BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PONDICHERRY

C.C.No.03/2014

Dated this the 10^th day of July 2015.

Sekar K.R., M.A., LL.B.,

No.24,  Bharathiar Nagar,

Periyakalapet,

Puducherry-605 014.                                                          ….       Complainant

Vs.

1. The Branch Manager,

    HDFC Standard Life Insurance Company Ltd.,

    No.17-A, 2^nd Floor, Sri Velyutham Complex,

    Natesan nagar, Puducherry-605 005.

2. S. Baskar,

    Sales Development Manager,

    HDFC Standard Life Insurance Company Ltd.,

    No.17-A, 2^nd Floor, Sri Velyutham Complex,

    Natesan nagar, Puducherry-605 005.

3. The Vice-President-Operations,

    HDFC Standard Life Insurance Company Ltd.,

    11^th Floor, Lodha Excelus Apollo Mills Compound,

    N.M. Joshi Marg, Mahalakshmi, Mumbai-400 011.

                                                                                                  … Opposite Parties.

BEFORE:

            THIRU.A.ASOKAN, B.A., B.L.,

            PRESIDENT 

Tmt. PVR. DHANALAKSHMI, B.A.,B.L.,

           MEMBER

FOR THE COMPLAINANT                                  :  Dr.R.Ramalingam, Advocate.

FOR THE OPPOSITE PARTIES: OP.1& 2        :  Thiru.K.Ravikumar, Advocate.

                                                                        OP.3     :  Exparte.

O R  D  E  R

(By Thiru.A.ASOKAN, President)

This is a complaint filed by the complainant under section 12  of the Consumer Protection Act, 1986 praying to:

1. Direct the opposite parties to despatch the original HDFC Life Insurance Policy Bond immediately to the policy holder vide Police No.15405072, to enable the policy holder to seek for refund of policy premium amount, or

Direct the opposite parties to pay the loss amount of Rs.30,000/- paid by the complainant.

2. Direct the opposite parties to pay the loss for mental disturbances and mental agony of Rs.50,000/- to the complainant.
3. Direct the opposite parties to pay Rs.10,000/- as the cost of this proceedings which is inclusive of speed post charges.

2.  The case of the complainant is as follows:

            The complainant was approached by the second opposite party, who is working as Sales Development Manager and explained the plan of the HDFC Standard Life Insurance.  The complainant accepted the plan and signed in the plan and issued cheque no.13029 dated  Aug'2012 for Rs.30,000/- as premium.  For the said payment, no receipt was issued by the second opposite party but he has given assurance that original insurance bond will be sent by the Mumbai Office to the complainant directly through post.  The statement of accounts issued by the complainant SB Account No.413240637 for month of August 2012 is enclosed with this complaint for the perusal of this Forum.   As the original insurance bond was not received by the complainant within the stipulated time,  he approached the second opposite party so many times but the second opposite party has not shown interest to trace out the original insurance bond.  Even after lapse of 13 months from the date of first premium paid, the complainant has not received the insurance policy bond.  The third opposite party has totally failed to send the original HDFC Standard Life Insurance policy bond to the complainant within a reasonable time from the date of admission of policy holder.

3.         The complainant further submits that on 18.09.2013, the complainant received a letter from the third opposite party stating that "from our records we observe that the total premium which was due on 30/08/2013 was not received for the above mentioned policy.  The grace period has also elapsed thereby resulting in cancellation of all the benefits under the policy.  Kindly deposit the outstanding premiums alongwith the revival charges (Rs.250/- extra) … and continue to enjoy the benefits of your policy.   The complainant submits that as he has not received the policy bond, he did not know the policy number and other details.  Without knowing the details, the complainant cannot pay the premium for the second year.  Further, the third opposite party has sent the reminder belatedly with compulsion to pay the premium alongwith extra amount towards revival fees.  Aggrieved by the activities of the opposite parties, the complainant has sent representation to the third opposite party to refund the entire standard life insurance policy amount of Rs.30,000/- with accrued interest of 13 months of lapse.  Hence this complaint.

4.         The following are the averments narrated in the reply version filed by the opposite parties 1 and 2:

            The opposite party denied all the averments in the complaint except those that are specifically admitted in the reply version.  The complainant was and is residing at No.8, B Pallatheru, Chinnamudaliarchavady, Pondicherry-605 104.  The complainant had wantonly concealed the fact, in order to make a false claim.  The complainant had contacted the first opposite party and had asked about various policies and then he had made a duly singed proposal in August 2012, to the opposite parties for taking a policy.   At the time of taking a policy, he had represented the he is residing in the above said address.  On the basis of proposal the opposite parties have processed the application of the complainant and had issued  HDFC SL Classic Assurance Insurance Plan under policy No.15405072 dated 04.09.2012.  As per the policy the installment premium was Rs.30,000/- and the policy term was 10 years and the premium paying term was 7 years.  The complainant was also aware of the website of the opposite parties, namely "HDFCLife.com", and he had his own account by which he could readily refer and verify the details of the policy and the next due dates.   The first premium receipt dated 30.08.2012 had been issued to the complainant and the same was received by the complainant.

5.         The opposite parties state that the policy document was duly sent to the address mentioned in the proposal form through Blue Dart courier via Airway Bill No.46136773723 dated 07.09.2012 and the policy document dispatch SMS has been sent the complainant on 07.09.2012.  But the courier containing the policy document was returned by the courier with endorsement "no such person".  Blue Dart courier had issued a letter to that effect that the courier could not served on the complainant. Hence the obligation has been discharged by the opposite parties.  The complainant has to pay the yearly premium and as per policy conditions (3)(i), he has given 15 days grace period to pay the next premium.  The complainant has not paid the premium.  Even after receipt of the revival letter on 18.09.2013, the complainant has not paid the premium amount.  Hence as per policy conditions No.3(ii) the policy taken by the complainant had lapsed.  The opposite parties further states that as per policy conditions No.3(iv) the complainant would get a guaranteed minimum surrender value only if he pays premium for a continuous period of the first three years. And as per policy conditions No.5(i) no benefits are payable to the complainant as he had not paid the premium within the first three years. The complainant knew about the policy conditions that he will have to pay atleast 3 years of premium to surrender the insurance policy.   As the second premium was not paid, the opposite parties have issued a revival letter as per the policy conditions.  Only at this juncture, the complainant had for the first time made an allegation that he had not received the policy document.  The opposite parties further submitted that as per the policy conditions the policy of the complainant had lapsed and these opposite parties are not liable to pay any benefits to the complainant.  The opposite parties have acted only as per the Insurance Act and the IRDA guidelines and there is no contravention of any enactment by the opposite parties. There is no deficiency in service on the part of the opposite parties. Hence the complainant prays to dismiss the complaint with costs.

6.         On the side of the complainant, Exs.C1 to C10 are marked.  On the side of the opposite parties, one Mr.Irfanbasha, Senior Corporate Manager of opposite party has been examined as RW.1 and marked Exs.R1 to R3 through him. 

7.         Points for determination are:

1. Whether the complainant is the Consumer?
2. Whether the opposite parties attributed any deficiency in service?
3. To what relief the complainant is entitled for?

8.         Point No.1:

            The complainant availed insurance policy from the opposite parties on 30.08.2012 vide payment made through cheque and honoured on 01.09.2012 for Rs.30,000/- as first premium to the opposites parties as per Ex.C10.  Hence the complainant is the consumer.

9.         Point No.2:

            We have perused the pleadings, reply version and documents and evidence adduced by both the parties.  The case of the complainant is that on 30.08.2012 he was convinced by the opposite party's agent and agreed to avail the insurance policy and paid the first premium amount of Rs.30,000/-.  The complainant signed the proposal form and demanded the original policy from the second opposite party.  The second opposite party assured to give the original policy to the complainant.  The complainant submits he has repeatedly demanded to issue the original policy, but the opposite parties have not sent the original policy.   The opposite party No.3 sent an intimation Ex.C2 on 18.09.2013 to pay the premium for the second year commencing from 30.08.2013.  The Ex.C2 contains the details of the premium to be paid and indicate that the policy will be terminated for non-payment of premium.  The Ex.C2 further contains that the last date for payment of premium was also lapsed and benefit for the policy will be terminated.

10.       The complainant sent the Ex.C3, C5, C7 to the opposite parties requesting them to send the original policy to him for making payment for second year premium.  The complainant further submits that even after repeated demand made by him, the opposite parties never sent the original policy to him. The complainant pleaded that without seeing the original policy and terms and conditions how can pay the premium amount to the opposite parties.

11.       The complainant further submitted that the second year of policy commences from 30.08.2013 but the opposite parties sent the reminder only on 18.09.2013.  The second opposite party has not informed the policy number even after lapse of 13 months.  The complainant pleaded that without knowing the policy number and terms and conditions how can remit the second year premium to the opposite parties.  The third opposite party has to send the original policy within reasonable time and the reminder letter should be sent before expiry of the renewal date.  But the third opposite party sent the letter Ex.C2 after 13 months and imposed Rs.250/- as revival fee.  The opposite parties have not taken any steps to reply Exs.C3, C5, C7.  Thus the e complainant prays for compensation for the negligent act of the opposite parties.

12.       The opposite parties 1 and 2 submitted that the complainant had contacted the first opposite party and had asked about various policies and then he had made a duly signed proposal in August 2012, to the opposite parties for taking a policy.   At the time of taking a policy, he had represented the he is residing at No.8, B Palla Theru, Chinnamudaliarchavady, Pondicherry-605 104.  On the basis of proposal the opposite parties have processed the application of the complainant and had issued  HDFC SL Classic Assurance Insurance Plan under policy No.15405072 dated 04.09.2012.  As per the policy the installment premium was Rs.30,000/- and the policy term was 10 years and the premium paying term was 7 years, to be paid annually from the date of commencement. All these information has been known to the complainant from inception of the policy.   The complainant was also aware of the website of the opposite parties, namely "HDFCLife.com", and he had his own account by which he could readily refer and verify the details of the policy and the next due dates.   The first premium receipt dated 30.08.2012 had been issued to the complainant and the same was received by the complainant.

13.       The opposite parties state that the policy document was duly sent to the address mentioned in the proposal form through Blue Dart courier via Airway Bill No.46136773723 dated 07.09.2012 and the policy document dispatch SMS has been sent the complainant on 07.09.2012.  But the courier containing the policy document was returned by the courier with endorsement "no such person".  Blue Dart courier had issued a letter Ex.C3 to that effect that the courier could not served on the complainant. Hence the obligation has been discharged by the opposite parties.  The complainant has to pay the yearly premium and as per policy conditions (3)(i), he has given 15 days grace period to pay the next premium.  The complainant has not paid the premium.  Even after receipt of the revival letter on 18.09.2013, the complainant has not paid the premium amount. Hence as per policy conditions No.3(ii) the policy taken by the complainant had lapsed.  As per policy conditions No.3(iv) the complainant would get a guaranteed minimum surrender value only if he pays premium for a continuous period of the first three years. And as per policy conditions No.5(i) no benefits are payable to the complainant as he had not paid the premium within the first three years. The complainant knew about the policy conditions that he will have to pay atleast 3 years of premium to surrender the insurance policy.   As the second premium was not paid, the opposite parties have issued a revival letter as per the policy conditions.  Only at this juncture, the complainant had for the first time made an allegation that he had not received the policy document.  The opposite parties further submitted that as per the policy conditions the policy of the complainant had lapsed and these opposite parties are not liable to pay any benefits to the complainant.

14.       From the above facts it is clear that the opposite parties have not sent the original policy to the complainant event today. The complainant waited for the original policy for more than one year.  The complainant demanded the original policy vide Exs.C3, C5, C7.  Even after the repeated demand made by the complainant, the opposite parties have not sent the original policy.  The reminder letter was sent by the third opposite party after lapse of 13 months only.  It should be sent well in advance to the complainant prior to the last date.  The complainant is having every right to avail the policy bond to make payment in time.  In the absence of the original policy and without knowing the terms and conditions the complainant unable to pay the premium.  The proposal is only the offer made by the complainant and the policy is the agreement between the parties.  The Ex.R3 filed by the opposite party clearly shows it was obtained only on 31.01.2014 and it shows that the shipment undelivered due to 'no such street' on 12.09.2012.  The opposite parties have not taken any other steps to deliver the original policy to the complainant till date.  It is bounden duty of the opposite parties to deliver the insurance policy to its customer and to ensure that the insurance policy is properly received by its customer. At this juncture, after lapse of the policy due to the negligent act of the opposite parties, there is no use in continuing the policy by the complainant.  The complainant is not liable for paying the penalty to the opposite parties for the negligent act of the opposite parties.  The revival of the policy after lapse of three years with stained relationship between the parties should not solve the purpose for taking the policy.  The complainant justified his act for nonpayment of the premium in time. The negligent act of the opposite parties have caused loss and suffering to the complainant. To meet the ends of justice we are inclined to allow this complaint and the opposite parties are jointly and severally liable to pay the loss and injuries suffered by the complainant.

15.       Point No.3:

            In view of the decision taken in point no.2, this complaint is hereby allowed.

The opposite parties are jointly and severally directed

1. To repay the premium amount of Rs.30,000/- to the complainant.
2. To pay a sum of Rs.10,000/- as compensation to the complainant for their negligent act.
3. To pay a sum of Rs.5000/- as cost to the complainant.

Dated this the 10^th day of July 2015.

1. ASOKAN)

PRESIDENT

(PVR. DHANALAKSHMI)

MEMBER

COMPLAINANTS' WITNESS:   Nil

OPPOSITE PARTY'S WITNESS: 

RW.1              04.11.2014                            Irfanbasha

COMPLAINANTS' EXHIBITS MARKED THROUGH CONSENT:

OPPOSITE PARTY'S EXHIBITS:

1. ASOKAN)

PRESIDENT

(PVR. DHANALAKSHMI)

MEMBER