Tamil Nadu

South Chennai

cc/172/2012

M. Swaminathan - Complainant(s)

Versus

Met life India Insurance Company Ltd., - Opp.Party(s)

Party in Person

04 Aug 2015

ORDER

                                                                         Date of Filing :   17.07.2012

                                                                        Date of Order :   04.08.2015.

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM, CHENNAI(SOUTH)

     2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

PRESENT: THIRU. B. RAMALINGAM M.A.M.L.,                      : PRESIDENT

                 TR. T.PAUL RAJASEKARAN, M.A PGDHRDI, AIII,BCS : MEMBER I

 

                             C.C.NO.172/2012

TUESDAY THIS 4^th DAY OF AUGUST 2015

 

M.Swaminathan,

G-1, Guru Galaxy Apartments,

New No.1, Old No.10,

21^st Street, Nanganallur,

Chennai 600 061.                                                  ..Complainant

 

                                                 ..Vs..

 

1.  The Manager,

PNB Metlife India Insurance Co. Ltd.,

2^nd Floor,

Chellam Tours,

No.52/100, Lattice Bridge Road,

Adyar, Chennai 600 020.

 

2. The Managing Director,

PNB Metlife India Insurance Co. Ltd.,

Brigade Sesha Mahal,

No.5, Vani Vilas Road,

Basavangudi,

Bangalore 560 004.                                                .. Opposite parties.

 

For the Complainant             :  Party in person.     

 

For the Opposite parties       :  M/s. King Stubb &  others.

  

 

 

        This complaint is being filed by the complainant u/s 12 of the C.P. Act 1986 for a direction to the opposite parties to pay a sum of Rs.30,000/- and also to pay a sum of Rs.20,000/- for mental agony and to the complainant.      

ORDER

 

THIRU. B. RAMALINGAM PRESIDENT        

 

         

1.The case of the complainant is briefly as follows:-

      The complainant has taken a Metlife policy via No.1200800552397 (ID NO.MSWA 150919511A) was issued by the 2^nd opposite party with a annual premium of Rs.30,000/- for a period of 10 years covering a insurance of Rs.3,00,000/- on the recommendations made by the 1^st opposite party.    The above policy was taken by force when the complainant approached AXIS Bank to open a locker.   The officer concerned suggested to take a policy if bank locker is required to be opened.  Since the complainant has to go out of station and want of a locker to keep important things in safe custody, the complainant agreed for the same.    Then the concerned insurance staff who was in bank premises asked to pay the first installment premium of Rs.30,000/- vide cheque and after a medical examination the insurance company staff who was in bank premises asked to sign the application from by wrongly explaining the terms and conditions of the policy.  Within a period of one week the complainant received the said policy from Bangalore office in which the terms and conditions were varying as was explained by the insurance staff when issuing the application form. 

2.     In the second year i.e. on 2009 the 2^nd opposite party approached for the 2^nd installment of annual premium.  Since the terms and conditions which were explained were differed from the original policy the complainant have not continued the policy instead asked for refund of the money by telephone which was paid.    The 2^nd opposite party mentioned over phone that the amount cannot be refunded unless the policy continued for ten years, or else to get a meager amount i.e. 1/3^rd of the 1^st installment premium paid which was to be continued for three years as per the insurance company rules.   

3.     The complainant sent a registered letter with acknowledgment to the 1^st opposite party with a copy to 2^nd opposite party on 19.6.2010 to refund the 1^st premium amount by cancelling the policy of Rs.30,000/- with interest within 15 days from 2008.    The letter got returned as the insurance company changed the address to Adyar.  Again the complainant sent the same letter to Adyar office by registered post with acknowledgment on 21.6.2012.   The complainant received the acknowledgment from duly acknowledged.  The opposite party sent a message through phone that the surrender claim will be settled within ten days.   Even though nearing one month the opposite parties have not responded any message in writing or through telephone.  As such the act of the opposite parties amounts to deficiency of service and which caused mental agony and hardship to the complainant.  As such the complainant has sought to pay a sum of Rs.30,000/- and also to pay a sum of Rs.20,000/- for mental agony and to the complainant.  Hence the complaint.      

Written version of  opposite parties  is  as follows:-

4.      It denies all the averments and allegation contained in the complaint except those that are specifically admitted herein.   The opposite parties has stated that  the instant complaint is false, malicious, incorrect and with malafide intent and is nothing but an abuse of the process of law and it is an attempt to waste the precious time of this forum as the same has been filed by the complainant just to avail undue advantage.   The complaint is thus liable to be dismissed under section 26 of the Consumer Protection Act 1986.    From perusal of the instant compliant, it would be observed that averments made therein, are vague, baseless and with malafide intent. The complainant  has made misconceived and baseless allegations of deficiency of service and mis-selling without any documentary evidence in support of his allegations made in the complaint. 

5.     The opposite parties further stated that the policy was issued on 16.4.2008 and the policy documents were dispatched at the complainant’s mailing address on 18.4.2008 through courier  and were further delivered to complainant, the receipt of which has been admitted by him in the instant complaint. 

6.     The opposite parties also stated that it is the duty of the complainant to review the terms and conditions of the policy after receipt of the policy documents and raise his objections or complaint challenging the terms and conditions of the policy in case he was not satisfied with the same or also file a complaint in case the policy was mis-sold to him and apply for cancellation of the policy within 15 days of free look period from the date of receipt of the policy documents pursuant to clause 36 of the terms and conditions of the policy.   However the complainant even after receipt of the policy documents did not raise any complaint or objections either with regard to mis-selling of the policy or challenging the terms and conditions thereof.  As a result of which the contract of insurance which we had with the complainant attained its finality and was presumed to be legally concluded and as such the complainant is stopped from challenging the concluded contract at such a belated stage.  

7.     The opposite parties further stated that the complainant after paying the initial premium on 16.4.2008 failed to remit further renewal premium due on 16.4.2009, in spite of our repeated reminders as a result of which the policy moved to lapsed status as per the terms and conditions of the policy.  Further the complainant also failed to get his policy reinstated within the reinstatement window period and as a result of which the policy of the complainant was auto foreclosed on 29.8.2011 subject to terms and conditions of the policy.    In spite of reminding to the complainant that his policy would be foreclosed if he does not get his policy reinstated within the reinstatement window, the complainant failed to pay any premium due to which the policy got foreclosed on 29.8.2011 as per the terms and conditions of the policy.

8.     The opposite parties also further stated that after three years of issuance of the aforementioned policy the opposite party received a letter from the complainant for cancellation of the policy and refund of the premium.  That the surrender value is payable after completion of first three policy years.  However, since the fund value in the policy account of was less than the surrender charges, no surrender value was payable to the complainant.  But due to inadvertent error a requirement letter requesting to provide the copy of the cancelled cheque was sent erroneously to the complainant by the opposite party.   The surrender value is calculated after deduction of charges as per terms and conditions of the policy.   The charges levied by the opposite party are clearly mentioned in the policy terms and conditions.   Clause-11 of the terms and conditions.    The opposite party has acted as per the terms of the policy and has provided its services from time to time and also covered the life of the complainant for the period for which he had paid the premium and has performed its part of contract.   As such the allegations of the complainant that the policy was mis-sold to him by the opposite party and that he was forced to take the policy at the time of availing the locker facility with Axis bank are all false, frivolous and untenable in the eyes of law in the absence of any evidence to the contrary and the complainant be put  to strict proof of the same.      Hence there is no deficiency of service on the part of the opposite parties and  prays to dismiss the complaint.  

9.     Complainant has filed his Proof affidavit and  Ex.A1 to Ex.A4 were marked on the side of the complainant.    Opposite parties have filed their proof affidavit and Ex.B1 series were marked on the side of the opposite parties.  

10.       The points that arise for consideration are as follows:-

1. Whether there is any deficiency in service on the part of the opposite parties ?

 

2. To what relief the complainant is entitled to?

 

11. POINTS 1 & 2 :

        Perused the complaint filed by the complainant,  written version filed by the opposite parties, proof affidavit of both side and documents Ex.A1 to Ex.A4 filed on the side of the complainant and the documents Ex.B1 series filed on the side of the opposite parties  and considered the both side arguments.  There is no dispute that the complainant has taken policy namely “Met Smart Plus” insurance policy with the opposite party.  Ex.A1 is the copy of the insurance policy dated 17.4.2008 to prove the same.   For the said insurance policy the complainant has paid Rs.30,000/- as annual premium on 16.4.2008.  As per the above said policy the annually premium of Rs.30,000/- payable for 10 years and assured amount is Rs.3,00,000/- are all no dispute.

12.    The complainant has stated in the complaint that the said policy was taken by the complainant at the compulsion of the  Axis bank where he wanted to open locker account.  This is denied by the opposite parties.  However the complainant neither proved the said allegation nor impleaded  the Axis bank as a party in this case.  As such as contended by the opposite parties the allegation of the complainant that the said insurance policy was taken by the complainant on the complusion of the Axis bank is not acceptable, but it has been taken by the complainant at his voluntarily as stated by the opposite parties is acceptable.

13.    Further the complainant has stated within a week he has received the said policy from Bangalore office of the opposite party in which the terms and conditions were varying from what was explained by the insurance staff when issuing the application form.    As such he has signed the proposal form for taking of the said insurance policy on the wrong information of the terms and conditions of the policy by the opposite parties.   For this contention the complainant has not narrated or explained in the complaint  that what are the terms and conditions found to be different in the terms and conditions attached with the policy from the terms and conditions originally said to have been told him by the opposite parties at the time of issuance of application.  Therefore the allegation of the complainant in this regard itself appears to be vague as contended by the opposite parties.

14.    Further the complainant himself admitted that he has received the policy as well as the terms and conditions within the week from the date of taken the policy from the opposite party’s Bangalore office.  However the complainant has not given any written compliant with regard to the alleged grievance over the terms and conditions of the said policy to the opposite party immediately but  as per his own admission the complainant has given written complaint  raising grievance about the terms and conditions of the said policy to the opposite party by letter dated 19.6.2012 and further stated that the said letter was returned and unserved  and again sent letter dated 21.6.2012 to the opposite party.  In this regard the  opposite party has raised objection as per clause 6  (2) of the Insurance Regulatory and Development Authority (Protection of Policy holder’s  Interests) Regulations, 2002, While acting under regulation 6 (1) in forwarding the policy to the insured, the insurer shall inform by letter forwarding the policy that he as a period of 15  days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms and conditions, he has the option to return the policy stating reasons for his objections and further stated that as per the above terms of the regulation in the terms and conditions attached  with the policy Clause 36 is mentioned that 15 days time for the policy holder from the date of receipt of the policy document to review the terms and conditions of the policy if he has got any objection he should have sent written submission for the change of policy or to cancel of policy. 

15.    The learned counsel for the opposite parties contended that on the basis of the above said regulation and terms and conditions of the said policy clause 36 if the complainant has got any grievance over the terms and conditions of the policy and nor to change the policy or to cancel the policy the complainant would have given a written compliant for the same to the opposite parties within 15 days from the date of receipt of the said policy and terms and conditions thereon.   Having failed to do so the complainant also having remained not paying the subsequent annual premium for the said policy have sent letter dated 19.6.2012 without mentioning any valid reason for raising grievance over terms and conditions requested the opposite party for cancellation of the policy that too after a period of four years from the date of receipt of the said policy that too not paying subsequent annual premium payable by the complainant for the year 2009, 2010, 2011 and 2012.  The request of the complainant for cancellation of the said policy made under letter Ex.A3 dated 19.6.2012 is not valid barred by limitation as per the terms and conditions of the said policy.

16.    Therefore we are of the considered view that  as per the said policy if the complainant got any  valid grievance over the terms and conditions of the said policy or to change the policy or to cancel the policy the complainant would have written a complaint or a letter for cancellation of the said policy to the opposite parties within 15 days from the date of receipt of the said policy and terms and conditions thereon.  But the complainant has not did so.  But as per the complainant’s own case it is very clear that he has written letter to the opposite parties for the cancellation of the said insurance policy letters dated 17.5.2012 i.e. Ex.A2,   and Ex.B3 letter dated  19.6.2012  for the cancellation of the said insurance policy  after lapse of four years from the date of receipt of said policy which is clearly out of period of 15 days as mentioned in the terms and conditions of the said policy.   Therefore as contended by the opposite parties the complainant having received the terms and conditions and given proposal form duly signed after going through the terms and conditions and subsequently remained without paying subsequent annual premium payable for the said policy for the year 2009, 2010, 2011 and 2012 the complainant sent the letters  Ex.A2, Ex.A3 for cancellation of the said policy to the opposite parties are all proves that the complainant has not acted in accordance to the terms and conditions of the policy  as contended by the opposite parties.   Therefore the complainant having committed violation terms and conditions of the said policy raising grievance against the opposite parties and attributing that the opposite parties have committed deficiency of service and claiming compensation are all not sustainable. 

17.    Therefore we are of the considered view that the complainant has miserably failed to prove the allegation made against the opposite parties.  As such the complainant is not entitled for any relief sought for in the complaint  against opposite parties and the complaint is liable to be dismissed.  Considering the facts and circumstances parties have to bear their own cost of litigation and as such the points 1 & 2 are decided accordingly.

        In the result this complaint is dismissed. No costs.  

 Dictated to the steno-typist transcribed and typed by her corrected and pronounced by us on this  4^th   day of August  2015.

 

MEMBER-I                                                                                                       PRESIDENT.

Complainant’s Side documents :

Ex.A1-  18.4.2008     - Copy of the insurance policy issued by the insurance company.

Ex.A2- 17.5.2012      - Copy of the letter sent to insurance company.

Ex.A3- 19.6.2012      - Copy of the letter sent to the insurance company.

Ex.A4- 25.6.2012      - Copy of the AD received by the insurance company.

 

Opposite parties’ side documents: -    

 

Ex.B1-           -                - Copy of the proposal form, benefit illustration form, declaration

                               For the unit linked product and the standard terms and conditions

                               Of the policy.  

 

 

 

MEMBER-I                                                                                                       PRESIDENT.