Complaint filed on: 20-10-2015 Disposed on: 30-11-2016
BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL FORUM,
OLD DC OFFICE COMPOUND, TUMAKURU-572 101
CC.No. 116/2015
DATED THIS THE 30th DAY OF NOVEMBER 2016
PRESENT
SMT.PRATHIBHA. R.K. BAL, LLM, PRESIDENT,
SRI.D.SHIVAMAHADEVAIAH, B.A, LLB, MEMBER
SMT.GIRIJA, B.A., LADY MEMBER
Complainant: -
Smt.Lakshminadigar,
S/o. Sri.R.N.Nadigar,
Resident of Municipal Layout,
SS Puram, Tumakuru,
Now Residing at B-307,
Oasis Vijaya Apartment,
20th Main3rd Cross,
Arehally, Bengaluru-61
(Advocate by Sri.G.S.Ramasesha)
V/s
Opposite parties:-
- The Branch Manager,
Exide Life Insurance Company Ltd, Near Shivakumaraswamiji Circle, B.H.Road, Tumakuru
- Exide Life Insurance Com. Ltd.,
1st Floor, Gold Hill Square,
No.690, Hosur Road, Begur Hobli,
Bengaluru-68
(1st OP -Exparte)
(2nd OP by Sri.H.K.Ramamurthy- Advocate)
ORDER
SRI.D.SHIVAMAHADEVAIAH, MEMBER
This complaint has filed by the complainant against the OP No.1 and 2, under Section 12 of the Consumer Protection Act. The complainant prays to direct the OPs to settle the claims by directing to return the amount of Rs.1,20,111=00 deposited/paid by the complainant under the valid policy with interest @12% from the date of starting the policy till realization of the amount, and to pay Rs.25,000=00 towards inconvenience, mental agony and to award Rs.10,000=00 toward cost of this litigation and grant such other relief, in the interest of justice and equity.
2. The brief facts of the complaint is as under.
The complainant held policy in OP Company, vide policy No.01634534 (ING Vysya Life Insurance, No.02988280 in the name of complainant Mrs.Lakshmi Nadigar, date of proposal is 18th Agu.2009 and date of commencement of policy is 20th Agu.2009 and vesting dated (Maturity date) is 20th Aug. 2014, under the product name is Life Insurance “Exide Life Immediate Annuity with return of Purchase price (UIN 114N050V02) of Lakshminadigar” But the insurance product was obtained by the complainant under ING Vysya Life Insurance but subsequently the complainant got to know that OP company had taken over ING Life Insurance wherein the terms and conditions was not known to the complainant nor informed. But subsequently the complainant policy terms and conditions are changed unilaterally which is seriously prejudicing the complainant lawful interest and pertaining to the same. The complainant lodged the complaint vide complaint ID No.EXL30006114 and the same was assigned to a grievance officer named Ms.Nandini.C. and one more complaint was registered at OP office vide ID No.EXL300010813 dated 28-4-2015 and at that point of time grievance officer named was Ms.Nisha.K. and the above stated complaints has been acknowledged by OP office. But till date, no action has been initiated in order to satisfy the complainant. Repeated remainders in the form of complaints, notice, oral request at the branch office, Tumkur has been repeatedly asserted by complainant, but to no avail and so in order to initiate further action in accordance with law, complainant resorted as finally in getting legal notice issued to OP office wherein by getting reply notice issued dated 21-8-20015 by OP denying the claim made by complainant but has not stated what remedy is there for the complainant to meet the needs of the complainant but the contents of the reply notice by OP establishes that the OP are not interested to place remedy for the beneficial of the complaint.
The complainant further submitted that, the complainant’s records are very much available at OP offices as ID number has already been provided by OP office only but inspite of the same no action has been initiated and due to the illegal and unlawful act of OP, the complainant investment has been misused by misrepresenting without any information as to what has happened to the investment made by complainant even as on the day of getting filed this complaint. In fact the complainant had also requested to return back the amount that has been already been deposited with ING life insurance which has now been taken over by the OP but even to that no action nor any information has been provided by OP.
The complainant further submitted that, in fact complainant has also requested to depute a responsible officer and be pleased to contact complainant’s husband also who is a senior counsel over his mobile and be pleased to take appointment and meet him and see that the problem is solved. Keeping that and considering the same the complainant preferred to provide one more opportunity before resorting to further action but no action has been initiated by OP and under the said compelling circumstances, the complainant has approached the Forum seeking for necessary relief.
The complainant further submitted that, the dispute caused by the OP has caused and is causing lot of mental agony and harassment which is quite understandable. Further the act of the OP institution in handling the matter is causing irreparable damage to complainant that cannot be compensated under any circumstances and in any manner whatsoever. Therefore it is of paramount importance the OP along with authorities so involved in causing damage to complainant welfare and interest are liable to compensate the complainant for causing mental agony coupled with harassment.
The complainant further submitted that, pertaining to the above stated facts all the necessary documents along with requisition letter had been submitted to OP, but the OP has failed to address to the complainant’s grievances by settling the claims of complainant under the policy maintained by the complainant with the OP, but the OP has failed to settle the complainant’s claims which amounts to deficiency of service. Further in accordance with law it is the bounden duty of OP to look into the matter and should initiate necessary action/steps to settle the claim that too life insurance to which the OP has failed to do so. Hence the present complaint is filed.
3. In response to the notice, the 2nd OP has appeared through his counsel and filed version. The 1st OP has not appeared before the forum and he was called out absent and placed him exparte.
4. In the version, the 2nd OP has submitted that, the present complaint is not maintainable either on legal grounds or on factual basis. The complainant is guilty of suppressing material and pertinent facts relevant for the adjudication of the present complaint apart from filing a vexatious and frivolous complaint. Thus the complaint deserves to be dismissed on this ground alone.
The 2nd OP further submitted that, the complainant being an educated person was well aware that she is applying for the retirement plan which secures her future with regular pension amount. In this regard, the complainant had submitted a proposal form with the OP on 18-8-2009 proposing for “Best Years Retirement Plan Viz. “Immediate Annuity with Return of Purchase Price” which is approved by the Insurance Regulatory Development Authority of India (IRDAI). The initial contribution made by the complainant was Rs.25,000=00 and agreed to pay Rs.2,000=00 annually and vesting date under the policy was 54 years. Further the complainant had also chosen the preferred option of annuity under the said policy where annuity will be paid as along as annuitant is alive.
The 2nd OP further submitted that, based on the answers, statements, contribution amount opted and declaration made in the proposal form duly executed and submitted by the complainant, the OP had issued a policy bearing no.01634535 along with the terms and conditions governing the policy and a welcome letter to the complainant. The policy schedule along with a welcome letter, the terms and conditions applicable to the policy were delivered to the complainant at her addressed as provided in the proposal form and there is no allegation of non-receipt of policy bound by the complainant.
The 2nd OP further submitted that, as per clause 6 (2) of IRDAI Regulation 2002 on protection of policyholder’s interests the policy terms and conditions specifically provide for a free look period of 15 days, during which period the policy holder is entitled to review the policy terms and conditions and request for a cancellation, if she dissatisfied with any of the terms and conditions of the policy. In the present case as the complainant had not raised any objection or complaint during the statutory period of 15 days therefore the contract is concluded. Important terms and conditions are applicable to the best year’s retirement plan. The complainant as per terms of the policy is not entitled to receive full benefit amount in one lump sum under the policy as claimed in the complaint.
The 2nd OP further submitted that, the complainant thereafter three contributions toward her policy. Subsequently, policy vesting date was nearing therefore the OP had sent the communication vide letter dated 22-1-2014 and 21-6-2014 mentioning current value of policy and gave an option to the complainant to choose her option as per the policy terms and conditions. But the complainant had failed to choose any such option within stipulated period. Hence, the OP had sent one more letter dated 21-8-2014 giving him 30 days extra period from the receipt of letter to choose her option but all such efforts of OP gone vain, because of which the OP is constrained to act as per clause 3.12.3 of the policy terms and conditions. Accordingly the OP had issued “Immediate Annuity with Return of Purchase Price Plan” to complainant having policy bearing no.02988280 and same got duly delivered to her.
The 2nd OP further submitted that, thereafter the complainant had approached the OP and submitted the Surrender request form dated 28-4-2015 i.e. after 6 months from issuance of the annuity plan requesting for surrendering her policy. However, the same could not be processed as surrender is permissible prior to vesting date only. Further the complainant had also requested for cancelling the annuity plan which was also rejected starting it’s beyond free look period. Subsequently, the OP sent a letter dated 1-8-2015 seeking the complainant to submit requisite documents for enabling first annuity payout. On receipt of such confirmation the OP had duly sent a cheque bearing no.247722 dated 15-9-2015 amounting to Rs.5,833=00 to the complainant.
The 2nd OP further submitted that, the complainant being an educated person was well aware on the terms and conditions of the policy which was issued to her and in order cover up her faults by not opting the choice given to her with in stipulated time intentionally trying to bring name change of the OP as bone of contention when such changes will not impart the operation of the company nor it can escape from its commitments and obligations made to their policyholders and IRDA of India has a regulator ensure all the Indian Insurance Companies Act in accordance with it. The policy was issued to the complainant was retirement plan where there is no withdrawal of the entire corpus amount after vesting date as per policy terms and conditions. The OP has strictly followed the terms of the policy and thus has not committed any deficiency of service as defined under CP Act. Hence it is prayed to dismiss the complaint with costs.
5. In the course of enquiry into the complaint, the complainant and 2nd OP have filed their affidavit evidence reproducing what they have stated in their respective complaint and version. The complainant has produced documents along with the complaint which were marked as Ex-C1 to C8 and the 2nd OP has produced documents which were marked as Annexure-1 to 9. We have heard the arguments of both parties and perused the documents and posted the case for orders.
6. Based on the above materials, the following points will arise for our consideration.
- Whether there was deficiency in service on the part of the OP Nos.1 and 2 as alleged by the complainant?
- What Order?
7. Our findings on the above points are;
Point no.1: Partly affirmative
Point no.2: As per the final order below.
REASONS
8. At the very threshold, we must point out that, the case of the complainant is that, he had held insurance policy no.01634535 (ING Vysya Life Insurance) No.02988280. The above policy commencement date is 20th Aug. 2009 and maturity date is 20th Aug.2014, premium paid by the complainant is also not disputed by the OP. Then the policy was take over by the OP No.1 and 2 and changed the name of the policy as Exide Life Insurance on 29-4-2014. The OP while admitting the above facts in their reply notice dated 21-8-2015, however specifically contended that, the company will continue to honour its commitments and obligations under the insurance policy issued in the name of ING Vysya Life Insurance Co. Ltd, it is seen at Ex-C3.
9. Further the complainant submitted that, though the surrender request form along with necessary document s were given to the OPs for settle the claim amount. But the OPs did not turned up. Then the legal notice was issued on 6-8-2015, but the OPs did not settle the claim of the complainant, it is seen at Ex-C6 and C1.
10. So on this aspect, the main point urged on behalf of the OP is that, as per clause 6 (2) of the IRDAI Regulation 2002 on protection of policy holder’s interest, the policy terms and conditions specifically provide for a free look period of 15 days, during which period the policy holder is entitled to review the policy terms and conditions and request for a cancellation, if he/she dissatisfied with any of the terms and conditions of the policy.
11. But as pointed out by the learned advocate for the complainant, the said ING Insurance Vysya Life Insurance Policy terms and conditions were not supplied to the complainant and subsequently the policy terms and conditions are changed unilaterally, it is prejudice to the lawful interest of the complainant and it was not served on the complainant. In the sense, the complainant was not made aware about such terms and conditions of the policy by the OP, till the same is produced by the OP in the instance case and it is not marked. On careful perusal of the ING Vysya Life Best Years Retirement Plan, conditions applicable to the Basic policy, it is separate sheet. Moreover, the OP did not substantiate neither this terms and conditions were supplied to the complainant or not. Further the OP produced another terms and conditions copy by name Exide Life Immediate Annuity with Returns of purchase price (CUIN 114N050 VOL) Terms and conditions and it is not marked. On careful perusal of the said terms and conditions, it is totally different from the ING Vysya Life Insurance terms and conditions. Therefore when such terms and conditions noted in the so called Insurance Policy’s bearing no.01634535 and No.2988289 was neither made known to the complainant nor served; such terms and conditions are not binding on the complainant, as rightly submitted by the learned council for the complainant. It is also pertinent to note that, the OP though the policy with the OP he did not produce the said insurance policy before this forum. To substantiate the terms and conditions attached to the policy in question to the notice of the complainant while issuing policy. Under this circumstance, the repudiation of the claim of the complainant by OPs certainly amounts to deficiency in service. Before jumping to such conclusion it become the bounden duty of this forum to consider as to whether the complainant has made her efforts to get the claim, the complainant produced certain documents like legal notice/Ex-C1 reply notice/Ex-C3, requisition to the OP regarding settle the claim it is at Ex-C4, change of address it is at Ex-C5 and surrender request form it is at Ex-C6. So the substantial evidence furnished by the complainant could not dilute, disturbed or disproved by the OP in any manner. Under the circumstances, we answer this point No.1 in affirmative and accordingly we answer this point in the affirmative.
12. Point No.2: The finding under the issue no.1 supra certainly empowers this forum to direct the OP to settle the claim of the complainant. In this connection, the OP produced one document dated 21st August 2014 that is letter issued by the OP to the complainant, therein it is clearly mentioned that “They are happy to inform you that, your policy is maturing on 20-8-2014. The current value in your IPA (Individual Pension Account) is INR 1,20,111=00. You are requested to choose your annuity option”. Surrender request form that is at Ex-C6 is only a material price of documents, one can easily come to the conclusion that, the total sum matured amount on 28-8-2014 is Rs.1,20,111=00. Therefore, we find it is just and proper to direct the OPs to pay a sum of Rs.1,20,111=00 to the complainant. The complainant also claimed Rs.25,000=00 towards mental agony and Rs.10,000=00 to the cost of this litigation. In this connection, the complainant has not placed any iota of evidence. Therefore we are of the considered view that, it is not a fit case to award any damage claimed by the complainant. However, the deficiency of service on the part of the OP alleged in the complaint naturally compelled the complainant to approach this forum by filing the complaint for redressal; the OP shall pay the cost of this proceeding which quantify at Rs.5,000=00 it is also found just and proper to award future interest on the payable amount, under this order at the rate of 9% interest p.a. in case, the OPs failed to comply the order within the stipulated time. In the result, for the foregoing reasons, we proceed to pass the following order.
ORDER
The complaint filed by the complainant is hereby allowed in part with cost of Rs.5,000=00.
The OP is directed to pay a sum of Rs.1,20,111=00 to the complainant within a period of 30 days from the date of communication of this order, failing which, the payable amount under this order shall carry future interest at the rate of 9% p.a. from the date of complaint till realization.
Supply free copy of this order to both parties.
(Dictated to the Stenographer, got it transcribed and corrected, pronounced in the Open forum on this, the 30th day of November 2016).
MEMBER MEMBER PRESIDENT
