CONSUMER DISPUTES REDRESSAL FORUM, PALAKKAD
Dated this the 22th day of June 2013
Present : Smt. Seena.H.President,
: Smt Preetha.G.Nair, Member,
: Smt .Bhanumathi.A.K.Member Date of filing :27/02/13
C.C.48/13
Sunil Chandran,
S/o.M.K.Chandran, Chandravihar, : Complainant
H.No.9/475, Parithipully (P.O),
Palakkad- 678 573
(By Adv. M.J.Vince)
Vs
M/S.Max Life Insurance Co.Ltd,
(Formerly known as M/S.Max New : Opposite party
York Life Insurance Co.Ltd., Rep by its
Manager, 2nd Floor, Vinayaka Building,
Sulthanpet, Palakkad.
(By Adv.C.Madhavankutty)
O R D E R
By.Smt. PREETHA G.NAIR.,MEMBER.
Case of the complainant is as follows :-
Attracted by the advertisements given by the opposite party coupled with the information, instructions and advises given by the agent, the complainant has joined in unit linked individual life insurance policy bearing No.610503765 dated 22/8/08, which is a unit linked scheme in which the fund value fluctuates according to the ups and downs in the share market. The complainant has paid a sum of Rs.45000/- being the Ist instalment and the opposite party has issued a policy. The complainant has paid a sum of Rs.47500/- for the next instalment also. The payments were made through the agent to the opposite party. The complainant had called the agent of opposite party to collect the amount for the 3rd instalment. Though she had promised to collect the same, she failed to meet the complainant and get the amount paid. Hence the complainant could not remit the amount in time. Finally he went to the office of the opposite party and as advised by them he has given a request to them. Even after that the complainant has not heard anything from the opposite party. The complainant sent a lawyer notice to the opposite party. Though the notice was received by the opposite party on 17/01/13, so far they have not informed anything to the complainant. The act of opposite party amounts to deficiency of service and unfair trtade practice. Considering the indifferent attitude followed by opposite party, the complainant has decided to withdraw the amount deposited. Hence the complainant prays an order directing the opposite party to pay a sum of Rs.92,500/- being the amount paid with interest @ 12% per annum from the date of payment and pay a sum of Rs.50,000/- as compensation for deficiency in service and cost of the proceedings.
Opposite party filed version stating the following contentions. It is the responsibility of every policy holder to ensure timely payment of the premiums in order to keep the insurance policy active. Also the complainant was required to pay the premium on the due dates regularly . As per clause 16 of the policy document a grace period of 30 days from the due date of payment of premium shall be allowed for the payment of the unpaid premium. The policy document comprising the terms and conditions was sent to the complainant. The complainant never raised any objections within the free look period. Moreover the complainant paid the second premium well in time. The relationship between the complainant and opposite party are regulated by the IRDA Rules and terms and conditions of the policy contract.
It is admitted that on 8/8/2008 after understanding all the terms and conditions of the policy, the complainant filled up and signed a proposal form for a “Max Amsure Secure Returns Builder ULIP Increasing” for a sum of assured of Rs.4,72,500/-. Under the policy and annual target premium of Rs.45000/- was to be paid annually. In the proposal form the complainant has also given a declaration that he was fully understood the meaning and scope of the proposal form and the contents of the same and only after understanding he signed the proposal form. On 25/08/08 the policy documents were dispatched to the complainant after the receipt of the initial premium amount . The complainant paid the initial premium of Rs.45000/- dated 22/8/2008 and the second year premium through cheque for the amount of Rs.47,250/- dated 20/8/2009. In case the complainant wanted to make the payment he could have visited the branch to make the payment of renewal premium. However the complainant visited the branch office to give the letter that he is not able to pay 3rd premium due to some personal problem. Furthur it is not agent's responsibility to collect the premium rather it is policy holder's responsibility to deposit the premium well within time.
On 13/01/2013 the complainant issued legal notice to provide status of the policy and to collect the premium. The same was not replied by them as the opposite party received the complaint dated 27/2/13. It was a service issue that he wanted to pay the premium and the agent was not collecting the premium. It is not agent's duty to collects the premium. The company is not liable to pay the full refund. Hence there is no deficiency in service on the part of opposite party. So they prayed that dismiss the complaint with cost.
Both parties filed their chief affidavit. Ext.A1 to A2 marked on the side of the complainant. Ext.B1 to B5 marked on the side of opposite party. Both parties filed argument notes. Matter heard.
Issues to be considered are,
Whether there is any deficiency in service on the part of opposite party?
If so, What is the relief and cost?
Issues I & II
We perused relevent documents on record. It is evident from Ext.A1 that Rs.45000/- annual target premium received and effective date of coverage was 22 August 2008. According to the complainant the next instalment of Rs.47,500/- also paid. Opposite party also admitted that the complainant had paid two instalments. According to the complainant he was ready to pay the further instalment. But the opposite party has not ready to collect the 3rd instalment. The complainant stated that he had called the agent to collect the amount for the 3rd instalment. But she failed to meet the complainant and get the amount paid. Finally he went to the office of the Ist opposite party and given a request to them to pay the 3rd instalment as advised by them . Even after that the opposite party had not given any reply . But the complainant has not produced evidence to show the request given to them. In Ext.B3 dated 7/11/2012 the complainant had sent a letter to the opposite party stating that “due to personal family problems in 2010, not able to pay third premium in 2010 August. As a result my policy is inactive since 2010. So I request to kindly refund the amount as earliest”. According to the complainant the signature in Ext.B3 is totally different and he had not given any such request to the opposite party. Ext.B3 is the photocopy of the the letter given to opposite party, marked with objection. The complainant has joined in unit linked individual life insurance policy dated 22/08/2008. As per Ext.A1, the annual target premium is Rs.45000/- and the premium payable date is 22nd of August every year. Admittedly the complaianant had paid the 1st instalment for an amount of Rs.45000/- on 22/08/08 and the 2nd instalment for an amount of Rs.47,500/- on 20/08/2009. According to the opposite party as per clause 16 of the policy document, a grace period of 30 days from the due date of payment of premium shall be allowed for the payment of the unpaid premium. But the complainant has not paid the 3rd instalment within the period. The complainant stated that he was waited the agent for paying the 3rd instalment. The opposite party has not sent letter to demand the 3rd instalment. Opposite party stated that the complainant called on 2/9/11 and 6/9/11 for due premium enquiry. But opposite party has not produced evidence to show that they had given information. On 16/01/2013 the opposite party received a legal notice from the complainant regarding the collection of 3rd premium and to provide the status of the policy. According to the complainant the opposite party has not sent any reply . The complaint filed for directing the opposite party to pay a sum of Rs.92,500/- being the amount paid with interest @ 12% per annum from the date of payment and Rs.50,000/- as compensation. The complainant has not produced evidence to show that he is ready to pay the 3rd installment.
The opposite party stated that since the non payment of 3rd premium makes the contract in fractus and they had no duty or liability to give update information about the policy. Answers filed by complainant stating that as per policy conditions he was informed that only 3 premium need to be paid.
As per Clause 7 (IV) (2) of Insurance Regulatory and Development Authority Regulations 2010 provides that in the case of discontinued policy the company can deduct the charges levied on the date of discontinuance do not exceed Rs.5000/- In Bajaj Allianze Life Insurance Co. Ltd. V. Ramakrishnan the Hon'ble State Commission held that “ The regulations is only classificatory in nature and is applicable to all products of discontinued policies which are discontinued after 1/07/2010”. Further in the present case the complainant discontinued the policy in 2010 and surrendered the same in 2012. Therefore we are of the view that the Regulation is applicable to the present case. Admittedly the complainant paid Rs.92,500/- as the two installments.
In the above discussions we are of the view that there is deficiency in service on the part of opposite party. In the result complaint allowed. We direct the opposite party to pay the complainant an amount of Rs.87,500/- ( 92500-5000) ( Rupees eighty seven thousand five hundred only ) as the amount paid and 10,000/- ( Rupees ten thousand only ) as compensation for deficiency in service and pay 1000/- (Rupees thousand only) as cost.
Order shall be complied with in one month from the date of receipt of Order, failing which the whole amount shall be carry 9% interest per annum from the date of order till realization.
Pronounced in the open court on this the 22nd day of June, 2013.
Sd/-
Smt.Seena.H
President
Sd/-
Smt.Preetha.G.Nair,
Member
Sd/-
Smt.Bhanumathi.A.K.
Member.
APPENDIX
Exhibits marked on the side of complainant
Ext.A1: Copy of Life Insurance Policy Document.
Ext.A2series : Copy of the Lawyer notice, Acknowledgement and Postal Receipts
Exhibits marked on the side of opposite party
Ext.B1: Copy of Proposal Form
Ext.B2: Copy of Policy document.
Ext.B3: Copy of written request of cancellation of the policy dated 09.11.2012.
Ext.B4: Copy of the letter sent to the complainant dated.18.12.2012.
Ext.B5: Copy of the legal notice from the complainant dated 16.01.2013
Wtness Examined on the side of the complainant
Nil
Witness examined on the side of opposite party
Nil
Cost Allowed
Rs. 1000/- (One Thousand only ) allowed as cost of the proceedings.
