Tamil Nadu

South Chennai

CC/389/2016

K.Ranasinsh s/o.Kasinadar - Complainant(s)

Versus

The General Manager, Exide Life Insurance Co Ltd - Opp.Party(s)

Balakrishna E.Malarkodi

15 Jul 2022

ORDER

Date of Complaint Filed : 11.11.2016

Date of Reservation      : 01.07.2022

Date of Order               : 15.07.2022

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (SOUTH), CHENNAI-3.

 

PRESENT:    TMT. B JIJAA, M.L.,                                             : PRESIDENT

                        THIRU. T.R. SIVAKUMHAR, B.A., B.L.,           :  MEMBER  I 

                        THIRU. S. NANDAGOPALAN., B.Sc., MBA.,    : MEMBER II

 

 

CONSUMER COMPLAINT No. 389/2016

FRIDAY, THE 15^th DAY OF JULY 2022

Thiru.K.Ranasingh (M/A 57),

S/o.Kasi Nadar No:67,

5th Main Road,

CIT Nagar,

Chennai-35.                                                                                                                                                         ... Complainant                             

 

..Vs..

1. The General Manager,

    Exide Life Insurance Co., LTD.,

    III Floor, JP Techno Park,

    No:3/1, Miller's Road,

    Bengaluru.

 

2. The General Manager,

    Exide Life Insurance Co., LTD.,

    Prince Kushal Towers,

    Ground Floor No:96,

    Annasalai,

    Chennai-2.

 

3. The Insurance Regulatory &

    DevelOpposite Partyment Authority of India,

    3rd Floor, Parisrama Bhavan,

    Basheer Bagh,

    Hyderabad-500 004,

   Telangana State.                                                                                                                                            ...  Opposite Parties

 

      ******

Counsel for the Complainant            : M/s. Thanga Vadhan Balakrishnan

Counsel for the 1^st Opposite Party     : M/s. Samuthra Vijayan

Counsel for the 2^nd Opposite Party    : Exparte

Counsel for the 3^rd Opposite Party    : Party in Person

 

        On perusal of records and after having treated the written arguments as oral arguments on the side of Complainant and 1^st Opposite Party, we delivered the following:

ORDER

Pronounced by the President Tmt. B. Jijaa, M.L.,

1.      The Complainant has filed this complaint as against the Opposite Partyunder section 12 of the Consumer Protection Act, 1986 and prays to refund the Premium amount paid till date for the past 26 months which amounts to a sum of Rs.2,14,339/- along with an interest of 18% Per Annum and direct the First and second Opposite Party to pay a sum of Rs.1,00,000/- as  compensation to the Complainant.

2.     The averments of Complaint in brief are as follows:-

         That the Complainant has been an Insurance Policy Holder under the Opposite PartyInsurance Company namely M/s.Exide Life Insurance Company formerly denoted as the ING Vysya Life Insurance Company Ltd., Viz Policy No:02817099 dated the 16 Dec 2013 under the Plan "Exide Life Reassuring Life Endowment Plan" assuring the Life of Mrs.Niraimathi, the Complainant's Wife. The said Plan reaches Maturity on the 16th December 2023. As per the Policy Plan the Complainant had to pay an amount of Rs.8,247/- as monthly premium for ten years. The same was arranged to be payable from the Complainant's Account at the Karur Vysya Bank branch at T-Nagar, Chennai vide Account No:123172000004282.  The Premium had to be paid on the 16^th day of every month as per the policy documents, likewise the Complainant also assured that his account balance was sufficient for making the payment on the 16th day of every month and had been regularly making the payment without fail, while so the Second Opposite Party has opted to withdraw the Premium amount from the Complainant's Bank Account on 12.02.2016 prior to the Premium date whereas the Complainant's Account had insufficient balance. Anyway, the Complainant's bankers were kind enough to credit the amount to the Second Opposite Party's account resulting in a balance amount of Rs.7,703/- in the Complainant's Account. Following which the Second Opposite Party has again credited back the amount to the Complainant's Account on the same day. After the above incident the Second Opposite Party has not opted to effect ECS on the due date that is on 16.02.2016 in result of which the Complainant's Premium payable for the month of February has been left unpaid. Subsequently the Complainant received an intimation stating that his premium was not remitted, hence the Complainant has issued a Cheque for an amount of Rs.16,328/ payable for the month of February and March. The Second Opposite Party presented the same before their bankers and the amount was debited from the Complainant's Account on 15.03.2016. Whileso, the Complainant received a Letter dated 18.03.2016 from the Opposite Party stating that the Policy has been lapsed and the amount of Rs.16,328/- has been retained as deposit. The Complainant was shocked and approached the office of the Second Opposite Party wherein he was not attended by the executives in a proper manner and was made to wait for hours and then sent back stating that they would sent the details by post. After the above incident on 08.06.2016 the Complainant received a Cheque for Rs.16,328/- from the Second Opposite Party with a covering letter stating that the above is the re-fund of the excess amount paid as premium.  On receipt of the above letter the Complainant has approached the Second Opposite Party's Office to verify the same where he came to know that his policy has been lapsed further there were no responsible customer care executives who would take initiative to redress his grievance. Aggrieved by the above the Complainant sent a Legal Notice to the first and second Opposite Parties claiming them to refund the amount paid so far as monthly premiums and pay a compensation of Rs.1,00,000/- as to compensate the Mental and physical agony he has undergone due to the negligence of the Opposite Parties. On receipt of the Notice the Opposite Partiesreplied stating that, in the month of Jan 2016 the Complainant's ECS was rejected due to insufficient funds, since premium was not paid for the month of March 2016 the said Cheque issued by the Complainant for Rs.16,328/- could not be adjusted hence it was refunded.  The Complainant submits that, after the above certain customer care executives have called the Complainant over phone but his grievance was not taken care of but he received only vague and evasive replies from the customer care executives. The due date of the premium payment falls on the 16^th day of every month but the Second Opposite Party has effected ECS on 12.02.2016 which shows his negligence, further for the month of January 2016 there was sufficient funds in his account and the premium amount of Rs.8,164/- was debited on 18.01.2016 as per his Bank account statement but the First and Second Opposite Parties said that the Complainant had insufficient funds in the month of Jan 2016 hence policy was lapsed which again amounts to negligence and in to deficiency of service. After the above incidents on demand the Complainant has issued a Cheque for Rs.16,328/- which was first encashed and then the amount was returned to the Complainant on 08.06.2016 with reasons "Excess amount of premium Paid". This shows the lethargic functioning of the Opposite Parties who never cares for their customers once they are registered with them. He is very much frustrated that he is now taking steps to surrender the second Policy namely Policy No: 03198068 registered with the above First and Second Opposite Parties. The Complainant is a business man and has subscribed the above mentioned Insurance Policies for the welfare of his family but now he is put into great mental and physical agony due to the irresponsibility of the First and second Opposite Parties towards their customers. He was made to run from Pillar to Post by the executives of the First and second Opposite Parties when he visited their Office to submit his grievance whereas they were so charming and inviting when the Policy was being initiated by the Complainant. Hence the complaint.

3. Brief Facts of the Written Version Filed by the 1^st Opposite Party are as follows:-

        The Complainant had availed a “ING Life Reassuring Life Endowment Plan” in the name of his wife Smt. Niraimathi bearing No.02817099. The Policy details are;

I.Date of Policy Commencement -16-12-2013

lI. Date of Risk Commencement -23-01-2014

iii. Premium payable Monthly - Rs 8,247/-.

iv. Premium payment Term- 10 years

v. Policy Term – 10 years

vi. Maturity date-16.12.2023

vii. Sum Assured under Basic Policy - Rs 7,01,999/-.

viii. Sum Assured under ING Term Rider-Rs 3,00,000.

As per Regulation 6(2) of Regulation 2002 issued by the IRDAI, the policyholder/Proposer is at liberty to review the terms and conditions of the policy and has the option to cancel the policy by stating the reason for his/her objection within 15 days of receipt of policy bond (Free Look Period) and these facts were clearly intimated in the welcome letter which was issued to the Complainant along with the policy schedule and terms & conditions. However as Complainant had never sought for cancellation of both Policies within free look period (i.e. within 15 days). Hence it is presumed that Complainant is duly satisfied with the Policies terms and conditions which was issued to him and the contract is concluded.  The Complainant has also submitted Electronic Clearing System / Direct Debit/ Standing Instruction Mandate to The Karur Vysya Bank Limited wherein he is having Account bearing No.12131724288 to debit said account every month and credit the Premium amount to Opposite Party/ Respondents No. 1 & 2 Insurance Company. Accordingly the Premiums were received till December 2015. However in the month of January 2015 the monthly premium mandate which was scheduled on 16.01.2016 in view of directive from RBI clearing cycle Saturday and Sunday were being treated as non-working days for debits was presented only on 18.01.2016 by the Opposite Party/ Respondents No. 1 & 2 Insurance Company. However, despite Complainant bank who is she governed by RBI directive rejected ECS mandate. The rejection of mandate from the statement of accounts of the Complainant seems based on the credit balance available in the in the accounts on 16.01.2016 being only Rs. 2,334.54 which is not sufficient to honour the ECS mandate.  Thus the action of the Complainant and Complainants Bank alone solely and absolutely responsible for lapse of payment of Premium amount for the month of January 2016 and not on account of Opposite Party/ Respondents 1&2 Insurance Company.

 It is the basic responsibility of the Complainant to check and verify his bank account every month and ensure whether the Premiums have been debited regularly to his account and is paid to the Insurance Company. It is also the absolute responsibility of the Complainant to ensure that sufficient credit balance is maintained in his account for the Bank to honour the ECS debit mandate. In the instant case as on the specific date of 16.01.16 the credit balance was only Rs 2,334.54 which is not sufficient to honour the ECS mandates. Thus the contributory negligence on the part of the Complainant alone is solely responsible for the lapse of payment of Premium for the month of January 2016 and not due to negligence of Opposite Parties / Respondents No 1 & 2 Insurance Company as alleged by the Complainant in the Complaint. Had the Complainant checked his account or taken note of the Reminder notice 17.02.2016 (copy of the reminder notice is attached and marked as a document No.3) of the Opposite Parties/Respondents No 1&2 Insurance Company towards the pending premium of the Jan-2016, he would have come to know January 2016 premium has not been paid and would have instanty paid the premium to the Opposite Parties/ Respondents No. 1 & 2 Insurance Company and thus prevented the lapse nonpayment of Premium. Further, ECS mandate for the month of February was also rejected by the Complainant's Bank. It is seen from statement of accounts the Credit balance available in the account as on 16.02.2016 is only Rs 3,000 which is not sufficient to honor the ECS mandates. In view of the non payment premium/rejection of ECS debit mandate by the Complainant Bank, of premiums due for January and February 2016, further ECS mandate could not be further proceeded with.

However, the Complainant on 15.03.2016 remitted through ECS for Rs 16,328/- for the two months due premiums for the months of February and March instead of three months pending Premiums for the months of January, February and March 2016. Thus due to shortfall of the Premium for the month of January 2016, Opposite Parties / Respondents No.1 & 2 Insurance Company could not adjust the above amount the Policy was under shortfall of premium category. Accordingly the Opposite Parties/ Responders No 1&2 Insurance Company informed the same to the Complainant vide its letter dated 19.03.2016. Further, in view of the above the payment of Rs 16,328.65 was refunded to through a cheque to the Complainant on 08.06.2016. The same was also communicated to the Complainant by the Opposite Parties/ Respondents No 1 & 2 Insurance Company vide its letter dated 12.08.2016 and Complainant was also through this letter was given an opportunity to remit the outstanding premiums in full of Rs 65,400 on or before 30.08.2016. From supra it is evident the Complainant is alone responsible for the Policy to reach the lapsed status. The Complainant is not entitled to seek for cancellation of the Policy after free look period of 15 days of the Policy and after commencement of Risk period. In case if some misfortune would have happened to the LA during the pendency of Policy then, the Opposite Parties/Respondents No 1 & 2 Insurance Company would have been forced by the Nominee to settle the claim amount of Sum Assured to the Nominee. Thus, the LA/ Complainant cannot enjoy the twin benefit of death claim benefit to the Nominee and also simultaneously seek refund of Premium amount when LA is alive. Thus it is very evident from Supra that the LA/Complainant is legally not entitled for cancellation of the Policy and refund of Premium and his demand is not legally tenable. Thus it is also very evident that the LA/Complainant is legally not entitled for cancellation of the Policy and refund of Premium as his demand is not legally sustainable. The Complainant under the false pretext not supported by any evidence makes this complaint sans adducement of evidence and as such is legally not maintainable. Therefore, Opposite Parties/Respondents Insurance Company  humbly submits that it has not committed any "Deficiency of Service" or "Unfair Trade Practice" within the meaning of the Consumer Protection Act 1986. As per Sec 2 (9) of the Act, the main Ingredient to constitute deficiency of service shall be "Non performance of any of the terms undertaken to be performed by a person in pursuance to the contract or otherwise in relation to the service” Whereas, in the Instant case the Complainants in fact have failed to establish non performance of any obligations of the Opposite Party Company under the Terms and Conditions of the insurance policy issued by it. The Complainants in spite of the legal position as above has filed the above Complaint / Case before this Hon'ble Forum on frivolous and baseless grounds which are not tenable in the eyes of law. The complainant thus wants to wriggle out of the terms and conditions of a concluded contract has intentionally twisted the facts to the core and is trying to misrepresent before the Forum by alleging deficiency of service unfair trade practices. The Opposite Parties/ Respondents No 1 & 2 Insurance Company  neither committed any deficiency of service nor adopted any unfair trade practices while dealing with the Complainant. The Complainant has failed to set up a nexus between the compensation claimed in the present complaint and the alleged damage suffered. The compensation claimed is arbitrary, unreasonable and is an abuse of the process of law. Complainant is legally not entitled to pray for cancellation of Policy and payment thereon in view of the reasons as narrated in the above Paragraphs, The Opposite Parties/Respondent Insurance Company denies all the allegations of the Complainants in the Complaint as false and as they fall beyond the scope of contract  i.e. Policy Terms. The Complainant has failed to make out a case of "Deficiency of Service" and "Unfair Trade Practice" as alleged or otherwise, within the meaning of the Consumer Protection Act 1986, hence the present complaint is not maintainable and liable to be dismissed.

4.      The Complainant submitted his Proof Affidavit and Written Arguments. On the side of the Complainant, documents Ex.A-1 to Ex.A-10 were marked. The 1^st Opposite Party submitted his Proof Affidavit and Written Arguments. On the side of the 1^st Opposite Party, documents Ex.B-1 to Ex.B-5 were marked. The 3^rd Opposite Party submitted his Written Version by post and Proof Affidavit of 3^rd Opposite Party is closed.

5.     in spite of sufficient notice, the 2^nd Opposite Party did not appear before this Commission and hence set exparte.

Point for Consideration:-

1. Whether there is any deficiency in service on the part of the Opposite Parties?
2. Whether the complainant is entitled to get compensation as claimed in the complaint?
3. To what relief, the complaint is entitled?

Point No.1:-

Upon perusal of records the undisputed facts are that the Complainant had availed Insurance Policy vide Policy No.02817099 dated 16.12.2013 under the plan “Exide Life Reassuring Life Endowment Plan” formerly denoted as ING Vysya Life Insurance Company Ltd., assuring the Life of his wife Mrs.Niraimathi from M/s Exide Life Insurance Company. As per the Policy the Complainant had to pay a sum of Rs.8,247/- as the monthly instalment premium for a period of 10 years from 16.12.2013 to 16.12.2023 and the premium had to be paid on the 16^th of every month as evident from Ex.A-1 and Ex.A-2. The premium was arranged to be payable from the Complainant’s Account at the Karur Vysya Bank branch at T.Nagar vide Account No.123172000004282.

The dispute arose when the 2^nd Opposite Party to withdraw the premium from the Complainant’s Account on 12.02.2016 when the Complainant had no sufficient fund in his account as the due date for payment of premium is on 16.02.2016, on which date the 2^nd Opposite Party did not Opposite Party to effect ECS resulting in payment of premium for the month of February 2016 remaining unpaid. The Complainant had issued a cheque for Rs.16,328/- being the premium for the month of February and March 2016, which was presented by the 2^nd Opposite Party and debited from the Complainant’s Account. However, the Opposite Parties by letter dated 18.03.2016 vide Ex.A-4 informed the Complainant that the Policy has been lapsed and is kept in deposit till revival. Whileso, on 03.06.2016, the 2^nd Opposite Partyhad issued a letter Ex.A-5 enclosing a cheque of Rs.16,328/- stating to be the refund of excess amount towards payment of premium. As per Ex.A-7, the Complainant had issued legal notice dated 25.07.2016 to the 1^st and 2^nd Opposite Partyclaiming refund of the premiums paid and for compensation, on receipt of which the 1^st and 2^nd Opposite Partyreplied on 12.08.2016 seeking the Complainant to remit the outstanding amount of Rs.65,000/-.

The 1^st and 2^nd Opposite Parties contended that as per the terms and conditions of the Policy, Ex.B-2, the Complainant had the Opposite Partytion to cancel the policy within 15 days of receipt of policy bond and as the Complainant had not sought for cancellation it is presumed that the Complainant is satisfied and the contract is concluded. Ex.B-3 is the Policy Lapse notice issued by the 1^st and 2^nd Opposite Parties alleging policy lapse for the month of January 2016 without any proof of issuance of delivery to the Complainant. It was also contended that credit balance available in the Complainant’s bank as on 16.02.2016 was only Rs.3,000/- which was not sufficient to honour the ECS mandate. While the premiums for the months of January, February and March 2016 remains unpaid the Complainant had remitted cheque for Rs,16,328.65 only for the month of February and March 2016, 2 months and due to the shortfall of the premium for the month of January 2016, they could not adjust the amount paid and the payment of Rs.16,328.65 was refunded to the Complainant on 08.06.2016. As per Sec 2 (g) of the Act the main ingredient to constitute deficiency is non performance of any terms undertaken to be performed in pursuance to the contract. In the instant case the Complainant failed to establish non performance of any obligation of the 1^st and 2^nd Opposite Parties. The 1^st and 2^nd Opposite Party as matter of good gesture was prepared to keep the Policy alive and continue provided the Complainants remits up to date premiums.

Though the 1^st and 2^nd Opposite Party contend that the premium for the month of January 2016 remains unpaid by the Complainant hence the remittance of Rs.16,328.65 could not be adjusted towards payment of premium could not be sustained in view of the fact that a perusal of the Statement of Account, Ex.A-6 would reveal that on 18.01.2016 the ECS clearing by the 1^st and 2^nd Opposite Parties has been effected and the premium amount is debited from the Complainant’s account, though after a delay of 2 days from the due date. However the Opposite Party vide Ex.B-3 has sent a policy lapse notice as though premium for the month of January was not paid. Subsequently it is seen that the 1^st and 2^nd Opposite Parties had sought for ECS on 12.02.2016 with the Complainant’s bankers instead of 16.02.2016, which is the due date on which premium is to be paid. It is seen that on 16.02.2016, the Complainant had sufficient balance to clear the ECS for the month of February 2016. But the 1^st and 2^nd Opposite Parties had presented for ECS on 12.02.2016 which is well before the due date. Further when the Complainant had issued a cheque for Rs.16,328.65 being the premium for the month of February and March 2016, it was credited  by the 1^st and 2^nd Opposite Parties, afterwards on 19.03.2016 had issued a letter informing that as the policy was in lapse, the money is kept in a deposit.  Only on 08.06.2016, the 1^st and 2^nd Opposite Parties had refunded the sum of Rs.16,328.65 to the Complainant.

Considering the facts and circumstances of the case, we are of the considered view that the 1^st and 2^nd Opposite Parties having received premium for the month of January 2016 and sending a Policy lapse notice on 17.02.2016, presenting the ECS for the month of February on 12.02.2016 prior to the due date, which resulted in return of cheque and failing to present ECS on the due date i.e., on 16.02.2016 when there was sufficient account balance and after receiving premium for the month of February and March 2016 and having given credit to the said amount, informing on 19.03.2016 the payment could not be adjusted as the policy is in a lapse  and further keeping the same as a deposit till June 2016 and refunding the amount on 08.06.2016 amounts to deficiency in service.

Point No.2 and 3:-

As discussed and decided in point No.1, that the 1^st and 2^nd Opposite Party have committed deficiency in service, the 1^st and 2^nd Opposite Party are liable to refund the premium amount of Rs.2,14,339/- with interest at the rate of 6% from the date of Complaint i.e., 11.11.2016 till the date of this order, to pay a sum of Rs.50,000/- as compensation to the Complainant along with cost of Rs.3000/-.

In the result the complaint is allowed in part. The 1^st and 2^nd Opposite Parties are jointly and severally directed to refund a sum of Rs.2,14,339/- (Rupees Two Lakh Fourteen Thousand Three Hundred and Thirty Nine Only) being the premium amounts paid by the Complainant together with 6% interest from the date of complaint till the date of order  and to pay a sum of Rs.50,000/- (Rupees Fifty Thousand Only) as compensation along with cost of Rs.3000/- (Rupees Three Thousand Only) to the Complainant, within 8 weeks from the date of the order, failing compliance, the Complainant is entitled to recover the above said amounts with interest at the rate of 9% per annum from the date of the order till the date of realization.

          In the result the complaint is allowed.

Dictated to Steno-Typist, transcribed and typed by her, corrected and pronounced by us in the Open Commission, on 15^th of July 2022.  

 

 

S. NANDAGOPALAN                                                       T.R. SIVAKUMHAR                                                              B.JIJAA

         MEMBER II                                                                     MEMBER I                                                                  PRESIDENT

 

List of documents filed on the side of the Complainant:-

 

Ex.A1	23.01.2014	First Premium receipt
Ex.A2	-	Policy Schedule
Ex.A3	30.01.2014	Welcome letter by M.D
Ex.A4	19.03.2016	Policy lapse Notice
Ex.A5	03.06.2016	Refund Letter
Ex.A6	13.07.2016	Account Statement from 01.01.2016 to 30.06.2016
Ex.A7	25.07.2016	Legal Notice
Ex.A8	29.07.2016	AD Card of Opposite Party-2
Ex.A9	30.07.2016	AD Card of Opposite Party-3
Ex.A10	12.08.2016	Reply Notice

 

List of documents filed on the side of the 1^st Opposite Party:-

 

Ex.B1	-	Proposal Form
Ex.B2	-	Insurance Policy with terms and Conditions
Ex.B3	17.02.2016	Reminder Notice of 1st Opposite Party
Ex.B4	19.03.2016	Letter of 1st Opposite Party
Ex.B5	12.08.2016	Letter of 1st Opposite Party

 

 

 

S. NANDAGOPALAN                                                         T.R. SIVAKUMHAR                                                                       B.JIJAA

         MEMBER II                                                                        MEMBER I                                                                         PRESIDENT