This complaint under the C.P. Act, 2019 was initially filed against the Opposite Party (O.P.) The Branch Manager, HDFC Life Insurance, Office at Saharan House, 1^st Floor, Sevoke Road, Above ICICI Bank, P.O.- Sevoke Road, P.S.- Bhaktinagar, Dist.- Jalpaiguri, Pin Code- 734001 who contested the case by filing Written Version (W.V.).     

The case of the complainant as per his complaint is as follows-

The complainant was a policy holder of the O.P. being Policy No. 22195919, HDFC Life Sanchay Plus and the policy started from 11.01.2020 and matured on 11.01.2026 (for a term of 06 years) with a total premium of Rs. 5,00,000/- (Rupees Five Lac) only per annum. The complainant had paid 02 premiums per annum with a amount of Rs. 5,00,000/- (Rupees Five Lac) only to the O.P. and the O.P. had duly received Rs. 10,00,000/- (Rupees Ten Lac) only. Thereafter due to worldwide breakdown of COVID 19, there was lockdown all over India and due to this the complainant had suffered a severe loss in his business and was facing financial crisis and for this reason he was unable to pay further premium amount of Rs. 5,00,000/- (Rupees Five Lac) only to the O.P. As per his complainant the complainant had no capacity to continue the said policy and to make further payments of the premium amount. In this situation the complainant wanted to surrender the aforesaid policy as per the clause of Surrender as mentioned in the Policy Book of the aforesaid Policy and for this purpose on 04.05.2022 he visited the O.P. for claiming his surrendered value amount but one of the Agents of the O.P. refused to give him his surrendered value amount showing a ground that the complainant is only liable to claim after the maturity of the said Policy. As per complaint the O.P. was taking the advantage of the old age of the complainant and forced him for continuing to make further payment of the premium amounts till the maturity of the policy but as per the terms of the insurance policy the O.P. is legally liable to pay the surrendered value amount when it is mentioned in the Policy Book under the clause head OF PART D 1.

The complainant several times tried to make contact with the O.P. regarding his surrendered value issue but the O.P. deliberately ignored him. Moreover, the local Representative Officer of the O.P. of Siliguri had refused to make any correspondence with the complainant. The complainant follow- up this issue in a regular basis and in spite of repeated requests, reminders and demands the O.P. did not refund his said surrendered value and even after lapse of reasonable period the O.P. neither took any action in the same respect nor made any correspondence with him. Then, on 04.06.2022 the complainant sent a Demand Notice to the O.P.  with a prayer for refunding his  surrendered value of Rs. 10,00,000/- (Rupees Ten Lac) only to him within 15 days from the date of receipt of the legal notice. The O.P. received the legal notice on 06.06.2022O and on 13.06.2020 the O.P. sent reply by stating a baseless ground for the refusal of the payment of the surrendered value to the complainant.

The complainant also argued in his complaint that there was a deficiency in service in the part of the O.P. for which he became mentally breakdown as his major savings of his life had been invested to the said insurance policy. Finally, having no other alternative the complainant lodged this complaint.

 The prayers of the complainant are as follows-

1. To pass an order directing the O.P. to make the payment of the surrendered value of Rs. 10,00,000/- (Rupees Ten Lac) only to the complainant as per policy mentioned.

2. To pass an order directing the O.P. to pay a sum of Rs. 1,00, 000/- (Rupees One Lac) only to the complainant for mental pain, agony and harassment as compensation.

3. To pass an order directing the O.P. to pay a sum of Rs. 45, 000/- (Rupees Forty Five Thousand) only to the complainant towards the return of the premium charges.

4. To pass an order directing the O.P. to pay a sum of Rs. 50, 000/- (Rupees Fifty Thousand) only to the complainant as litigation cost.

5. Interest @18% on the amount of Award till realization.

6. Any other relief or reliefs for which the complainant may be found entitled to under the law.

5. The total claim amount of Rs. 11,95,000/-(Rupees Eleven Lac Ninety Five Thousand) only.

         List of documents filed by the complainant:

1. Photocopy as well as original of HDFC Life Sanchay Plus, vide Policy No. 22195919, dated 11.01.2020.
2. Photocopy as well as original of Demand Notice, dated 04/06/2022.
3. Photocopy as well as original of Postal Receipt being No. EW921940082IN, dated 04.06.2022.
4. Photocopy as well as original of Postal Track Report showing the delivery date on06.06.2022.
5. Photocopy as well as original of Reply Notice, dated 13.06.2022.

             Regarding this instant case, the Opposite Party (O.P.) The Branch Manager, HDFC Life Insurance, Office at Saharan House, 1^st Floor, Sevoke Road, Above ICICI Bank, P.O.- Sevoke Road, P.S.- Bhaktinagar, Dist.- Jalpaiguri, Pin Code- 734001 who contested the case by filing Wrtten Versio (W.V.) and as per the W.V. the case is as follows.

             In the W.V. the O.P. denied all the facts of the complainant and argued that the complainant is not a consumer and there was no deficiency in service or any unfair trade practice from the side of the O.P. and as such the case of the complainant is not maintainable in the eye of law.

             The O.P. also argued that in January 2020 they received a duly filled up and signed proposal form through online from the complainant for issuance of a HDFC Life Sanchay Plus. In usual course of business, the agent explains the terms and conditions and working benefits of the policy to the proposer and in the present case also, the complainant was duly informed about the terms and conditions and benefits of the policy. The said policy was for a term of 06 years with an annual premium of Rs. 5,11,250/- (Rupees Five Lac Eleven Thousand Two Hundred and Fifty) only (including service charges and applicable tax) payable for 05 years. Upon receipt of duly filled up and signed proposal form along with premium cheque the O.P. issued a policy being Policy No. 22195919 and the original document of the said policy along with covering letter was duly dispatched to the complainant which was also duly delivered to the complainant. The O.P. provided the complainant a 15 days Free Look Period option as per the IRDA Guidelines but the complainant did not opt for the option of return of the policy within its Free Look Period. As per the policy terms, the premium paying term was 05 years and for policy term it is 06 years with death sum assured of Rs. 52,50,000/- (Rupees Fifty Two Lac Fifty Thousand) only  and from the 7^th year of the said policy , policy holder will get Rs. 1,70,000/- (Rupees One Lac Seventy Thousand) only till 35^th year of the policy (If policy status is inforced) and in 36^th year of the policy, policy holder will get Rs. 22,70,000/- (Rupees Twenty Two Lac Seventy Thousand) only and all will be payable in enforce policy. Also policy can be surrendered after payment of 2^nd premium to/ till 6^th year of the policy. 

          The O.P. mentioned in the W.V. that the complainant had paid initial premium at the time of purchase the said policy and renewal premium also paid on 08.02.2021 (Corona period) by account transfer but thereafter failed and neglected to pay the subsequent premiums for which the policy reached to lapse status as per the terms and conditions. The O.P. did not receive any surrender request from the complainant and thereafter on 04.06.2022 the O.P. received a notice from the Advocate of the complainant and accordingly the O.P. sent the reply of the said notice on 13.06.2022.

          The O.P. also argued in his W.V. that the complainant is not entitled to the relief (s) claimed and besides, it is an established legal paradigm that compensation awarded on the basis of materials on record and the compensation awarded must have a rational relation to the nature and extent of injury, inconvenience, physical and mental actually caused to the complainant by action or omission of the O.P. 

          List of documents filed by the O.P.:

1. Photocopy of Proposal Form. (Annex. A).
2. Photocopies of the policy documents and illustration documents. (Annexed collectively as Annex. B )
3. Photocopy of the reply letter, dated 13.06.2022. (Annex. C)

Having heard, the Ld. Advocate of the complainant and on perusal of the Complaint and documents filed by the complainant the following points are taken to be decided by this Commission.

Points for consideration

1) Whether the complainant is a consumer?

2) Whether the case is maintainable under the CP act 2019?

3) Whether this Commission has its jurisdiction to decide this case? 

4) Whether there is any deficiency in service in the part of the O.P. as alleged by the complainant?

5) Is the complainant is entitled to get any award and relief as prayed for? If so, what extent?               

Decision with reason:-

            All the points are taken up together for consideration and decision.

Seen and perused the complaint petition filed by the parties, supported by the affidavit, documents filed by the parties. We are also heard argument of both sides in full length.

In this case the complainant was a policy holder of the O.P. being Policy No. 22195919, HDFC Life Sanchay Plus and the policy started from 11.01.2020 and matured on 11.01.2026 (for a term of 06 years) with a total premium of Rs. 5,00,000/- (Rupees Five Lac) only per annum and the complainant had paid 02 premiums per annum with a amount of Rs. 5,00,000/- (Rupees Five Lac) only to the O.P. and the O.P. had duly received Rs. 10,00,000/- (Rupees Ten Lac) only. So, this Commission has no doubt to hold that the complainant is a very much consumer under the C.P. Act 2019.

The complainant resides in Jalpaiguri district and the O.P. is also carrying his business in Jalpaiguri district. Thus, there is no doubt that this Commission has its territorial jurisdiction to decide this case.

In this instant case, it is clear from the documents and evidences filed by the complainant that the complainant wanted to surrender the said policy and this was in the knowledge of the O.P. but the O.P. did not take any positive initiative regarding this issue. When a consumer purchase a policy from a reputed company like HDFC Life Insurance with an expectation for delivery of a good quality of service as well as better offerings from the company which is a part of a good practice but in this instant case the company failed to deliver his best services to his consumer and this Commission has no doubt to hold that the O.P.s did not provide their best service to his consumer.

In this case, O.P. did not produce any evidence that the terms and conditions of the policy was properly briefed to the complainant and it is clear that the O.P. did not intimate the complainant by serving any notice before or after laps of the policy.  Being a common citizen it is very hard to understand the delicate points of the terms and conditions of the policy in detail and in this case the Commission thinks that there is a deficiency in service in the part of the O.P. and the complainant should be received his fair dues from the O.P.  

So, this Commission holds that there is a deficiency of service from the part of the O.P. insurance company (HDFC Life Insurance) and the complainant is entitled to get Rs. 7,50,000/- (Rupees Seven Lac and Fifty Thousand) only from the O.P. within 45 days from the date of this order failing which the complainant is entitled to get @ 6% simple interest per annum from the date of the payment of the first premium till the realization of the entire amount. The complainant is also entitled to get Rs. 5,000/- (Rupees Five Thousand) only for mental pain, agony and harassment and Rs. 5,000/- (Rupees Five Thousand) only for litigation cost. The O.P. is also directed to deposit Rs. 10,000/- (Rupees Ten Thousand) only to Consumer Legal Aid Account of this Commission within 45 days from the date of this order.         

Hence, it is therefore,

ORDERED

That the Consumer Case No. 79/2022 be and same is allowed in contest against the O.P. (HDFC Life Insurance).

The O.P. (HDFC Life Insurance)is directed to pay Rs. 7,50,000/- (Rupees Seven Lac and Fifty Thousand) only to the complainant within 45 days from the date of this order failing which the complainant is entitled to get @ 6% simple interest per annum from the date of the payment of the first premium till the realization of the entire amount. The complainant is also entitled to get Rs. 5,000/- (Rupees Five Thousand) only for mental pain, agony and harassment and Rs. 5,000/- (Rupees Five Thousand) only for litigation cost. The O.P. is also directed to deposit Rs. 10,000/- (Rupees Ten Thousand) only to Consumer Legal Aid Account of this Commission within 45 days from the date of this order.         

Let a copy of this judgment be given to the parties directly or through their representative Ld. Advocate for compliance free of cost.