Tamil Nadu

North Chennai

CC/378/2018

Mr.Raja Gopal - Complainant(s)

Versus

Met Life India Insurance Private Ltd. - Opp.Party(s)

K.Janarthanan

05 Jul 2022

ORDER

Complaint presented on :21.05.2012           Date of disposal            :05.07.2022

                                                                                  

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (NORTH)

@ 2^ND Floor, T.N.P.S.C. Road, V.O.C. Nagar, Park Town, Chennai – 600 003.

 

                PRESENT : THIRU. G. VINOBHA, M.A., B.L.,                          :PRESIDENT

                                      TMT. KAVITHA KANNAN, M.E.,                         : MEMBER-I

                              THIRU.V.RAMAMURTHY,B.A.,B.L.,PGDLA.,    :MEMBER-II

 

C.C. No.378/2018

 

DATED TUESDAY THE 05^th  DAY JULY OF 2022

P. Raja Gopal,

No.7, 27^th street,

Natesan Nagar, Alapakkam,

Chennai-600 116.                                                                    .…..Complainant

 

 

 ..Vs..

1. The Managing Director

MET LIFE INDIA INSURANCE PRIVATE LTD.,

Brigade sesha Mahal,

No.5, Vani vilas road,

Basavana gudi,

Bangalore-560 084.

 

2. The Manager,

MET LIFE INDIA INSURANCE COMPANY PRIVATE LTD.

Nescare Centre,

No.16, Cenotaph road,

Teynampet, Chennai-600 018.

…..Opposite Parties

 

 

Counsel for Complainant                          : M/s. K.Janarthanan &

 D.Muthukumarappa

 

Counsel for  opposite parties                        : M/s. B. Dhanasekaran

ORDER

 

THIRU. G. VINOBHA, M.A., B.L., PRESIDENT :

This complaint has been filed by the complainant against the 1^st and 2^ndopposite parties under section 12 of the Consumer Protection Act, 1986 prays to direct the opposite parties to pay the balance amount of  Rs.14,22,857/- and to pay the damages of Rs.5,00,000/- for mental agony and hardship caused by the opposite parties and to pay the cost.

This complaint was originally filed before the District Commission, Chennai (South) and taken on file in C.C. No. 138/2012.  Thereafter, the said complaint has been transferred to this Commission as per the proceedings of the Hon’ble S.C.D.R.C. and taken on file as C.C. No.378/2018.

1.THE COMPLAINT IN BRIEF:

          The complainant stated that the representatives of the opposite parties approached the complainant that they have come up with a new insurance policy named as “MET-SMART PLUS’ scheme and also arranged a meeting with him in their office and there he was informed that he would get Rs.21,00,000/- offer 3 years by paying Rs.15,00,000/- within 3 years. The complainant submitted that the complainant taken a policy under the above said MET SMART PLUS SCHEME bearing policy in No.00307566 from second opposite party having office at chennai and having head office in bangalore which is the first opposite party herein for the period from 2007 and extended upto 23.04.2012. The complainant had paid the above said premium amount Rs.15,00,000/- through chequest with in the stipulated three years period without any default. The complainant submitted that in the mean time he withdrawn a sum of Rs.6,77,173/-  as partial withdrawl against the policy on 27.04.2010 and he was informed by the 2^nd opposite party that the balance amount of Rs.14,22,857/- after the maturity period. The complainant submitted that the above said MET SMART PLUS POLICY matured on 23.04.2012 and in that connection the complainant, the 2^nd opposite party and in the 2^nd opposite party’s and in the 2^nd opposite party’s office only, the complainant paid the premium amount but the complainant was put to shock and surprise when he was informed by the 2^nd opposite party that he could be paid only Rs.3,98,000/- and that was the amount lying in his account at this juncture only, when the complainant looked into policy papers and statement, he came to know that the sum assured is 50,00,000/- instead of 21,00,000/- and 21,00,000/- was the amount informed to the complainant by the opposite party and in a hasty manner received the signature of the complainant in the unfilled form and scrupulously entered the amount of Rs.50,00,000/- as sum assured.  When the complainant met the officials of the 2^nd opposite party and sought explanation, he was bluntly informed that he would be given only Rs.3,98,000/- rather that in 14,22,857/- .  The complainant caused legal notice on 30.04.2012 to the opposite parties never received any reply till now and even though the complainant paid Rs.15,00,000/- as premium, the 2^nd opposite party refused to pay the balance amount of Rs.14,22,857/-by breaching the terms and conditions of the contract, the 1^st and 2^nd opposite parties caused irreparable loss and hardship to the complainant.

2.WRITTENVERSION FILED BY THEOPPOSITE PARTY 1 and 2 IN BRIEF:

          The opposite parties submitted that the instant complaint is barred by limitation under section 24 A of the consumer protection act 1986.  It is pertinent to note that in the present dispute the cause of action arose in April 2007 when the said policy was issued to the complainant whereas the complainant has filed the present complaint in 2012, that is much after the period of expiry of two years.  The opposite parties submitted that the complaint filed by the complainant does not fall within the definition of a consumer disputes under the Consumer Protection Act. 1986 as there is neither  any unfair trade practice adopted by this opposite party nor any deficiency in service being established against this opposite party.  Free look provision  has been incorporated by this opposite party in Clause 36 of the terms and conditions  of “Met Smart Plus” plan taken by the complainant, which clearly stated that, ‘You have a period of 15 days from the date of receipt of the policy document to review the terms and conditions of this policy.  It you have any objections to any of the terms and conditions, you have the option to return the policy stating the reasons for the objections and you shall be entitled to a refund of the premium paid subject to a deduction of the stamp duty charges. The opposite party submitted that on 19.12.2006 the complainant after completely understanding the terms and conditions of our policy ‘ Met Smart Plus’ had voluntarily filled up of the proposal form bearing no. 107135181, signed it and offered a Modal premium Rs.5,00,000/- annually for premium paying term of 44 years under the said plan.  The opposite party evaluated and processed the proposal form on the basis of the information provided by the complainant and the issued policy bearing no.00307566 to the complainant at a premium of Rs.5,00,000/- to be paid annually for a period of 44 years against the sum assured of Rs. 50,00,000/-. As per clause 19:- ’ During the first three policy years, if the Regular premium is not paid within the grace period, the policy shall lapse. Once the policy is lapses, the coverage under the policy ceases. That the complainant negligently failed to remit the premium and as a result the policy got auto foreclosed on 26.03.2012 as per the standard terms and conditions. As per clause 21:’ If the policy is lapsed during the first three years and not reinstated within two years from the date of such lapse as mentioned in clause.19, the policy would be terminated by paying the surrender value as on the date of expiry. The opposite party submitted that in the said proposal form complainant had signed the declaration in Section 6 at Page no.6 of the proposal form thereof that he has read the proposal form and after fully understanding the contents thereof. There has been no negligence deficiency of service or unfair trade practice on the part of the opposite party which had acted with diligence and in good faith.

3. POINTS FOR CONSIDERATION:

1. Whether there is any deficiency in service or unfair trade practice on the part opposite parties 1 and 2 as alleged in the complaint?

2. Whether the complainant is entitled for the reliefs prayed in the complaint.     If, so to what extent?

Both side arguments heard. The complainant filed proof affidavit and Ex.A1 to A10 were marked on his side and written arguments.  The opposite parties filed proof affidavit and Ex.B1 and B2 were marked on the opposite parties side and written arguments.

4. POINT NO :1 :-

          The complainant had taken a policy from the 2^nd opposite party namely MED SMART PLUS SCHEME bearing policy No. 00307566 for the period from 23.04.2012  and the complainant paid premium amount of Rs.15,00,000/- through cheques within the stipulated period and it is alleged by the complainant on 27.04.2010 he with drawn a partial amount of Rs.677173/- against the policy and he was informed by the 2nd opposite party that the balance amount of Rs.14,22,857/- will be paid after maturity period, but to his shock when the policy matured on 23.04.2012 he was informed  by the 2^nd opposite party that he would be given only Rs.3,98,000/- instead of R.14,22,857/- and further the complainant alleged that he was put to mental agony and hardship by the opposite party due to deficiency in service and unfair trade practice.

          5. But on the other hand the opposite party contended that the above policy was taken  by the complainant in the year 2006 by accepting to the terms and conditions of the policy and as per the same the complainant has to pay Rs.5,00,000/- every year and the maturity period is 44 years and the sum assured is Rs.50,00,000/- and further contended that the complainant being a graduate fully understood the terms and conditions and also the maturity period and benefits under the policy and voluntarily taken the policy and therefore contended that the complainant is estopped from contending otherwise and further contended that there is no deficiency in service or unfair trade practice on the opposite party.  Further according to the opposite party the complainant paid premium of Rs.5,00,000/- every year for only three years and thereafter due to the default in payment of premium as per the terms and conditions of the policy the policy lapsed and the complainant having withdrawn partial amount of Rs.6,77,173/- on 27.04.2010 is only entitled to the balance amount of Rs.4,10,905.08 and not entitled to claim Rs.14,22,857/- as claimed in the complaint. Though the policy was taken in the year 2006 there was partial withdrawl of policy amount on 27.04.2010 and further legal notice issued on 30.04.2012 and hence the complaint filed by the complainant is found to be not barred by limitation since the complaint is based on the policy taken by the complainant on payment of the premium and the prayer is for non-payment of assured policy amount due to alleged deficiency on the part of opposite party it is found that the disputes raised in the complaint is a consumer disputes and the contention to the contrary is incorrect.  On perusal of Ex.A1 to A7 it is found that the complainant has paid Rs.5,00,000/- as premium for each year from 2007 to 2009 for three years.  It is found from Ex.A8 that the complainant has received a part withdrawl from the above said policy on 27.04.2010 amounting to Rs.6,77,173/- Ex.A9 is statement of account and Ex.A10 is legal notice by the complainant. The opposite party has filed Ex.B1 which contains copy of proposal form and benefit illustration and declaration for the unit linked product and the terms and conditions of the policy. As per Ex.B1 the premium amount is Rs.5,00,000/- payable per annum and the sum assured is Rs.50,00,000/- and not 21,00,000/- as claimed in the complaint. There is no documentary proof filed by the complainant to prove that the policy matures on 23.04.2012 further there is no proof to show that the period of the policy is only three years and the sum assured is Rs.21,00,000/- as claimed by the complainant,  though the complainant stated that his signature was received in the unfilled form in a hasty manner by the opposite party without informing to him about the policy on perusal of Ex.B1 it is found that while entering into policy the complainant had full knowledge about the terms and conditions of the policy and he signed the proposal form and also declaration after knowing fully about the contents of the document.  The complainant who is a graduate is not entitled to allege that he was forced to sign in blank forms by the opposite party.  As per clause 19 of the policy during the 1^st three policy years, if the regular premium is not paid, the policy shall lapse and if the policy lapses and the coverage under the policy ceases.  As per clause 21 if the policy lapsed during 1^st three years and not reinstated within two years as mentioned in clause 19 the policy would be terminated and only the surrender value will be paid as on that date to the policy holder. As per clause 36 if the policy holder has any objections to any of the terms and conditions within 15 days from the date of receipt of policy the complainant can return the policy is stating the reasons and the proportionate amount would be refunded to the policy holder.  But the complainant herein has not made any request for cancellation or objection in writing during the said period of 15 days which is free look period.  It is found from the benefits of the illustration annexed with Ex.B1 that the premium has to be paid for 44 years and the sum assured Rs.50,00,000/- which was duly informed to the complainant by the opposite party. But admittedly the complainant has paid premium only for three years and hence based on terms and conditions of the policy which was agreed and accepted by the complainant the opposite party has rightly informed the complainant that he will be entitled Rs.4,10,905.08 after deducting the charges as per the terms and conditions of the policy and though the complainant claimed Rs.14,22,857 in the complaint in the written argument submitted by him it is admitted by the complainant in para.5 that he has received subsequently Rs.4,10,905/- from the opposite party which is actual balance amount to be paid by the opposite party to the complainant and therefore there is no force in the contention of the complainant that the policy was entered by the 2^nd opposite party without explaining the details and wrong full gains, there is no unfair trade practice or deficiency in service on the part of the opposite party as alleged in the complaint.   Point no 1 answered accordingly.

6. Point. No.2:-

          Based on findings given to point. No.1.  the complainant is not entitled to any of the reliefs claimed in the complaint.Point.no.2 is answered accordingly.

          In the result the complaint is dismissed. No costs.

Dictated  by the President to the Steno-Typist taken down, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 05^th   day of  July 2022.

 

MEMBER – I                MEMBER – II                                 PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1		Receipt for policy delivered.
Ex.A2	06.06.2007	Address change acknowledgement letter
Ex.A3	20.04.2007	Statement of account
Ex.A4	26.05.2008	Renewal premium receipt.
Ex.A5	29.06.2009	Cheque issued by the complainant to the 2nd opposite party
Ex.A6	20.05.2008	Cheque issued by the complainant to the 2nd opposite party
Ex.A7	31.05.2009	Renewal premium receipt
Ex.A8	27.04.2010	Acknowledgement slip for partial withdrawl
Ex.A9	19.04.2007 to 23.04.2012	Statement of account
Ex.A10	30.04.2012	Legal Notice.

 

LIST OF DOCUMENTS FILED BY THE OPPOSITE PARTY:

Ex.B1		The copy of the proposal form, benefit, illustration and declaration for the unit linked product and the standard terms and conditions of the policy.
Ex.B2		Surrender request

 

 

 

 

MEMBER – I                MEMBER – II                                 PRESIDENT