DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,
PATIALA.
Consumer Complaint No.201 of 1.6.2018
Decided on: 02.08.2019
Pushpa Devi Yadav aged about 63 years wife of Sh.Ramesh Chand Yadav, resident of House No.181, Maharaja Yadwindra Enclave, Patiala,Punjab,
Now residing at House No.224,Maharaja Yadwindra Enclave, Patiala,Punjab.
…………...Complainant
Versus
1. Max Life Insurance Co. Ltd., Leela Bhawan Market, Patiala through its Manager.
2. Max Life Insurance Co. Ltd., Operations Centre, 90-A, Udyog Vihar, Sector-18, Gurgaon-122015, through its Managing Director.
3. Axis Bank Ltd.,Branch DLF Colony, Sirhind Road, Patiala through its Manager.
…………Opposite Parties
Complaint under Section 12 of the
Consumer Protection Act, 1986.
QUORUM
Sh. M. P. Singh Pahwa President
Smt. Inderjeet Kaur Member
Sh. B. S. Dhaliwal Member
ARGUED BY
Sh. Jatinder Ahuja, Advocate Counsel for complainant.
Sh. S. P. Singh, Advocate, Counsel for OPs No.1&2
Sh. Vaibhav Mangla, Advocate Counsel for OP No.3.
ORDER
M. P. SINGH PAHWA, PRESIDENT
1. This is the complaint filed by Pushpa Devi (hereinafter referred to as the complainant) against Max Life Insurance Co. Ltd. and others (hereinafter referred to as the OPs).
2. Briefly the case of the complainant is that she was having saving account with OP No.3 vide saving account No.913010001687352. In the year 2013, when the complainant visited OP No.3, she was offered policy namely ‘Max Life Guaranteed Income plan’. OP No.3 also allured the complainant by giving assurance of lots of benefits including income tax rebate and extra benefits with regard to less premium rates than general premium rates.
3. The complainant purchased the policy namely Max Life Guaranteed Income Plan vide policy No.887224723 through OP No.3. The basic features of the policy were as under:
1. The policy was having 6 years of premium paying terms on annually premium basis.The policy was a non-linked guaranteed income plan.
2. That the annual premium was minimum Rs.75000/- per annum (excluded service tax etc.), however, as the complainant was a customer of Axis Bank i.e. the OP No.3, there were less premium rates than general applicable i.e.Rs.70200/-(excluded service tax etc.)
Policy commenced in the year 2013.Complainant paid first premium through OP No.3 vide cheque No.004383 dated 30.7.2013 amounting to Rs.72,369/- on the instructions of OPs No.1&3.On 14.8.2014, complainant paid Rs.71284/- through cheque bearing No.063966 dated 14.8.2014 as second premium. On 20.8.2015,the complainant visited OP No.3 and paid Rs.70430/- through ATM card payment in the bank branch as 3rd premium. On 18.8.2016, complainant visited to OP No.3 to pay 4th premium but OPs No.1and 3 refused to accept the payment as there was some inaccuracy in calculating the premium amount. OPs No.1&3 asked the complainant that whenever the issue shall be resolved she will be informed to deposit the required premium amount. Since then complainant again and again visited office of OPs No.1&3 to know the status of the policy and to deposit the amount of premium but she got no proper reply. She was asked to wait and bank will call itself to deposit the amount of premium. Lastly in the month of February 2017, OPs No.1&3 asked the complainant that the policy has lapsed. The complainant was asked to receive the amount of Rs.64225/- i.e. 30% of the total premiums paid as settlement of the claim but the complainant refused to accept the same being on lower side. OPs No.1&3 again asked the complainant to wait for some time and her request would be forwarded to OP No.2. The complainant asked OPs to return her deposited amount of Rs.2,14,083/-. In August ,2017 the OP No.3 refused the demand of the complainant. In August , 2017, the complainant got issued legal notice to OPs.The OPs delivered cheque of Rs.75129.56 for making part payment. Complainant was asked to wait for some time for remaining amount but no reply was received from the OPs. Complainant again got issued reminder-cum-legal notice to OPs No.1&2 claiming remaining amount alongwith interest. The reply was received from OPs against reminder cum legal notice which was full of concealment and concocted facts.
4. It is alleged that the rejection of the claim of the complainant is unjust and amounts to deficiency in service. The complainant has suffered huge monetary loss and mental agony and harassment. For these sufferings the complainant has claimed compensation to the tune of Rs.one lakh in addition to remaining amount of Rs.1,38,953.44 and Rs.11000/- costs of the litigation.
5. Upon notice OPs appeared through their respective counsel. OPs No.1&2 filed their joint written reply wherein it is stated that the complainant had submitted her duly signed proposal form, after fully understanding and deliberating upon the terms and conditions of the policy. The terms and conditions of the policy are in strict adherence to norms set by IRDA and was duly communicated to the complainant/policy holder. The OPs have taken all necessary precautions and kept the complainant/policy holder adequately informed of policy terms and conditions obligations. No cause of action has arisen in favour of the complainant to file the complaint. OPs have acted strictly on the basis of terms and conditions contained in the policy. The complainant does not fall under the definition of consumer as per Consumer Protection Act. This Forum has no jurisdiction to try and decide the complaint. The relief claimed by the complainant is in violation of the terms and conditions contained in the policy. The OPs had also explained exclusion clauses, the payment plan and other benefits under the policy, at the time of issuing the policy. The complainant has approached this Forum with un- cleaned hands by not disclosing the true and material facts and mis-representing the real facts. The complaint is abuse of legal process. The complainant has no locus standi and cause of action to file the complaint. The complaint is time barred. The complainant has purchased the insurance policy in question in the year 2013.If she has any issue with regard to insurance policy, she should have to raise the objection within the prescribed period. The OPs have also given the factual detail pertaining to the policy as under :
i. That on 31.7.2013, answering respondents received a duly signed and filled the proposal form No.887224723.
ii. That on 3.8.2014 insurance premium receipt.
iii. That on 3.8.2014 annual credit summary was issued.
iv. That on 11.9.2013 policy was issued and documents were sent to the policy holder.
v. That on 5.8.2014 ECS bounce letter was sent to the policy holder.
vi. That on 14.8.2014 annual credit summary was sent to the policy holder.
vii. That on 14.8.2014 insurance premium receipt
viii. That on 21.8.2014 ECS bounce letter was sent to the policy holder.
ix. That on 1.8.2015 Annual credit summary was sent to the policy holder.
x. That on 1.8.2015 insurance premium receipt was sent to the complainant/policy holder.
xi. That on 4.8.2015 ECS bounce letter was sent to the policy holder.
xii. That on 17.8.2015 annual credit summary was sent to the policy holder.
xiii. That on 17.8.2015 insurance premium receipt
xiv. That on 19.8.2015 ECS bounce letter was sent to the policy holder.
xv. That on 30.8.2015 policy lapse intimation letter was sent to the policy holder.
xvi. That on 31.8.2015 policy lapse intimation letter was sent to the policy holder.
Thereafter OPs No.1&2 submitted parawise reply, wherein all the material averments of the complainant are denied.
6. It is pleaded that the policy was purchased by the complainant as per her own sweet will and without any pressure. The authorized representative of the OPs explained different insurance policies and their terms and conditions. The complainant herself opted for policy in question after going through terms and conditions of the same. The total sum assured was Rs.5,40,000/-. Policy was enforced on 31.7.2013.Mode of premium under the policy was annual. Only target premium was Rs.70,200/-.The proposal form alongwith declaration was submitted by the complainant herself after being fully satisfied from the terms and conditions of the policy. On the basis of this document, the policy was issued and sent to the claimant.
7. It is denied that on 18.8.2016 OP No.3 refused to accept the payment. It is further mentioned that the story of the complainant is based on wrong facts and is completely false. The complainant has never approached the OPs to pay the premium amount which was due towards the complainant. Due to non-payment of the required premium it became lapse. Lapsed intimation was sent to the complainant but even thereafter she has not approached OPs No.1&2 to deposit the required premium under the policy. The lapsed intimation was given to the complainant vide letters dated 30.8.2015 and 31.8.2015 but even thereafter she never approached the OPs to deposit the premium. It is also mentioned that the 3rd premium was short premium and the same was refunded to her. There is no question of part payment as alleged.
8. It is further mentioned that the intimation with regard to the lapsed policy was given to the complainant vide letters dated 30.8.2015 and 31.8.2015.Even thereafter complainant has never approached the OPs for revival of policy. The complainant is defaulter. After controverting all the averments OPs No.1&2 prayed for the dismissal of the complaint.
9. OP No.3 in its reply has denied all the material averments and has supported the version of OPs No.1&2 on material points. In the end OP No.3 also prayed for the dismissal of the complaint.
10. In support of her case, the complainant tendered into evidence her affidavit, Ex.CA, copy of schedule of policy, Ex.C1, copies of payment receipts, Exs.C2 &C3, copy of statements of account, Ex.C4, copies of legal notices,Exs.C5and C6, copy of legal notice,Ex.C7, copy of postal receipt,Ex.C8, copy of reply,Ex.C9, copy of postal receipt,Ex.C10,.
11. OPs No.1&2 tendered in to evidence affidavit of Dhiraj Malik, Ex.OPA, copy of proposal form, Ex.OP1, copy of policy,Ex.OP2, copy of insurance premium receipt,Ex.OP3, copy of credit summary,Ex.OP4,copy of letter dated 5.8.2014,Ex.OP5, copy of credit summary, Ex.OP6,copy of receipt, Ex.OP7,copy of letter dated 21.8.2014, Ex.OP8, copy of credit summary,Ex.OP9, copy of receipt,Ex.OP10, copy of letter dated 4.8.2015,Ex.OP11, copy of credit summary,Ex.OP12, copy of receipt,Ex.OP13, copy of letter dated 19.8.2015, Ex.OP14, copy of lapse intimation letter dated 30.8.2015,Ex.OP15, copy of lapse intimation letter dated 31.8.2015,Ex.OP16.
12. OP No.3 tendered into evidence affidavit of Amandeep Singh Dua, Ex.OPB and closed the evidence.
13. We have heard the ld. counsel for the parties and gone through the record of the case carefully.
14. The ld. counsel for the parties have reiterated their averments as taken in their respective pleas.
15. It is submitted by the ld. counsel for the complainant that it is admitted that the complainant paid Rs.72369/- on 30.7.2013, Rs.71,284/- on 14.8.2014 and Rs.70430/- on 20.8.2015. In this way the total sum paid by the complainant was Rs.2,14,083, but the OPs have repaid only Rs.75129.56.The complainant was rather entitled to the interest on the paid amounts. The 4th installment payable by the complainant and complainant approached OP No.3 for deposit of the same, but OPs failed to accept the installment on the ground that there is some issue with the company. Complainant is not to suffer for this reason. Therefore, deficiency in service on the part of the OPs stands proved. Complaint be accepted.
16. On the other hand, the ld. counsel for the OPs has submitted that the complainant has purchased the policy in question. It is not the case of the complainant that she has not received the Policy. The policy is not disputed by the complainant. Complainant has not disputed any terms and conditions and has not taken benefit of free look period. Therefore, the complainant has accepted the terms and conditions of the policy.
17. As per complainant herself she has paid only three installments. The 3rd installment was short for Rs.998/-.Notice was issued to the complainant , copy of which is Ex.OP5. The complainant was required to pay Rs.998.50 to continue enjoying policy benefits. Again letter dated 31.8.2015 Ex.OP16 was written to the complainant requiring her to pay Rs.1,098.50 but the complainant failed to response to these letters. Ultimately the policy lapsed.
18. Complainant herself has produced on record reply to legal notice Ex.C9.Vide this letter also the OPs offered as a service gesture to revive the policy, which has already expired on 31.1.2016. The complainant has not taken any steps to get the policy revived. Complainant has also not impugned lapse of the policy. Therefore, the complainant was entitled to benefits only as per policy terms and conditions, copy of which is Ex.OP2.
19. As per clause 5 of the policy, the guaranteed surrender value was available only on receipt of at least three conjunctive policy years premiums. Of course the complainant paid premium for three years but the premium of the 3rd year was short. As such no guaranteed surrender value was available to the complainant. The OPs have refunded the amount received from the complainant as 3rd year premium, which is certainly more than 30% of the total amount paid by the complainant. The OPs have strictly acted as per terms and conditions of the policy. No deficiency can be attributed on its part.
20. We have considered the rival submissions, carefully.
21. The complainant availed the policy in question through OP No.3. It is immaterial that whether the complainant availed the policy at her own or at the insistence of OP No.3. The fact remains that policy was availed by the complainant. Terms and conditions were supplied to the complainant. Complainant has not opted to get it cancelled during free look period. Inference is that complainant has accepted the terms and conditions of the policy. In these circumstances, parties are bound by the terms and conditions.
22. As per complainant she had paid premium for the years 2013,2014 and for year 2015. The OPs have produced on record copies of letters dated 30.8.2015,Ex.OP15 and 31.8.2015,Ex.OP16 whereby the complainant was intimated that there is shortage of premium amount for 3rd year payment and complainant was asked to pay the difference to get the policy revived. There is nothing on record to prove that the complainant took any steps on these letters to get the policy revived. The complainant has pleaded that she approached OP No.3 for payment of 4th installment but the OP No.3 has not accepted the same on the ground that there is some issue with the OPs. There is no documentary evidence to prove this fact. Even otherwise also the complainant was to pay the premium to OPs No.1&2 and not OP No.3.
23. In these circumstances, it is to be accepted that the complainant has not opted to pay the installment due after the year 2015. The complainant herself has relied upon reply to legal notice, Ex.C9 received from OPs No.1&2.In the last paragraph of this reply, it was made clear to the complainant that the policy revival period has expired on January 31,2016 but as a service gesture, the OPs were ready to revive the policy. There is nothing to show that in response to this offer also the complainant opted to get the policy revived.
24. In these circumstances, the fact remains that complainant had paid only three installments, out of which the 3rd installment was short to some amount. As per clause 5 of the policy the guaranteed surrender value was payable only after payment of at least three consecutive policy year which shall be equal to 30% of the sum received. The complainant has paid total sum of Rs.2,14,083/- , 30% of which is worked out as Rs.64225/- but the OPs have refunded the sum of Rs.75129.56, which is certainly more than 30% of guaranteed value.
25. In these circumstances, no deficiency in service can be attributed on the part of the OPs. Therefore, the complaint is without merit and is hereby dismissed. Parties are left to bear their own costs.
26. Certified copies of this order be sent to the parties free of cost under the Rules. Thereafter, file be indexed and consigned to the Record Room.
ANNOUNCED
DATED: 2.8.2019
B. S. Dhaliwal Inderjeet Kaur M. P. Singh Pahwa
Member Member President
