Punjab

Ludhiana

CC/16/676

P.N Ramnan - Complainant(s)

Versus

Oppo Mobile Ltd. - Opp.Party(s)

17 Jul 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

 

Consumer Complaint No. 676 of 14.09.2016

Date of Decision          :   17.07.2017

 

Mr.Sukhdev Singh s/o Ramrakha Singh r/o 2A, Lal Bagh, Tehsil Ludhiana West, Village Tharike, District Ludhiana.

……Complainant

                                                       Versus          

1.DLF Pramerica Life Insurance Company Limited, 4^th Floor, Building No.9, Tower B, Cyber City, DLF City, Phase-11, Gurgaon-122002 through authorized signatory.

2.DLF Pramerica Life Insurance Company Limited, 5^th Floor, Kunal Towers, The Mall, Ludhiana through authorized signatory.

3.Mr Varun Chopra, Code-SE00013488 C/o DLF Pramerica Life Insurance Company Limited, 4^th Floor, Building No.9, Tower B, Cyber City, DLF City, Phase-11, Gurgaon-122002.                                                                                                                                                            ……...Opposite Parties

 

 

 (COMPLAINT U/S 12 OF THE CONSUMER PROTECTION ACT, 1986)

 

 

QUORUM:

SH.G.K.DHIR, PRESIDENT

SH.PARAM JIT SINGH BEWLI, MEMBER

 

COUNSEL FOR THE PARTIES:

For Complainant              :       Sh.M.S.Sethi, Advocate

For OPs                          :       Sh.Surinder Kashyap, Advocate

 

PER G.K DHIR, PRESIDENT

 

1.                 Complainant approached OP3,Mr.Varun Gupta, the agent of Op1 and OP2 on 7.9.2012 and thereafter, on being impressed by the schemes disclosed by the said agent and after believing his words, complainant signed two blank proposal forms at Ludhiana. Complainant did show his gross income earning for 2012-13 in the income tax return as Rs.2,77,334/-. Complainant paid premium of Rs.96,600/- for two policies from his saving amount. Thereafter, complainant received policies bearing No.000170054 and 000170055 dated 17.9.2012 on 17.11.2012 in his name as policy holder, but Balwinder Singh Sidhu(son of the complainant) as life assured. After receiving the policy No.000170054, the complainant came to know as if Ops have not fulfilled their promise as given through agent. Rather, it is claimed that policy issued by mis-representing the material facts. As per policy, the complainant was required to pay the premium of Rs.96,600/- per year for 10 years against the policy tenure of 20 years. It is not possible for the complainant to pay this hefty yearly premium amount because of his annual income being less than  Rs.3 lakh including pension and interest. The factum regarding income of the complainant being less than Rs.3 lac was in the knowledge of Ops because of submission of income tax return for the assessment year of 2012-13 with Ops. Despite various visits by the complainant to Ops, no proper response was received by the complainant and as such, he lodged protest in writing with OP2 on 7.5.2013 for claiming as if signatures of his son are forged on the policy documents. Son of the complainant was not present at the time of signing the documents actually. OP2 on 10.5.2013 orally refused to cancel the policy and thereafter, letter dated 22.5.2013 was received by the complainant in that respect. As above policy no.000170054 issued on mis-represented facts and as such, prayer of the complainant for cancelling the policy deserves to be allowed, but the same has not been allowed and that is why, complainant claims to have filed this complaint. Reference of Insurance Regulatory and Development Authority Regulations, 2010 also made in the complaint. Reference to regulation 6(1) and (2) of those IRDA Regulations specifically made for claiming that on discontinance of the policy, premium amount is refundable, subject to deductions mentioned in tabular form in the complaint. Act of refusal of cancellation of the policy alleged to be an act of deficiency in service on the part of Ops and as such, prayer made for directing Ops to cancel the policy No.000170054 dated 17.9.2012 by refunding the amount of Rs.96,600/-after deducting genuine charges as per notification of the IRDA. That refund sought with interest @9% per annum. Compensation for mental harassment of Rs.50,000/- and Rs. 11,000/- as litigation expenses more claimed.

2.                 Earlier, Ops were ex-parte and after hearing the arguments after closure of ex-parte evidence, complaint was dismissed vide orders dated 22.01.2014 passed by this Forum. On appeal being preferred against those orders of 22.1.2014, Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh, remanded the case back to this Forum with direction to dispose of the complaint on merits. Copy of those orders dated 11.8.2016 passed in First Appeal No.332 of 2014 titled as Mr.Sukhdev Singh vs. DLF Pramerica Life Insurance Company Limited and others is there on record. After receipt of those orders from the Hon’ble State Consumer Disputes Redressal Commission, Punjab, Chandigarh, Ops appeared and submitted written reply for claiming as if name of DLF Pramerica Life Insurance Company is changed to DHFL Pramerica Life Insurance Co.Ltd as per Certificate of Incorporation dated 2.1.2014 issued by ROC, National Capital Territory of Delhi and Haryana. So, the written reply is filed virtually  with changed name. Complaint alleged to be false,              vexatious and same alleged to be not maintainable in view of Section 26 of the Consumer Protection Act, 1986(hereinafter in short referred to as ‘Act’). Prayer made for dismissal of complaint at admission stage. Besides, it claimed that complainant has not approached this Forum with clean hands because even on baseless allegations, cause of action has not accrued to the complainant. Complaint is alleged to be based on mere surmises and conjectures. Complainant has enclosed documents pertaining to policy No.000170054, despite the fact that he has made complaint with respect to that policy as well as to the policy No.000170055. Complainant submitted two application forms with Ops on 7.9.2012 for subscribing to ‘Tatkaal Suraksha Gold’, an endowment plan offered by Ops. That plan approved by the Insurance Regulator, a Statutory body constituted under the provisions of Insurance Regulatory & Development Authority of India(hereinafter in short referred to as ‘IRDAI’). IRDAI(Protection of Policy Holders’ Interest) Regulations 2002 provides the terms and conditions specifically for a free look period of 15 days from the date of receipt of the policy documents, during which period, policy owner entitled to review the policy terms and conditions with request of cancellation, if he is dissatisfied with the terms and conditions of the policy. Complainant voluntarily applied for the insurance policy after fully knowing well about the terms and conditions of the same. Insurer through forwarding letter informed the complainant about free look period of 15 days for exercising option of cancellation of policy. In view of non-exercise of the option within period of 15 days of free look period, complainant alleged to be bound by the terms and conditions of the policy. Proposal forms were duly filled by the complainant and he signed the same for purchase of two policies on 7.9.2012 each. Each of those policies were for insured sum of Rs.10 lac and premium   of Rs.97,635/- and Rs.98,092/- annually respectively were paid by the complainant. Those payments were made by the complainant after understanding all the terms and conditions of the policies. Even due information regarding terms and conditions of the policy was provided to the complainant. Complainant himself provided the requisite and relevant documents like that of copies of Pan Card, Income tax return at the time of filling of the proposal forms. The policies were duly issued with commencement date of 17.09.2012. Welcome calls were sent by Ops to the complainant on 5.10.2012 and 12.10.2012. Through those welcome calls, complainant was informed about the policies features such as sum assured, premium amount, duration and next date of payment of premium etc. Complainant did not raise  any objection regarding the policy terms and conditions at that time and as such, complainant now estopped from challenging the terms and conditions of the concluded contract. The policies were issued in September 2012. Ops received letter for the first time on 7.5.2013 from the complainant regarding complaint of tampering or of forgery of proposal forms etc. Ops conducted detailed investigation and thereafter, sent letter dated 30.5.2013 to complainant regarding both the policies for disclosing that duly signed application forms were received by Ops with necessary documents consisting of KYC document also. After expiry of one year and seven months from the date of issue of the first policy, the above referred protest letter dated 7.5.2013 was received regarding which reply was sent on 30.5.2013 as referred above. The policies were duly issued and complainant did not raise any concern during free look period or at the time when the welcome calls made to him and as such, this complaint alleged to be filed for getting undue advantage over the Ops. Contract of insurance is a contract of utmost good faith. That contract is for coverage of the risk of life of complainants and as such, challenge to that contract at belated stage is not permissible. Complainant alleged to have not approached this Forum with clean hands because he has twisted the facts for mis-representation. Other averment of the complaint denied by praying for dismissal of complaint.

3.                 Complainant to prove his case tendered in evidence his affidavit Ex.CA1 along with documents Ex.C1 to Ex.C4 and thereafter, counsel for the complainant closed the evidence.

4.                 On the other hand, counsel for OPs tendered into evidence affidavit Ex.RA of Sh.Parmal Singh, Deputy Manager, Legal of OPs along with documents Ex.R1 to Ex.R3 and then closed the evidence.

5.                 Written arguments not submitted by any of the parties. Oral arguments alone addressed by counsel for the parties and those were heard. Records gone through minutely.

6.                 Proposal form Ex.R2 was submitted by the complainant for purchase of the policy in question. In that proposal form itself, it is mentioned as if complainant being proposer is Graduate, but Balwinder Singh Sidhu(son of complainant), the life assured is Post Graduate in Computer Engineering. Name of organization, in which, life assured is working mentioned as LG Electronics. That proposal form Ex.R2 is signed in English by the complainant as well as by said Sh.Balwinder Singh Sidhu. This proposal form is of date 7.9.2012. No evidence virtually is produced to show that signatures of complainant or of life assured namely Sh.Balwinder Singh Sidhu are forged on Ex.R2. This is despite the fact that premium receipt Ex.C2 was sent to the complainant with details of plan on 17.9.2012. Date 17.9.2012 is endorsed on premium receipt itself. So, virtually intimation regarding the term of the policy in question as 15 years with date of commencement as 17.9.2012 was disclosed to the complainant through this premium receipt Ex.C2 of date 17.9.2012 itself. The next due date of premium mentioned in Ex.C2 as 17.9.2013. However, the complainant lodged complaint Ex.C4 dated 7.5.2013 for claiming as if signatures of his son and daughter on the policy in question as well as on the policy documents pertaining to the policy No.000170055 are forged. In response to this Ex.C4, Ops conducted inquiry and then sent letter dated 30.5.2013 Ex.R3 to the complainant for informing him that as option for cancellation of policy not exercised within free look period and as such, the terms and conditions of the policy are binding on the complainant. Further, through this letter Ex.R3 itself, it was disclosed as if at the time of issuance of the policy, KYC documents consisting of Pan card copy of Sh.Darvinder Sidhu and school marksheet copy of Balwinder Sidhu was submitted. So, it is obvious that virtually on inquiry, it was found that policy was duly issued and if that be the position, then there is no deficiency in service on the part of Ops.

7.                 Proposal forms bear the signatures of insured as well as of complainant each and as such, contention of counsel for complainant not acceptable that proposal forms were not signed by Balwinder Singh Sidhu or by the present complainant. Had these proposal forms been not signed by the complainant or Balwinder Singh Sidhu, then affidavit of Balwinder Singh Sidhu could have been produced, but affidavit of Balwinder Singh Sidhu not at all produced and as such, complainant failed to establish that proposal forms were not signed by Balwinder Singh Sidhu. Besides, as proof of age in the shape of school certificate along with Pan Card etc, was provided by the complainant at the time of submitting the proposal forms and as such, said circumstance leads to the only conclusion that actually contents of proposal forms were explained to the insured and that is why, they submitted proof of income. As name of organization, in which, life insured was working also disclosed in the proposal forms and as such, said circumstance further leads to the irresistible conclusion that policies in question were issued after submission of PAN Card and record of school leaving certificate and details of marks. No insurance agent could have known the particulars of educational qualification of the proposer/insured and nor he could have know the name of organization or institution in which, life assured was working until those facts disclosed to him and as such, inference is obvious that actually policy in question was duly issued to the complainant after accepting the premium through receipt Ex.C2.

8.                 In premium receipt Ex.C2, date of commencement of the policy as 17.9.2012 specifically mentioned and even it is mentioned that for further details, information may be collected from customer service helpline or from email contact mentioned in Ex.C2 and as such, complainant or the life assured, being Graduate or Post Graduate, could have collected the evidence by browsing at the website of OP1 and OP2. Option of 15 days free look period for getting the policy cancelled is available with the complainant as per IRDAI Regulations, 2010, but that option has not exercised by the complainant or the life assured and as such, complainant or life assured estopped from claiming that they are not bound by the terms and conditions of the policy. Rather, letter dated 7.5.2013 Ex.C4 was written by the complainant after more than 7 months of date of commencement of the policy and as such, it is obvious that the complainant did not exercise the option for getting the policy in question cancelled within free look period of 15 days. Even no proof of forgery of signatures adduced because expert has not been examined and as such, the issued policy documents could not be held to be issued after commission of forgery of signatures.

9.                 Contract of insurance binding on the parties. Nothing can be added or subtracted to the terms and conditions of the insurance policy. In holding this view, we are fortified by law laid down in cases titled as Ind Swift Limited vs. New India Assurance Co.ltd and others-IV(2012)CPJ-148(N.C.); Usha Sharma and others vs. New India Assurance Co.Ltd and others-I(2012)CPJ-488(N.C.); United India Insurance co.Ltd. vs. Harchand Rai Chandan Lal-IV(2004)CPJ-15(S.C.) and Deokar Exports Private Limited vs. New India Assurance co.Ltd-I(2009)CPJ-6(S.C.). As terms and conditions of the policies are binding on the complainant and as such, he cannot wriggle out of the terms and conditions of the policies now. These policies issued are Unit Link Products as per counsel for OPs and as such, Insurance Regulatory and         Development Authority (Linked Insurance Products) Regulations, 2013 as notified in The Gazette of India : Extraordinary Part III through notification No.F.No./IRDA/Reg./15/73/2013 published on 16.2.2013 to govern the case.

10.               Regulation 1.A(d) of the above said regulations provides that date of payment of premium means the date on which premium payment is received by the insurer. Further, as per Regulation 1.A(f) of above said regulations, discontinuance means the state of a policy that could arise on account of surrender of policy or non-payment of the contractual premium due before the expiry of the notice period provided for stipulated in sub regulation (i) of Regulation 13(a) of these regulations. As the premium is payable annually and as such, on account of commencement of the policies w.e.f.17.9.2012 onwards, the next date for payment of premium was around 17.9.2013. That premium not paid and as such certainly the policies in question went in state of a discontinuance as per Regulation 1.A(f) of above pointed regulations.

11.               Regulation 1.A(o) of above said regulations of 2013 provides that lock in period means the period of five consecutive years from the date of commencement of the policy, during which period the proceeds of the discontinued policies cannot be paid by the insurer to the policyholder or to the insured, as the case may be, except in the case of death or upon the happening of any other contingency covered under the policy. Present case is not a case of discontinuance on account of death or on account of happening of any contingency covered under the policy, but it is a case of discontinuance of the policy due to non-payment of contractual premium due on after year i.e. on 17.9.2013 and as such, in view of provision of lock in period of 5 years, certainly the complainant not entitled for the refund of any amount until 17.9.2017, when the lock in period of 5 years will elapse.

12.               Even as per Regulation 7 contained in Chapter IV of the above said regulations, the minimum policy term for individual products shall be at least five years and as such, in view of this regulation and in view of stipulation of lock in period of 5 years from the date of inception of the policy through regulation 11 of the above said regulation, complainant not entitled to balance amount after deductions of discontinuance charges until 17.9.2017.

13.               As per Regulation 15 of above said regulations, where the policyholder does not exercise the option available in terms of proviso to sub regulation (i) of Regulations 13 (a), the fund value/policy account value of the policy shall be credited to the discontinued policy fund/policy account value. Further, as per this Regulation 15(a) of the above said regulations, the proceeds of the discontinued policy shall be refunded only upon the completion of the lock in period. So, in view of this regulation 15(a) and in view of non exercise of option of discontinuance of the policy in time, complainant entitled to the fund value/policy account value as per scale prescribed by regulation 13 of above said regulations only.

14.               Even as per Regulation 2(i)(vi) of Insurance Regulatory and Development Authority(Treatment of Discontinued Linked Insurance Policies) Regulations, 2010 published in Government of India Gazette in III Part on 1.7.2010, situation of discontinuance of the policy to arise on account of non-payment of the contracted premium due before the expiry of the notice period provided by sub regulation (1) of 5 of these regulations. Lock in period of 5 years from the date of commencement of the policy is envisaged by regulation 2(i)(viii) of above said regulations of 2010 bearing notification No.F.No.IRDA/Reg./2/52/2010.

15.               As per Regulation 6 of these regulations 2010, the fund value of the policy to be credited to the discontinued policy fund after lapse of period of 5 years i.e. lock in period, but after deductions of discontinuance charges etc as provided by Regulation 7 of these regulations 2010. So, complainant is not at all entitled to the refund of the value of discontinued policy till 17.9.2017 and as such, complaint being pre-mature is not maintainable. However, entitlement of the complainant for withdrawal from the policies will remain as per IRDA Regulations after expiry of lock in period of 5 years commencing from the      date of issue of policy and as such, order passed accordingly.

16.               As a sequel of above discussion, complaint disposed of in terms that entitlement of the complainant for withdrawal from the policy will be as per IRDA Regulations after expiry of lock in period of 5 years only commencing from the date of issue of policy. No order as to compensation and litigation costs is passed. Copies of order be supplied to parties free of costs as per rules

17.                         File be indexed and consigned to record room.

 

                              (Param Jit Singh Bewli)                       (G.K.Dhir)

                                           Member                                                           President

Announced in Open Forum

Dated:17.07.2017

Gurpreet Sharma.