Delhi

East Delhi

CC/37/2016

SANJEEV SHARMA - Complainant(s)

Versus

S.B.I LIFE INS - Opp.Party(s)

19 Sep 2019

ORDER

               DISTRICT CONSUMER DISPUTE REDRESSAL FORUM EAST Govt of NCT Delhi

              CONVENIENT SHOPPING CENTRE, 1^st FLOOR, SAINI ENCLAVE, DELHI 110092  

 

                                                                                                   Consumer complaint no.          37/2016

                                                                                                   Date of Institution                01/02/2016

                                                                                                   Order reserved on                19/09/2019                                                                                                   

                                                                                                   Date of Order                        23/09/2019                                                                                     

In matter of

Mr. Sanjeev Sharma  

HN 302. Block 22, East End Apartments

Mayur Vihar Phase I, Extn. Delhi 110096……..………………...…………….Complainant                                                                   

                                                                                

                                                                  Vs

1-The Manager,

S. B.I. Life Insurance Co.   

Sansad Marg, Connaught Place, New Delhi 110001……….………………Opponents

 

Complainant                         In Person

Opponent’s Advocate         M/s AVP Legal Firm       

 

Quorum                                 Sh Sukhdev  Singh       President

                                                Dr P N Tiwari                 Member

                                                Mrs Harpret Kaur         Member

 

Order by Dr P N Tiwari, Member-

 

Brief Facts of the case

Complainant applied for education loan of 30 lacs for his son/ Shubham Sharma from SBI, RACPC, Parliament Street New Delhi vide loan account 33086904525 and was advised by SBI to take Life Insurance of same amount and had to pay premium amount Rs 29,967/-was paid through ICICI Bank cheque cleared on 05/07/2013. Thereafter on 15/07/2013 a call was received from OP for required medical checkup of Mr Shaubham, but complainant’s son had left out of country.  

It was stated that complainant had intimated OP about his son/Shubham departure by 05/07/2013, but OP intimated on 15/07/2013 so medical checkup was not possible. On his fact, OP assured for refund of premium amount as policy could not be issued.

 

 

It was stated that complainant had mortgaged his house in lieu of education loan so sent a written note to RACPC branch of OP on 13/08/2013. When no reply was received wrote email to Op (Ex CW1/A) on 12/09/2013 and again reminded (Ex CW1/B). OP replied in affirmative and assured for early response (Ex CW1/C). Thus complainant continued follow up for refund of his premium amount (Ex CW1/ D,E,F,G,H,I, J,K, L,M,N,O).

Complainant stated that though refund process was not actively followed by him later on, but OP did not care to refund despite of assuring him (Ex CW1/P). Later complainant approached Bank Ombudsman, but did not do much. Later on OP offered to refund Rs. 24,579/-which was less than Rs.5,388/- . So filed this complaint and claimed full premium amount from 28/06/2013 with 18% interest per annum and Rs 40,000/-as compensation for harassment and Rs 5000/- for litigation charges.  

 

OP submitted written statement and denied all the facts and allegations in the complaint. It was stated that complainant did not get required medical tests as per the policy terms. On receiving information from complainant/father of Mr Shubham Sharma that his son had gone abroad and would not be available for getting medical tests done, so refund of additional premium amount was offered as per RACPC direction to reduce sum assured insurance to Rs 25 Lacs in which no medical tests were required. The tenure of Insurance was of three years now, but premium was wrongly calculated (Ex OPW1/Anne.B).

 

It was also stated that excess premium amount paid for thirty lacs was refunded immediately to the complainant. This was done in response to the letter received from their main office, RACPC (Retail Assests Central Processing Centre). Thereafter OP issued policy documents (COI) on 10/07/2013 vide policy no 70000001001 under SBI Rinn Raksha Master Policy for a sum assured Rs 25,00000/-and the policy documents were received by the complainant. The additional premium amount was to be refunded to Rs 5388/-(Ex OPW1/C, D & E). It was also stated that OP considered details from earlier policy proposal form filled by the son of complainant,            Mr Shubham Sharma.

 

As far as communication between bank and complainant was not known to OP as loan amount was sanctioned by SBI Bank and OP were only for issuing insurance policy from master policy as SBI was the policy holder. Under para 8 of written statement, OP stated that they were ready to refund the premium amount despite of policy rules issued with said issued policy, but complainant’s had not opted Free look Period of 15 days still offer was given. It was also stated that complainant was an educated person working as Chief Manager with Indian Oil Corporation and had read over all the contents of policy proposal form (Ex OPW1/1) so it could not be said that he did not understand Free Look Period option, still OP had offered refund of premium amount. Hence there was no deficiency in the service of OP in reference to the terms and conditions of the policy and as per the guidelines of IRDA.

 

Complainant filed his rejoinder to the written statement and denied all the replies submitted OP and stated that instead of refunding his premium amount had issued another policy without notice or consent. OP had earlier taken premium amount for issuing policy against Rs 30 Lacs, but after informing about non availability of his son and request for refund, issued another policy for a sum of Rs 25,00000/-(twenty five lacs) for which neither consent was taken for issuing non medical policy nor refunded total premium amount. It was also stated that OP had nowhere explained about the alternate process of issuing new policy when no medical tests could be done or taking policy was mandatory where complainant had mortgaged his house for taking educational loan. So, all facts in his complaint were true and correct.

He had also submitted his evidences on his own affidavit and relied on all notices given to OP (Ex CW1/ D to O). He also relied on this fact as his son had gone abroad and could not appear for required medical test as per his written letter. Hence, OP be directed to refund entire premium paid to OP.   

 

OP submitted their evidences on affidavit through Ms Neelam Singh, AVP Legal with OP and reaffirmed that SBI Life Insurance Company was an authorized company and this complaint had no merits so be dismissed as all their work was based on the guidelines of IRDA and the provisions of Insurance Act, 1938. It was stated that complainant had never been issued “Cover Note”, so complainant had no locus to demand for cancellation of policy and refund of premium  amount. It was also submitted that complaint was beyond the limitation of two years as presuming cause of action occurred in July 2013 and complaint was filed in Jan. 2016.

 

It was also submitted that OP had relied upon Anne. A of membership form of SBI, and letter received from their head office regarding Master Policy holder as SBI Anne. B. OP also relied upon Anne.C & D pertaining to policy documents vide policy no. 70000001001 dated 10/07/2013 for sum assured to Rs 25,00000/-. Anne. E was also relied pertaining premium amount paid and excess amount refunded besides details of communications in Anne. F. It was submitted that OP had called for cancellation of policy on 31/03/2015 vide Anne. G.Hence there was no deficiency in their services.

 

Arguments were heard from complainant who was present in person and Ld. Counsel for OP. After  perusal of file, order was reserved.

After analyzing all the facts and evidences of both the parties, we have also observed that OP nowhere written or explained that taking education loan mandatory insurance cover would be taken and complainant had to pay the premium, though premium was paid as per demand from OP. It is also evident that due to delay from the OP side, required medical tests were not got done where as complainant had approached OP bank/SBI for education loan. Subsequently OP had reduced sum assured amount and converted a non medical policy for a sum assured Rs  25,00000/- from Sum assured Rs 30,00000/-. We could not find any consent on record where OP had taken to issue another policy if no medical tests were got done. It was also seen in written statement and evidences forwarded by OP that they were ready to cancel the policy and refund the premium amount. Taking this fact in issue, it amounts deficiency in services of OP.

So we direct OP to refund Rs. 29,967/- paid as premium amount within 60 days.

 

 

 

The order copy be sent to the parties as per the Regulation 18(6) of the Consumer Protection Regulations, 2005 (in short the CPR) and file be consigned to the Record Room under Regulation 20 (1) of the CPR. 

 

 (Dr) P N Tiwari  Member                                                               Mrs Harpreet Kaur, Member                       

 

                                                         Sukhdev Singh  President