THE KARNATAKA STATE CONSUMER DISPUTES
REDRESSAL COMMISSION, BANGALORE. (ADDL. BENCH)
DATED THIS THE 29th DAY OF NOVEMBER 2021
PRESENT
SRI RAVI SHANKAR – JUDICIAL MEMBER
SMT. SUNITA C.BAGEWADI - MEMBER
APPEAL NO. 1800/2012
M/s Bajaj Allianz Life Insurance Co., Ltd.,
No.897, B Silver Line Arcade, 80 feet Road,
6th Block II Floor, Pizza Hut, Koramangala,
Bangalore-560 045. Reptd. by its
Authorized Signatory Mr. M.Aravinda,
Zonal Legal Manager.
….Appellant/s.
(By Shri/Smt. J.R.Jagadeesh, Adv.,)
-Versus-
1. Miss. Pallavi .D
D/o Devareddy,
Aged about 20 years,
Dibboorahalli (Village & Post),
Shidlaghatta Taluk,
Kolar District.
2. Mr. K.s.Narayanaswamy
Manager, Branch Office,
Bajaj Allianz Life Insurance Co.,
Near Police Quarter Road,
Dinnehosahalli Circle,
Chikkaballapur District.
(In persons)
……….. Respondent/s
:ORDERS:
SMT. SUNITA C.BAGEWADI – MEMBER
This appeal is filed by the appellant/Opposite Party against the order dated:15/05/2012 passed by the Kolar District Consumer Commission in C.C.No.228/2011.
2. The brief facts of the complaint are as under:-
The Opposite Party No.2 approached the complainant and insisted her to invest the amount for 5 years and persuaded her in this regard for 2 or 3 months. The Grand Father of the complainant refused stating that complainant is studying in PUC and for her education and for the marriage, he is going to invest the amount in Post office for 3 years and whenever required he may withdraw it, then Opposite Party No.2/Respondent No.2 told him that even in their company i.e. appellant/Opposite Party No.1 there will be deposit scheme of 3 years and if deposited they will get better facilities, bonus etc., and showed certain bogus planning vouchers and also assured that he will give away the commission that is going to be given to him. Accordingly, the Opposite Party No.2 collected Rs.20,000/- each for 3 policies i.e., 0085660574, 0085440895 and 0085459795.
2(a) The complainant further submitted that Opposite Party No.2 has received Rs.60,000/- from the complainant on 11.10.2007 and gave duplicate receipt and when asked the Opposite Parties stated that they will send correct receipts by post within 3 days. But the Opposite Party No.2 has not issued the receipts. Three months later, when questioned, he has issued receipt dated:01.02.2008 for 3 policies each, when questioned again, he has stated that the computer has gone wrong and it will be rectified. The Opposite Parties have collected for 3 years i.e. Rs.1,80,000/- from the complainant. The Opposite Parties have issued receipts without containing policy numbers and wrong dates from the beginning. When these discrepancies were found out, the complainant contacted the Opposite Party No.2 and quarreled with him and Opposite Party No.2 told somehow these mistakes had crept-in and he would rectify the same. Thus he has collected the amount for 3 years without rectifying the receipts. On 24.02.2010, when Rs.60,000/- had been paid, the computer section madam of the Opposite Party gave receipt dated:19.07.2010 and on seeing the receipt, Venkatareddy, Grand Father of complainant told to rectify the mistakes in the receipts.
2(b) The complainant further submitted that she demanded the amount of Rs.1,80,000/-, at that time, the Opposite Party No.2 threw away the receipts and Opposite Party No.2 got some letter written in English allegedly stating that he will rectify the defects and took the signature of Venkatareddy-grandfather of complainant who does not know the English language. It is further submitted that when the complainant wanted her amount back, the Opposite Parties gave letter stating that she is getting only Rs.1,64,450.13. This is nothing but deficiency in service and unfair trade practice. When the complainant had paid Rs.1,80,000/-, she should get more, but statement of the Opposite Party that she is getting only Rs.1,64,450.13 is nothing but unfair trade practice, fraud, cheat and deficiency in service. Hence, filed the complaint.
3. After receipt of notice, the Opposite Party No.1 appeared through his counsel and filed the version contending that the complaint is bad for mis-joinder of necessary parties and the complaint is barred by time. Policies are lapsed for non-payment of renewal premiums. Complaint is to be dismissed on the principles of Allegatio contra factum non est admittenda and Nullus commodum capere potest ex sua injuria propria. Complainant has voluntarily approached the Opposite Parties seeking to take policy under scheme “New Unit Gain”. The Opposite Party further contended that the policy No.0085453536 given by them does not belong to the complainant. The Opposite Party No.1 is not aware of Opposite Party No.2 approaching the complainant. The complainant has filed the complaint before the District Legal Aid Services and withdrawn the complaint therein. In the said complaint before the District Legal Aid Services, the Opposite Parties have clearly stated what would be the surrender value the complainant is entitled to. Being not satisfied with it, the complainants have withdrawn the complaints there and come before this Forum. Mere perusal of the documents of the policies clearly proves that it is not for three years. The surrender value is as per the terms of the policy. Now the policies are in lapsed condition. Hence, the amount will be still less and therefore prays to dismiss the complaint.
3(a) The Opposite Party No.2 also appeared and filed the version contending that he is not an agent of Opposite Party No.1, but he is a Sales Manager and admitted about obtaining of the policy from complainant. The question of inducement by this Opposite Party does not arise. Through the Agent Mr.Devraj, complainant approached the Opposite Party No.1 regarding New Unit Gain Policy. There is free look period of 15 days in the policy. Complainant has not availed of the same. Period of the policy was not for three years and it did not end on 11.02.2011. All the allegations to the contrary are denied and prays to dismiss the complaint.
4. We have heard the arguments from appellant side. In spite of giving sufficient opportunities, the respondent has not argued the matter.
5. Perused the appeal memo, order passed by the District Commission, Kolar and materials on record, we noticed that it is an admitted fact that the respondent had taken three insurance policies of Rs.20,000/- premium per year from Opposite Party No.1 and the respondent/complainant had paid the premium for three years, in all the respondent/complainant had paid Rs.1,80,000/- to the Opposite Parties/appellants and denies all other allegations of the respondent/complainant. The appellant/Opposite Party further contended that period of the policy was not for three years and it did not end on 11.02.2011 and the policies are lapsed for non-payment of renewal premiums. The appellant/Opposite Party further contended that the complainant has filed the complaint before the District Legal Aid Services and withdraw the complaint and in the said complaint, the appellant has clearly stated that what would be surrender value, the complainant is entitled to.
6. Perused the appeal memo, we noticed that the same contention was taken by the appellant that the respondent No.1 would be entitled to Rs.1,64,450.13 after deducting mortality charges fund management charges and surrender value as per Section 6(c) of the terms and conditions of the policy, which was taken before the District Legal Aid Services. Perused the materials on record; the policy which was taken by the respondent is regular premium policy and premium must be paid before 11th February of every year and due date of last premium is 11.02.2027, that means the period of policies was not for three years and it did not end on 11.02.2011. The complainant has paid the premium every year without fail for three years and this fact was admitted by the Opposite Parties.
7. Perused the terms and conditions of the policy Section 6(c), which reads as under:-
“ (i) The surrender value, if any is payable only after first three policy years provided all due Regular Premiums during the first three policy years have been paid. If Regular premiums due during first three policy years have not been paid, the payment of surrender value shall be subject to Section 5)b).
(ii) The Surrender Value payable will be equal to the Regular Premium Fund Value less the Surrender charge as per Section 33)g) plus the Top Up premium value if any”.
And (5)(b) of the police terms and conditions reads as under:-
“In the event of failure to make payment of full Regular premium falling due during the first three policy year and non-payment of complete amount due even within the grace period the policy shall automatically and immediately lapse for the insurance cover including the …….”
8. In the present case, the respondent had paid premium for first three policy years without fail. Hence, the respondent is entitled to the amount which she paid towards insurance policy after deducting the surrender charges as per Section 6(c) of the terms and conditions of the policy. The insurance policy is the contract between the insurance company and customer and both are binding to the terms and conditions of the policy. There is no any provision or Clause for full refund of the premium paid. It is not the duty of the Courts to change the terms and conditions of the policy and directed to Opposite Parties to pay Rs.1,80,000/- with 12% interest. Moreover, the Opposite Parties contended in his objection that when the complainant was raised the dispute before the Legal Aid Services Authority, the appellant has clearly stated that the surrender value is Rs.1,64,450.13 and the appellant cannot pay more than that. The complainant/respondent has also submitted that when the complainant wanted her amount back, the Opposite Parties gave letter stating that she is getting only Rs.1,64,45.13. Hence, in our opinion, the District Commission failed to appreciate the terms and conditions of the policy of insurance company and passed an order and directed the appellant to pay an amount of Rs.1,80,000/-, full refund with interest @ 12% P.A. Based on the above discussion, the order of the District Commission is required to be modified to the extent that the complainant is entitled to Rs.1,64,450.13 as per Section 6(c) of the policy terms and conditions along with 12% interest from the date of obtaining the polices till the date of filing the complaint before the District Commission, Kolar. Accordingly, we proceed to pass the following:-
:ORDER:
The appeal is Allowed.
The impugned order dated:15.05.2012 passed by Kolar District Consumer Disputes Redressal Commission in C.C.No.228/2011 is modified as under:-
The Opposite Parties are directed to pay Rs.1,64,450.13 to the complainant along with interest @ 12% P.A. from the date of obtaining the respective policies till the date of filing of the complaint before the District Commission. The Opposite Parties are also directed to pay Rs.10,000/- to the complainant towards cost of the litigation.
The Opposite Parties are further directed to comply the above order within 30 days from the date of receipt of this order, failing which the complainant is at liberty to proceed against the Opposite Parties as per the Consumer Protection Act.
The amount in deposit shall be transmitted to the concerned District Commission to pay the same to the Respondent No.1/complainant.
Send a copy of this order to both parties as well as Concerned District Commission.
Sd/- Sd/-
Member. Judicial Member.
Tss
