PBEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, ERNAKULAM.
Dated this the 29th day of June 2012
Filed on : 26/07/2010
Present :
Shri. A Rajesh, President.
Shri. Paul Gomez, Member.
Smt. C.K. Lekhamma, Member
C.C. No.420/2010
Between
Jayasankar. K., : Complainant
S/o. Late P.K. Menon, (By Adv. Balagopalan A,
Lakshmy Bhavan, C.K. Aravindaksha Menon Asso-
Jawahar Nagar road, ciates, 40/595, Swami Chinma-
Kadavanthara, Kochi-682 020. yananda road, Ernakulam,
Cochin-16)
And
1. M/s. Metlife India Insurance : Opposite parties
Com. Ltd., Regional Office, (By Adv. Nelson J Manayil,)
2nd floor, Thadikaran Centre
Building, Palarivattom,
Ernakulam, Kochi-682 025,
rep. by its Regional Manager.
2. M/s. Metlife India Insurance
Com. Ltd., Head/Regd office,
Brigade Seshamahal, 5,
Vani Vilas road,
Basavanagudi,
Bangalore-560 004,
rep. by its Managing Director.
3. Sreeja, Operations Head,
M/s. Metlife India Insurance
Com. Ltd., Regional Office,
2nd floor, Thadikaran Centre
Building, Palarivattom, Ernakulam,
Kochi-682 025.
4. Prajeesh P.A.,
Operations Head,
M/s. Metlife India Insurance
Com. Ltd., Regional Office,
2nd floor, Thadikaran Centre
Building, Palarivattom, Ernakulam,
Kochi-682 025.
5. M/s. Sumithy Prince,
M/s. Metlife India Insurance
Company Ltd., 1st floor,
Omer Square, Next to Lulu Mall,
Edappally, Ernakulam.
O R D E R
Paul Gomez, Member.
Complaint is prompted by the following facts.
The complainant joined the Met smart plus ULIP scheme promoted by the 1st and 2nd parties on 29-09-2006. The annual premium was Rs. 50,000/- to be paid in two instalments in the months of April and September. Complainant committed default in making payments first in September 2008 and second in April 2009. Complainant paid the arrears in lump on 17-06-2009 and obtained receipt. Still he was asked to pay dues. When enquired with the officers they admitted their fault and assured him that everything will be set right. But to his surprise, he received a letter stating that the policy has lapsed. A cheque worth Rs. 50,000/- was also enclosed. When he contacted the 2nd opposite party office, he was informed that his policy would be revived in case certain conditions were fulfilled. One of such conditions was to undergo a medical check up in Medivision. He was also asked to pay Rs. 1,00,000/-. In addition the complainant was also directed to submit a “Thyroid Questionnaire”. The complainant is apprehensive of the bonafides of the opposite parties and hence this complaint seeking various reliefs.
2. In the joint version filed by opposite parties the remittance of Rs. 50,000/-, towards arrears due against September 2008 and March 2009 along with DGH Form has been admitted. The opposite parties refused to satisfy the lapsed policy since complainant refused to sales by the requirements under clause 20 of the policy conditions. That ;is why the said amount is refunded. Hence it is urged to dismiss the complaint with costs.
3. Complainant was examined as PW1. Exts. A1 to A8 marked for him. No oral evidence to opposite parties. Exts. B1 to B3 were marked for them. Learned counsel appearing for parties were heard.
4. The following points arise for settlement.
i. Whether the policy is revivable or not?
ii. What are the consequent reliefs if any?
5. There is mutual agreement as to the fact that complainant had defaulted in paying instalments of September 2008 and April 2009. But it can be seen from Ext. A2 that he was allowed to pay Rs. 50,000/- towards Renewal of the lapsed policy as indicated in the said document. Ext. B3 Reinstatement requisition form also leads us to infer that the complainant was allowed to take proceedings for the renewal of the policy. Still opposite party is seen to have forwarded Ext. A3 letter asking the complainant to pay the premium of September 2008 and he was asked to pay Rs. 25,000/- on or before 15th February 2010 which is followed by Ext. A5 and A5(a) communications refunding Rs. 50,000/-. In Ext. A7 the grounds for lapse of the policy is stated and expressed the willingness to revive it provided certain requirements were satisfied. Those conditions include a litany of medical tests, which are cumbersome for an ordinary person.
A close perusal of these documents will indicate that opposite party has been making efforts to hide its administrative failure in reviving the lapsed policy once the insured had paid the arrear premium on 17-06-2009. Incidentally the careless manner of handling such things is evident from Ext. A7 where it is stated, “We regret to inform that the policy was moved to lapse status due to non receipt of the payment towards Sept 2008 December and March 2008 “ This is factually incorrect. Of course, it is a clerical error, still it shows the inadvertence of the staff.
We are of the view that opposite parties are estopped from denying the complainant the right to revive the lapsed policy once they have allowed to do so. By Ext. A7 letter, they ;have imposed conditions for the same, which are in the ordinary course can be taken ;only as a punishment for having moved an application for revival. Clause 20 of Ext. A1 conditions permits the policy holder to revive the lapsed policy on satisfying certain conditions including providing satisfactory evidence for insurability. After all, the term ‘insurability’ is so vague and flexible a term that it can be interpreted according to one’s owns sweet will. We are of the view that complainant was entitled for revival as soon as he had paid the arrear on 17-06-2009.
Unfortunately, complainant has not demanded revival of the policy as relief. He has urged us to allow Rs. 1,50,000/-together with fund growth. But no evidence is produced to substantiate the claim. We think justice would be done if the deposited amounts are refunded along with reasonable interest.
In the result, the complaint is allowed as follows:
(i) 1st opposite party shall refund to the complainant the remitted amount along with interest @ 12% p.a. from the date of receipt of each instalment till realization.
(ii) 1st opposite party shall pay Rs. 1,000/- towards costs of litigation.
The above said order shall be complied with within a period of one month from the date of receipt of a copy of this order.
Pronounced in the open Forum on this the 29th day of June 2012.
Sd/-
Paul Gomez, Member.
Sd/-
A Rajesh, President.
Sd/-
C.K. Lekhamma, Member.
Forwarded/By Order,
Senior Superintendent.
Appendix
Complainant’s Exhibits :
Ext. A1 : Brochure
A2 : Copy of receipt dt. 17-01-2009
A3 : Copy of letter dt. 16-11-2009
A4 : Copy of letter dt. 04-02-2010
A5 : Copy of letter dt.18-02-2010
A5(a): D.D. dated 25-02-2010
A6 : Copy of letter dt. 18/05/2010
A7 : Copy of letter dt. 04-06-2010
A8 : Copy of letter dt. 16-06-2010
Opposite party’s Exhibits :
Ext. B1 : Application for Life Insurance
B2 : Copy of letter dated 06-10-2006
B3 : Copy of reinstatement requisition
form
Depositions:
DW1 : Jayasankar K
