State Consumer Disputes Redressal Commission
Bajaj Allianz Life Insurance Co. Ltd. vs Raj Kumar Singh on 21 June, 2016
CHHATTISGARH STATE
CONSUMER DISPUTES REDRESSAL COMMISSION,
PANDRI, RAIPUR (C.G).
Appeal No.FA/2016/135
Instituted on : 25.04.2016
Bajaj Allianz Life Insurance Company Limited,
Shiv Mohan Bhawan, Pandri,
Vidhan Sabha Road,
Raipur (C.G.) ..... Appellant
Vs.
Rajkumar Singh,
Residing At - Jay Durga Provision Stores,
Adarsh Chowk, Rajatalab,
Raipur (Chhattisgarh) ......Respondent
PRESENT :
HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT
HON'BLE MISS HEENA THAKKAR, MEMBER
HON'BLE SHRI D.K. PODDAR, MEMBER
HON'BLE SHRI NARENDRA GUPTA, MEMBER
COUNSEL FOR THE PARTIES :
Shri Anurag Sharma, for the appellant.
Shri Rajesh Pandey, for the respondent.
ORDER
DATED : 21/06/2016 PER :- HON'BLE SHRI JUSTICE R.S. SHARMA, PRESIDENT. This appeal is directed against the order dated 10.02.2016, passed by District Consumer Disputes Redressal Forum, Raipur (C.G.) (henceforth "District Forum") in Complaint Case No.425/2014. By the impugned order, learned District Forum, has partly allowed the complaint of the respondent (complainant) and directed that :-
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(a) The O.P. will pay a sum of Rs.50,000/- (Rupees Fifty Thousand) to the complainant along with interest @ 09% p.a. from 11.07.2007 till date of payment.
(b) The O.P. will pay a sum of Rs.10,000/- (Rupees Ten Thousand) to the complainant towards compensation for mental agony.
(c) The O.P. will pay a sum of Rs.2,000/- (Rupees Two Thousand) to the complainant towards advocate fees and cost of litigation.
2. Briefly stated the facts of the complaint of the respondent (complainant) are that the O.P. is doing life insurance business and its agent T. Ajay Rao, at present, who had died, gave false information to the complainant and gave a unit gain life insurance policy No.0056796871 dated 11.07.2007. In the above policy, the complainant paid a sum of Rs.50,000/- as model premium to the O.P. on the basis of which the O.P. issued the above policy. The fund settlement of the above policy as on 27.11.2007 was Rs.56,990/-. In the month of June, 2014 the complainant went to the O.P. for taking Rs.50,000/- which is premium amount, then the O.P. informed him that the amount of Rs.50,000/- would not be refunded but onlyRs.14,000/- would be refunded to him. The complainant was surprised because he had paid a sum of Rs.50,000/- towards premium to the O.P. After lapse of six years, the O.P. did not refund the amount of Rs.50,000/- and directed the complainant to approach District Forum. The agent of the O.P. Late T. Ajay Rao and Praveen Kumar obtained signature of the complainant // 3 // in some form but they did not give information to the complainant that in which form they are obtaining his signature. The complainant is not well educated and the agents of the O.P. gave him false information and the complainant presumed that the information given by the Agents, is correct. They have never told the complainant that under the above policy more than one premium is required to be paid, they have told the complainant that this is a single premium policy and by saying this they have fraudulently got his signature in the policy form and the complainant came to know regarding the same when he went to the O.P. for taking Rs.50,000/-, which is amount of premium. The O.P. informed the complainant that only a sum of Rs.14,000/- would be refunded. The complainant went to the office of the O.P. several times and demanded the amount, but the O.P. did not refund the amount. According to the policy of the O.P. when the above premium get higher value then the above amount would be provided to the insured, whereas according to the fund statement provided by the O.P. in the year 2007 the fund value of the complainant was Rs.56,990/-. The O.P. did not provide the increased amount and also did not refund the premium amount, which comes in the category of deficiency in service and unfair trade practice. Hence the complainant filed consumer complaint before the District Forum and prayed for granting reliefs, as mentioned in relief clause of the complaint.
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3. The O.P. filed its written statement and averred that the complaint is barred by time because the complainant paid the first premium of Rs.50,000/- on 10.07.2007 and thereafter the second premium was payable which was not paid by the complainant. The policy became lapsed because second premium of the policy and subsequent premium were not paid. The cause of action had arisen after 10.07.2008 and within two years the complaint was to be filed whereas the complainant has filed complaint in the month of September, 2014, which is barred by time. The complainant did not come before the District Forum with clean hands. The complainant himself filled up the proposal form and accepted the terms and conditions of the policy according to which a contract has been executed between the complainant and the Insurance Company, therefore, both the parties are binding by the terms and conditions of the policy. According to condition of the Insurance Company, if the complainant was not satisfied with the policy when he received receipt of first premium, then as per free look period of 15 days he would have demand the premium amount within 15 days by informing the reasons in writing, but the complainant did not make any such demand within 15 days of free look period i.e. within 15 days of receipt of first premium receipt, therefore, he was fully satisfied with the policy, therefore, the averments made in the complaint, is afterthought. The complainant was provided true information and after receiving true information he signed the proposal // 5 // form. The complainant did not make any efforts for surrender of the lapsed policy, due to which the Insurance Company has not committed any deficiency in service. In the Unit Gain Policy there is no profit or return with guarantee. The above insurance policy is combination of Investment Cum Insurance, which does not assure the customer any specific profit or return. The agent of the O.P. explained the complainant regarding terms and conditions of the insurance policy and about the benefit and before obtaining insurance policy, the complainant filled up the proposal form. Thereafter the complainant was explained all things regarding maturity of the above policy. At that time the complainant did not tell that he did not understand the terms and conditions of the policy. The complainant was informed that the premium is payable every year. The complainant signed the proposal form and after understanding the terms and conditions signed the proposal in respect of premium. In the above proposal form, there is signature of the complainant in Declaration for Unit Linked Policy and Declaration in which the amount of premium and terms and conditions of the policy etc. have been mentioned. The complainant obtained terms and conditions of the above policy and he filled up proposal form before taking the policy. The premium amount is payable for minimum three years and in the declaration of premium the complainant put his signature after understanding it. The above policy is based on market risk and fluctuation. In the proposal it is mentioned :-
// 6 // "Commencement of cover : I / We Understand that the cover applied for under this application will commence after consideration of my our application and realisation of the required premium. Declaration for unitlinked Policy : I understand that the insurance policy that will be issued if the proposal is accepted by Bajaj Allianz Life Insurance Company, is a unit linked Insurance policy. I understand and agree that the same will be subject to market risks, conditions and fluctuations and that Bajaj Life Insurance Company may not be able to guarantee any minimum return of the said policy. I undertake not to bring in any action or demand against Bajaj Allianz Life Insurance Company for any minimum of other return under the said policy". After understanding the terms and conditions of the policy, the complainant purchased the policy and he was very well knowing this fact the premium of the above policy is required to be paid annually. The policy which was obtained by the complainant depends on the conditions of the market and the risk which is in the market is also for the policy holder along with policy. The above policy is investment policy which is based on profit and loss of share market. On this basis, the complainant does not come in the category of the consumer. The above policy is based on risk of the market. In the instant case the policy became lapse because regular premium was not paid according to the contact executed between the complainant and the Insurance Company and on the basis of contact accrued under the lapsed policy the complainant cannot bring any claim because the insured and Insurance Company both are binding by the terms and conditions of the // 7 // policy and if the terms and conditions are violated, then the insured is not entitled to get any benefit which is contract to the insurance policy. The Insurance Company gave intimation regarding payment of premium amount but even then the complainant did not regularly pay the premium amount, thus the Insurance Company did not commit any deficiency in service. The Insurance Company sent several letters to the complainant to pay the premium but the complainant did not reply the above letters and also did not try to revive the policy and after four years he is filing complaint, which is not within limitation and is liable to be dismissed. The complaint is liable to be dismissed.
4. The respondent (complainant) has filed documents. Document P- 1 is registered notice dated 17.07.2014 sent by Shri D.D. Dhage, Advocate to the Branch Manager, Bajaj Allianz Genera Insurance Company Limited, Raipur (C.G.) and K. Arjun Rao, Insurance Agent, P-2 are postal receipts, P-3 is acknowledgement, P-4 is undelivered envelope, P-5 is Fund Statement as on 27th November, 2007, P-6 is letter dated 12.07.2007 sent by P. Branch Manager, Bajaj Allianz Life Insurance Co. Ltd. to Mr. Rajkumar Singh, P-7 is Premium Slip,P-8 is receipt issued by Bajaj Allianz Life Insurance Co. Ltd., P-9 is letter dated 14.08.2007 sent by Bajaj Allianz Life Insurance Co. Ltd. to the appellant (complainant).
5. The appellant (O.P.) has filed documents. Document OP-1 is proposal form dated 10.07.2007, OP-2 are Moral Hazard Report, // 8 // Statement of Accounts, of Mrs. Bharti Singh Thakur, Basic Certificate of Identity Proof, PAN Card of Rajkumar Singh, OP-3 is Policy Schedule, First Premium Receipt, Initial Unit Statement, OP-4 is Bajaj Allianz Capital Unit Gain Policy document, OP-5 is Present Fund Value.
6. Learned District Forum after having considered the material placed before it by the parties has partly allowed the complaint and directed the appellant (O.P.) to pay amounts to the respondent (complainant), as mentioned in para one of this order.
7. Shri Anurag Sharma, learned counsel appearing for the appellant (O.P.) has argued that the complaint of the respondent (complainant) is barred by limitation and the complaint filed by the respondent (complainant), is gross misuse of process of law and is liable to be dismissed on this ground alone. The present complaint is false, and abuse of the process of the Consumer Forum, therefore, is liable to be dismissed. The respondent (complainant) only paid a sum of Rs.50,000/- to the appellant (O.P.) as first premium and thereafter he had not paid premiums regularly, therefore, the policy became lapsed.
The respondent (complainant) paid single premium in the year 2007 and later on he had not paid any premium in spite of knowing the fact that the policy was of regular premium. First renewal premium was supposed to be paid on 10.07.2008, however it was not paid and as a result his policy got lapsed and later on foreclosed. The respondent // 9 // (complainant) himself filled up the proposal form and after understanding the terms and conditions of the policy, he accepted the terms and conditions and signed the proposal form, therefore, the terms and conditions are binding on the respondent (complainant). It appears that the respondent (complainant) was having knowledge that the policy is having annual premium of Rs.50,000/-, but the respondent (complainant) did not pay the second and third premium, therefore, the policy became lapsed. Therefore, the respondent (complainant) is not entitled to get any amount under the insurance policy. The impugned order passed by the District Forum, is illegal and is liable to be set aside. The appeal of the appellant (O.P.) may be allowed.
8. Shri Rajesh Pandey, learned counsel appearing for the respondent (complainant) has argued that T. Ajay Rao and Praveen Kumar, who were agents of the appellant (O.P.) came to the respondent (complainant) and informed the respondent (complainant) regarding Unit Gain Life Insurance Policy and gave a Unit Gain Life Insurance Policy to the respondent (complainant) on 11.07.2007. The respondent (complainant) paid a sum of Rs.50,000/- to the appellant (O.P.) as model premium and the appellant (O.P.) issued Unit Gain Life Insurance Policy. T. Ajay Rao had informed the respondent (complainant) that only single premium was required to be paid and the policy was having single premium. T. Ajay Rao and Praveen Kumar, obtained signatures of the respondent (complainant) in the proposal form with false // 10 // representation. The respondent (complainant) belongs to a middle class family and his income is very low, therefore, it is not possible for the respondent (complainant) to purchase policy, which is having annual premium of Rs.50,000/-. It appears that misrepresentation was given by T. Ajay Rao, Agent of the appellant (O.P.) to the respondent (complainant). Only signature of the respondent (complainant) was affixed in the proposal form. It appears that after giving misrepresentation, T. Ajay Rao, Agent of the appellant (O.P.) obtained signature of the respondent (complainant) in the proposal form and the rest of the proposal form was filled up by the Agent himself. Therefore, learned District Forum, has rightly allowed the compliant of the respondent (complainant) and awarded the amount. The impugned order passed by the District Forum, is just and proper and does not call for any interference by this Commission. The appeal of the appellant (O.P.) is liable to be dismissed.
9. We have heard learned counsel appearing for both the parties and have also perused the record of the District Forum as well as impugned order.
10. Firstly, we shall consider whether the complaint is barred by limitation ?
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11. According to the appellant (O.P.), the policy was obtained by the respondent (complainant) on 11.07.2007 and first premium was paid on 10.07.2007 and next premium was due in the month of July, 2008. The second premium was payable in the month of May, 2010 and thereafter within six months the policy was required to be renewed but within period of six months i.e. till January, 2011 the complainant did not renew the policy, whereas the complaint was filed on 05.08.2014 i.e. after two years of accrual of cause of action. The above contention of the appellant (O.P.) is not acceptable.
12. The respondent (complainant) specifically pleaded that he purchased Unit Gain Life Insurance Policy from the appellant (O.P.) which is having single premium and deposited a sum of Rs.50,000/- towards model premium. On 27.11.2007, the fund settlement of the policy was Rs.56,990/-. In the month of June, 2014, the respondent (complainant) went to the appellant (O.P.) for taking Rs.50,000/- which is premium amount of the policy, then the appellant (O.P.) informed him that amount of Rs.50,000/- would not be refunded to him and only Rs.14,000/-, would be refunded. It appears that appellant (O.P.) refused to pay the premium amount to the respondent (complainant) in the month of June, 2014, therefore, the cause of action had accrued to the respondent (complainant) in the month of June, 2014, whereas the complaint has been filed on 05.08.2014, which is within limitation.
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13. The appellant (O.P.) has filed document OP-1 which is proposal form dated 10.07.2007. In the proposal form, the annual income of the insured is mentioned Rs.1,50,000/-. In the proposal form, only signature of the respondent (complainant) Rajkumar Singh was affixed in the internal page No.4 and the proposal form was filled up in English and the respondent (complainant) put his signature in Hindi.
14. Looking to the proposal form and averment made in the complaint, it appears that the respondent (complainant) purchased Unit Gain Insurance Policy from the appellant (O.P.), which is having single premium.
15. The respondent (complainant) specifically pleaded that T. Ajay Rao, who was agent of the appellant (O.P.) gave him false information and on being giving false representation, the respondent (complainant) purchased Unit Gain Life Insurance Policy from the appellant (O.P.), which is having single premium. In the proposal form, the annual income of the respondent (complainant) is mentioned Rs.1,50,000/- only, therefore, it is not possible for the respondent (complainant) to purchase a policy, having annual premium of Rs.50,000/-, hence, the averment made by the respondent (complainant), is reliable. The finding recorded by the District Forum is reasonable and does not suffer from any infirmity or illegality and does not call for any interference by this Commission.
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16. Hence, the appeal filed by the appellant (O.P.) being devoid of any merits, deserves to be and is hereby dismissed. No order as to cost of this appeal.
(Justice R.S. Sharma) (Ms. Heena Thakkar) (D.K. Poddar) (Narendra Gupta) President Member Member Member 21/06/2016 21/06/2016 21 /06/2016 21 /06/2016