Hon’ble Mr. Sudip Niyogi, President
The Complainant Tapas Singha Roy filed the instant case u/s 12 of the C.P. Act, 1986 against the Ops stating that he had bought a Policy bearing No.004928479 of Birla Sun Life Insurance Co. Ltd. in the month of June, 2011 through local representative at Cooch Behar. The monthly premium of this Policy was Rs. 4,999.90, which had been regularly deducted from his Account No.910010012155508 of Axis Bank, Cooch Behar Branch through ECS upto the month of April, 2016. The last premium of the said Policy was due in May, 2016, but despite there being sufficient available balance in his Bank Account, the premium for the month of May, 2016 was not transferred from his Account. The said intimation for non-deduction of the monthly premium was not communicated to the Complainant. Thereafter, a cheque bearing No.789857 amounting to Rs.3,59,898/- was delivered to him on behalf of OP No.2 by post after the said Policy was terminated. The Complainant immediately informed the matter to Sri Bhupen Chandra Roy, Advisor of the said Insurance Co. and also Sri Jayanta Roy, Branch Development Manager, Cooch Behar Branch, Birla Sun Life Insurance Co. Ltd. and made a prayer through Mobile No.9832060788 and Mobile No.9475411931. However, he was assured that they would take up the matter with the competent authority. The Complainant also informed the matter to OP No.1 requesting them to let him know as to why the last premium of the said Policy was not transferred from his Bank Account through ECS. But, till date, no intimation was given to the Complainant by the OP No.1. According to the Complainant, he was put in much hardship and he suffered irreparable loss due to unethical activities of the Ops. Thereafter, finding no other alternative, he filed this case claiming several relief(s) as made in the petition of complaint.
Both the Ops contested this case by appearing before this Forum and also by filing written objections, evidence and arguments etc. In the written version, OP No.1 claimed to have a role of facilitator only and asserted that the ECS form was solely filled-in by OP No.1. They credited the Policy premium from his Savings Bank Account to the designated Account on monthly basis. It is further claimed that on being approached by the Complainant, OP No.1 informed him to take up his case with the OP No.2. It was further stated in the w/v that from the information gathered from the CMS Direct Debit Team, it was revealed that the ECS mandate was expired on 13.05.16 and no new mandate for ECS deduction was given and OP No.1 prayed for dismissal of the instant complaint.
Besides raising a dispute about Complainant’s case beyond the purview of the CP Act, 1986, OP No.2 claimed that annual premium of Rs.60,000/- was payable on monthly basis for Rs.4,998.98 and the Policy was issued on 14.06.2011, but the Complainant stopped paying monthly premium from the month of May, 2016. As a result of such non-payment of premium from 14.05.16, the Policy got lapsed. One lapsation notice was issued to the Complainant on 09.06.2016 asking him to pay all the due premiums by 18.07.2016 and upon non-payment of such premium, the Policy would be deemed to have been withdrawn. The Complainant, even after that, did not respond and thereby the Policy got lapsed. This Op also sent one ECS intimation dated 04.06.2016 to the Complainant informing him that the ECS for 14th May, 2016 was unsuccessful. Finally, as the outstanding premium was not cleared, the Op issued a cheque for Rs.3,59,898/-, being the fund value of the Policy as on the date of lapse. The said cheque was encashed by the Complainant on 03.08.16. This Op denied all the allegations made against them by the Complainant and prayed for dismissal of the complaint.
POINTS FOR CONSIDERATION
- Is the Complainant a Consumer as per provision under Section 2(1)(d)(ii) of the C.P. Act, 1986?
- Has this Forum jurisdiction to entertain the instant complaint?
- Have the O.Ps any deficiency in service, as alleged by the Complainant?
- Whether the Complainant is entitled to get any relief/reliefs, as prayed for?
DECISION WITH REASONS
Point No.1 & 2.
Both the parties have filed their evidence on affidavit and also written argument. Though, a dispute has been raised on behalf of the Ops that the Complainant cannot be a consumer under the provision of the CP Act, 1986, we find that the Complainant maintained a Bank Account with the OP No.1 and he made an arrangement for payment of Policy premium to Op No.2 through his Bank Account with OP No.1 through ECS. The grievance of the Complainant is that the last premium was not paid through ECS by OP No.1 and his Policy got lapsed, resulting of which, he sustained loss.
Considering the facts and circumstances of the case and also contentions of the parties in view of the provision of the Act, we think that the instant case is maintainable and this Forum has got jurisdiction to entertain the complaint.
Point No.3 & 4.
Admittedly, the Complainant bought a Policy bearing No.004928479 of Birla Sun Life Insurance Classic Life Plan in the month of June, 2011, the annual premium of which was Rs.60,000/- payable equally on a monthly basis for 5 years and the basic sum assured was Rs.12 lakh. The last premium of the said Policy was due in May, 2016. Admittedly also, the Complainant has an Account being No.910010012155508 with the Axis Bank, Cooch Behar Branch i.e. Op No.1.
It is also admitted that from the month of June, 2011 upto the month of April, 2016, the monthly installment of premium @Rs.4999.98 was deposited through ECS from the said Savings Bank Account of the Complainant with the OP No.1 but the amount of the last installment which was due in the month of May, 2016 was not deposited from the said Savings Account through ECS, as a result, the said Policy got lapsed.
The Memorandum of Birla Sun Life Insurance Co. Ltd. (Annexure-1) provides inter-alia for Policy Discontinuance. According to the said provision, if they (Op No.2) do not receive the entire policy premium by the end of the grace period of 30 days, a notice would be sent within 15 days asking the insured to exercise one of the following two options within 30 days from the date of notice.
- Revive the Policy, or
- Completely withdraw from the Policy.
The Policy can be revived by paying the due and unpaid Policy premium. If the Policy is not revived within 30 days from the date of notice, the insured shall be deemed to have exercised the option to completely withdraw from the Policy and the date of discontinuance is the date when the Policy is completely withdrawn or the date when the Policy is deemed to have been completely withdrawn, whichever is earlier.
It is found from the materials on record that after the non-payment of the last Policy premium, which fell due in the month of May, 2016 and following the aforesaid provision of Policy discontinuance, a notice was issued in June, 2016 by OP No.2 whereby it was communicated to the Complainant to pay all the dues and unpaid premiums by 29.05.16. The Complainant was also informed by the said notice that the said Policy can still be revived by payment of dues and unpaid premium by 18.07.16. It was also observed therein that in case of non-receipt of premium, it shall be deemed that the Complainant has exercised the option to completely withdraw from the Policy and his Policy status would be “discontinuance”. On such discontinuance, the insurance coverage will cease and the Policy proceeds, if any, will be payable to the Complainant after completion of 5 years as per Policy terms. It is further found that one ECS dishonour letter was issued to the Complainant in June, 2016 on behalf of Birla Sun Life Insurance Co. Ltd. i.e. OP No.2 informing him that automatic premium debit through ECS from 14th May, 16 was un-successful because it was declined by his Bank for reason which has been shown as “Miscellaneous”. In the said letter, the Complainant was asked to pay the dues within 30 days from the due date which was 14th May, 2016 to ensure continuity of his Policy. Ultimately, as the dues including the premium for the month of May, 2016 were not paid by the date given in the said notice, OP No.2 issued a Mail to the Complainant on 19.07.16 informing him about the issuance of a cheque amounting to Rs.3,59,898/- on the ground of discontinued Policy. Admittedly also, the Complainant encashed the said cheque later.
Thus, the OP No.2 is found to have complied with all the formalities after the last premium which was due in the month of May, 2016 was not deposited.
All these contentions of Op No.2 about issuing notice in giving an opportunity to revive the Policy by making the dues within a specified period were not denied by the Complainant. Rather, curiously enough, the Complainant made no whisper in this regard neither in his evidence nor in the written argument filed on his behalf despite having got sufficient opportunity to do so.
From the aforesaid circumstances, it cannot be said that OP No.2 was at fault or that they had any negligence or laches leading to the ultimate lapsation of the Policy of the Complainant.
The Op No.1, with whom the Complainant has got his Account and from which the monthly Policy premium was deducted through ECS on regular basis barring the last one, claimed in the w/v to be a facilitator merely acting as Collecting Agent on behalf of OP No.2 to do all functions on behalf of the Complainant upon a written request. The monthly Policy premiums from June, 2011 upto the month of April, 2016 were found to have been paid on regular basis through ECS and the said amount was debited from the Savings Bank of the Complainant with Op No.1. It is found, despite having sufficient balance, the Policy premium for the month of May, 2016 was not sent through ECS, for which the Complainant lodged a complaint with OP No.1. In their w/v, as well as evidence and written argument, it was stated by OP No.1 that the ECS form was filled-in by the Complainant and he had given a mandate to OP No.1 to duly credit the Policy premium amount from the Savings Account of the Complainant to the designated Account of the insurance on monthly basis. It was also stated that on being approached by the Complainant, OP No.1 had consulted and taken up the issue with the CMS Direct Debit Team and it was observed that the ECS mandate was expired on 13.05.16 and thereafter, no new mandate was issued. Apparently, by this observation, OP No.1 wanted to establish that as the mandate for payment of premium through ECS expired on 13.05.16, no deduction or payment of premium could be made from the Account of the Complainant after that date.
The O.P. No.1 found to have filed one paper dated 16/06/2017 (Annexure-1) which was issued by CMS Direct Debit to Cooch Behar operations Head, copy of which was also sent to Cooch Behar Branch head informing that the mandate i.e. mandate for ECS deduction got expired on 13/05/2016. Be it noted here that the ECS mandate was given by the Complainant at the time of obtaining the policy by filling in the prescribed form. But nowhere therein, it is mentioned that the said mandate to be expired on 13/05/2016. The said Annexure-1 dated 16/06/2017 filed by O.P. No.1 does not reveal anything specifically that the said mandate for deduction through ECS was withdrawn/cancelled by the Complainant on and from 13/05/2016. In fact, the said document annexure-1 is not at all sufficient to make us believe about alleged expiry of ECS on 13/05/2016 or that the Complainant withdrew or cancelled the mandate from that date. Thus, the document annexure-1 is not going to help O.P. No.1 to absolve them of their liability in this case.
It is found that the Complainant maintained all through sufficient balance with the OP No.1, from which the monthly deduction was made through ECS on regular basis and the Complainant had also sufficient balance in his Account to make payment of the amount of the last premium which fell due in May, 2016 i.e. 14.05.2016. In such a situation, it cannot at all be reasonably believed that a person, herein the Complainant, would withdraw his mandate for ECS deduction of his last premium just before the date when it was supposed to be deducted when he is found to have been successfully maintained adequate balance in his Account for the last 5 years. Even, after the said payment was not paid through ECS, the Complainant was not informed by OP No.1. As Op No.1 could not produce any document, whatsoever, to substantiate their claim that the last premium could not be made through ECS because of lack of required mandate, we think it is the Axis Bank ( OP No.1 ) who is responsible for non-payment of the amount of the last installment in May, 2016. This is nothing but deficiency in service on the part of OP No.1 which resulted in financial and other loss of benefit associated with the Policy and harassment to the Complainant.
So, following the aforesaid discussion, it is now clear that the Complainant should get relief (s) in this case from Op No.1.
So far as the amount of compensation is concerned, Complainant is found to have claimed all the benefits along with the insurance coverage of Rs.12 Lac which is the assured value of the Policy. This apart, Complainant claimed compensation of Rs.7 Lac for mental pain and agony etc.
As discussed earlier, that the Policy of the Complainant got lapsed due to non-payment of the last premium from his Account with Op No.1. The Complainant failed to show any laches or fault of OP No.2 in the matter of non-payment of the amount of the last premium. In such a situation, Op No.2 cannot be compelled to extend further insurance coverage or the benefits of that Policy.
The Complainant also did not raise any dispute as to the amount of Rs.3,59,898/- which was paid by cheque to him by Op No.2 after the Policy was found to have been terminated, or, in other words, Complainant did not tell that even after the lapse of his Policy, his total entitlement would have been much more than Rs.3,59,898/- which he actually has been paid.
But there is no doubt that due to premature lapse of the Policy, Complainant must have sustained loss which cannot be easily ascertained on the basis of the evidence and documents placed before us. At the same time, it needs to be pointed out that Complainant also could have continued with this Policy by reviving the same following complying with the notice issued to him on behalf of Op No.2 that is to say, he had the opportunity but for no known reason, he declined.
Taking into consideration all these things and also considering the present rate of interest on R/D or Term Deposit etc., we think the Complainant may be compensated adequately in the given facts and circumstances of this case, if a sum of Rs. 30,000/- along with Rs.5,000/- towards mental pain and agony and Rs.5,000/- towards cost of litigation is awarded.
Thus, these two issues were also decided in favour of the Complainant. With this, all the issues are disposed of.
Hence, it is
Ordered
That the instant complaint/case is allowed on contest with cost.
The Complainant is entitled to Rs.30,000/- towards compensation from O.P. No.1. Accordingly, OP No.1 is directed to pay Rs.30,000/- as compensation to the Complainant.
The O.P. No.1 is also directed to pay Rs.5,000/- towards mental pain and agony and Rs.5,000/- as cost to the Complainant.
The O.P. No.1 is to comply with this order within a month from this date, failing which the Complainant is at liberty to execute the same through due process of law.
Let a plain copy of this Order be supplied to the parties concerned by hand/by Post forthwith, free of cost for information & necessary action. The copy of the Final Order/Judgement also available at confonet.nic.in.
Dictated and corrected by me.
