DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BARNALA, PUNJAB.
Complaint Case No : 70/2015
Date of Institution : 22.04.2015
Date of Decision : 23.10.2015
Desh Raj son of Sukh Ram C/o UNIT ABH YARN 4, DEPT MAINTANC RING FRAME M/C, ABHISHEK INDUSTRIES LTD., (Now known as Trident Ltd.) Barnala, Tehsil and District Barnala.
…Complainant
Versus
PNB Met Life India Ins. Co. Ltd., (previously known as Met Life India Insurance Co. Ltd.,) Brigade Seshmahal, 5 Vani Vilas Road, Basavanagudi, Banglore-560004 through its Manager/Director.
PNB Met Life India Ins. Co. Ltd., PNB Bank, Main Branch, Shaheed Bhagat Singh Road, Barnala-148101 through its Branch Manager.
PNB Met Life India Ins. Co. Ltd., SCO 14-15, Ist Floor, Madhya Marg, Sec. 8, Chandigarh through its Manager/Incharge.
PNB Met Life India Ins. Co. Ltd., Monga Complex, Ist Floor, Haji Rattan Chowk, Mansa Road, Bathinda through its Manager/Incharge.
…Opposite Parties
Complaint Under Section 12 of Consumer Protection Act, 1986.
Present: Sh. N.K. Garg counsel for complainant.
Sh. P.S. Aulakh counsel for opposite parties.
Quorum.-
1. Shri S.K. Goel : President.
Sh. Karnail Singh : Member.
Ms. Vandna Sidhu : Member.
ORDER
(BY SHRI KARNAIL SINGH MEMBER):
The complainant namely Desh Raj has filed the present complaint under Consumer Protection Act, 1986 (hereinafter called as Act) against PNB Met Life India Insurance Company & others (hereinafter called as the opposite parties) on the ground that in the last week of January 2009, agent namely Neha (code No. 11070911) of opposite parties met the complainant and told that Met Life India Insurance Company Limited have launched a scheme that “if any investor invests a total amount of Rs. 36,000/- in three years with the opposite parties, in that event after five years the depositor will get Rs. 55,000/-”. It is further alleged that on the assurance of the agent of the opposite parties the complainant deposited Rs. 6,000/- in cash and also signed some blank papers. After few days the complainant received policy bearing No. 1200900793707 and customer ID No. DESH040519841A.
2. It is further alleged that the complainant paid Rs. 6,000/- as first premium on 11.2.2009 vide receipt No. FPF/2009/0016460. Thereafter, the complainant again paid an amount of Rs. 6,000/- but this time no receipt was issued by the opposite parties. Complainant again paid an amount of Rs. 6,000/- vide receipt No. C7141343 dated 23.2.2010 and again paid Rs. 18,000/- vide receipt No. C7469622 dated 22.12.2011 and in total the complainant paid Rs. 36,000/- to the opposite parties.
3. It is further alleged that in the month of August 2014 complainant telephonically contacted the opposite parties and requested the opposite party No. 4 to pay the above said amount of Rs. 55,000/- as assured by them, but the opposite party No. 4 put off the matter on one pretext or the other. On this the complainant approached the agent Neha and requested her to fulfill the promise and she assured the complainant that his amount will be returned as Rs. 55,000/- by the opposite parties and also told that he has to wait 5-6 months for the same.
4. It is further alleged that in the month of February 2015 the complainant again approached the opposite party No. 4 and requested for the payment of Rs. 55,000/-, but of no use. It is further alleged that ultimately the opposite parties flatly refused to talk or hearing the request of the complainant. The act of the opposite parties caused mental tension, agony, physical harassment and financial loss to the complainant. Thus, the present complaint is filed seeking the following reliefs.
To pay the amount of Rs. 55,000/- instead of Rs. 36,000/- alongwith interest.
To pay Rs. 25,000/- as compensation and Rs. 15,000/- as litigation expenses.
5. Upon notice of this complaint, the opposite parties appeared and filed a joint written version taking preliminary objections on the grounds that complaint is false, malicious, incorrect and malafide and further the same is baseless and vague. It is averred in the preliminary objections that, there is no 'consumer dispute' among the parties, as per the averments of the complaint etc. On merits, it is averred that the complainant with best known reasons has not pleaded that he had voluntarily applied for the insurance policy after fully knowing about the terms and conditions of the policy. That as per clause 6(2) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations, 2002, “While acting under regulation 6(1) in forwarding the policy to the Insured, the Insurer shall inform by letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms and conditions, he has the option to return the policy stating reasons for his objections, only then he shall be entitled to a refund of the premium paid, subject only to a deduction of a proportionate risk premium for the period on cover and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges”.
6. It is further averred that, the policy was issued on 10.2.2009 and the policy documents were dispatched to the complainant on 12.2.2009, which was duly delivered to the complainant. However, the complainant in spite of receipt of the policy documents, has not raised any objections or complaints during the free-look period and hence it was presumed that the contract of insurance, which we had with the complainant was legally concluded.
7. It is further averred that on 7.2.2009 the complainant after completely understanding the terms and conditions of our product “Met Growth RP” had voluntarily filled up the proposal form bearing No. 00793707 and signed it and offered a Model Premium of Rs. 6,000/- to be paid semi-annual towards the premium under the said policy. The complainant also signed the declaration for Unit Linked Products and Benefit Illustration Form on 7.2.2009. Thereafter, the policy documents alongwith the schedule and the standard terms and conditions, a welcome letter were dispatched to the complainant, which were duly delivered to him.
8. It is further averred that the complainant paid three premiums towards the said policy till 10.2.2010, which is amounting to Rs. 18,000/- and the complainant further failed to pay the premium due on 10.8.2010 and thus, as a result of which the policy was lapsed as per the terms and conditions of policy. Thereafter, on 22.12.2011 the complainant made payment of Rs. 18,000/- towards the premium due for 10.8.2010, 10.2.2011 and 10.8.2012. However, the same were not accounted into the said policy account as the complainant failed to submit the Declaration of Good Health Certificate with the opposite parties. It is further averred that the amount of Rs. 18,000/- was refunded to the complainant vide cheque bearing No. 16799 dated 25.5.2012 and the cheque was dispatached to him on 28.5.2012 through Blue Dart Courier vide consignment number 40364149195. However, the said cheque was returned undelivered. Subsequently, the undelivered cheque was cancelled and the amount is lying into suspense account of the opposite parties.
9. It is further averred that since the said policy was not reinstated by the complainant during the reinstatement period of two years thus, the policy was foreclosed on 10.8.2012 as per the terms and conditions of the said policy. However, an amount of Rs. 18,000/- lying in the suspense account needs to be refunded to the complainant and the opposite parties are always ready to refund the same to the complainant. They have dined the other allegations of the complainant and finally prayed for the dismissal of complaint.
10. In order to prove his case, the complainant tendered into evidence an affidavit of Vikas Kumar Ex.C-1, his own affidavit Ex.C-2, copy of proposal form Ex.C-3, copy of ledger prepared on 3.2.2009 Ex.C-4, copy of letter dated 11.2.2009 Ex.C-5, copy of schedule of policy Ex.C-6, copy of insurance beneficiary Ex.C-7, copies of receipts Ex.C-8 to Ex.C-10, copy of statement of account Ex.C-11, copy of service guidelines Ex.C-12, copy of terms and conditions Ex.C-13 and closed the evidence.
11. The opposite parties have failed to adduce any evidence despite many opportunities and therefore the evidence of opposite parties is closed by the order of this Forum order dated 15.9.2015.
12. We have heard the Ld. Counsels for the parties at length and have gone through the documents placed on record by the complainant.
13. In order to prove his, the complainant tendered in evidence his detailed affidavit Ex.C-2, wherein he has taken the same stand as taken in the complaint. Further, in support of his case, the complainant tendered in evidence copy of receipt No. C7141343 dated 23.2.2010, which shows that the complainant has paid a premium of Rs. 6,000/- to the opposite parties. Ex.C-9 is the another receipt No. C7469622 dated 22.12.2011, which also shows that the complainant has paid a premium of Rs. 18,000/- to the opposite parties. In support of his case the complainant tendered in evidence Ex.C-10 the first premium receipt No. FPF/2009/0016460 dated 11.2.2009 of policy No. 1200900793707, which also shows that the complainant paid the first premium of Rs. 6,000/- at the time of subscribing the policy. The complainant in his affidavit Ex.C-2 has specifically stated that after paying the first premium of Rs. 6,000/- vide receipt dated 11.2.2009 he also paid an amount of Rs. 6,000/-, but no receipt was issued by the opposite parties in respect of this premium. The complainant stated in his affidavit that in total he has paid Rs. 36,000/- to the opposite parties in the shape of premiums of his policy.
14. On the other hand the case of the opposite parties is that the complainant purchased a policy issued on the basis of the proposal form duly filled by the complainant and the policy was for five years and Rs. 6,000/- to be paid semi-annual towards the premium under the said policy. However, the complainant paid three premiums towards the said policy till 10.2.2010, which is amounting to Rs. 18,000/- and the complainant further failed to pay the premium due on 10.8.2010 and thus, as a result of which the policy was 'lapsed' as per the terms and conditions of policy. Thereafter, on 22.12.2011 the complainant made payment of Rs. 18,000/- towards the premium due for 10.8.2010, 10.2.2011 and 10.8.2012. However, the same were not accounted into the said policy account as the complainant failed to submit the Declaration of Good Health Certificate with the opposite parties. The amount of Rs. 18,000/- was refunded to the complainant vide cheque bearing No. 16799 dated 25.5.2012 and the cheque was dispatached to him on 28.5.2012 through Blue Dart Courier vide consignment number 40364149195. However, the said cheque was returned undelivered. Subsequently, the undelivered cheque was cancelled and the amount is lying into suspense amount of the opposite parties. However, the said amount is still lying in the suspense Account. The said policy was not reinstated by the complainant during the reinstatement period of two years, therefore the policy was 'foreclosed' on 10.8.2012 as per the terms and conditions of the said policy.
15. It is specifically mentioned in the version of the opposite parties that the policy could be reinstated within two years from the date of first unpaid premium, which is not remitted within that period. It is admitted fact by the opposite parties that the complainant on 22.12.2011 made the payment of Rs. 18,000/- towards the premium due for 10.8.2010, 10.2.2011 and 10.8.2012. It is further submitted by the opposite parties that an amount of Rs. 18,000/- was refunded to the complainant vide cheque bearing No. 16799 dated 25.2.2012 and the same was dispatched to him on 28.5.2012. However, the cheque was returned 'undelivered' and the amount is lying into the suspense account of the opposite parties.
16. It is admitted by the opposite parties in Para 10 of the written version that the complainant has paid three premiums towards the said policy till 10.2.2010 amounting to Rs. 18,000/- and the complainant since failed to pay the premium due on 10.8.2010 and therefore, it is submitted that the policy was lapsed as per terms and conditions of the policy.
17. Now the question arises whether the complainant paid the remaining three premiums as per terms and conditions of the policy. The procedure for reinstatement mentioned in the prospect as:-
4.6 Discontinuance of Premium
a. Discontinuance of Regular Premium within the first three Policy Years:
If any Regular Premium due within the first three years of the Effective Date of Policy remains unpaid even after the grace period from the dateof last unpaid premium, the benefit of the Sum Assured in the Policy will cease to exist and the Policy will lapse with effect from the due date of first unapid premium (“Lapse Date”).
Reinstatement of the Policy: When the Regular Premium is not paid during the grace period, the policy shall lapse. You may, however apply for reinstatement of the lapsed Policy while the Person Insured is alive subject to the following conditions:-
Request in writing for reinstatement within two (2) years from the date of the First unpaid premium.
Payment in full of an amount equal to all the Regular Premiums due but unpaid till the Effective Date of reinstatement and
Applicable reinstatement fee
The Effective Date of Reinstatement is the date on which the abovbe requirements are met and approved by the Company. On this date, all outstanding Policy charges shall be deducted from the above payment for the period between the Lapse Date and the Effective Date of Reinstatement.
In case of the death of the Person Insured during the time allowed for reinstatement of a lapsed policy, the Fund Value in the Unit Acount will be paid to the Policy Holder or Nominee, as applicable. Fund Value shall be calculated in accordance with the provisions mentioned in Section 4.5.The Fund Value shall be subject tothe performance of the underlying Unit Linked Funds and applicable Fund Management Charges.
If the Policy is not reinstated during the period allowed for reinstatement, the Policy will be terminated and the fund value net of the surrender charge shall be payable at the end of the reinstatement period or at the expiry of the third policy year, which ever is later.
18. The reinstatement of the policy was not done by the opposite parties as the complainant failed to fulfill the conditions as mentioned in the ibid clause. As per the ibid clause, the complainant is entitled to the fund value net of the surrender charge shall be payable at the end of the reinstatment period or at the expiry of the third policy year, whichever is later.
19. As a above discussion, the premium of first three installments amounting to Rs. 18,000/- due on 10.8.2010 is lying with the opposite parties and therefore in view of the above clause the complainant is entitled to the fund value net as referred to above after the expiry of the third policy year.
20. It is also worthmentioning here that the amount of Rs. 18,000/-, which is the amount of three installments i.e. Rs. 18,000/- is lying with the opposite parties. It is also admitted by them that the cheque was cancelled due to 'undelivered' and the amount is lying into suspense account. Since this amount is lying with them for the last three yeaers and the opposite parties are therefore liable to pay the sum of Rs. 18,000/- alongwith interest @ 9% on the said amount.
21. In view of the above discussion, the complaint of the complainant is partly accepted and the complainant is entitled to fund value net of the surrender charge of three installments of Rs. 18,000/- deposited till 10.8.2010 along with interest @ 9% per annum as discussed above, which is lying with them. The complainant is also entitled to Rs. 18,000/- along with interest @ 9% per annum from the date of deposit. There is no order as to costs. This order of ours shall be complied within 45 days from the date of the receipt of this order. Copy of this order be supplied to the parties free of costs. The file after its due completion be consigned to the records.
ANNOUNCED IN THE OPEN FORUM:
23rd Day of October, 2015.
(S.K. Goel)
President.
(Karnail Singh)
Member.
(Vandna Sidhu)
Member.
