Karnataka

Bellary

CC/71/2014

RAVI KUMAR.T - Complainant(s)

Versus

THE MANAGER,BAJAJ ALLIANZ LIFE INSURANCE COMPANY LTD & OTHERS - Opp.Party(s)

SHRI THIPPESWAMY.K

05 Mar 2015

ORDER

FILED ON:	22-04-2014
ORDER ON:	05-03-2015

 

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AT BELLARY

 

C.C.No.71 of 2014

Present :

 

(1)   Shri. R.Bandachar,

B.Com, LL.B.  (Spl) ……    President

(in-charge)

 

(2) Smt Mary Havila,

B.A.                       ……        Member

 

DATED THIS THE 05^th DAY OF MARCH 2015.

 

COMPLAINANT   By-Shri Thippeswamy K Advocate, Bellary.           //VS//	Ravikumar.T, S/o Channabasappa T, Age: 48 years, Ward No.9, Near Kuna Complex, Kurugodu village-583 116.
RESPONDENTS       By-Shri T.Srinivasa Reddy, Advocate, Bellary,	(1) The Manager, Bajaj Allianz Life Insurance Co. Ltd., SLS Towers, 2nd floor, No.68, Cherry Road, Hasthampatty, Salem, Tamil Nadu – 636 007.   (2)  The Branch Manager, Bajaj Allianz Life Insurance Co. Ltd., Branch at Near City Hospital, Dam road, Hospet, Bellary district-583 201

// O R D E R //

 

Per Shri. R.Bandachar.

The complainant filed the complaint against the respondents U/Sec-12 of the Consumer Protection Act, 1986.

of the life insurance policy obtained b          

   2.  The complaint in brief is that the complainant obtained a  life insurance policy from the respondents’ insurance

company on 28-03-2010 by paying Rs.12,500/- towards yearly premium and the commencement date of the policy was 28-03-2010 and the maturity date is 28-03-2035. The complainant has paid three premiums amount towards the said policy totally Rs.37,500/-. Thereafter, due to unavoidable circumstances the complainant being unable to continue the policy asked for refund of the premium amount paid, with the respondents.  As per the policy terms and conditions and IRDA rules, after paying the premiums for 3 years, the policy holder is entitled for refund of the premium amount already paid. However, the respondents’ insurance company refused to pay the same.  Therefore, the complainant got issued legal notice to the respondents calling upon them to refund the amount paid as premium for the policy obtained by him.  In spite of service of the said notice, the respondents have not complied with the demand made in the notice. This amounts to deficiency in service on the part of the respondents’ insurance company.   Therefore, the complaint seeking reliefs as prayed for.

3. The respondents filed the written version stating that

save those averments of the complaint which are specificall

admitted or traversed, rest are deemed to have been denied.  All the allegations made in the complaint are false and are not maintainable either in law or on facts. The complaint is misconceived, misconstrued and contrary to the contract between the parties.  The complaint is barred by limitation. The policy availed by the complainant is a unit linked policy and as per the terms and conditions of the policy and provisions of insurance law with regard to the unit linked insurance policy, risk of investment in the market under the policy has to be borne by the policy holder.  The premium amount is the consideration for taking risk of life of insured and the premiums so paid takes risk for the period for which the premium has been paid. Hence, the complainant’s prayer for refund of entire premium amount along with other prayer is unsustainable in law. Since the premium is appropriated for the period of risk no right or equity arises in favour of the insured/complainant for seeking refund of premium amount.  Since the policy of the complainant is still in force he can either surrender the policy or continue the policy by paying regular premium. If the complainant is not willing to continue the policy he can surrender the policy and the company shall pay the account value after deduction of surrender charges and withdrawal penalty charges applicable as on date of surrender of the policy.  The averments made in para-1, 2 and 6 to 10 of the complaint are denied as false.  Nowhere in the policy terms and conditions it is agreed that the complainant is entitled for refund of entire premium amount paid by him if the complainant is unable to continue the policy.  As per the terms and conditions of the policy, the complainant is entitled to surrender the policy if the policy is in force only and if he has paid all 3 years premium amount in full and the respondents shall pay the surrender value.   The complainant has not approached this Forum with clean hands as he has willfully and intentionally suppressed the material facts to make wrongful gain. There is no deficiency in service on the part of the respondents.  The complainant is not entitled for any of the reliefs as prayed for. Therefore, the complaint be dismissed with exemplary costs.

4.  The complainant to prove his case, as his evidence, filed his affidavit, which is marked as P.W.1 and got marked 05 documents as Ex.P.1 to Ex.P.5. The respondents as their evidence, filed one affidavit, which is marked as Rw.1 and no documents are marked.

5.  The written argument is filed by the respondent and heard arguments on both sides.

6.  The points that arise for our consideration are;

1.	Whether the complainant has proved deficiency in service on the part of the respondents towards him, as alleged in the complaint?
2.	Whether the complainant is entitled for the reliefs prayed for in the complaint?
3.	What order?

 

 

 

 

 

 

 

 

 

 

 

7.   The findings on the above points are as under.

 

Point No.1:	In the affirmative.
Point No.2:	Partly in the affirmative.
Point No.3:	As per final order.

// R  E A S O N S //

Point No.1: -

8.  The respondents have not denied that the complainant’s case that he obtained a life insurance policy from their company  which was to commence from 28-03-2010 and to mature on                 28-03-2035 and he had paid three yearly premiums amounting to Rs.37,500/- and thereafter due to some unavoidable circumstances, he could not continue the policy.

9.  It is the case of the complainant that after payment of 3 years premiums as he could not continue the policy he asked the respondents to refund the premium amounts paid by him and as per the terms and conditions of the policy, after payment of 3 years premiums the insured is entitled to get refund of the same and the respondents failed to refund it.

10.   However, it is the contention of the respondents that the policy availed by the complainant is a is a  unit linked policy, risk of investments in the market under the policy has to be borne by the policy holder and the premium amount being the consideration received for taking risk of life of the insured for the period for which the premium has been paid, the complainant’s prayer for refund of entire premium amount is unsustainable in law and if the complainant is not willing to continue the policy, he can surrender the policy and the company shall pay the surrender value after deduction of surrender charges as well as withdrawal penalty charges and nowhere in the terms and conditions it is agreed that the complainant is entitled for refund of the entire premium amount paid by him if he is unable to continue the policy and accordingly, they are willing to pay the surrender value to the complainant.

11.  Perused the policy of insurance pertaining to the complainant which is produced before us and in it clause 6(c) deals with surrender value which reads thus;

c) Surrender Value i)  The Surrender Value payable, if any, will be equal to the Regular Premium Fund Value less the Surrender Charge as per Section 33(g) plus the Top Up Premium Fund Value, if any subject always to sub section ii), iii) and iv) below.   ii) If the policyholder has failed to make payment of Regular Premium within the grace period falling due during the first three Policy years and the Company has not received any written request from the policyholder to surrender the policy, the Surrender Value as defined in Sub-Section i) above will be based on the Unit Price as on date of termination of the Policy.   iii)  If the Policyholder has failed to make payment of Regular Premium within the grace period falling due during the first three policy Years and the Company has received a written request from the Policyholder to surrender the Policy, the Surrender Value as defined in Sub-Section i) above will be based on the Unit Price as on date of receipt of request for surrender of the Policy.   iv) If the Policyholder has failed to make payment of Regular Premium within the grace period falling due after the first three Policy Years and the Policyholder has paid all Regular Premium due during the first three Policy Years, the Surrender Value as defined in Sub Section i) above will be based on the Unit Price as on date of termination of the Policy.

12.    On the basis of the admitted facts as well as the above clause of the policy, as the complainant had paid three yearly premiums towards the life insurance policy obtained by him from the respondents’ insurance company which is also proved by policy document/premium receipts, we are of the opinion that the complainant is entitled for surrender value which is the amount payable after deduction of surrender charges as well as withdrawal penalty charges out of the premium amount paid by the insured. Non-payment of the same amounts to deficiency in service on the part of the respondents’ insurance company.

13.   The decisions relied on by the respondents reported in III (2005) CPJ 31 (SC), 2009(2) CPR 2, unreported order passed in Revision Petition No.2356 of 2013 of Honb’le National Consumer Disputes Redressal Commission and Appeal No.4251/2009, 1788/2011, 732/2011 and 3166/2011 to 3168/2011 of Karnataka State Consumer Disputes Redressal Commission and that of order passed in First Appeal No.907/2012 of State Consumer Disputes Redressal Commission, Odisha, Cuttack, are carefully perused and found not applicable to the facts of this case as it is not at all the case of the respondents’ insurance company that the premium for 3 years period was not paid by the complainant or that the insurance policy stood lapsed due to non-payment of the premiums payable.

14.  For the reasons discussed above, this point is answered in the affirmative.

Point No.2:-

15.  As it is found that the complainant is entitled for surrender value in respect of the life insurance policy obtained by him, the respondents’ insurance company is liable to pay the same with interest as well as cost of the proceedings, which shall be as per final order. With these reasonings, this point is answered partly in the affirmative.

Point No.3: -

16. In view of the discussions made under Point No.1 and 2, we pass the following;

 

//ORDER//

The complaint filed by the complainant is partly allowed.

The complainant is entitled to recover surrender value y him with interest @ 9% p.a. from the date of the complaint i.e. 22-04-2014 till its realization, from the respondents’ insurance company, within two months from the date of this order, if the policy document was actually supplied to him by the respondents.

The complainant is also entitled to recover sum of Rs.2,000/- towards cost of the proceedings, from the respondents’ insurance company.

Inform the parties accordingly.

 

(Dictated to the Stenographer, typescript edited, corrected and then pronounced in the open court  this  05TH day of March 2015)

 

 

 

	(R.BANDACHAR) PRESIDENT.
	(MARY HAVILA) MEMBER

 

 

 

 

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