BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

VAZHUTHACAUD, THIRUVANANTHAPURAM.

PRESENT

SRI. P. SUDHIR                                       :  PRESIDENT

SMT. R. SATHI                                         :  MEMBER

SMT. LIJU B. NAIR                                  : MEMBER

C.C. No. 70/2012 Filed on 03.03.2012

ORDER DATED: 30.06.2017

Complainant:

Balagopal. K, Anaswara, H. No. 4/341, Nemom, Ookodu P.O, Thiruvananthapuram.  (Expired)

Additional Complainants/Legal heirs:

1. Neethu, D/o Balagopal. K,           ..do..           ..do..

2. V. Anithakumari, W/o Balagopal,                   ..do..           ..do..

                                   (By Adv. Majida. S)

Opposite parties:

1. Managing Director, Bajaj Allianz Life Insurance Company Ltd., No. 1078, IInd Floor, Uni Campus, Safety Road, Tamil Nadu-641 006.

2. The Regional Manager, Bajaj Allianz Life Insurance Company Ltd., 1^st floor, Federal bank Building, College Road, Kattakkada, Neyyattinkara, Thiruvananthapuram.

                             (By Adv. Sreevaraham G. Satheesh)

This case having been heard on 17.05.2017, the Forum on 30.06.2017 delivered the following:

ORDER

SMT. LIJU B. NAIR: MEMBER

Gist of the case is as follows:  The original complainant was a govt. employee who availed a life insurance policy from the 2^nd opposite party with policy number 180114786 (UG PROTECTION PLUS II SIZE-I) and paid an amount of Rs. 50,000/- as first premium on 21.07.2010 vide cheque No. 356415 dated 12.07.2010 on the condition that the original certificate will be sent to him by registered post with immediate effect.  The complainant had availed a life insurance policy from the 2^nd opposite party which is the branch office of the 1^st opposite party.  The ICC/F name of the complainant is Sandhya. T.M.  That at the time of paying first premium with opposite party’s branch office at Vazhuthacaud one duplicate receipt was issued to the complainant mentioning the policy number and other details.  Thereafter the complainant had gone through the medical examination as per the instruction in letter dated 16.07.2010 from the 2^nd opposite party.  The complainant thereafter approached the opposite party for several times and made many personal requests for issuing the original policy certificate to him.  The complainant contacted the 2^nd opposite party in person along with his authorized agent Sandhya T.M, but the opposite party had failed miserably to issue the original policy certificate to the complainant.  Thereafter the opposite party had issued a letter requesting the complainant to pay the next premium amount.  On that occasion also the complainant approached the opposite party for issuing the original policy certificate before making the second payment.  But the opposite parties never send the original policy certificate to the complainant.  While so even without sending the original policy certificate to the complainant the opposite party had cancelled the policy unilaterally for not paying the further premium amount and intimated the same to the complainant on 11.11.2011.  The opposite party had no authority to cancel the policy without issuing the original policy certificate to the complainant.  The acts of the opposite party are arbitrary and against the law.  Under this constrained situation the complainant had issued a legal notice to the opposite party intimating them that he is ready to continue and renew the policy if the opposite party issue original policy certificate to him within 7 days from the date of receipt of the notice, failing which he demanded to return the first premium amount.  Even then the opposite party neither sent original policy certificate or returned the premium amount.  Hence the complaint is necessitated. 

Opposite parties filed version contending as follows:  The original policy certificate and policy documents were sent to the complainant by way of speed post and the same was delivered to the complainant on 26.07.2010 and as per proof of delivery record the policy bond was received by complainant’s wife Mrs. Anitha Kumari. V.  To prove this fact opposite parties refer clause 3 of the proposal form executed by the complainant wherein he had nominated his wife Anitha Kumari. V as a nominee to the policy, which substantiates the fact that the policy bond was in fact received by the complainant and now he has come up with frivolous and false claim in order to avoid compliance of policy terms since failure to comply the terms may result in forfeiture of already paid premium amount since policy will accrue surrender value only upon third policy anniversary.  Moreover the complainant can at any time get the details regarding his policy or any assistance through the agent, customer care centre, by post, by fax, by phone or by e-mail.  This fact is clearly given in page 12 of the policy document.  All other averments to the effect that he was not given the policy or any reply is not correct.  It is true that the premium payment notice was issued and also that the policy was cancelled due to non-payment of premium.  The averments that the complainant was not given the policy and due to that reason the premium was not paid etc. are not correct.  He is in receipt of the policy documents and is now raising false allegation of non-receipt to escape from his default in payment of premium.  The complainant is not entitled for any amount.  The premium term is 15 years and the complainant has only paid premium for 1 year.  He is not entitled for claiming refund of the amount as if a fixed deposit.  This policy is for covering the risks of death, accident etc. also.  Those risks were covered for the last 1 year and the complainant cannot demand back the premium paid.  The complainant is having no cause of action as alleged.  There is no deficiency of service or unfair trade practice on the part of these opposite parties.  The allegations to that effect are made out of ignorance of policy conditions and also with malafide intention.  The rights and liabilities in between the complainant and opposite parties are only based on the contract of insurance and both parties are bound by its conditions and clauses.  Ignoring the policy conditions, the complainant is claiming for the benefits alone as per his will and pleasure.  The opposite parties have already explained to the complainant that the policy bond was duly served and if complainant had lost the policy bond he can follow laid down process for getting duplicate bond.  When the complainant could not service future premium as agreed in the proposal form and policy terms, conveniently the complainant on later date has falsely raised the issue of non-receipt of policy bond.  If at all if the complainant had genuinely not received the policy bond he would have diligently completed the process meant for getting duplicate bond instead of indulging in frivolous case which is nothing but abuse of process of law.  As per clause 5(b) of the policy terms, ‘in the event of failure to make payment of full regular premium falling due during the first three policy years and non-payment of the complete amount due even within grace period, the policy shall automatically and immediately lapse for the insurance cover including the cover under all Riders’.  Further as per clause 5(b)(2) of the terms ‘the policy holder may revive the policy within revival period of four years from the due date of the first unpaid regular premium subject always to section 5(d) and the company shall recover any due but unrecovered charges as per Sec. 33 and Sec. 34except the mortality charge and any Rider Premium Charge, since the due date of first unpaid regular premium, failing which the policy shall stand terminated and the surrender value, if any as on date of termination as per Sec. 6 (c) shall be paid at the expiry of revival period of four years and in case if policy holder commits default of payment of premium within 35 months from commencement of policy then as per Sec. 33(g) the surrender charge would be 60% of the first year premium.  The complainant is fully aware of all such terms and conditions since he has already received the policy bond and terms and he had concealed the actual fact come before this Forum with unclean hand to procure orders by hook or crook.  The complainant still can apply with opposite parties for duplicate bond by following simple process and also can revive the policy by paying all premium outstanding.  Therefore there is no cause of action arose at this stage and the opposite parties are not liable for any relief as claimed by the complainant.  These opposite parties had committed no service deficiency and hence the complaint needs to be dismissed and the complainant is not eligible for any relief as prayed in the complaint. 

Issues raised:

1. Whether the complaint is maintainable?
2. If so, is there any deficiency in service from the part of the opposite party?
3. Reliefs and costs if any.

Issues (i) to (iii): The complainant’s case is that he has availed a life insurance policy from the opposite parties and paid an amount of Rs. 50,000/- as first premium.  He was not given the original policy in spite of repeated requests.  Hence the complainant did not pay the second installment of premium.  The opposite parties, without sending the original policy certificate to the complainant, cancelled the policy as the further premium amounts were not paid.  Hence the complainant prays for the return of the premium amount with compensation.  The original complainant was examined as PW1 and another witness was examined as PW2.  Exts. P1 to P5 were marked.  Exts. D1 & D2 were marked.  The policy under consideration is ‘Unit Gain Protection Plus-II’ which is a unit linked policy and the consumer courts are lacking jurisdiction to entertain disputes related to such matters.  The decision of Hon’ble National Commission in ‘Abanti Kumari Sahoor Vs. Bajaj Allianz Life Insurance Company Ltd.’ and ‘Ram Lal Agarwalla Vs. Bajaj Allianz Life Insurance Company Ltd.’ are the settled positions on this point.  Hence this complaint is only to be dismissed as lacking jurisdiction.  On this sole ground the complaint fails.

Going into the merits of the case, the complainant had taken a policy for a period of 15 years and after paying only one premium he came up before us with this complaint.  His contention is that he had not received the original policy document.  Opposite parties strongly denies this statement and to prove the same, they produced Ext. D2 which is the proof of delivery of the policy document which has been sent to the address of the complainant.  It is seen signed by Anitha Kumari. V on 26/7, as the person taking delivery of the item.  Complainant vehemently denies this.  In his deposition also he denies this. So the opposite party filed a petition to examine the wife of the complainant as the witness of the complainant.  She did not turn up.  Subsequently the original complainant died and the wife and daughter got impleaded as additional complainants.  Therefore instead of examining the wife as witness, the opposite parties filed a petition under Order XII Rule 4 C.P.C to direct the additional complainant to admit or deny her signature in Ext. D2.  But no such affidavit is filed and thereafter there is no representation from the side of the complainant for a number of postings.  During the course of this trial, original complainant died and an impleading petition was filed from the side of complainant to implead the legal heirs as the complainants.  Complainant’s wife i.e; Anitha Kumari and their daughter Neethu were impleaded.  Very cleverly, in order to escape from the verification of signature in that petition, impleading petition was filed by the daughter of the complainant instead of his wife, whose signature is to be proved as necessitated by the opposite party to prove their case.  So something is rotten somewhere.  So complainants failed miserably to establish their case, which is only to be dismissed. 

In the result, complaint is dismissed with no order on cost and compensation.   

   A copy of this order as per the statutory requirements be forwarded to the parties free of charge and thereafter the file be consigned to the record room. 

          Dictated to the Confidential Assistant, transcribed by her, corrected by me and pronounced in the Open Forum, this the 30^th day of June 2017.

Sd/-

LIJU B. NAIR                        : MEMBER

 Sd/-

P. SUDHIR                            : PRESIDENT

Sd/-

                        R. SATHI                               : MEMBER

jb

C.C. No. 70/2012

APPENDIX

  I      COMPLAINANT’S WITNESS:

          PW1  - Balagopal. K

          PW2  - Sandhya T.M

 II      COMPLAINANT’S DOCUMENTS:

P1     - Duplicate copy of premium receipt

P2     - Renewal premium notice 

P3     - Lapse intimation letter

P4     - Copy of advocate notice

P5     - Acknowledgement card

III      OPPOSITE PARTY’S WITNESS:

                             NIL

 IV     OPPOSITE PARTY’S DOCUMENTS:

          D1     - Copy of proposal form for life insurance

          D2     - Copy of proof of delivery

                                                                                                      Sd/-

PRESIDENT

jb