Date of filing : 12-12-2012
Date of order : 27-10-2014
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.328/2012
Dated this, the 27th day of October 2014
PRESENT:
SMT.P.RAMADEVI : PRESIDENT
SMT.K.G.BEENA : MEMBER
SMT.SHIBA.M.SAMUEL : MEMBER
Mahesh.V.S/o.Govindan, : Complainant
Vayambil House, Po.Parakalai,
Kasaragod District. 671531.
(Adv.Eappen.C, Hosdurg)
The Manager, : Opposite party
ICICI Prudential Life Insurance,
Ganesh Tower, T.B.Road Junction,
Po.Kanhangad, Kasaragod.Dt.
(Adv.Rajesh.K. Kasaragod)
O R D E R
SMT.SHIBA.M.SAMUEL, MEMBER
The gist of complainant’s case is that the complainant has subscribed the opposite party policy for a total sum of Rs.3,80,000/-. The term of policy was for 5 years while canvassing and issuing the policy then manager of opposite party appraised the complainant the facility of surrendering the policy after 3 years which would fetch the complainant the total amount remitted in addition to the bank rate interest or more amount whichever is higher. Accordingly he remitted Rs.20,000/- consecutively for 3 years. After the 3 years the complainant approached the opposite party to surrender the policy since his father was hospitalized due to acute cancer. But contrary to the opposite party’s earlier assertion the complainant was informed that he would get only Rs.43,000/-. The complainant was not able to surrender his policy. Hence the act of the opposite party amounts to unfair trade practice with deceitful designs which resulted in untold miseries and hardships to him. Hence the complaint.
2. Opposite party appeared and filed detailed version by denying all the averments levelled against him and contended that the complaint is not maintainable since it is barred by limitation, the Forum has no jurisdiction to entertain the complaint and there is no deficiency or negligence on the part of the opposite party. The opposite party further contended that as per the terms of the policy contract if the policy is not suitable, the policy holder may get his policy reviewed by returning it within 15 days i.e. in free look period. Moreover, as per the opposite party the policy is a legal contract between the complainant and the opposite party and hence complainant is bound by its terms and condition. As per the clause 27 A of the proposal form the complainant has paid Rs.25,000/- each for 3 consecutive years and it is evident that the complainant has applied for regular annual premium policy with a 5 years premium payment term and 10 years coverage term. The averments of the complainant that he approached the opposite party with an intention to surrender the policy was highly opposed by this opposite party and stated that there is a fixed procedure for the surrender policy that is to submit a surrender request form together with KYC documents. In this case there is no such requests and further stated that the policy is a regular premium unit linked insurance policy where the premium received are invested and subject to market risk and investment risk and on surrender of the policy fund value is paid after deducting applicable surrender charges as specified in the policy terms and conditions. As per clause 2.2 the policy documents states that “The policy acquires a Surrender Value after the payment of full premium for the first Policy year. However, the surrender value would be payable only after completion of three policy years or whenever the Policy is surrendered thereafter. The surrender value payable is the Fund Value after deducting the following surrender charges.
(b) Applicable surrender charge where three full years’ premium have been paid
No of Policy years for which the premiums have been paid | Surrender Charge as a % of Fund Value |
3 years | 20% |
4 Years | 10% |
5 Years | 0 |
The surrender shall extinguish all the rights, benefits and interest under the Policy.
3. In the present case the complainant paid the premium for 3 years hence the surrender applicable charges are 20% of the fund value. So if the complainant wants to discontinue the policy surrender value will be strictly as per terms and conditions. The contention raised by the complainant that the then Manager promised that the complainant will get the total amount along with bank rate is vehemently denied by the opposite party and added that the opposite party neither issues or authorized any employee to state any such communication which is contrary to the policy terms and condition. And further contended that the complainant is an educated person who receive the policy document by fully knowing the terms and condition. There is no negligence on the part of opposite party and the complaint is liable to be dismissed.
4. Complainant was cross examined as PW1 and Exts A1 to A11were marked from his side. Opposite party has represented that he has no oral evidence and Exts.B1 to B5 were marked.
5. The points for consideration
1 Whether there is any deficiency in service on the part of opposite party?
2 If so, what is the relief?
6. Point No.1.
While considering the first point the forum has perused the documents produced before us by the complainant and the opposite party and on the scrutiny of the documents especially on the basis of Ext.A1 it is proved that the complainant had taken a policy and that the 6th page onwards the terms and conditions of the policies were described by the opposite party and the policy was commenced on 3-6-2009 and Exts A2 to A4 are the receipts issued by the opposite party for the remittance of the premium for 3 consecutive years by the complainant herein. PW1 deposed in his chief examination that he had joined the policy only on the basis of the assertion given by the Manager of the opposite party while canvassing him at the time of the issuance of policy and appraised him the facility of surrendering the policy 3 years after joining the scheme which would give total amount remitted in addition to the bank rate or more amount whichever is higher. Being satisfied by this promise the complainant subscribed the policy and remitted the premium. When he approached the opposite party for surrendering the policy the opposite party informed that he will get only Rs.43,000/- which is against the promise made by opposite party at the time of joining the policy. Therefore the complainant sent a registered lawyer notice which is produced and marked as Ext.A.5 before us for which the opposite party had sent a false reply along with its acknowledgement cards marked as Ext.A6 & A7. The complainant herein sustained loss since the opposite party retracted from his earlier assurance made by him.
7. It is true that the opposite party while promoting their business gives a very positive message with their very interesting moto caption that is “Jeethe Raho” which itself is a misleading message enticing the innocent public to their scheme. Moreover, the oral assertions made by the opposite party’s staff and the agents are nothing but misleading the general public. Usually the prospective subscribers are always kept in darkness with regard to the terms and conditions in the policy. In this particular case the customer who is the PW1 herein always set apart from how the premium is utilized by the opposite party company eventhough they are assuring that the amount will be put it in the share market. Infact generally the real terms and conditions of the insurance will be concealed by the company. The innocent customers will not be in a position to foresee the consequence of share fluctuation in the market and even the insurer is not in a position to assess the surrender charge which is decided by the company itself. The surrender charges of fund value is usually 100% is nothing but highly illegal and against natural law. Those who surrender the policy shall extinguish the rights, benefits and the interest under the policy. This is not a bilateral agreement since the same is forcibly imposed on the customers. It is just a unilateral agreement. Moreover, the receipt issued by the opposite party for the collection of premium also differs in its shape shows that there is no consistency at all for the opposite party for any of their procedure. On perusal of Ext.A8 to A11 i.e the treatment records of the father of the complainant, the Forum convinced that the situation of the complainant urged him to facilitate to surrender the policy to meet his ends.
8. The famous slogan that the customer is a king cannot be expected in every case since the persons like opposite parties are making the customer who is a king a mere bargainer. The acts of the opposite party amounts to a white color crime and a socio economic crime. The complainant herein joined the opposite party insurance only on the basis of the enticement, offer, allurement and the persuation given by the opposite party eventhough opposite party contended that the complainant never challenged the genuenity of the insurance but the forum convinced that the terms and conditions of the policy is typed in microscopic letters which cannot be a readable mode for the general public most of the time that itself makes a customer away from the real terms and conditions. The only option before them is believing the oral assertions made by the opposite party’s staff at the time of joining for the insurance. Therefore we are of the opinion that there is gross deficiency in service from the opposite party and hence the complainant herein may be liable to be compensated for his mental agony and suffering.
9. Point No.2. In the case of Max New York Life Insurance Co. Ltd. V. Insurance Ombudsman reported in 2011(4) KLT 397 it was held that : Non disclosure by companies of the real price at which their service is provided suppressing the prevailing taxes and levies will amount to material misleading which would count as unfair trade practice.
Hence considering the damages and mental agony suffered by the complainant we are of the opinion that he is entitled for refund of Rs.60,000/- which we had remitted towards the opposite parties scheme with 12% interest per annum from the date of deposit till realization along with an amount of Rs. 15000/- as compensation for mental agony with a cost of Rs.5000/- Time for compliance is 30 days from the date of receipt of copy of order.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Exts.
A1. Policy document
A2.01-06-2009 Premium Receipt.
A3.10-06-2010 Premium(s) Deposit Receipt
A4.06-06-2011 Premium(s) Deposit Receipt
A5.01-09-2012 Copy of Lawyer notice
A6.Postal acknowledgment card
A7.20-09 2012 Letter sent by OP to complainant.
A8.12-06-2012 CT Scan report
B1.Copy of Proposal form submitted by complainant.
B2. Policy document
B3. Copy of SMS details
B4. Letter sent by OP to complainant
B5. Copy of Advisors Confidential Report
PW1. V.Mahesh.
PW2. Manikandan.M.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
Forwarded by Order
SENIOR SUPERINTENDENT
Pj/
