Haryana

Ambala

CC/242/2017

SURESH KUMAR Khanna - Complainant(s)

Versus

M/S MAX NEW YORK LIFE INSS. - Opp.Party(s)

In Person

24 May 2018

ORDER

BEFORE THE DISTT.CONSUMER DISPUTES REDRESSAL FORUM; AMBALA.

C.C.No.242 of 2017.

Date of Instt.:17.07.2017.

Date of Order: 24.05.2018.

Suresh Kumar Khanna son of late Shri Ram Chand aged about 65 years resident of 48, Etka Vihar, Ambala Cantt.

..Complainant.

     Versus

1.M/s Max New York Life Insurance Company Limited Regd. Office 1^st Floor, Shree Complex, Cross Road No.3, Punjabi Mohalla, Ambala Cantt. through its Branch Manager.

2.M/s Max New York life Insurance Company Limited, Regd. Office MAX House 1, Dr.Jha Marg, Okhla, New Delhi-110020, through its Managing Director.

3.Vishal Sakoria, resident of CA/8C, Shalimar Bagh, New Delhi 110088, new c/o M/S Max New York Life Insurance Company Limited.

          ..Opposite parties.        

Complaint under Section 12 of the Consumer

 Protection Act, 1986

 

BEFORE:       SH. D.N. ARORA, PRESIDENT.

                        SH. PUSHPENDER KUMAR, MEMBER.

                        MS. ANAMIKA GUPTA, MEMBER.

                       

Present:          Complainant in person.

                        Sh.Sandeep Kashyap, Advocate for OP Nos.1 & 2.

                        OP No.3 given up.

ORDER

                   Brief facts of the complaint that the OP No.3 had approached the complainant and on his persuasion the complainant agreed for the life insurance policy in terms of money back policy keeping in view his date of retirement. The complainant had accepted the scheme Money Back Life Insurance Policy and paid first installment of Rs.10,000/- by way of cheque bearing No.743222 dated 23.03.2004 of Indian Overseas Bank, Ambala  and Op No.3 had procured the signatures of complainant on proposal form. The complainant had paid premium of April, 2005 and 2005 of Rs.10,000/- each and paid a total sum of Rs.30,000/-. The complainant had further sent premium of Rs. 10,000/- through cheque but he sooner realized that it was a money back policy and he was to get money before 4^th premium. Vide letter dated 04.04.2007 the complainant stopped the bankers to stop the payment of cheque dated 27.03.2007  but the representative of the company told that it was a whole life policy and the complainant was bound to pay Rs.10,000/- per annum.  The complainant got served legal notice and after holding meetings with representative of the company it was narrated to him that policy in question cannot be changed into Money Back One but can be changed to bonus option to premium reduction. The complainant left with no alternative had to accept the proposal and  sent a cheque for Rs.7311/- dated 07.12.2007 towards the premium due in April, 2007 i.e. 3^rd premium on the basis of a chart alongwith a form of cheque in bonus option. Vide letter dated 16.04.2008 the company after 4 more months demanded a sum of Rs.2688.58 for installment of premium of April, 2007 (i.e.10000 – 2688 = 7311) which was again a blow from insurance company as it did not do anything towards changing the policy from WLPP towards Bonus Reducing and the policy was running under the same scheme i.e. Whole Life Participating Plan. The complainant again sent a cheuqe dated 25.05.2008 of Rs.6416/- for the premium of April, 2008. The insurance company vide its letter dated 23.06.2008 again required the complainant to pay Rs.12688/- * Rs.2688 of 2007 & Rs.10000 of 2008 Health Declaring Form and Medical Examination Report. The complainant was medically examined by the AMO of insurance Company and sent the fitness report to complainant. As per discussion held on telephone and it was told that cheque bearing No.778775 for Rs.7311/- has been received and credited to the account of the insurance company but change in option from has not been received which was unbelievable. Total sum of Rs.47311/- was credited to the account of the company upto 26.08.2008 whereas it was due at 43727/-. The insurance company vide its letter dated 21.10.2008 refunded a sum of Rs.17311 stating to be overpayment. Nothing was due from the complainant upto the installment of April, 2008 rather over subscription to the tune of Rs.3584/- was there but vide letter dated 24.10.2008 the insurance company again demanded a sum of Rs.19999.16 towards premiums against the policy of the complainant.  The complainant deposited a sum of Rs.20,000/- on 08.11.2008 with its Branch Office at Ambala Cantt. though it was not due. The payment of same had to be stopped because a cheque of Rs.17311/- was received on the same day or a day letter when cheque of Rs.20,000/- was deposited. The complainant wrote a letter on 22.03.2009 and asked the insurance company that how much amount the company wanted to be deposited upto March, 2009 after adjustment of bonus etc. Vide letter dated 17.08.2009 the company informed the complainant about lapsing of policy since 22.03.2007  and to reinstate the policy a sum of Rs.30397.01 aongwith Health Declaration form and medical of category be sent, although the same have already been sent on 15.07.2008 by Dr.Ravinder Kapoor, AMA of the company. The complainant made correspondence with the company but to no effect.  The complainant further wrote a letter dated 30.05.2013 but no reply was given. The company has been demanding money from 2007 by tantalizing that bonus would be allowed. The complainant got served notice through advocate but in response thereof it was informed to him vide letter dated 12.09.2016 that the policy is running under non-forfeiture option and revival period is already over on March 22, 2010. The act and conduct of the OPs is deficiency in service and unfair trade practice. In evidence, the complainant has tendered affidavit annexure CW1/A and documents Annexure C1 to Annexure C13.

2.                On notice OPs appeared and filed their joint reply wherein preliminary objections such as jurisdiction, locus standi, estopal, cause of action etc. have been taken.  The complainant had approached to the OPs for purchase of whole life insurance policy proposal form dated 23.03.2004 to the Ops on 24.03.2004. The complainant was provided with free look period of 15 days but the complainant has not availed this opportunity, therefore, the complainant was having no cause of action to file the present compliant and even the present complaint is barred by limitation also because two years period has already been lapsed in the April, 2006. The complainant has not approached to this Forum with clean hands as he was very well aware about the purchase of the policy in question under Whole Life Participating Plan. Now, the complainant with dishonest intention has filed the present false complaint. After expiry of free look period the complainant never raised any objections upto two years.  Other allegations have been controverted and prayer for dismissal of the complaint has been made. In evidence, the OPs have tendered affidavit Annexure RX and documents Annexure R1 to Annexure R2.

3.                We have heard learned counsel for the parties and gone through the case file very carefully.

4.                The complainant has allegedly purchased the Money Back policy and had deposited annual amount of Rs.10,000/- for three years started in the year 2004 and complainant has sent a cheque for the year 2007 for Rs.10,000/- dated 27.03.2007 in routine manner but when he came to know from the OP that it is not a money back policy rather it is a whole life participating policy. The complainant stopped the further payment and he wrote a letter to the company and hold the meeting with Gulshan Rohni and Vishal Bhalla they made it clear to the complainant that policy in question is not a money back policy cannot be changed into money back one but can be changed to bonus option  to premium reduction. The complainant has accepted and proposal of insurance company and sent a cheque of Rs.7311/- but the above said amount has been returned back by the op that the policy allegedly purchased by him in lapsed condition and cannot be changed into bonus option to premium reduction. From the perusal of the policy, it is clear that, it is a Whole Life Participating Policy and not money back policy as per Annexure R2. It is not disputed that complainant has deposited Rs.30,000/- and the policy in question is in a lapsed condition and as per the policy terms and conditions No.1  which is reproduced as under :

                   After the policy has been inforce for atleast three years and provided all the premiums have been paid for three full years, then the company will grant a cash surrender value which will not be less than 30 % of the premium (s) (excluding the first year’s premium) received but never more than the base face amount of the policy. The case surrender value payable will be subject to the condition that policy is in full force and that there are no statutory or other restrictions to the contrary. Indebtedness, if any, to the company will be deductible from the cash surrender value.

                    Though the complainant has alleged that fraud has been committed as it was promised to give money back policy but they have issued the Whole Life Participating Policy and when he came to know about the said fraud played with him he stopped the above said payment and prayed for retund the amount Rs.30,000/- with interest but this plea is not maintainable in view of the above term and condition and this Forum cannot interfere with the terms and conditions allegedly agreed between the parties without adding or alteration anything, therefore, it would be appropriate if we direct the insurance company to pay the surrender value keeping in view the term and condition No.12 of the policy. Accordingly, partly we allowed the present complaint with costs which is assessed at Rs.5,000/- with a direction to the insurance company to pay the surrender value in view of above said term and condition within a period of 30 days after receiving the copy of order failing which the amount would carry interest @ 12 % per annum from the date of filing of the present complaint till its realization. Copy of this order be supplied to both the parties free of cost. File be consigned after due compliance.

 

ANNOUNCED IN OPEN FORUM                            

Dt. 24.05.2018.                                          

                                                                   (D.N.Arora)

                                                                   President,

(Pushpender Kumar)                           Distt.Consumer Disputes

      (Member)                                      Redressal Forum, Ambala.

 

 

                                      (Anamika Gupta)

                                            (Member)