DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA CC.No.135 of 25-03-2011 Decided on 18-07-2011
Balbir Kaur, aged about 57 years, wife of Ranjit Singh, H.No.22346, Shant Nagar, Bathinda. .......Complainant Versus
The Reliance Life Insurance, through its Chairman, H Block, Ist Floor, Dhirbubhai Ambani, Knowledge City Navi Mumbai, Maharashtra. The Reliance Life Insurance, through its Branch Manager, Sukhdev Singh Ahluwalia Complex, Hazi Rattan Chowk, Bathinda.
......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM
Smt. Vikramjit Kaur Soni, President. Sh.Amarjeet Paul, Member. Present:- For the Complainant: Sh. P.P.Nayyar, counsel for the complainant. For Opposite parties: Sh.Sanjay Goyal, counsel for opposite parties.
ORDER
Vikramjit Kaur Soni, President:-
1. The present complaint has been filed by the complainant under Section 12 of the Consumer Protection Act, 1986 as amended up-to-date (Here-in-after referred to as an ’Act’). The brief facts of the complaint are that the complainant had purchased Insurance Policy under the name of Reliance Automatic Investment Plan from the opposite party No.2 on the allurement of the agent of the opposite parties and has filled his particulars on the prescribed performa vide application No.72968555 dated 20.02.2008 by authorized agent of the opposite parties and a cheque no.083930 dated 21.02.2008 drawn on HDFC Bank, Bathinda for a sum of Rs.25,010/- was issued in the name of the opposite parties by the complainant. The opposite parties issued a receipt No. Y 80022693 and also issued ID number of the complainant 3399743 and Contact No.11571123. At that time, the complainant was not issued any policy papers nor she was given any copy of terms and conditions of the Insurance Policy rather she was told that the papers would be given to her later on as the same has not been received from their higher officials i.e. Mumbai. The said Insurance Policy of the opposite parties was for a period of 5 years and also assured that the Policy will yield good returns and the complainant can also avail Tax rebate under 88 CC. For the first time, the complainant came to know that the premium term is 5 years, Policy term is also 5 years but the opposite parties mentioned the date of commencement 12.05.2008 while the complainant issued the cheque of Rs.25,010/- in the month of February, 2008 but the Policy was issued for a sum of Rs.25,000/- only and the opposite parties made the Insurance of the complainant w.e.f. 12.05.2008 which means the opposite parties utilized the said amount of Rs.25,000/- which was duly received on 21.02.2008 for their personal use. The opposite parties are showing the installment premium of Rs.25,000/- and Rs.10/- showing depositing in hand. The opposite parties did not make the Insurance Policy of Rs.25,010/-. Thereafter, the complainant wrote a letter to the opposite party No.1 and stated that the complainant has taken tax rebate but after receiving policy, the complainant came to know that it had been issued to the complainant on 12.05.2008 and the amount invested is also shown as Rs.25,000/- due to that the allocation charges has been increased by 2.5% but the opposite parties have given no reply to the said letter. The complainant again approached the opposite party No.2 and requested for the return of Rs.25,010/- i.e. Premium amount. The complainant has also issued a legal notice dated 26.10.2010 to the opposite parties. In reply to the legal notice, the opposite parties have replied that they had sent a letter dated 28.02.2008 requesting her to undergo medical examination and further stated that the complainant did not comply with the said requisition subsequently and again on 10.05.2008, they written another letter to the complainant for producing the medical test report and they have issued the Policy on non medical term with reduced sum assured with the condition that if she is not agreeable to the terms of the Policy, she has a right to cancel the policy within 30 days and thereafter, a policy bearing No.11571123 was issued on May 12, 2008 with yearly premium of Rs.25,000/- for sum assured of Rs.1,25,000/- with the risk commencement date as May 12, 2008. The complainant has alleged that neither the agent disclosed any medical tests nor any letter for medical test was issued to the complainant. If the complainant did not produce her medical examination test, the policy should be stopped/cancelled automatically by the opposite parties at that time and returned the amount of the Policy but in the present case, the opposite parties have not stopped or cancelled the policy and issued the policy on 12.05.2008. Hence, the complainant has filed the present complaint for seeking directions of this Forum to the opposite parties to pay the entire amount alongwith with Rs.10/- and interest @ 18% alongwith cost and compensation. 2. The opposite parties have filed their joint written statement and pleaded that the complainant had availed the Reliance Automatic Investment Plant Regular Policy by paying yearly premium amount of Rs.25,000/- for a Sum Assured of Rs.1,25,000/- through application Form No.72968555. She had applied for Reliance Automatic Investment Plan Regular Policy by submitting the Proposal Form and issued a cheque bearing No.083930 dated 21.02.2008, drawn on HDFC Bank amounting to Rs.25,010/- for the payment of first installment of the premium. On the receipt of Proposal Form, the opposite parties sent a letter dated February, 2008 requesting the complainant to undergo the medical examination to underwrite the risk as the complainant had reached 53 years of age. The complainant failed and neglected to provide the medical reports as instructed by the concerned letter dated February, 2008. Subsequently, the opposite parties sent a letter dated 10.05.2008 whereby the complainant was intimated that since she has not submitted the required medical test reports inspite of repeated requests made to her. The opposite parties are constrained to issue the policy to her on non medical terms with reduced sum assured alongwith the option to cancel the said Policy within 30 days if she is not agreeable to the terms and conditions. The premium applicable to the sum assured of Rs.1,25,000/- for the complainant was Rs.25,000/- and as such, an amount of Rs.25,000/- was adjusted in May 2008 out of the amount of Rs.25,010/- paid by the complainant. The opposite parties have further pleaded that the complainant had not exercised the option to cancel the aforesaid policy within the stipulated 30 days provided for cancellation which amounted to acceptance of the terms and conditions of the said Policy. 3. Parties have led their evidence in support of their respective pleadings. 4. Arguments heard. Record alongwith written submissions submitted by the parties perused. 5. The main allegation of the complainant is that the opposite parties have got deposited Rs.25,010/- from the complainant and the complainant was issued ID number 3399743 and Contact No.11571123 but when she received the receipt of first premium, she was astonished to know that the Policy term was of 5 years and the commencement date was written as 12.05.2008 on the Policy and the amount deposited by the complainant i.e. Rs.25,010/- has been used by the opposite parties since February 2008 and the Insurance has been issued on 12.05.2008 and has further submitted that the opposite parties have to release the entire amount of the Insurance Policy alongwith Rs.10/- as the Policy has been issued quite late to the complainant. The complainant has also sent a legal notice to the opposite parties. The opposite parties have given reply to the said legal notice. In para no.2 of the reply of the legal notice, the opposite parties have specifically mentioned that Balbir Kaur had expressed her willingness to apply for a Reliance Automatic Investment Plan – Regular and accordingly she had filled the Proposal Form and paid the premium amount vide cheque bearing No.083930 dated February 21, 2008 drawn on HDFC Bank for Rs.25,010/-. On receipt of the Proposal Form, the opposite parties sent a letter dated 28.02.2008, requesting her to undergo the medical examination for underwriting the risk vide Ex.C-4. However, Balbir Kaur the complainant/policy holder did not comply with the said requisition. Subsequently, on May 10, 2008 the opposite parties sent a letter to the complainant wherein they have again intimated her that she has not submitted the medical test report despite their repeated requests. Hence, they constrained to issue the Policy on non medial term with reduced sum assured, with the condition that if she is not agreeable to the terms of the Policy, she has a right to cancel the policy within 30 days of the issuance of the Policy vide Ex.C-5. The relevant portion of the Ex.C-5 is reproduced as under:- “In the Company’s underwriting norms, we had keeping in view, the Sum Proposed for insurance and other factors such as the age of the life to be insured, the information furnished in the Proposal advised you to undergo a medical examination/Laboratory tests as stated in our communication dated 28.02.2008. However, we have observed that we have not yet received your medical examination/laboratory tests, as a consequence of which we are unable to process the proposal form any further. In case you are not inclined to undergo the medical examination/ laboratory tests, the Company is prepared to consider the proposal without the medical test/lab tests under its Non-medical category where the proposal will be evaluated for acceptance or otherwise on the basis of the information furnished in the proposal form though for a lower Sum Assured of Rs.1,25,000/-. In light of the above situation, we would be issuing a policy with a Sum Assured of Rs.1,25,000/- which is within the non medical limits of the Company. Kindly go through the sum assured and premium details and in case, you are not agreeable to the above, you may inform us your disagreement, not later than 30 days from the date of receipt of this letter, failing which, it will be presumed that you are agreeable to the above action of the Company as also to the terms and conditions of the Policy.” 6. During this period of 30 days, the complainant did not approach the opposite parties to cancel the said Policy. Therefore, agreeing with the terms and conditions of the said Policy, the Policy bearing No.11571123 was issued on 12.05.2008 with yearly premium of Rs.25,000/- for the Sum Assured of Rs.1,25,000/- with the Risk Commencement dated as May, 12, 2008. The opposite parties had received the cheque bearing No.083930 dated 21.02.2008 drawn on HDFC Bank for Rs.25,010/- but on repeated intervals, the complainant has been asked for medial checkup and reports which is an underwriting pre-requisite for issuance of policy for assessment of the risk but the complainant has failed to pay any heed to the same, forcing the opposite parties to issue the policy to the complainant on non-medical terms. The complainant has not complied with the requisite formalities for submitting the medical test reports. Therefore, the Policy was issued on non medical terms and reduced the Sum Assured. 7. A perusal of Ex.C-6 i.e. Photocopy of Reliance Automatic Investment Plan shows in plan details, column No.11, policy terms 5 years, premium paying terms 5 years, Sum Assured Rs,1,25,050/- and the installment/Single premium Rs.25,010/-. This plan has been fully accepted and signed by Balbir Kaur, the complainant which shows that the complainant was fully aware the contents of this plan. Thereafter, the complainant has written a letter bearing no date at all to the opposite parties regarding discrepancies in issuance of the policy, its date and amount invested for insurance vide Ex.C-7. 8. A perusal of Ex.C-9 also shows that the date of commencement is 12.05.2008, the policy terms 5 years and date of last premium is 12.05.2012. Further, a perusal of Ex.C-10 i.e. first premium receipt shows that the amount of Rs.10/- is held in depositing. The opposite parties have duly quoted the reasons that why the policy has been issued in May, 2008 and why the premium has been credited as Rs.25,000/- in her account. 9. Naresh Garg, Branch Manager, Reliance Life Insurance Co Ltd has deposed in his affidavit Ex.R-1 that the complainant had applied for the Reliance Automatic Investment Plan Regular Policy by submitting the Proposal Form and issued a cheque bearing No.083930 dated 21.02.2008 drawn on HDFC Bank amounting to Rs.25,010/- for the payment of first installment of the premium. Thereafter, the complainant was requested by the opposite parties to submit the medical report but when the complainant has failed to submit the medical examination report. Ultimately, the opposite parties have issued a policy on non medical terms with reduced Sum Assured and had given option to the complainant to cancel that policy within the stipulated period of 30 days but the complainant has not applied for cancellation of the Policy. The premium applicable to the Sum Assured of Rs.1,25,000/- was of Rs.25,000/- as such, the amount of Rs.25,000/- was adjusted in May 2008 as first premium/installment out of Rs.25,010/- deposited by her. Further, the complainant has filed the present complaint on 25.03.2011. If he was not satisfied, he should have approached the opposite parties earlier. 10. Therefore, in view of what has been discussed above, this Forum is of the considered view that there is no deficiency in service on the part of the opposite parties. Hence, this complaint is dismissed without any order as to cost. 11. A copy of this order be sent to the parties concerned free of cost and file be consigned for record. ’ Pronounced 18.07.2011 (Vikramjit Kaur Soni) President
(Amarjeet Paul) Member |
