BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

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Rajinder Singh Raj s/o Late S. Sarain Singh, r/o H.No. 2103, Sector 19-C, Chandigarh.

…..Complainant

                 V E R S U S

1]  SBI Life Insurance, Regd. Office: State Bank Bhawan, Madame Cama Road, Nariman Point, Mumbai, through its Chief Executive Officer.

2]  The Branch Manager, SBI Life Insurance, Opp. K.C. Theatre, Sector 17, Chandigarh.

                      ……Opposite Parties

CORAM:   SH.P.D.GOEL                 PRESIDENT

         SH.RAJINDER SINGH GILL       MEMBER

         DR.(MRS).MADANJIT KAUR SAHOTA  MEMBER

Argued by: Complainant in person.

Sh.Varun Chawla, Proxy Counsel for Sh.Rajneesh Malhotra, Counsel for OPs.

PER DR.(MRS).MADANJIT KAUR SAHOTA, MEMBER

        The Complainant was having an insurance policy (SHIELD Plan B 5% Incr.) of the OPs bearing No.16000170705 for a sum of Rs.5,00,000/-. As per the said Policy, the Complainant was to get nothing from the OPs, at the time of its termination, whereas during the subsistence of it, the OPs had covered the life risk of the insured for a sum of Rs.5 lacs in the first year. There was an increase of 5% in the risk covered amount i.e. Rs.25,000/- every year. In the final year of the policy i.e. in the year 2017, the amount of risk covered would have increased to Rs.8.25 lacs.

         It is averred that the said policy was lapsed due to default in payment of premium. However, on receipt of special offer for revival of lapsed policy from the OPs, the complainant contacted OP No.2, filled the application form as well as the declaration of good health (Ann.C-1) and made payment of Rs.24,455/- on account of revival of the policy. But the OPs instead ore reviving the policy, vide letter dated 5.10.2010 (Ann.C-2), informed him that the amount could not be adjusted towards the renewal premium and the same is kept in deposit. Thereafter, to his utter shock, the OPs vide another letter dated 14.10.2010 (Ann.C-3), asked him to undergo a medical examination at the Oxford Heart and Multispeciality Hospital, Sector 19-D, Chandigarh, as a matter of requirement. Since the OPs were subsequently imposing such conditions on him, after receiving the amount for the revival of the policy, the Complainant served a legal notice dated 05.01.2011 (Ann.C-6) upon the OPs, requesting that the amount paid by him be adjusted towards the renewal of the policy as per their offer. After receiving the legal notice, OP No.1 hurriedly shoot off a letter dated 13.01.2011 (Ann.C-1), intimating that they could not adjust the amount lying as deposit against the policy, and refunded same through cheque (Ann.C-8). Hence, this complaint.

2]     OP Nos.1 & 2 in their joint written statement, while admitting the factual matrix of the case, pleaded that the policy in question was in lapsed status due to non-payment of premium dues since 10.06.2008. During the revival campaign a letter dated 31.8.2010 (Ann.D), giving a special offer of revival with 20% concession on interest and complete waiver of medial charges for medical reports was sent to the Complainant during the month of September. It was admitted that the replying OPs received Rs.24,455/- as on 30.09.2010 towards the revival of the Complainant’s policy. On receipt of the Complainant’s declaration of good health on 06.10.2010, the replying OPs raised the requirement of medical check-up, as per their internal norms, vide letter dated 14.10.2010 (Ann.F). But the Complainant did not comply with the requirement of medical examination. After waiting nearly for two months, the case of the Complainant was processed for refund of the revival money and ultimately, the replying OPs refunded the money lying as deposit, to the Complainant vide Cheque dated 31.12.2010 (Ann.G). All other material contentions of the complaint were controverted. Pleading that there was no deficiency in service on their part, a prayer has been made for dismissal of the complaint.

3]  Parties led evidence in support of their contentions.

4]       We have heard the complainant in person and learned counsel for the OPs and have also perused the record.

5]       The dispute of the complainant, in this complaint, is that despite making payment, in response to the offer made by the OPs for the revival of the lapsed policy; to his utter shock, the OPs, instead of adjusting the amount/premium, so paid towards the renewal of the policy in question, kept the same in deposit. They, instead, imposed upon him, a condition to undergo further a medical examination at Oxford Heart & Multispeciality Hospital, Sector 19-D, Chandigarh, whereas he had already submitted DGH (Declaration of Good Health) along with application for revival of the policy as well as requirement premium amount.  Meaning thereby, he, in one go, had complied with all the requirements for the revival of the policy. Only then, the complainant sent a legal notice, whereupon the OPs, without assigning any reason, refunded the premium amount, lying as deposit against the policy.

6]       Whereas the OPs, while admitting the off of launching of Special Revival Campaign of the lapsed policies, giving a special offer of 20% concession in interest and complete waiver of charges for medical reports, has also admitted the receipt of an amount of Rs.24,455/- along with declaration of good health, from the complainant, for the revival of his lapsed policy.

7]       The OPs have further pleaded that the complainant did not comply with the requirements of another medical check-up, henceforth, after waiting nearly for 2 months and having no other option, ultimately, compelled to process for refund of the amount, paid by the complainant and lying in the deposit, for revival of his policy.

8]       In order to come to the conclusion and to clinch the matter in dispute, we have gone through the documents placed on record as well as the pleadings of both the parties.

9]       The OPs vide letter dated 31.8.2010 (Ann.D, page No.46) made an offer for revival of the lapsed policies that also before 31.10.2010.  The relevant extract of this letter is reproduced as under:-

“We are pleased to launch Special Revival Campaign for the lapsed policies.  The Revival Campaign offers concession in interest and complete waiver of charges for medical reports for revival of lapsed policies.”

10]      Furthermore, the letter (Annexure-D, at page NO.47), dated 5^th Oct., 2010, issued to the complainant by the OPs, says that “This is with reference to the remittance received for your above mentioned SBI Life Policy.  In this regard we would like to inform you that the remittance could not be adjusted towards the renewal premium and is kept in DEPOSIT.  As your Policy is in ‘Lapsed’ Status, we request you to revive the policy by remitting the ar5rears of premium and by submitting a duly filled Declaration Good Health (DGH) enclosed herewith.  We wish to inform you that your policy will be revived based on the DGH and submission of other health requirement raised by us, if any.”

11]      The matter did not end here, rather the OPs further shoot another letter on 14.10.2010 (Ann.F, at Page No.48), in which they had duly made reference regarding receipt of DGH (Declaration of Good Health) sent by the complainant; however, they again requested the complainant to undergo a medical check-up at Oxford Heart & Multispeciality Hospital, Sector 19, Chandigarh, in order to comply with the requirements, as per internal norms for considering the revival of his SBI policy.

12]      Thereafter, the OPs sent another letter to the complainant on 13.1.2011 (Ann.G, Page-50) informing the complainant about the lapsed status of his policy as well showed their inability to adjust his premium amount, lying as deposit under his captioned policy.  In this very letter, the OPs had intimated about the refund of amount of Rs.24,496/- by way of cheque No.410505, dated 31.12.2010, drawn on State Bank of India. 

13]      After perusing the entire facts & circumstances of the case, which gave rise to the present complaint as well as making thorough consideration of the documents, placed by both the parties, it has been made out that after receipt of communication from the OPs regarding Special Revival Campaign, the complainant, though remitted the premium amount as well as submitted the duly filled declaration of good health (DGH) towards compliance of the requirement for the said revival, yet he did not adhere to the further requirement of another medical check-up from Oxford Heart & Multispeciality Hospital, Sector 19, Chandigarh, as directed by the OPs vide letter dated 14.10.2010 (Ann.F), even though there was an offer of complete waiver of charges for medical report as per letter dated 31.8.2010 (Ann.-D).  The reason, for non-compliance of prescribed medical examination by the complainant, is best known to him. 

14]      Undisputedly, the complainant had failed to comply with the condition precedent of medical check-up, as asked vide letter dated 14.10.2010 (Ann.F), at Oxford Heart & Multispeciality Hospital, Sector-19-D, Chandigarh, to fulfill the requirement for revival of his policy. 

15]      Evidently, it is crystal clear that OPs gave ample time to the complainant to meet the said requirement of medical check-up/examination per their internal norms, but he miserably failed to comply with such requirement.  The OPs have given plausible justification towards their inability for the revival of the lapsed policy of the complainant.  At last, the OPs, left with no other option, had to refund the premium amount to the complainant, which was lying as deposit under the captioned policy. The intimation letter dated 31.1.2011 (Ann.G at Page-50), is self-explanatory, which cleared the whole dust & doubt. 

16]      After going through all the averments, pleadings and documents placed on file, by both the parties as well as thoroughly considering the facts & circumstances of the case, we determine & arrived at a conclusion that averments made by the complainant, is totally lacking authenticity.  Further, he failed miserably to prove his case against the OPs by leading authentic/cogent documentary evidence.  On the other hand, the OPs have fully & legitimately been able to prove their defence by placing on record valid documents.  Therefore, we are of the view that the present complaint has no merit, weight or substance. The same is accordingly dismissed.  The parties are left to bear their own costs.

         Certified copies of this order be sent to the parties free of charge. The file be consigned.