Haryana

Kurukshetra

05/2018

Gurdarshan Kaur - Complainant(s)

Versus

PNB - Opp.Party(s)

Ashok Bansal

23 Jul 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KURUKSHETRA.

                                                     Complaint Case No.05 of 2018.

                                                     Date of institution: 09.01.2018.

                                                     Date of decision: 23.07.2019.

Gurdarshan Kaur aged about 60 years wife of Sr. Jagtar Singh, resident of House No.667, Sector-3, Kurukshetra. HHo

…Complainant.

                        Versus

1. PNB Metlife India Insurance Company Limited (Insurance Regulatory and Development Authority Life Insurance Registration No.117), Registered Office “Brigade Seshamahal” 5 Vani Vilas Road Basavanagaudi Banglore- 560004 through its Chief Operating Officer.
2. PNB Metlife India Insurance Company Limited, SCO No.36, Sector-11, Panchkula through its Branch Manager.
3. Punjab National Bank, Branch Office, Railway Road, Kurukshetra through its Branch Manager.
4. Surender Chahal, Circle Manager, Bancassurance-I India-I, PNB Metlife India Insurance Company Limited, Chadha Complex, Pipli, Near Heritage Hotel, District Kurukshetra.
5. Kamal Sachdeva PNB Metlife India Insurance Company Limited, SCO No.68/69, 2^nd Floor, Sector-17B, Chandigarh.

….Opposite parties.

Before:      Smt. Neelam Kashyap, President.

                Ms. Neelam, Member.

                Sh. Sunil Mohan Trikha, Member.

Present:     Sh. Ashok Bansal, Advocate for complainant.   

Sh. Arvind Bhardwaj, Advocate for opposite parties No.1,2,4 and 5.

                Sh. Lovkesh Machhal, Advocate for opposite party no.3.

Defence of op no.3 struck off.

ORDER

                This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Smt. Gurdarshan Kaur against the PNB Metlife India Insurance Company Limited and others, the opposite parties.

2.            It is stated in the complaint that complainant has purchased an insurance policy bearing No.21356877 which was issued by op no.1 on 25.7.2014 and the risk cover under the policy commenced from 23.7.2014. The policy was issued by op no.1 through its Branch office i.e. op no.2 and as per record of op no.1, the client ID is 52757394. That the complainant paid the regular installments of Rs.25,000/- each for the last four years to the ops. That the complainant paid the third premium under the policy of insurance through cheque No.006250 of OBC, Branch Office Umri and deposited with Punjab National Bank i.e. op no.3 and the said cheque has been cleared in favour of op no.1 on 27.6.2016. That op no.1 inspite of receipt of premium of third premium through encashment of cheque has not issued the receipt rather started to harass the complainant by doing the telephonic calls and to send message with regard to the lapse of the policy and giving a chance to the complainant for reviving the same. After receipt of the messages and phone calls, the complainant inquired the matter from the Punjab National Bank i.e. op no.3 and op no.3 asked the complainant to submit an application for correction in the record. Accordingly, the complainant moved an application to op no.3 for correction in the installment of policy No.21356877 despite the fact that she was not at any fault. After receipt of the said application, the op no.3 forwarded the matter to the op no.4 namely Surender Chahal and complainant also met him personally. The op no.4 assured the complainant that he will soon get corrected the said mistake and further directed the complainant to deposit the next/4^th premium of the policy and assured that he will provide her both the premium receipts. It is further averred that as per instructions of op no.4, the complainant handed over the cheque bearing No.006261 qua the forth premium of the policy to op no.4 and the same has been deposited by op no.4 in the account of op no.1 but after depositing fourth premium, the op no.4 issued the receipt only for the fourth premium and has not issued the receipt for the third premium which they considered as disputed. That op no.1 is continuously sending the messages and doing the phone calls to the complainant for reviving the policy after deposit of third premium, which the complainant had already deposited to op no.1 on 27.6.2016. That the complainant alongwith her husband contacted several times to the ops namely Surender Chahal, Circle Manager and op no.3 and requested them that she has already deposited the third policy premium, so there is no requirement to revive the policy in question, but inspite of this, the ops and their officials are blackmailing the complainant by making phone calls only with the intention to harass her inspite of sorting out the matter regarding third premium on their own level. That this act and conduct of the ops is totally illegal, unreasonable and in violation of the terms and conditions of the policy of insurance and there is great deficiency in the service on the part of ops and they have adopted illegal and unfair trade practices. Hence, this complaint for a direction to the ops to release the amount of Rs.1,00,000/- deposited in four installments with the ops alongwith interest @18% per annum and other benefits, to pay a sum of Rs2,00,000/- as compensation for harassment, to further pay a sum of Rs.11,000/- as litigation expenses and to issue receipt of third premium.

3.             Upon notice, opposite parties appeared. Ops no.1,2, 4 and 5 filed joint reply taking certain preliminary objections. It is submitted that complaint is false and fabricated and mere concocted story on her own imagination, that through present complaint, complainant has tried to mislead this Forum by baseless averments, that complainant has made all false averments with no documentary proof on record. It is submitted that subject policy was issued on 23.7.2014 on payment of first premium vide cheque no.697379. Thereafter, the next premium was due on 23.7.2015 which was also received by the op company hence policy continued. That the third premium installment was due on 27.6.2016 which was not received by the company even during the grace period of 30 days hence the policy entered into lapsed mode on 22.8.2016. Thereafter, the company was in receipt of premium on 13.9.2017 through direct debit from the complainant after which various reinstatement requirement letters regarding medical examination were sent by the op company to the complainant. That ultimately complete medical reports were uploaded on 9.12.2017 by the complainant and policy got reinstated on 14.12.2017. However, since premium towards 23.7.2017 was still pending policy status again got changed to Paid up on 14.12.2017 itself. It is further submitted that complainant has wrongly made ops no.4 and 5 parties to the present complaint as they are Circle Manager of the insurance company and they are neither necessary parties nor proper parties for present complaint. It is further submitted that prayer of complainant for refund of premium in the present case is completely against established laws relating to life insurance. It is trite law that the premium is given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period for which the premium has been paid. It is not the case of complainant that risk was not covered for the period for which the premium was given. In view of same, the risk stood covered for the period for which premium had been paid, hence there is no question of refund of any premium amount. It is further submitted that insurance company acted as per the mandate given to the life assured in proposal form and terms of subject policy and issued insurance policy and took all decision in conformity of insurance terms and conditions which is concluded contract between insurance company and life assured. It is further submitted that it is settled law that insurance terms have to be construed strictly and no relief which travels beyond terms of subject insurance policy can be granted. It is further submitted that life assured was duly informed that in case she is not satisfied with the features or the terms and conditions of the policy she can withdraw/ cancel the policy under the “Free Look Period” provision which is within 15 days from the date of receipt of policy document. The life assured retained the policy document and did not raise any objection towards the policy during the free look period with any grievance regarding the policy or its terms and conditions, policy terms, meaning thereby that the life assured agreed to the policy and its terms and conditions. It is further submitted that complainant has concealed and suppressed the material and relevant facts. It is further submitted that copy of second and third premium receipt is annexed. That on 26.8.2016, an email was received by insurance company with respect to subject policy from one namely “Jagtar Sandhu” from email ID as

4.             Opposite party no.3 appeared through official and then through counsel and adjournments were sought for filing written statement but op no.3 did not file written statement and as such its defence was struck off.

5.             Learned counsel for complainant tendered affidavit Ex.CW1/A and documents Ex.C1 to Ex.C8. On the other hand, learned counsel for ops no.1,2, 4 and 5 tendered affidavit Ex.RW1/A and documents Ex.R1 to Ex.R5.

6.             We have heard learned counsel for the parties and have perused the case file carefully.

7.             It is an admitted fact between the parties that complainant purchased insurance policy No.21356877 from ops no.1 and 2 on 25.7.2014 and according to the complainant she has paid premium amount of Rs.25,000/- each for four times in time and the bone of contention between the parties is regarding third premium. The complainant claims to have deposited the amount of Rs.25,000/- on 27.6.2016 through cheque no.006250 deposited with Punjab National Bank i.e. op no.3 but the ops no.1,2,4 and 5 have averred that first two premiums were received from complainant in time and third premium which was due on 27.6.2016 was not received by the company even during the grace period of 30 days, hence the policy entered into lapsed mode on 22.8.2016. It is further the case of above said ops that thereafter the company was in receipt of premium on 13.9.2017 through direct debit from the complainant after which various reinstatement requirement letters regarding medical examination were sent  by the op company to complainant and ultimately complete medical reports were uploaded on 9.12.2017 by the complainant and policy got reinstated on 14.12.2017. Learned counsel for op no.3 has contended that there is no fault of any kind of op no.3 as the amount of Rs.25,000/- received from the complainant through cheque was deposited in the account of op no.1 on the same day i.e. 30.6.2016 and has placed on record copy of transactions inquiry. From the copy of transaction enquiry placed on record at the time of arguments, it is evident that an amount of Rs.25,000/- was deposited with Punjab National Bank branch Thanesar i.e. op no.3 against the premium of the policy in question by way of cheque on 30.6.2016 as premium for policy No.21356877 and same was deposited in the account of ops no.1 and 2 on the same day by op no.3 and as such op no.3 is not at fault. Since the ops no.1 and 2 received the premium on 30.6.2016 itself from the complainant through op no.3 but despite that they have pleaded that policy became lapsed due to non payment of third premium which is gross deficiency in service on their part due to which the complainant has to suffer as she has to undergo medical examination etc. for reinstatement of the policy in question. The ops no.1 and 2 are also liable to count the third premium deposited on 30.6.2016 and to continue the policy in question. However, no liability of remaining ops is made out.

8.             In view of the above, we allow the present complaint and direct the opposite parties no.1 and 2 to pay compensation of Rs.20,000/- for harassment and litigation expenses to the complainant within a period of 45 days from the date of receipt of copy of this order. We also direct the ops no.1 and 2 to count the third premium deposited on 30.6.2016 and to continue the policy in question within above said period. A copy of this order be supplied to the parties free of costs. File be consigned to the record room.

Announced in open Forum:

Dt.: 23.07.2019.                                                  (Neelam Kashyap)

                                                                        President.

(Sunil Mohan Trikha),           (Neelam)       

Member                             Member