DATE OF FILING : 13.08.2015.
DATE OF S/R : 20.09.2015.
DATE OF FINAL ORDER : 15.11.2016.
Sri Ratikanta Paul,
son of late Anukul Chandra Paul,
residing at village Pranballavpur, P.O. Benapur chandanapara,
P.S. Bagnan, Howrah,
PIN 711312 and also
Village Santoshpur, P.O. Kulitapara, P.S. Bagnan,
Howrah 711312. ……………………………………………………… COMPLAINANT.
1. The Senior Executive,
PNB Metlife India Insurance Co. Ltd.,
having its registered office
at 5, Vani Vilas Road, Brigad, Seshamahal,
Basavangudi, Bangalore 560004,
State of Karnataka.
2. The Branch Manager,
PNB Metlife India Office Insurance Co. Ltd.,
Having its branch office at Krishna Enclave,
1st floor, Bhanjalal Lohia Lane, Salkia,
Howrah 711106.
3. The Axis Bank Limited,
Bagnan Branch, O.T. Road, behind Chhayagiti Cinema,
P.O. & P.S. Bagnan,
Howrah 711303. ………………….………………………OPPOSITE PARTIES.
P R E S E N T
Hon’ble President : Shri B. D. Nanda, M.A. ( double ), L.L.M., WBHJS.
Hon’ble Member : Smt. Jhumki Saha.
Hon’ble Member : Shri A.K. Pathak.
F I N A L O R D E R
- This is an application U/S 12 of the C.P. Act, 1986 filed by the petitioner, Sri Rati Kanta Paul, against the o.ps., PNB Metlife India Insurance Co. Ltd., being o.p. nos. 1 & 2 and o.p. no. 3, Axis Bank Ltd. Bagnan Branch, praying for a direction upon the o.p. nos. 1 & 2 to return his invested amount of Rs. 60,000/- with interest till realization and also to pay Rs. 1 lakh as compensation.
- The case of the petitioner is that he purchased an insurance policy being no. 1200900782895 from the o.p. nos. 1 & 2, PNB Metlife India Insurance Co. Ltd., on 30.01.2009 with coverage of 14 years and the yearly premium being Rs. 20,000/-. The employee of the insurance company told him that he requires three annual premiums to be paid and then if he does not want to continue the policy then he could withdraw the money invested by him with interest which would come up Rs. 1 lakh. The petitioner made the policy even if he was a poor man and he paid three premiums and then applied before o.p. no. 2 to withdraw Rs. 60,000/- but he was disappointed to know that the o.ps. actually practiced fraud on him through their unscrupulous agent who committed fraud on him. The o.p. no. 2 told him to continue the annual premium up to the 5th year to evade the surrender charge and would get back Rs. 20,000/-. The petitioner wrote a letter to the o.p. no. 2 on 17.12.2014 requesting him to return 60% with interest and the o.ps. informed him that he would be paid Rs. 19,680.56 after deduction. They sent registered mail in the address of the petitioner through Blue Dart but the said mail was undelivered and returned to the o.ps. The petitioner not yet received any amount and simply harassed due to the mal activities of the o.ps. who initially got the insurance policy in his name fraudulently and then wanted to pay him about Rs. 19,680/- after deduction of surrendered charge and service tax even if he paid Rs. 60,000/- and so he filed this case with the above prayers.
- The o.p. no. 3 contested the case by filing a written version denying the allegations made against them and submitted that this Forum has no jurisdiction to entertain and adjudicate the dispute involved in this case as this is not a consumer dispute. The o.p. no. 3 is not engaged in the business of insurance and cannot run such business as per the Banking Regulation Act, 1949 and there is no deficiency in service on the part of the o.p. no. 3 and the case be dismissed against the o.p. no. 3.
- The o.p. nos. 1 & 2, PNB Met Life India Insurance Co. Ltd., contested the case by filing a written version denying the allegations made against them and submitted that the company is engaged in the business of life insurance being duly approved by the Government of India through the Insurance Regulatory and Development Authority and has branches all over India and working with good reputation and its registered office at Bangalore. The present case is barred by limitation U/S 24A of the C. P. Act, 1986 because the policy was issued on 30.01.2009 and the last installment paid on 01.02.2011 and thus the case ought to have been filed within two years i.e., within 01.02.2013 but the petitioner filed this case on 13.8.2015 after long lapse of over two years. The o.ps. further submitted that the instant case is not maintainable as the dispute does not come under the definition of consumer because the petitioner here invested money to gain profit. They further submitted that as per Clause 6(2) IRDAI Regulations, 2002 “While acting under regulation 6(1) in forwarding the policy to the insured, the insurer shall inform by letter forwarding the policy to the insured that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms and conditions, he has the option to return the policy stating reasons for his objections and is entitled to get refund of the premium paid but in the instant case no such action taken by the petitioner. The policy was issued on 30.01.2009 and the policy document was despatched on 03.02.2009 through courier and despite receipt of the policy document the petitioner raised no objection during the free look period of 15 days and thus it is presumed that the contract of insurance was legally concluded and thus no question of cancellation arises.
- Further in the instant case the petitioner paid the premium of Rs. 20,000/- per year from 30.01.2009 to 01.02.2011 being three premiums amounting to Rs. 60,000/- and failed to pay renewal premium due on 30.01.2012 resulting the policy status was changed due to such discontinuation of policy and the policy got auto foreclosed on 19.08.2013 and the fund value as on date was Rs. 20,806.16 wherefrom Rs. 1,000/- was deducted as surrendered charge, Rs. 123.6 p. deducted towards service tax and the petitioner is entitled to that amount only. The proposal form duly signed by the petitioner clearly shows that he signed in the document and accepted the policy and raised no objection during the free look period and now the insured cannot claim any thing what is not covered under the policy as per terms and conditions of the same. Thus the complaint being not maintainable being dismissed.
- Upon pleadings of parties the following points arose for determination :
- Is the case maintainable in its present form ?
- Whether the petitioner has any cause of action to file the case ?
- Whether there is any deficiency in service on the part of the O.Ps. ?
- Whether the complainant is entitled to get any relief as prayed for ?
DECISION WITH REASONS :
- All the issues are taken up together for the sake of convenience and brevity for discussion and to skip off reiteration. In support of his case the petitioner filed affidavit as well as documents wherefrom it is noticed that he deposited three premiums of Rs. 20,000/- each and thus deposited a total sum of Rs. 60,000/- and he claimed in this case the above amount of Rs. 60,000/- with interest till realization. The o.p. bank i.e., o.p. no. 3 actually has nothing to contest the case. However, they also filed written version as well as filed written argument but having nothing to contest the case because the petitioner filed this case against the o.p. nos. 1 & 2 being the insurance company claiming a sum of Rs. 60,000/- with interest and there is no claim against the o.p. no. 3, Axis Bank. The case of o.p. nos. 1 & 2 being that the petitioner signed the proposal form and accepted the policy document and raised no objection against the said policy and paid premiums in three consecutive years and now after discontinuance of the policy the petitioner is entitled to the surrendered value and the o.p. nos. 1 & 2 are always ready and willing to pay and steps taken by them for such payment. Both parties here filed documents being the application no. 301731188 which was duly signed by the petitioner, Ratikanta Paul and the contents of policy document clearly proving the fact that the same was issued in the name of Ratikanta Paul and also the policy holder’s declaration in the policy containing the terms and conditions of the same and clearly stating in Clause 2.3 that the petitioner is entitled to a 15 days free look period during which he has to raise objection if any and also he was entitled to send request for cancellation of policy but in the instant case no such cancellation was made and it is also clearly seem from the document in Clause 4.6 being discontinuance of premium after the first three years as happened in this case and in such a case the policy stands terminated and the surrender value shall be paid and in the instant case the surrender value depends on the fund value and after deduction of surrender charge the amount would be paid. In the instant case the insurance company wrote a letter to the petitioner on 18.12.2014 in respect of his policy stating that he paid three premiums and he raised no complaint about the mis-selling of the policy during the period and he was covered for the insurance of Rs. 10 lakh till the policy got foreclosed and so the first premium has been deducted towards premium allocation charges towards the policy from 2nd years onwards and thus the policy offered the benefit of guarantee loyalty additions on completion of 10th and 15th year of policy and the company requested the petitioner to refer the terms and conditions. Thus this Forum noticed that the petitioner by his letter dated 17.12.2014 wanted return of Rs. 60,000/- + interest from the o.p. nos. 1 & 2 insurance company which informed him by letter dated 18.12.2014 that he is entitled to Rs. 19,680.56 after deduction of surrendered charge and service tax as communicated to him. Both the insured and insurer are bound by the terms and conditions of the policy and in the policy there is clear mention that the petitioner is entitled to one year premium of Rs. 20,000/- minus surrendered charge and service tax and here also the petitioner made policy as noticed from the proposal form and did not object to the said policy within the free look period of 15 days and accepted the policy and continued the same for three years and so as per Clause 4.6 B when he continued the regular premium after the first three years then he is entitled to the surrendered value as the policy got terminated and here the surrendered value being Rs. 19,680.56 p. the petitioner cannot get the claim amount as prayed for and also entitled to no interest except the surrendered value.
In the result, the application succeeds in part.
Court fee paid is correct.
Hence,
O R D E R E D
That the C. C. No. 287 of 2015 be and the same is allowed in part on contest without costs against the O.Ps.
The petitioner is entitled to the amount as offered by the o.p., insurance company, as per terms and conditions of the contract being Rs. 19,680.56 p. after deduction of surrendered charge and service tax.
His prayer regarding compensation is not considered because the o.ps. already offered him the said amount as per contract and he did not accept the same and so no deficiency in service on the part of o.ps.
The o.ps. are directed to pay the above sum to the petitioner within 30 days from the date of this order with interest @ 9% p.a. since his entitlement till realization.
The case is thus disposed of accordingly.
The complainant is at liberty to put the final order into execution after expiry of the appeal period.
Supply the copies of the order to the parties, free of costs.
DICTATED & CORRECTED
BY ME.
( B. D. Nanda )
President, C.D.R.F., Howrah.
