SMT. RAVI SUSHA : PRESIDENT
Complainant has filed this complaint U/S 35 of Consumer Protection Act 2019 ,seeking to get an order directing the opposite parties to pay the matured amount of Rs.40,00,000/- and also Rs.9,85,000/- towards compensation to the complainant for the mental agony caused to him due to the deficiency in service of OPs along with Rs.15,000/- towards the cost of the complaint.
Facts of the case in brief are that the complainant had taken a Life time Super pension scheme policy from OPs on September 2008 and accordingly she paid 1st premium amount of Rs.14,521/-, but the OPs denied the policy amount. Complainant has stated that the policy was misplaced , neither the company nor the agent had not contacted her to pay the subsequent premium. Further stated that on 7/9/2020 the OP sent a letter by clearly indicating that we refer to your ICICI Prudential life time super pension plan with policy No.09992586 in which you are eligible to receive a payment of Rs.42,51,37,000/- and requested to submit list of documents mentioned in the letter. On 4/11/2020 vide e mail , the complainant contacted the 2nd OP about the contents of the letter dt.7/9/2020 , it is a clear fact that if any mistake was there the company could have correct it and could have inform the complainant as there was almost two months difference between 7/9/2020 and 4/11/2020. That on 6/11/2020 by replying and referring to the complainant’s letter dtd.4/11/2020 and its policy No.09992586 the company again assured and requested the cancelled cheque, bank account number etc for processing the above amount Rs.42,51,37,000/- to the name of the complainant. That in Nov. 2020 the complainant approached company with all the details, however, the manager told to the complainant that she is not even eligible for the amount which she had paid for the first premium. In November 2020 the complainant addressed her concern to the PMO via token No 11-20-015191 pertaining to the issue in question. That on 11/12/2020 the OP sent a mail to the complainant saying that they had processed the refund of Rs.3,204.98/- and the same was reverse and reprocessed the same with interest of Rs.4,007.41/-. On 2/11/2021 the OPs again sent a letter by stating that the complainant is legible only to Rs.4,433.74/- through the policy No.09992586 . The complainant waited from December 2008 to Feb,2022 for the details of the policy through the maturity date was in 2017. Therefore the conduct of OPs amount to deficiency in service and unfair trade practice. Hence the complainant
The complaint was resisted by the OPs. The contention of OPs are that the premium under the policy in dispute was to be paid by the complainant in tune of Rs.14521/- every year for a period of 10 years. However the complainant only paid one premium, instalment and thereafter discontinued paying premiums even after receiving premium reminders sent to the complainant by OPs. Despite the premium reminders, the complainant did not pay any of the subsequent premiums which led to the foreclosure of the policy in accordance with clause 5&10 of the policy. OPs submits that as per clause 4 of the terms and conditions , the complainant is entitled to get the surrender value of Rs.3204.98 along with interest. Hence dispatched the amount of Rs.4007.41 through cheque on 22/9/2011 , however the same was not encashed. OPs further submitted that the present complaint is a time barred one and the present complaint has been filed after 11 years of cause of action, if any arose and thus the present complaint has been filed , well beyond the 2 years statutory period of limitation. It is further submitted that the disputed letter dtd.7/9/2020 was erroneously dispatched to the complainant and mistakenly stated that the complainant was entitled to receive Rs.42crores owing to a technical error and the multiple SMS in the years 2009, 2010,2011,2020 and the emails in 2020 were sent letters to the complainant clearly intimating that she was entitled to pay out of Rs.3204.98 along with accumulated interest. Since, the complainant failed to pay the second renewal premium on the due date ie on 22/9/2009 and during the 30- day grace period ie, within 22/10/2009 . As per clause 5 of terms and conditions of the policy the Life insurance cover ceased. Although there was no obligation to do, the company sent multiple premium payment reminders via SMS to the complainant but she still failed to pay only premium instalment was paid and due to non-payment of the second renewal premium within the 2 year revival period, the policy foreclosed on 22/9/2011 as per clause 10 of the T&C and surrender value of Rs.3204.98/- was payable on 22/9/2011 as per clause 4 of the T&C . The surrender value of INR 3204.98/- was duly dispatched via cheque on 22/9/2011 however the same was not encahsed. Thereafter, the payment was re-processed along with interest ie, Rs.4007.41 via cheque on 12/5/2019 however the same was again not encashed. The OPs submitted a number of judgements in support of its contentions. There is no deficiency of service and unfair trade practice on the part of OPs, hence prayed for the dismissal of the complaint.
Complainant filed her chief affidavit and documents. She was examined as PW1 and marked Exts.A1 to A8. She has been cross-examined for the OPs and marked Exts.B1 to B5 series. After that the matter was heard.
According to complainant she had taken Life time Super pension scheme policy of OPs on September 2008 and accordingly paid 1st premium amount of Rs.14,521/-, but the OPs denied the policy amount. Complainant has stated that the policy was misplaced , neither the company nor the agent had not contacted her to pay the subsequent premium. Further stated, on 7/9/2020 the OP sent a letter by clearly indicating that ” we refer to your ICICI Prudential life time super pension plan with policy No.09992586 in which you are eligible to receive a payment of Rs.42,51,37,000/- and requested to submit list of documents mentioned in the letter. On 6/11/2020 by replying and referring to the complainant’s letter dtd.4/11/2020 and its policy No.09992586 the company again assured and requested the cancelled cheque, bank account number etc for processing the above amount Rs.42,51,37,000/- to the name of the complainant. In November 2020 the complainant approached company with all the details, however, the manager told to the complainant that she is not even eligible for the amount which she had paid for the first premium. That on 11/12/2020 the OP sent a mail to the complainant saying that they had processed the refund of Rs.3,204.98/- and the same was reverse and reprocessed the same with interest of Rs.4,007.41/-. According to complainant, the action of OP amount to deficiency in service. Complainant claimed that she is eligible to get the matured policy amount ie Rs.40,00,000/-.
On the other hand OPs submit that the premium under the policy in dispute was to be paid by the complainant in tune of Rs.14521/- every year for a period of 10 years. But the complainant only paid one premium, instalment and thereafter discontinued paying premium even after receiving premium reminders sent to the complainant by OPs. OPs submits as per clause 4 of the terms and conditions , complainant is entitled to get the surrender value of Rs.3204.98 along with interest. Hence dispatched the amount of Rs.4007.41 through cheque on 22/9/2011 , however the same was not encashed by the complainant. OPs further submit that though the disputed letter dtd.7/9/2020 was erroneously dispatched to the complainant and mistakenly stated that the complainant was entitled to receive Rs.42croes , in 2009, 2010,2011,2020 OPs sent letters to the complainant clearly intimating that she was entitled only Rs.3204.98 along with accumulated interest .
We have noted the submissions made by the counsels . As clearly observed that complainant has paid only the 1st premium. As per the policy the insured has to pay premium on an annual basis for a term of 10 years.
In the instant case, complainant failed to pay the second renewal premium on the due date and during the 30- day grace period within 22/10/2009 . As per clause 5 of terms and conditions of the policy the Life insurance cover ceased. Although there was no obligation to do, the company sent multiple premium payment reminders via SMS to the complainant but she still paid only one premium instalment was paid and due to non-payment of the second renewal premium within the 2 year revival period, the policy foreclosed on 22/9/2011 as per clause 10 of the T&C and surrender value of Rs.3204.98/- was payable on 22/9/2011 as per clause 4 of the T&C . The surrender value of INR 3204.98/- was duly dispatched via cheque on 22/9/2011 however the same was not encahsed. Thereafter the payment was re-processed along with interest ie, Rs.4007.41 via cheque on 12/5/2019 however the same was again not encashed.
The learned counsel of OPs submitted a number of decisions of the apex court.
Another contention of OPs are that the complaint is barred by limitation. OPs submitted that the present complaint is a time barred one. OPs stated that the present complaint has been filed after 11 years from the date of taking the policy. Complainant submitted that she has waited from December 2008 to February 2022, for the details of the policy though the maturity date was in 2017.
With regard to the point of limitations, the facts to be noted are that the policy(Life time super pension) period is from 20//9/2008 to 19/9/2017. The premium amount is Rs.14521/- and the mode of premium – yearly for 10 years. Complainant has paid only the 1st premium ie on 20/9/2008. Considering the maturity period ie 2017, this complaint is barred by limitation because the present complaint was filed on 28/9/2022. The learned counsel of OPs submitted a decision of Hon’ble National Commission, Ashok Kumar Sainia vs Delhi Development Authority, in which the Hon’ble National Commission observed that exchange of letters between parties does not extend limitation under Consumer Protection Act. Hence, the instant case is barred by limitation as per Sec.69 of Consumer Protection Act 2019.
As per policy terms and condition in Ext.B2 policy clause 5 says Payment of Premiums (a) Premiums are payable on the due dates and at the amount mentioned in the Policy at time of commencement of the policy. However, a grace period of not more than 30 days, where the mode of payment of premium is other than monthly, and not more than 15 days in the case of monthly mode is allowed. . If a premium is not paid on the due date or during the days of grace, the provisions as per Clause 5.5 shall apply and the Policyholder will continue to have the benefit of investment in the respective unit funds.(b) Premiums are payable upto the original vesting date of policy (c) Premiums are payable without any obligation on the Company to issue a notice for the same. (e) If the Policyholder suspends payment of premium for any reason whatsoever, the Company shall not be held liable and the benefits, if any will be available only in accordance to the policy conditions.
If the premium is not paid on the due date or during the days of grace during the first three policy years, the Life Insurance Cover and the Rider Benefits, if any, shall cease and mortality and rider charges will not be deducted to be applicable.
“With regard to surrender value clause 4 says the policy acquires a surrender value after 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.
Complete Policy years for which premiums have been paid Surrender Charge as a % of the Fund Value Less than one year 100% One year 75% .
Clause 10 says that “foreclosure of the Policy If full premium for the first three Policy years is not paid and the policy is not revived within a period of two years from the due date of the first unpaid premium, then surrender value as described in Clause 4 will be paid at the end of the third policy year or at the end of the reinstatement period, whichever is later.
As discussed, and as per the terms and conditions in policy(Ext.B2) as mentioned, we are of the view that the complainant is only eligible to get Rs.4274.46 ie , the premium paid amount Rs.3204.98 along with interest. OPs have sent Ext.B4 series letters to complainant to receive the said amount. Hence as far as OPs are concerned, there is no deficiency in service on their part.
In the result, the complaint fails and hence it is dismissed. No order as to cost.
Exts:
A1-Policy
A2- copy of letter send by 1st OP
A3-copy of application filed by complainant
A4- copy of RTI application dtd 28/1/2021
A5-True copy of letter dtd.11/12/2020
A6-True copy of reply mail dtd.6/11/2020
A7-Acknowledgment card
A8-Postel receipt
B1- policy
B2- Policy terms & condition
B3-copy of letter and e mail dtd.3/11/20
B4series- e mail communications B5 series-
B5series- copy of letter sent by OP to complainant
PW1- Sweety-complainant
Sd/ Sd/ Sd/
PRESIDENT MEMBER MEMBER
Ravi Susha Molykutty Mathew Sajeesh K.P
eva
/Forwarded by Order/
ASSISTANT REGISTRAR
