Tamil Nadu

North Chennai

52/2014

V.Viswanathan,S/o.S.R.Viswanathan, - Complainant(s)

Versus

Rep by its General Manager& another - Opp.Party(s)

M/s.C.S.Kiran & S.Krishnaa

08 Feb 2017

ORDER

 

 

                                                            Complaint presented on:  06.09.2013

                                                                Order pronounced on:  21.02.2017

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHENNAI (NORTH)

    2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

PRESENT: THIRU.K.JAYABALAN, B.Sc., B.L.,        PRESIDENT

                    TMT.T.KALAIYARASI, B.A.B.L.,           MEMBER II

 

TUESDAY  THE 21^st  DAY OF FEBRUARY 2017

 

C.C.NO.52/2014

 

 

V.Vishwakiran,

S/o. S.R.Viswanathan,

‘Vishwapriya’ Plot Nos.33 & 34,

2^nd Street, Sairam Avenue,

Valasaravakkam,

Chennai – 600 087.

                                                                                    ….. Complainant

 

..Vs..

 

1. Bajaj Allianz Life Insurance Company Ltd.,

Regd. Office:GE Plaza, Airport Road,

Yerawada, Pune- 411 006,

Rep.by its General Manager,

 

2. The Manager,

Bajaj Allianz Life Insurance Company Ltd.,

Regional Off: No.13/L, Plot No.3631, 4^th Floor,

Bhagawathi Palace,

3^rd Avenue, ‘J’ Block,

Anna Nagar, Chennai – 600 102.

 

.....Opposite Parties

Date of complaint                                 : 18.03.2014

Counsel for Complainant                      : M/s.C.S.Kiran & S.Krishnaa

Counsel for Opposite Parties                   : M/s S.Namasivayam,J.Ravindranath

                                                                    Singh, R.Balambigai Gowri,

                                                                    T.Saminathan

 

 

O R D E R

 

BY PRESIDENT THIRU. K.JAYABALAN B.Sc., B.L.,

  This Complaint filed by the Complainant to refund the premium amount of Rs. 5,00,000/- and also to pay compensation  with cost of the Complaint  u/s 12 of the Consumer Protection Act.1986.

1.THE COMPLAINT IN BRIEF:

          The Complainant had taken a policy named as ‘Capital Unit Gain Size Two’ from the 2^nd Opposite Party The Complainant had paid a sum of Rs.5,00,000/- per annum. Towards the premium being payable annually for a period of three years for which the Opposite Party would insure the Complainant for a sum of Rs.75,00,000/- till the year 2027. The Complainant was also informed by the agents of the 2^nd Opposite Party at the time of taking the policy that the same could be cancelled anytime and in such case he would not be entitled to any benefits out of the policy but would be paid bank rate of interest for the amount paid by him. The Complainant took out a policy by paying the sum of Rs.5,00,000/- and was handed over his policy bearing No.0055443096, the policy commenced on 13.07.2007. The Complainant’s second premium payable was by July 2008. The Complainant states that due to his father’s sudden stroke/ill health, associated expenses and due to other reasons he was not in a position to pay the further premiums. The Complainant went to the 2^nd Opposite Party’s office in person on 18.07.2008 and informed them of his situation. However he was informed that a refund before three years was not possible and that he would have to wait three years before making any claim for refund. The Complainant therefore sent a letter dated 05.08.2008 to the 1^st and 2^nd Opposite Parties citing this personal visit and the events that occasioned and pointed out that their agents had promised them cancellation was allowed any time and this representation by the 2^nd Opposite Party’s agents was just like all other assurances given by them.  The Complainant states that to his letter dated 05.08.2008, the 1^st Opposite Party sent a letter dated 16.08.2008 merely  stating that they were in receipt of his letter and that the Complainant’s policy was in a ‘lapse status’ and advised him to pay the further premium. It was also interalia stated by the 1^st Opposite Party that the Complainant could make a withdrawal/surrender of the policy after three years from the policy provided three full premiums were paid. The Complainant again sent a letter dated 01.12.2008 to the 1^st Opposite Party pointing out the ambiguity in the Opposite Party’s policy document and also posed several questions which are of substantial importance.  However the Complainant did not receive any reply to his letter dated 01.12.2008 addressed to the 1^st Opposite Party. Therefore the Complainant sent a letter dated 24.01.2009 to the 1^st Opposite Party clearly stating that he did not want to continue the policy further and wanted to surrender the same and get a full refund of the amount paid by him in view of his father’s serious medical condition and associated medical expenses.  The Complainant states that the stand of the Opposite Parties in stating that the Complainant is not entitled to refund surrender of the policy is illegal and untenable. This condition was not informed to the Complainant at the time of taking the policy but informed to him only when he sought to surrender the policy. The acts of the Opposite Parties have caused untold misery, hardship and mental agony for the Complainant as he was put to severe financial hardship apart from the mental strain. Hence the Complainant filed this Complaint to refund the premium amount of Rs.5,00,000/- and also compensation for mental agony with cost of the Complaint. 

2. WRITTEN VERSION OF THE  OPPOSITE PARTIES IN BRIEF:

          The Complainant had opted for the premium payment and benefit term of 20 years. The Complainant had to pay a sum of Rs.5,00,000/- per annum, the premium being payable annually, for a period of 20 years for which the Bajaj Allianz Life Insurance would insure the Complainant for the Insurance Cover of sum of Rs.75,00,000 till the year 2027 provided all the renewal premiums are paid timely. Based on the information furnished by the Complainant in the proposal form and other documents, policy bearing no 0055443096 was issued and the policy commenced on 13.07.2007 and to mature on 13.07.2027. His wife was named the nominee. The policy Documents had been sent to the address and the receipt of the policy document has not been disputed by the Complainant. The policy was properly explained to the customer and at the same time he is also well qualified to read and understand the proposal form illustration and policy documents. It is pertinent to note that the Complainant is well qualified person working with leading IT company as mentioned in the proposal Form. The Complainant has failed to exercise his right under the clause “Option to Return/Free Look Cancellation” contained in the said policy which gives policy holder to return the policy to BAJAJ Allianz Life Insurance stating the reasons thereof, within 15 days of receipt of the policy in case he is not agreeable to any of the provisions stated in the policy and the details in the proposal form. The claims are always honoured so long as they are not in breach of the elementary insurance principle of uberrima fide or utmost faith. The policy is an Evidence of a contract of the life assurance between Bajaj Allianz Life Insurance Company Limited and the policy holder. The policy is based on the application and declaration which the Complainant made in the proposal form. The insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. The insured cannot claim anything more than what is covered by the insurance policy. The Complaint is barred by the limitation since the policy was issued in the year 2007 with an opportunity to review the same and opt for cancellation in case of any disagreement but the Complainant failed to do so and therefore is beyond the limitation specified in the Consumer Protection Act. There is no deficiency in service or unfair trade practice followed by the respondent company and the conduct of the company is in accordance with the policy terms and conditions as such the Complaint is not maintainable before the Hon’ble Forum. The Complaint is bad for the non-joinder of necessary parties against whom the major allegations are levelled but simply made a party to the branch office of the opponent without any particulars. The other allegations made in the Complaint are denied. The Opposite Parties have not committed any deficiency in service and prays to dismiss the Complaint with costs.

3. POINTS FOR CONSIDERATION:

           1. Whether the Complaint is barred by limitation?

           2. Whether there is deficiency in service on the part of the opposite parties?

           3. Whether the complainant is entitled to any relief? If so to what extent?

 

4. POINT NO :1

          The Opposite Parties contended that the policy was issued in the year 2007 and the Complaint filed only on June 2013 and therefore the Complaint is barred by limitation. Admittedly the policy was dated 13.07.2007. The 1st Opposite Party sent Ex.A5 letter to the Complainant that the withdrawal of the surrender of the policy cannot be accepted that the same has not been opted within the free look period for refund.  Assuming that Ex.A4 dated 05.08.2008 gives cause of action, the Complainant should have filed his Complaint within a period of two years i.e., on or before 04.08.2010. The fact remains that the Complaint is filed nearly after two years eight months from that date.  Therefore, the Complaint has been filed after expiry of the limitation period. Ex.A6 to Ex.A8 are only correspondences that will not give rise any cause of action. Therefore, it is held that the Complaint is clearly barred by limitation.

5. POINT NO :2

          It is an admitted fact that the Complainant applied for a policy “Capital Unit Gain Size Two” to the 2^nd Opposite Party through Ex.B2 proposal form and the policy amount per annum is Rs.5,00,000/- and sum assured is Rs.75,00,000/-  and the Opposite Parties issued Ex.A1 policy certificate and Ex.A2 policy documents and the Complainant paid the first premium and policy commenced 13.07.2007 and duration of the policy till the year 2027 and the next premium due on 13.07.2008.

          6. The Complainant contended that he is unable to pay second premium amount which was due on 13.07.2008 and hence he contacted the second Opposite Party to repay the premium amount and he had also written Ex.A4 letter to the 2^nd Opposite Party  that due  to his father fell ill and aged very old, he is in need of money for his medical expenses and therefore he is unable to pay the second premium and also not willing to continue the policy.  However the 1^st Opposite Party sent Ex.A5 reply that he should pay premium for 3 full years and then only his request will be considered and therefore they requested the Complainant to pay the premium amount and thereafter the Complainant wrote Ex.A7 & Ex.A8 letters to the Deputy Manager of the 1^st Opposite Party to refund the premium amount of Rs.5,00,000/- paid by him and the Opposite Party failed to pay the amount he had filed this Complaint.

7. The Opposite Parties  contended that if anything untoward happens to the insured, they are liable to pay the sum assured Rs.75,00,000/- and unless as per the conditions of the policy the insured pays premium for 3 full years, he is not entitled for refund of the premium and further even for cancellation of the policy he should have done within the free look period and the Complainant had not satisfied none of the condition and therefore the Opposite Parties have not committed any deficiency in service and the Complainant is not entitled for refund of premium amount.

8.  Ex.A2 policy document contains the terms and policy conditions. Clause 15 of the documents deals with Free Look Period. As per that clause within 15 days of the receipt of the policy, the policy holder if dissatisfied with any reason, he can return the document with a written notice to cancel the policy issued by the Opposite Parties. The policy holder has not taken any steps to cancel the policy within the period as stated above and therefore the Complainant is not entitled to get cancel the policy.

9. The next contention of the Opposite Parties is that  as per Ex.A2 policy document clause – 6 (C) (i) the  surrender value if any, is payable only after first three policy years. Further for part withdrawal with units is also allowed only after payment of regular premium for three full policy years has been paid. As stated above, the Complainant is entitled to surrender or to get refund of the premium paid by him only after payment of premium for three full years. Whereas, in this case the Complainant had admittedly paid only one premium and seeks refund of the same and hence he had not complied the condition of the policy document and therefore the Complainant is not entitled for refund of the premium amount paid by him under Ex.A1. In view of such conclusion, it is held that the Opposite Parties have not committed any deficiency in service.   

10. POINT NO:3

Since the Opposite Parties have not committed any Deficiency in Service, the Complainant is not entitled for any relief and the Complaint is liable to be dismissed.

          In the result the Complaint is dismissed. No costs.

          Dictated to the Steno-Typist transcribed and typed by her corrected and pronounced by us on this 21^st day of February 2017.

 

MEMBER – II                                                               PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1 dated 13.07.2007                   Policy Certificate

Ex.A2 dated NIL                     Policy document

Ex.A3 dated 18.07.2007                   Welcome letter with policy  schedule and receipt

Ex.A4 dated 05.08.2008                   Letter from Complainant to Opposite Parties

Ex.A5 dated 16.08.2008                   Letter from 1^st Opposite Party

Ex.A6 dated 14.09.2008                   Letter from Complainant to IRDA

Ex.A7 dated 01.12.2008                   Letter from Complainant to Opposite Parties

Ex.A8 dated 24.01.2009                   Letter from Complainant to Opposite Parties

 

LIST OF DOCUMENTS FILED BY THE OPPOSITE PARTIES :

 

Ex.B1 dated NIL                     Authorized Signatory

 

Ex.B2 dated NIL                     Proposal Form for Life Insurance

 

 

 

 

MEMBER – II                                                               PRESIDENT