Haryana

Ambala

CC/23/2021

Kanver Pal Chauhan - Complainant(s)

Versus

Punjab National Bank - Opp.Party(s)

Sunil Kumar Arya

25 Sep 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, AMBALA.

Complaint case no.	:	23 of 2021
Date of Institution	:	12.01.2021
Date of decision	:	25.09.2023

Kanver Pal Chauhan son of Sh. Aphalatoon Singh resident of village and post office Shahzadpur, Tehsil Naraingarh, District Ambala

          ……. Complainant.

                                                Versus

1. Punjab National Bank, Ram Gopal Colony, Tau Nagar, Sonipat Rd, Rohtak, Haryana 124001 through its authorized signatory.
2. PNB Met life India Insurance Company Limited, 1st Floor, Techniplex -1, Techniplex Complex, off Veer Savarkar Flyover, Goregaon (West), Mumbai - 400062 through its authorized signatory.
3. PNB Met life India Insurance Company Limited branch Chandigarh, 2nd & 3rd floor, SCO 68-69, 17B, Chandigarh, 160017 through its authorized signatory

                                                                                   ….…. Opposite Parties.

Before:        Smt. Neena Sandhu, President.

                             Smt. Ruby Sharma, Member,

          Shri Vinod Kumar Sharma, Member.           

 

Present:       Shri Sunil Kumar Arya, Advocate, counsel for the complainant.

                     OP No.1 already ex parte vide order dated 08.09.2021.

                   Shri Dev Batra, Advocate, counsel for the OPs No.2 and 3.

Order:        Smt. Neena Sandhu, President.

1.                Complainant has filed this complaint under Section 35 of the Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) praying for issuance of directions to them to reinstate the insurance policy in question after depositing the remaining whole premium amount or in the alternative to refund the remaining insurance amount i.e. Rs.1,63,658/- and also to pay Rs.1 lac as compensation for mental agony and harassment and Rs.21,000/-  as cost or litigation expenses or grant any other relief which this Hon'ble Commission may deems fit and proper.

2.             Brief facts of the case are that the complainant is an ex-service man. He opened a saving account bearing no. 6398000100045945 in the bank of OP No.1. In the month of February 2014, the officials of OPs No.2 and 3 represented themselves to be the agent of the insurance company namely PNB Met-life and induced the complainant to purchase the insurance policy from OPs No.2 and 3. As such, he purchased insurance policy bearing no.21265631 dated  27.02.2014. At the time of purchase of the said policy, the officials of the OPs  assured the complainant that he could surrender the said insurance policy at any time and 90% amount out of deposited amount will be refunded to him by OPs No.2 and 3. The amount of Rs.6390/- per month was automatically deducted from the saving account of the complainant as premium from February 2014 to November 2019 i.e. for 70 months and in this manner, the complainant paid total premium amount of Rs.4,47,300/- to OPs No.2 and 3 against the policy in question. In the month of December 2019, when the complainant asked the officials of OPs, as to how much amount will be refunded to him, in case, he surrenders the policy, it was replied that  approximately Rs.4,02,570/-  i.e.  90% of amount of Rs.4,47,300/- will be refunded to him. However, when the complainant was ready to surrender his policy, he was surprised to see that only amount of  Rs 2,38,912/- stood transferred in his account by  OPs No.2 and 3 as  full and final payment. Thereafter the complainant contacted the officials of OPs and requested payment of the remaining amount but to no avail.  Under those circumstances, the complainant has moved an application to the OPs with a request to reinstate the insurance policy, but nothing was done.  Neither by reinstating the insurance policy nor by refunding the balance amount to the complainant, the OPs have committed deficiency in providing service. Hence, the present complaint.
3.           Upon notice, none appeared on behalf of the OP No.1 before this Commission, therefore, it was proceeded against ex-parte vide order dated  08.09.2021.
4.           Upon notice, the OPs No.2 and 3 appeared and filed written version wherein they raised preliminary objections to the effect that the present complaint is not maintainable; the complainant has attempted to misguide and mislead this Commission; no cause of action ever arose in favour of the complainant and against the OPs No.2 and 3 to file the present complaint etc. On merits, while admitting the fact that the policy in question stood purchased by the complainant from OPs No.2 and 3, it has been stated that before acceptance of the proposal, adequate information with regard to contents of the proposal form, illustrations addendum forms, product, nature and its significance were explained to the policy holder/life assured in the language best known to him by the concerned financial consultant/agent. Accordingly, after understanding all the terms & conditions of the policy, the proposal form was duly signed by the policy holder/life assured to that effect. OPs No.2 and 3 had sent the policy documents to the communication address mentioned in the proposal forms, stating the policy terms and documents and a forwarding letter stating the free look provision along with a copy of proposal form. The act and conduct of the policyholder in not returning/surrendering the policy to OPs No.2 and 3 within the given time signifies his acceptance of the terms and conditions mentioned in the said policy document. On 18 July, 2018, OPs No.2 and 3 received a call from the complainant asking about the policy loan and all the information regarding the same were dully explained to him by the contact center team.  Thereafter, on 26th July 2018, complainant raised a request for his KYC Updation i.e. PAN and Adhaar updation and same was rejected due to mismatch in the information vide letter dated 28.07.2018. Thereafter, OPs No.2 and 3 had received a letter from complainant on 03.12.2019 regarding the surrender of policy. The policy was issued on 27.02.2014 and due opportunity of raising any objection in free look period was provided to the complainant. Now the complainant has raised his concern after 4 years of issuance of policy. Consequently, OPs No.2 and 3 sent a reply of letter dated 08.12.2019 by accepting his request and processed the refund amount of Rs.2,38,912/-  which had been credited to his account through NEFT. However, OPs No.2 and 3 again received a request from the complainant on 12.12.2019 to reinstate the policy and OPs No.2 and 3 have replied the request through letter dated 16.12.2019. Even according to the Clause 3.3 of the terms and conditions of the policy, if the Policy is surrendered it shall not be subsequently reinstated.  Rest of the averments of the complainant were denied by the OPs No.2 and 3 and prayed for dismissal of the present complaint with heavy costs.
5.           Learned counsel for the complainant tendered affidavit of the complainant as Annexure CA and affidavit of Shri Raj Kumar son of Prem Chand resident of Village and post office Shahzadpur, Tehsil Naraingarh, District Ambala as Annexure CB alongwith documents as Annexure C-1 to C-16 and closed the evidence on behalf of the complainant. On the other hand, learned counsel for the OPs No.2 and 3 tendered affidavit of Mr. Arijit Basu, Senior Manager-Legal of the OPs No.2 and 3-Company, PNB Metlife India Insurance Company Limited, Unit No.302, Worldmark-3, Sector-65, Gurugram, Haryana-122018 as Annexure OP-2/A, alongwith documents as Annexure OP-1 to OP-9 and closed the evidence on behalf of OPs No. 2 and 3.
6.           We have heard the learned counsel for complainant and the learned counsel for the OPs No.2 and 3 and have carefully gone through the case file and also gone through the written arguments filed by the learned counsel for the OPs No.2 & 3.
7.           Learned counsel for the complainant submitted that by neither refunding the entire amount of premium paid by him nor reinstating the policy in question, despite the fact that he requested the OPs number of times, they are deficient in providing service. 
8.           On the contrary, the learned counsel for the OPs No.2 and 3 submitted that because the complainant had himself surrendered the policy in question, as such, as per terms and conditions of the policy in question, he was not entitled to get the said policy reinstated. He further submitted that the surrender value was calculated as per terms and conditions of the policy in question, and, resultantly, the amount of Rs.2,38,912/-  has been credited to his account through NEFT. The insured cannot claim anything more than what is covered under the insurance policy. The learned counsel for the OPs No.2 and 3 has placed reliance on the judgment dated 17.01.2013, passed by the Hon’ble Supreme Court of India, New Delhi, in the case of Export Credit Guarantee Corpn. of India Limited Vs. Garg Sons International and judgment dated 31.11.2021, passed by the Hon’ble National Consumer Commission, New Delhi, in the case of Babulal Das and Ors. Vs. Branch Manager, Aviva Life Insurance Company Limited and Ors. He has also quoted the law cases referred in the written arguments, filed by him. 
9.           It may be stated here that the grievance of the complainant is against the insurance company only i.e OPs No.2 and 3 regarding non-refund of the entire amount of premium paid by him and not reinstating the policy in question, as such, the bank has nothing to do regarding the same, thus, the complaint filed by the complainant against the Bank i.e OP No.1 is liable to be dismissed.  So far as the grievance of the complainant against the OPs No.2 and 3 regarding not reinstating the policy in question is concerned. It may be stated here that from condition no.3.3.1, of the terms and conditions annexed alongwith Annexure OP-5, it is evident that only the lapsed policy in question could be reinstated within 2 years from the first unpaid regular premium by giving written notice to the company. However, at the same time, condition no.3.3.1 (iv) clearly provides that if the policy is surrendered it shall not be subsequently reinstated.  Thus, since in the present case, it is the own case of the complainant that he surrendered the policy in question, as such, now he cannot wriggle out of condition no.3.3.1 (iv) referred to above i.e. the policy in question cannot be reinstated by the company. 
10.           As regards to the other grievance of the complainant that the OPs No.2 and 3 did not refund the entire amount of premium paid by him. It may be stated here condition no.3.5 of the policy in question deals with the Policy Surrender. Under condition no.3.5.3 (i) it is specifically mentioned that on receipt of request for surrender of the policy in question, the assured person will get special surrender value which shall be calculated by discounting (reducing) the paid up value by a surrender value factor on the date of surrender. Condition no.3.5.3 (ii) further provided that surrender value factor depends on the then prevailing market conditions and is not guaranteed. It may be stated here that admittedly, in the present case, OPs No.2 and 3 have paid an amount of Rs.2,38,912/- out of Rs.4,47,300/-. At the time of arguments also, learned counsel for OPs No.2 and 3 has vehemently contended that the said amount of Rs.2,38,912/- stood refunded to the complainant strictly as per conditions no.3.5.3 (i) and (ii) aforesaid. However, on the other hand, learned counsel for the complainant has miserably failed to rebut the said contention raised by OPs No.2 and 3 by placing on record any cogent and convincing evidence or otherwise. It is significant to mention here that parties are bound by the terms and conditions of the policy and no one wriggle out from the same.  In the case of Export Credit Guarantee Corpn. Of India Limited Vs. Garg Sons International (Supra), the Hon’ble Supreme Court of India has held that- ― “The insured cannot claim anything more than what is covered by the insurance policy…...the terms of the contract have to be construed strictly, without altering the nature of the contract as the same may affect the interests of the parties adversely….”. In the case of Babulal Das and Ors. Vs. Branch Manager, Aviva Life Insurance Company Limited and Ors. (Supra), the Hon’ble National Commission has held that- “It is a settled principle of law that the policy bond is a concluded contract and insured and insurer are bound by the terms and conditions of the policy….:”  Thus, under these circumstances, this Commission is of the view that there is no deficiency in providing service on the part of the OPs No.2 and 3 also and the complaint filed against them is also liable to be dismissed.
11.           In view of the aforesaid discussion, it is held that the complainant has failed to prove his case, therefore, no relief can be given to him. Resultantly, this complaint stands dismissed with no order as to cost. Certified copy of the order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced:- 25.09.2023.

 

(Vinod Kumar Sharma)	(Ruby Sharma)	(Neena Sandhu)
Member	Member	President