| Final Order / Judgement | DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BATHINDA C.C. No.53 of 20-02-2018 Decided on : 25-05-2022 Balbir Singh aged about 63 years S/o Ajmer Singh R/o H. No.20024, Street No.12, Jhujhar Singh Nagar, Bathinda. ........Complainant Versus 1.Reliance Nippon Life Insurance Co. Ltd. (Formerly Known as Reliance Life Insurance Company Limited), Branch Office at Liberty Chowk Near Hazi Rattan Gurudwara, Mansa Road, Bathinda, through its Branch Head/Incharge/Authorized Signatory. 2.Reliance Nippon Life Insurance Co. Ltd. (Formerly Known as Reliance Life Insurance Company Limited), Regd. Office at H-Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai, Maharashtra-400710, through its Managing Director/Chairman/Director.
.......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986 QUORUM Sh.Kanwar Sandeep Singh, President. Sh.Shivdev Singh, Member. Smt.Paramjeet Kaur, Member Present For the complainant : Sh.Bharat Bhushan, Advocate. For opposite parties : Sh.Varun Gupta, Advocate. ORDER Kanwar Sandeep Singh, President The complainant Balbir Singh (here-in-after referred to as complainant) has filed this complaint U/s 12 of Consumer Protection Act, 1986 (Now C.P. Act, 2019, here-in after referred to as 'Act') before this Forum (Now Commission) against Reliance Nippon Life Insurance Co. Ltd. and other (here-in-after referred to as opposite parties). Briefly stated the case of the complainant is that in the month of January 2013, the officials of opposite parties approached the complainant and induced him to purchase the policy under 'Reliance Life Insurance Guaranteed Money Back Plan' by proclaiming that the complainant will be entitled to get the refund of the amount deposited by him at any stage after payment of two regular premiums of Rs.25,000/- each, after completion of five years from the date of purchase of the policy, without any deduction at the time of refund and amount shall be refunded alongwith interest, having sum assured of Rs.89,000/- each of policy. It is alleged that on the assurance of the insurance adviser of opposite parties, the complainant bonafidely purchased two policies in the month of February 2013 and deposited a sum of Rs.25,000/- each for purchase of the policies through cheques No.016688 and 016689 dated 15.2.2013 for Rs.25,000/- each vide receipts No.2299452-C and 2299461-C respectively and second premiums were paid by him regarding both the policies through cheque No.003730 dated 15.1.2014 for Rs.49,500/-. At the time of payment of the second premium, opposite parties issued two receipts with the heading of 'first premium receipt' against both the policies with the particulars of policy No.50762225 and policy No.50762232 vide receipt No.WC0021371106 and receipt No.WC0021371127 dated 13.1.2014 respectively, but no policy or its terms and conditions/documents have been supplied to the complainant by opposite parties till date or even the copies of the proposal forms have not been supplied to him. It is clear cut violation of IRDA guidelines. The complainant deposited the amount under the bonafide impression that he has to deposit only two premiums each in both the policies for Rs.25,000/- each and same has already been deposited by him through cheques i.e. Rs.50,000/- in each policy. As he has not received the policy documents alongwith terms and conditions, he remained unaware about the features of the policies and he could not review the terms and conditions of the policies. It is further alleged that since the period of five years from the date of purchase of the policies, matured on 14.2.2018, he visited the office of opposite party No.1 on 14.2.2018 and requested opposite parties to release the amount of both the policies alongwith upto date interest and other incentives, but he was completely astonished to hear that the policies have elapsed due to non-payment of regular premiums as he was required to pay regular premiums of Rs.25,000/- per annum for a period of 15 years against each policy although he was assured by the insurance adviser that he was required to deposit two premiums only. It is also alleged that the complainant repeatedly requested opposite parties to refund the total deposited amount in the policies i.e. Rs.1,00,000/- alongwith upto date interest on the amount, but to no effect. Due to the act and conduct of opposite parties, the complainant is suffering from great mental tension, agony, botheration and huge financial losses. On this backdrop of facts, the complainant has filed this complaint with the prayer for directions to opposite parties to cancel the policies and to refund the total amount i.e. Rs.1 lakh alongwith upto date interest @ 18% per annum w.e.f date of deposit till realization and pay compensation to the tune of Rs.50,000/- in addition to cost of Rs.11,000/-. Upon notice, opposite parties appeared through their counsel and filed written version. In written version, opposite parties have raised the legal objections that the complaint is not maintainable and it is liable to be dismissed as the complainant has attempted to misguide and mislead this Forum. In fact, he has suppressed the material facts from this Forum and it is a settled legal preposition that ''one who seeks justice must come to the court with clean hands'. The contents of this complaint are mis-conceived, misleading and afterthought. The complainant has no cause-of-action to file this complaint. The intricate question of law and facts are involved in this case. The parties have to lead his/its evidence by examining the witnesses and these witnesses are to be cross-examined by the other party. The procedure under 'Act' is summary in nature and complainant, if so advised, may file civil suit seeking the alleged relief. Neither there is any deficiency in service on the part of opposite parties nor any such deficiency in service has been alleged. As such, the complainant is not a 'consumer' as defined under 'Act'. He is estoppel from filing this complaint by his own acts, conduct, omissions and acquiescence. The complaint is false, frivolous and vexatious in nature and has been filed in order to cause undue harassment to opposite parties. As such, the complainant is liable to pay penalty as provided under 'Act' as amended upto date. He was at liberty and obligation to go through the terms and conditions of the policies. On receipt of the policy documents, he did not raise any complaints/objections regarding the policies either within the free look period of 15 days or within any reasonable time thereafter. The contract of insurance attained finality and opposite parties continued to provide coverage to the complainant before the elapse of the policies. The proposal form clearly states that policyholder has to be read with the key features document carefully clearly elaborating the term of the policies including premium paying term. Opposite parties float the insurance schemes for the public in general after prior approval of the Insurance Regulatory & Development Authority (IRDA) and all the terms and conditions of the respective insurance policies are set by the IRDA constituted under the IRDA Act, 1999 and Insurance Act, 1938. Further legal objections are that the true and correct facts pertaining to this case are that Balbir Singh, life assured had submitted two applications for insurance bearing No.D-2528902 and D-2528389 in his own name for 'Reliance Guaranteed Money Back Plan' for sum assured of Rs.89,000/- each. The insured opted for annual payment of premium and also signed the benefits illustration. On receipt of the applications and required documents, policies bearing No.50762225 and 50762232 were issued to the insured and these policies were delivered to him with immediate effects. Under the policy contract, it was the obligation of the life assured/complainant to pay the annual premium on due dates being the lawful consideration thereof and as per the terms and conditions of the policy contract failure on his part to pay the premium in time would render the policies to lapse. The life assured/complainant was given a detailed description about the features of the policies plan including all the charges that shall be levied on the same and was also appraised with its terms and conditions before signing of the applications. It was only after being completely aware as regards the risks and consequences of the policies and terms and conditions attached therewith that the life assured/complainant applied for the same vide applications. The policy documents inclusive of standard terms and conditions, policy schedule, right to reconsider notice and a copy of the proposal form, financial statement, benefits illustration, customer declaration form and customer information reports were dispatched to the life assured and same were duly delivered to him at the address mentioned on the applications. It is further pleaded that a welcome letter sent with the policies and it contained the free look option. The life assured/complainant did not avail the freelook option. He failed to revive and also his part of the obligations as per the terms and conditions of the policies. As per terms and conditions of the policies, opposite parties had the right to terminate the policy contract, in case the same was not revived within two years of the last unpaid premium and to pay the surrender value to the life assured/complainant, if any. At the time of entering into a contract of insurance with opposite parties, the complainant was duly apprised of the key features of the ST&C in detail and he after having understood the same, in complete cognizance of the standard terms and conditions of the policies, had entered into the contract with opposite parties. These documents clearly mentioned the terms of the policies, various charges and standard terms and conditions of the policies. On merits, opposite parties have pleaded that the complainant himself was willing to purchase their 'Life Insurance Policy' and for this, he approached their advisor. He got the entire information regarding all the plans of opposite parties in vernacular language and thereafter, after understanding all the terms and conditions of all the plans, only thereafter he opted to purchase 'Reliance Guaranteed Money Back Plan'. He filled the proposal forms No.D-2528389 and D-2528902 on 12.2.2013. At the time of filling the proposal forms, he opted to pay Rs.25,000/- premium as annual and term of the plan 15 years and premium paying term 5 years and premium frequency annually in both policies. After receiving the duly signed proposal forms and going through the entire contents of the proposal forms, the underwriters of the policies reached to such a conclusion that there is no risk to issue the policies to the complainant and accordingly, they issued the insurance policies bearing No.50762225 and 50762232 to the complainant and sent him policy documents alongwith all terms and conditions on the given address through speed post and same was duly received by him and same is in his possession. The complainant paid the second premiums against both the policies and thereafter he did not pay any renewal premiums. As such, his policies lapsed as per terms and conditions. Opposite parties have also referred the terms and conditions of the policies, detail of which is not necessary at this stage. After controverting all other averments of the complainant, opposite parties have reiterated their stand as taken in their legal objections as detailed above and prayed for dismissal of complaint. In support of his complaint, complainant has tendered into evidence photocopies of first premium receipts, (Ex.C1 and Ex.C2); photocopy of account statement, (Ex.C3); his affidavit dated 4.6.2018, (Ex.C4); photocopy of Aadhaar card, (Ex.C5) and closed the evidence. To rebut the evidence of complainant, opposite parties have tendered into evidence affidavit of Vishal Bansal dated 29.10.2018, (Ex.OP1/1); photocopy of policy documents, (Ex.OP1/2) and closed the evidence. We have heard learned counsel for parties and gone through the file carefully. Learned counsel for complainant has submitted that the complainant purchased two policies of opposite parteis under 'Reliance Life Insurance Guaranteed Money Back Plan' and deposited a sum of Rs.25,000/- each for purchase of the policies through cheques No.016688 and 016689 dated 15.2.2013 for Rs.25,000/- each respectively and second premiums were paid by him regarding both the policies through cheque No.003730 dated 15.1.2014 for Rs.49,500/-. Opposite parties did not issue the policy or its terms and conditions/documents or copies of the proposal forms to the complainant. It is clear cut violation of IRDA guidelines. The complainant has not received the policy documents alongwith terms and conditions, he remained unaware about the features of the policies and he could not review the terms and conditions of the policies. The policies of the complainant matured on 14.2.2018. He visited the office of opposite party No.1 and requested to release the amount of both the policies alongwith upto date interest and other incentives, but he came to know that the policies have elapsed due to non-payment of regular premiums as he was required to pay regular premiums of Rs.25,000/- per annum for a period of 15 years against each policy although he was assured by the insurance adviser that he was required to deposit two premiums only. On the other hand, learned counsel for opposite parties has submitted that on receiving the policy documents, the complainant did not raise any objections regarding the policies either within the free look period of 15 days or within any reasonable time thereafter. The complainant submitted two applications for insurance bearing No.D-2528902 and D-2528389 in his own name for 'Reliance Guaranteed Money Back Plan' for sum assured of Rs.89,000/- each. The insured opted for annual payment of premium and also signed the benefits illustration. On receipt of the applications and required documents, policies bearing No.50762225 and 50762232 were issued to the insured and these policies were delivered to him. The complainant did not avail the freelook option. He failed to revive and also his part of the obligations as per the terms and conditions of the policies. As per terms and conditions of the policies, opposite parties had the right to terminate the policy contract, in case the same was not revived within two years of the last unpaid premium and to pay the surrender value to the life assured/complainant, if any. At the time of filling the proposal forms, he opted to pay Rs.25,000/- premium as annual and term of the plan 15 years and premium paying term 5 years and premium frequency annually in both policies The complainant paid the second premiums against both the policies and thereafter he did not pay any renewal premiums. As such, his policies lapsed as per terms and conditions. We have given careful consideration to these submissions. The complainant has placed on file first premium receipts, (Ex.C1 and Ex.C2) and account statement, (Ex.C3) to prove that he has paid premiums against two policies in question. As per complainant, he is entitled to get the refund of the amount alongwith interest deposited by him at any stage after payment of two regular premiums after completion of 5 years from the date of purchase of the policies without any deduction as assured by opposite parties, but there is no document on file to prove this fact. Opposite parties have placed on file policy documents including proposal form duly signed by the complainant in English, (Ex.OP1/2). Plan Details of this policy documents reveals “Plan Applied For 'Guaranted Money Back Plan'; Policy Term (Yrs):- 15; Premium Paying Terms (Yrs):- 5 Years; Sum Assured (Rs.):-89000 and Premium (Rs.):-25000/-. Moreover the relevant Condition No.12 (12.1) of this policy document relates to discontinuance of payment of premium, which is reproduced as under:- “(12) Discontinuance of payment of premium: if policyholder discontinues payment of premiums, the policy will: 12.1) Lapse: If the premiums for first three years are not paid in full, the policy lapses at the end of the grace period and the insurance cover, inbuilt accidental death benefit, inbuilt waiver of premium benefit and rider benefits, if any will cease immediately. No benefits will be paid when the policy is in lapsed status. Accrued Guaranteed Loyalty Additions, if any, will not be payable for a policy in lapsed status. No further Guaranteed Loyalty Additions will be payable.” Thus, as per policy documents and Condition No.12 (12.1), if the premiums for first three years are not paid in full, the policy lapses at the end of the grace period and the insurance cover, inbuilt accidental death benefit, inbuilt waiver of premium benefit and rider benefits, if any will cease immediately. No benefits will be paid when the policy is in lapsed status. In the case in hand, the complainant has paid only two premiums against his two policies in question, but as per the policy terms and conditions, he should have deposited premiums for 5 years regularly to take benefits of his policies. Therefore, he is not entitled for any benefits of these policies. Therefore in view of what has been discussed above, there is no deficiency in service on the part of opposite parties, thus this complaint is hereby dismissed. The parties are left to bear their own costs. The complaint could not be decided within the statutory period due to heavy pendency of cases. Copy of order be sent to the parties concerned free of cost and file be consigned to the record. Announced:- 25-05-2022 (Kanwar Sandeep Singh) President (Shivdev Singh) Member
(Paramjeet Kaur) Member | |
