the complainant to purchase the policy of opposite party nos.1 & 2 ' Max Life Gain Plus 20 Participating Plan'. On the allurement of agent of opposite parties, the complainant has purchased the said policy and payment of Rs.25,000/- was made to opposite party nos.1 & 2 vide receipt no.876421389/2012-13/01 dated 10.02.2013. The complainant was told that the said policy was for five years and he can get the complete amount after five year alongwith interest on total amount and also told that any complication occurred and due to which he will unable to deposit the installment, then the opposite parties will return the deposited amount to complainant within a week. Unfortunately the financial condition of the complainant became took weak due to business loss and he was unable to deposit the installment. The complainant approached to opposite parties and told them about the whole facts and requested them to return the amount deposited by him. However, the complainant was told that the said amount was given to complainant after completion of 5 years and refused to make any payment. The complainant also approached to opposite party no.3, who also refused to make payment to complainant. Thereafter the complainant approached to opposite parties a number of times and requested them to return the amount of Rs.25,000/- received by them with interest, but to no effect. The complainant prayed that directions may kindly be issued to opposite parties to refund the amount deposited by him.

9.                On the other hand, counsel for opposite parties argued that the policy holder namely Chamkaur Singh himself approached the opposite parties with the motive to purchase an insurance policy of the Max New York Life Insurance Company, where different insurance plan were explain to him by the authorize representative of the insurance company. After going through the terms and conditions of the different insurance plans and as per her own sweet will, the complainant opted for Max Life Gain Plus 20 Year 6 Pay, wherein the total sum assured was Rs.175110/- and the annual target premium was Rs.24,199/-. The policy documents were also sent to the complainant by the answering opposite parties vide speed post on 18.02.2013 and welcome call was also done before issuance of the policy, where policy premium payment terms were confirmed. As per policy terms and conditions, if the complainant does not feel satisfied from the terms and conditions of the policy or it is disadvantage able for him, then he can opt for cancellation of the policy within 15 days i.e. free look period as per the policy terms and conditions and in that case he is entitled for the refund of the premium amount, but the complainant did not opt for the cancellation of the policy within free look period and he never submitted the required premium after the first year of the policy and as such the policy became lapse as per terms and conditions of the policy and same was intimated to complainant. The policy was in enforced on 01.02.2013 on the basis of the proposal form and only one premium was paid till date and the status of the policy at present is lapsed due to non payment of the premium under the policy. There is no deficiency in service and there is no any illegal act and conduct on the part of answering opposite parties. The complainant is not entitled for any amount as the policy of the complainant is in lapse mode due to non payment of the premium under the policy.

10.              Now, it is admitted case of the complainant that he purchased the insurance policy namely Max Life Gain Plus 20 Participating Plan from opposite parties and paid Rs.25,000/- as premium. The case of the complainant is at the time of issuing of policy, opposite parties assured him that if there was complication occurred and complainant was unable to pay installmnent, the amount deposited by the complainant will be returned. Unfortunately, the financial condition of the complainant became too weak and he approached to opposite parties for return of the amount, but despite several requests and reminders, the opposite parties failed to return the  amount deposited by him. On the other hand opposite parties argued that the complainant purchased the policy in question after understanding all the terms and conditions of the policy and the complainant never submitted the required premium after the first year of the policy and as such the policy become lapse as per terms and conditions of the policy and same was intimated to complainant. The policy was in enforced on 01.02.2013 on the basis of the proposal form and only one premium was paid till date and the status of the policy at present is lapsed due to non payment of the premium under the policy. As such, the complainant is not entitled to any relief and there is no deficiency in service and trade mal practice on their part. The first grievance of the complainant is that at the time of purchase of policy in question, he was misguided by the agent of opposite parties as he was assured by the agent that if he will unable to deposit installment, the opposite parties will return the deposited amount to complainant within few days, but he did not produce on record any documents to prove this fact that he was misguided by the agent at the time of purchase of policy. The second grievance of the complainant is that despite repeated requests opposite parties failed to return the amount deposited by him as premium. On the other hand, opposite parties contended that on receiving the duly signed proposal form from the complainant, the answering opposite parties issued the policy to complainant vide policy no.876421389. The policy documents were also sent to the complainant by the answering opposite parties vide speed post on 18.02.2013 and welcome call was also done before issuance of the policy, where policy premium payment terms were confirmed. As per policy terms and conditions, if the complainant does not feel satisfied from the terms and conditions of the policy or it is disadvantage able for him, then he can opt for cancellation of the policy within 15 days i.e. free look period as per the policy terms and conditions and in that case he is entitled for the refund of the premium amount, but the complainant did not opt for the cancellation of the policy within free look period and he never submitted the required premium after the first year of the policy and as such the policy became lapse as per terms and conditions of the policy and same was intimated to complainant. To prove this fact, they produced on record ECS Bounce letters and policy lapse intimation letters Ex.OP-1 & 2/5 to OP-1 & 2/10 from these documents it is clear that the policy of the complainant had already been lapsed due to non payment of premium of insurance policy. Moreover the complainant himself admitted that he had failed to pay the installment on time due to his financial condition and did not deny the receipt of these letters. The opposite parties further submitted that the present complaint is barred by period of limitation as the complainant purchased the policy in question on 01.02.2013 and paid his first and only premium on 01.02.2013. The opposite parties dispatched the policy documents to complainant on 18.02.2013, which was duly received by him and the complainant filed the present complaint on 14.06.2017 i.e. after morethan four years. They argued that if any cause of action to file the present complaint arose to complainant only on 01.02.2013 and under section 24 of the Consumer Protection Act, there is a limitation of two years for filing any complaint from the cause of action first arose. However, the complainant has filed the present complaint after morethan four years, as such, the present complaint is also barred by period of limitation. So, the complainant is not entitled for return of the amount deposited by him as premium with opposite parties.

11.              From the above discussion, we found no merit in the present complaint and the same is hereby dismissed. Parties are left to bear their own costs. Copy of this order be supplied to the parties, free of costs. File be consigned to record room.

Announced in Open Forum

Dated: 06.12.2017

 

                               (Bupinder Kaur)           (Vinod Bala)        (Ajit Aggarwal)

                                     Member                     Member                  President