DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, PALAKKAD
Dated this the 23rd day of March, 2022
Present : Sri.Vinay Menon.V President
: Smt.Vidya.A, Member
: Sri.Krishnankutty N.K., Member Date of Filing: 22/09/2018
CC/114/2018
V. Unnikrishnan,
S/o Kunju,
Vadakkummuri House,
P.O. Palappuram, Ottappalam
Palakkad – 679 103.
(By Adv. K. Dhananjayan) - Complainant
Vs
- M/s HDFC Life Insurance Co. Ltd.,
11th Floor, Lodha Excelus,
Apollo Mill Compound,
N.M. Joshi Road, Mahalaxmi,
Mumbai – 400 011
Rep. by Authorised Representative/Manager
- The Managing Director / Manager /Authorised Signatory,
M/s HDFC Life Insurance Co. Ltd.,
11th Floor, Lodha Excelus,
Apollo Mill Compound,
N.M. Joshi Road, Mahalaxmi,
Mumbai – 400 011.
- The Branch Manager,
M/s HDFC Life Insurance Co. Ltd.,
HDFC 52 Palakkad Branch,
2nd Floor, Udaya Towers,
Opp. Rappadi open air auditorium,
West Fort Road, Palakkad – 678 001.
- Branch Manager,
HDFC Bank Ltd., JRJ Complex,
Main Road, Ottappalam, Palakkad – 679 101.
- Manager,
HDFC Bank Ltd., Opp. Rappady
Udaya Towers, Palakkad. - Opposite parties
(O.P.s 1 to 3 by Adv. Ullas Sudhakaran
O.P. 4 by Adv. K.A. Kailas)
O R D E R
By Sri. Vinay Menon V., President
1. Shorn off all chaff, complaint pleadings relates to the grievance of the complainant whereby the benefits available to the complainant in accordance with the terms and conditions of an insurance policy floated by the opposite parties 1 to 3 were not paid to him after the premium period of 5 years from 2012.
Summarily, details of the policy are as follows:
Name of the Policy - HDFC Life Sampoorn Samridhi Insurance Plan
Date of commencement - 15.10.2012
Date of issuance of policy - 20.10.2012
Policy Term - 5 years
Premium paying term - 5 years
Frequency - Quarterly.
Premium amount/ frequency - 12,125.00
Final premium due date - 15.07.2017.
Grievance of the complainant is that even after paying the premium due on 15.07.2017, he was not endowed with the benefits arising thereof, upon maturity. He alleged deficiency in service on the part of the opposite parties and sought for the premium remitted with interest and attenuating benefits.
2. Opposite parties filed version admitting issuance of the policy, but averred that the complainant had failed to remit the premium. After the 3rd year, the complainant had not remitted the premium. Hence the policy had lapsed. The complaint was, therefore, only liable to be dismissed.
3. From the pleadings and counter pleadings, the following issues arise for consideration:
1. Whether the complainant is entitled to receive the entire premium for the policy period?
2. Whether there is deficiency in service or unfair trade practice on the part of the opposite parties as alleged in the complaint?
3. Reliefs, compensation and cost, if any?
4. Evidence on the part of the complainant comprised of proof affidavit and Exhibits A1 to A3. Opposite parties 1 to 3 and opposite party 4 filed separate proof affidavits. Exhibit B1 was marked by opposite party 1.
Issue no. I
5. Crux of the issue lies in proving or disproving the contention that the complainant had remitted the premium from 15.10.2012 till 15.07.2017. It was incumbent upon the complainant to prove his case by adducing evidence to prove that he had remitted the entire premia till 15/7/2017 by producing the premium receipts for the entire period. Mere pleadings would not suffice. Even if he was not in possession of the whole set of receipts, he could have filed an application seeking a direction to the opposite parties to produce the entire set of receipts upon receiving the version and going through the pleadings therein. But such an application too was not forthcoming.
6. The only implication is that the contentions of the opposite parties remain unchallenged. Even though the counsel for complainant made an attempt to argue (by way of contentions in argument notes), the complainant had paid premium upto 2017, this is only an argument made to misguide and mislead the Commission. The complainant had remitted premia upto the first quarter of 2015 only as can be seen from Ext.A3 notice in paragraph 2. Policy commenced from 15/10/2012. Hence, the complainant had not completed payment of premia for 3 years period. Therefore, the complainant is not entitled to the reliefs as sought for by him.
Issue No. 2
- On the face of the facts and Exhibits produced, the conduct of the opposite party is in the clear. But going through the Ext.A1 Life Insurance Kit issued by the opposite party we find an anomaly. Page 4 & 5 of Ext.A1 is the standard policy provision for HDFC Life Sampoorn Samridhi Insurance Plan. Some of the relevant clauses for adjudicating the dispute are clauses 3, 4, 5 and 6. Clause 3 deals with Benefits. Clause 4 deals with Payment and Cessation of Premiums. Clauses 5 & 6 deals with Guaranteed Minimum Surrender Value and Lapsed Policies, Paid-up Policies and Reinstatement respectively.
- Clause 4(ii) reads as follows:
“If any premium remains unpaid 15 days after the Due Date, your Policy may Lapse or become Paid-Up, as described in Provision 6, with effect from the Due Date of the first unpaid premium”.
Clause 6 reads as follows:
“6. Lapsed Policies, Paid-Up Policies and Reinstatement.
(i) Lapsed and Paid-Up Policies
If any premium remains unpaid 15 days after the Due Date during the first 3 years of the policy, the policy will be altered to lapsed status and no benefits would be payable.
In the event that any premium remains unpaid 15 days after the due date and your policy has acquired a guaranteed surrender value, your policy will be altered to a paid up policy, subject to any terms and conditions, which we may specify from time to time. These terms will involve a reduction in benefits and you will be informed accordingly.
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
9. A conjoint reading of the above said clauses reveal that the provisions contemplate payment of benefits to those who adhere to the complete payment schedule. It is to be kept in mind that benefits accrue over and above the amount deposited by the life assured by way of premium. The provisions also contemplate the fallout of cessation of payment of premium. The cessation occurs during the first 3 years of the policy. The policy will be altered to lapsed status and no benefits would be payable.
10. What is prevented in the event of cessation of premium is the payment of benefits as contemplated in clause (3) of Ext.A1 and not repayment of the premium paid by the life assured. The provisions are totally silent as to the fate of the premium already paid in the event of cessation of payment of premium before 3 years. That does not mean the opposite party insurance company gets to retain it. They are bound to repay the said premia after deduction of a reasonable amount for their charges.
11. Such a silence in Ext.A1 regarding repayment of premia is fatal to the bonafide interest of the complainant and those likely placed. This will lead to unjust enrichment of the company which can never be allowed. Such silence will tantamount to unfair trade practice. Even though the counsel for the complainant had submitted Insurance Regulatory and Development Authority (Treatment of Discontinued Linked Insurance Policies) Regulations, 2010 we are not seeking recourse to the same since the nature of the policy was not proved in the case. Further the date of coming into force of the regulation is also not known.
Therefore we hold that the opposite party has resorted to unfair trade practice.
Issue No.3
12. In the facts and circumstances of the case we hold that a sum amounting to 5% of the total premia remitted by the complainant would amply serve as charges for the opposite party.
13. Therefore, this complaint is being allowed in part and is being disposed off with the following directions.
1. The opposite party shall pay the balance amount after deducting the charges of 5%
from the total premia paid by complainant together with interest of 10% from the
date the insurance policy would mature till date of actual payment.
2. The complainant is entitled to a compensation of Rs.25,000/- (Rupees Twenty five
thousand only)
3. The complainant is entitled to a cost of Rs.15,000/- (Rupees Fifteen thousand only).
4. In the event the opposite party is not paying the aforesaid amount within the periods
specified below, the complainant is also entitled to a sum of Rs.200/-(Rupees Two
hundred only) per month or part thereof from date of receipt of a copy of this order
till date of payment by way of solatium
Comply with the above directions within 45 days from the date of receipt of a copy of this order.
Pronounced in open court on this the 23rd day of March, 2022.
Sd/-
Vinay Menon V
President
Sd/-
Vidya.A
Member
Sd/-
Krishnankutty N.K.
Member
APPENDIX
Exhibits marked on the side of the complainant
Ext.A1 – Original of the policy document bearing policy no. 15513332.
Ext.A2 - Copy of lawyer’s notice dated 06.01.2018
Ext.A3 - Copy of notice dated 20.02.2018 issued by the complainant.
Exhibits marked on the side of the opposite party
Ext. B1 – Copy of Exhibit A1.
Witness examined on the side of the complainant
NIL
Witness examined on the side of the opposite party
NIL
Cost : Rs.15,000/- allowed as cost of proceedings.
NB : Parties are directed to take back all extra set of documents submitted in the proceedings in accordance with Regulation 20(5) of the Consumer Protection (Consumer Commission Procedure) Regulations, 2020 failing which they will be weeded out.
