Sri. P. Satheesh Chandran Nair (President):

The complainant filed this complaint u/s.12 of the C.P. Act 1986.

2. The case of the complainant is as follows. The complainant is an overseas citizen who availed a life insurance policy from the 2^nd opposite party vide policy no. 002219088 for an amount of Rs. 2,50,000/- as a half yearly premium amount of Rs. 25,000/- on 14/07/2006.  The complainant paid a total amount of Rs. 1,25,000/- as premium up to the year 2008.  It is contended that the complainant sent premium amount through a cheque within the time limit but it was denied by the 2^nd opposite party by reason of over writing on the cheque.  In the year 2010 the complainant approached the opposite party for the refund of premium the opposite party compelled the complainant to stick on the policy and also advised for a medical checkup for the same.  It is also informed to the complainant that in order to avoid a medical checkup in home country the opposite party would give approval to the complainant for taking medical checkup in abroad.  Therefor the complainant paid a premium of Rs. 50,000/- to the opposite party.  It is further contended that instead of re instating the policy the 2^nd opposite party refunded the above said Rs. 50,000/- to the complainant on the basis of the medical checkup report.  According to the complainant he is entitled for the remitted premium Rs. 1,25,000/- with interest from the year 2009 onwards.  Though the complainants sent a letter dated:14/07/2014 by demanding the said amount the 2^nd opposite party did not take any steps to return the amount as requested by the complainant.  On 20/06/2016 the complainant again sent a letter to the opposite party which was also invain.  It is contended that the complainant paid the premium during the days of grace in the 1^st three years, therefore the policy would not be lapsed and benefit shall be payable to the complainant.  The complainant being a senior citizen suffering aged diseases is unable to suffer the mental agony and difficulties caused as a result of the act of opposite parties.  Hence this complaint, for the refund of the premium amount of Rs. 1,25,000/- with interest, compensation, cost etc. etc.
3. This Forum entertained the complaint and issued notice to opposite parties for appearance.  All the opposite parties entered appearance and filed a joint version as follows.  According to the opposite parties the case                     is not maintainable either in law or on facts since the case is barred by limitation.  It is contended that the complainant ought to have raised the complaint soon after the 1^st refusal of the claim by the opposite parties. According to the opposite parties            the policy in question is a unit linked policy.  Since the speculative                            gain  and  speculative  investment  are  involved  in  such  policies  the  complaint is liable to be dismissed by this Forum. The nonproduction of the policy documents  by the complainant is also an adverse presumption against the complainant.  It is further contended that the complainant availed this policy after agreeing to abide with the policy terms and conditions.  The policy details availed by the complainant is as shown below:

The complainant failed to pay premium regularly under the policy as such the policy lapsed and foreclosed.  As per the terms and condition if any regular premium is not paid within the days of grace in the 1^st three years the policy shall lapsed and no benefit shall be payable.  The complainant had not availed his right of cancellation of policy within ‘free look period’.  Therefore it is clear that complainant was fully aware of the terms and conditions of the policy and he had no grievances on it.  It is admitted that the complainant had requested for the revival of policy by his letter dated: 17/08/2011 the opposite party had directed the complainant to undergo medical examination towards “FBS+HbA1c(Glycosylated Hemoglobin) + Lipid Profile (S. Cholesterol, Triglycerides, HD, LDL, VLDL) + RUA + S. Creatinine” The medical examination revealed that he is suffering from uncontrolled DM (Diabetic Mellitus) with cardiac risk factors.  Therefore vide letter 05/09/2011 the opposite party rejected the request for the revival of the policy.  It is contended that since the premium is appropriated for the period of risk no right or equity arises in favour of the complainant for seeking refund of the premium amount.  It is submitted that there is no deficiency in service on the part of opposite party when relying the decision reported in Revneet Singh Bagga Vs. KLM Royal Dutch Airlines reported in (2000)1SCC 66 of our Hon’ble Supreme Court.  The complainant is not entitled for any relief whatsoever and not entitled to claim anything from the opposite parties.  Therefore this opposite parties prayed to dismiss the complaint with cost.

4. We peruse the complaint and records produced before this Forum and raised the following issues for consideration. 

1.  Whether the complaint is maintainable before the Forum?
2.  Whether the opposite parties are committed any deficiency in  

     service as alleged by the complainant?

3.  Regarding relief and costs?

5. In order to prove the case of the complainant, the complainant he who filed a proof affidavit as PW1 in lieu of his chief examination and marked Ext. A1 to Ext. A3 series in his favour. Ext. A1 is the Power of Attorney dated: 07/07/2016.  Ext. A2 is the Policy certificate dated: 14/07/2006. Ext. A3 series are the receipts issued by the Bajaj Allianz Life Insurance Company Ltd in favour of the complainant.  On the other side the Branch Manager of 2^nd opposite party he who filed a proof affidavit in place of chief examination and examined him as DW1.  Through DW1 Ext. B1 and B3 are also marked. Ext. B1 is the copy of policy certificate dated: 18/08/2016.  Ext. B2 is the statement of account of complainant dated:12/08/2016.  Ext. B3 is the copy of letter dated:05/09/2011 which is issued by the opposite party to the complainant.   After the closure of evidence we heard both sides. 
6. Point No.1 and 3:- For the sake of convenience we would like to consider the Point No.1 &3 together.  The opposite party strongly contended that this complaint is not maintainable either in law or on fact, since the case is bad for limitation.  As per the Sec. 24 A of the Consumer Protection Act two year is the limitation period for filing a consumer complaint before a Consumer Forum.  When we evaluate the evidence adduced from this case it is clear that the complainant who is admittedly a nonresidential Indian he who availed a Life Insurance Policy from the opposite parties.  The opposite parties are also admitted the inception of insurance policy and payment of Rs. 1,25,000/- as the premium of the policy up to 2008. As per Ext. B3 letter issued by opposite party in favour of the complainant which shows that the opposite party cannot revive the policy due to uncontrolled DM (diabetic mellitus) with cardiac risk factors.  This fact has not been disputed by the complaint in this case. The opposite party contended that if the complainant has any grievances with regard to Ext. B3 he ought to have file any appeal/revision before the High Court for the rederessal of his grievances for the revival of the policy.  It is to be noted that the complainant filed this case not for the revival of the policy but for the refund of the remitted premium of Rs. 1,25,000.  As per Ext. B2 we can see that the complainant paid premium up to 20/10/2008 to the opposite party and it also evident to see that the inception of the policy is on 14/07/2006.  As per Ext. B2 we can see that a total amount of Rs. 1,25,000 had been paid by the complainant to the opposite party as the premium of his policy.  If so there is no need of go into the details with regard to the limitation plea raised by the opposite parties.  In the light of the above discussion we can find that this Forum has every right to entertain this complaint.  The complainant he who examined as PW1 and deposed that he availed a policy from opposite party and paid the initial premium of Rs. 25,000/- on 19/06/2016 to 2^nd opposite party.  Ext. A1 is none other than a power of attorney executed by the policy holder in favour of the Prince Alex for conducting this case before this Forum.  Ext. A2 is a policy schedule issued by the opposite party in favour of the complainant, Mrs. Chandi Jacob.  The opening portion of the policy schedule says that “in this policy the investment risk in investment portfolio is borne by the policy holder”.  When we go thorough Ext. A2 we can clearly understand that this a unit link policy. In the relevant pages of Ext. A2 the details of unit gain– mortality charges etc are explained.  In UGP page 2 the unit value is also explained “Unit Value” means the value per unit calculated in Rupees in accordance with the following formula: Unit Value = Market/Fair Value of the Investments Plus Current Assets less Current Liabilities and Provision + Transaction Charge…Number of Units outstanding under the relevant Fund

No Units shall be created in a Fund unless assets equivalent in value at the Offer Price of such Units are added at the same time to the Fund.  No Units shall be cancelled in a Fund unless assets equivalent in value at the Bid Price of such Units are withdrawn at the same time from the Fund.

7. It is crystal clear that the Life Insurance Policy which was availed by the complainant was a unit link policy.  The opposite parties seriously contended in their version as well as the proof affidavit of DW1 to the effect that the complaint is not maintainable before this Forum since the policy in question is a unit link policy.  In order to substantiate their contention the opposite party’s learned counsel cited a decision reported in CPR 2013(2) page 389 in Ramlal Agarwala Vs. Bajaj Allianz Life Insurance Company Limited in this decision the Hon’ble National Commission held that Consumer Forum has no jurisdiction to entertained a case going under unit linked policies, since speculative gain and speculative investment are involved in such policies.  In the light of the evidence of this case we already find that the policy in question is a unit link policy.  Therefore we have to find that this Forum has no jurisdiction to entertain this case.
8.   According to the opposite parties if an insured has failed to pay premiums for three years in continuous of the policy have to be forclosed.  The complainant did not raise any series objection with regard to the plea of continuous payment of three years for this kind of policy.  Moreover the complainant is admitted the nonpayment of continuous premium for three years. After the lapse of the policy the complainant requested for a revival and it is seen that by receiving Rs. 50,000/- from the complainant the opposite parties directed to produce a medical certificate from the complainant.  The medical examination result shows that the complainant was suffering from uncontrolled DM with cardiac risk factors.  As per the terms and conditions of the policy the medical certificate is mandatory and the said medical certificate was against the terms and conditions of the policy.  If so, we cannot question the rejection of the opposite party regarding the revival of the insurance policy of the complainant.  Therefore the decision of the opposite party by rejecting the request of the revival can be seen as legally sustainable.  It is also to be noted that when the opposite party find that the revival or renewal of the policy is impossible as per the medical certificate ‘without making any delay’ the opposite party refunded Rs. 50,000/- to the complainant stating the reason for it.  As we already find that this Forum has no jurisdiction to entertain this case there is no need of go into the details with regard to the deposition given by PW1 and DW1 in this case.  Therefore Point No.1 to 3 are found against the complainant.  
9. In the result we pass the following orders.

1. .  The Case is dismissed.
2. .  No Order for cost. 

                    Dictated to the Confidential Assistant, transcribed and typed by her, corrected by me and pronounced in the Open Forum on this the 28^th day of February, 2018.

                                                                                       (Sd/-)

                                                                   P. Satheesh Chandran Nair,                                                                                                                                                                                                                                              

                                                                                          (President)

Smt. Sheela Jacob (Member)   :  (Sd/-)

Appendix:

Witness examined on the side of the complainant:

PW1 : Prince Alex

Exhibits marked on the side of the complainant:

A1 : Power of Attorney dated: 07/07/2016.   

A2 : Policy certificate dated: 14/07/2006.

A3 series: Receipts issued by the Bajaj Allianz Life Insurance Company Ltd. 

Witness examined on the side of the opposite parties:

DW1 : John Joseph

Exhibits marked on the side of the opposite parties:

B1 : Copy of policy certificate dated: 18/08/2016. 

B2 : Statement of account of complainant dated:12/08/2016.

B3 : Copy of letter dated:05/09/2011 issued by the opposite party to the

        complainant.  

                                                                                                   (By Order)

Copy to:- (1) Chandy Jacob (C/o Prince Alex)

 Vilavinal,

 Theppupara. P.O, Parackode,

 Pathanamthitta.

(2) The Manager,

               Bajaj Allianze Life Insurance Company,

               G E Plaza,

               Air Port Road, Yerwada, Pune 411006.

3.  The Manager,

               Bajaj Allianze Life Insurance Company,

               G E Plaza,

               Air Port Road, Yerwada, Pune 411006.

4.  The Stock File.