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2016 DIGILAW 493 (CHH)

Arvind Shamji Shah v. Tata A. I. G. Life Insurance Company Limited

2016-11-17

D.K.PODDAR, HEENA THAKKAR, NARENDRA GUPTA, R.S.SHARMA

body2016
ORDER : R.S. Sharma, President The complainant filed this consumer complaint under Section 17 of the Consumer Protection Act, 1986 against the OPs seeking following reliefs :- (1) To direct the OPs to pay the premium amount Rs.25,00,000/- (Rupees Twenty Five Lakhs) to the complainant along with interest @ 12% p.a. (2) To direct the OPs to pay a sum of Rs.10,00,000/- (Rupees Ten Lakhs) to the complainant towards compensation for mental agony. (3) To direct the OPs to pay cost of litigation and other reliefs as this Commission deems fit, to the complainant. 2. Briefly stated the facts of the complaint of the complainant are that the complainant obtained Tata A.I.G. Life Invest Insurance Unit Linked Apex Planned Policy from the OPs through their agent Rahul Gupta having Agent Code No.001568490 and at the time of obtaining insurance policy, the complainant provided all the information regarding him to the OPs. The policy No. was U0157944-II dated 18.03.2009. The above insurance policy was issued on 26.03.2009 and the maturity period is of 10 years i.e. 18.03.2019. As per terms and conditions of the insurance policy, the complainant was required to pay the premium amount till 03 years and on the date of maturity the OPs have to pay a sum of Rs.1,00,00,000/-. As per terms and conditions of the insurance policy, the complainant paid a sum of Rs.10,00,000/- on 27.03.2009, Rs.7,50,000/- on 19.03.2010 and Rs.7,50,000/- on 19.03.2011. Thus he paid total premium amount of Rs.25,00,000/- to the OPs. On 11.06.2014, without any reasonable cause and without obtaining consent of the complainant, the OPs sent cheque of Rs.2,242.21 along with payment letter to the complainant on the ground that the policy was surrendered. The OPs forfeited the amount of premium deposited by the complainant and also did not inform any ground for cancellation of the policy. The OPs without any justified reason cancelled the policy of the complainant and forfeited the premium amount. The OPs did not inform any reason for cancellation of the insurance policy and thus committed unfair trade practise and deficiency in service. Due to act of the OPs the complainant suffered mental agony. On being receipt of letter dated 11.06.2014 sent by the OPs to the complainant, the complainant contacted the O.P.No.2 and asked the reason for cancellation of the policy and forfeiture of the premium amount, but the O.P.No2 did not give any information to him. Due to act of the OPs the complainant suffered mental agony. On being receipt of letter dated 11.06.2014 sent by the OPs to the complainant, the complainant contacted the O.P.No.2 and asked the reason for cancellation of the policy and forfeiture of the premium amount, but the O.P.No2 did not give any information to him. The complainant sent notice to the OPs through his counsel on 22.04.2016 through registered post and demanded compensation, but in spite of receipt of the notice, neither they have given reply of the notice not made payment of premium amount and compensation for mental agony. Hence, the complainant has filed the instant complaint. 3. In the instant case, the OPs have not filed their written statement within prescribed period, hence this Commission closed the right of the OPs to file written statement vide order dated 21.09.2015. On the basis of judgments of Hon'ble Supreme Court in New India Assurance Company Ltd. v. Hilli Multipurpose Cold Storage Pvt. Ltd. 2016 (1) CLT 476, Hon'ble National Commission in Green View Apartment Welfare Society v. M/s. GAV Developers Pvt. Ltd. 2016 (3) CLT 18 and Vibgyor Infraprojects Pvt. Ltd. v. Millenium Towers Harmony CHS Limited, III (2016) CPJ 228 (NC), the written statement filed by OPs after lapse of prescribed period, cannot be taken on record. This Commission vide order dated 11.11.2016 held that the right of the OPs to file written statement had been closed and if the written statement filed by the OPs is taken on record, then it will be treated that this Commission has reviewed its earlier order, whereas this Commission has no jurisdiction to review its earlier order. It has also been observed that the OPs have filed written statement along with written arguments, but they have not filed any application for condonation of delay, therefore, due to above reason also the written statement filed by the OPs cannot be taken on record. 4. The complainant has filed documents. It has also been observed that the OPs have filed written statement along with written arguments, but they have not filed any application for condonation of delay, therefore, due to above reason also the written statement filed by the OPs cannot be taken on record. 4. The complainant has filed documents. Annexure A is application form, Annexure B is Statement to the Medical Examiner, Annexure C is Policy Information Page, Annexure D is First Life Insurance Premium Receipt dated 27.03.2009, Annexure E is Renewal Life Insurance Premium dated 23.03.2010, Annexure F is Renewal Life Insurance Premium Receipt dated 19.03.2011, Annexure G is letter regarding cancellation of the policy and cheque dated 11.06.2014, Annexure H is terms and conditions of the policy, Annexure I is notice dated 22.04.2016 sent by Shri Yashvant Shrivastava, Advocate to the OPs, Annexure J is postal receipts, Annexure K is Detailed Track Events for EC045459159IN and demand draft. 5. The OPs have filed documents. Annexure D/1 is Application Form, Annexure D/2 is documents containing talk held between the complainant and the employee of the Insurance Company, Annexure D/3 is Sales Illustration of the Policy, Annexure D/4 is terms and conditions of the insurance policy, Annexure D/5 is letter dated 09.09.2014 sent by the OPs to the complainant, Annexure D/6 is letter sent to the complainant by the OPs through email. 6. Shri Yashwant Shrivastava, learned counsel appearing for the complainant has argued that the complainant has obtained A.I.G. Life Invest Insurance Unit Linked Planned Policy from the OPs through their agent Rahul Gupta. The above insurance policy was issued on 26.03.2009 and the maturity period is 10 years i.e. 18.03.2019. As per the terms and conditions of the insurance policy, the complainant was required to pay the premium amount ill 3 years and on the date of maturity, the OPs have to pay a sum of Rs.1,00,00,000/- to the complainant. As per the terms and conditions of the insurance policy, the complainant paid a sum of Rs.10,00,000/- on 27.03.2009, Rs.7,50,000/- on 19.03.2010 and Rs.7,50,000/- on 19.03.2011. The complainant paid total premium amount of Rs.25,00,000/- to the OPs. It appears that the complainant had already deposited premium for three years, which is requirement for the complainant and fulfilled terms and conditions on his part. The complainant paid total premium amount of Rs.25,00,000/- to the OPs. It appears that the complainant had already deposited premium for three years, which is requirement for the complainant and fulfilled terms and conditions on his part. On 11.06.2014, without any reasonable cause and without obtaining consent of the complainant, the OPs sent cheque of Rs.2,244.21 along with payment letter to the complainant on the ground that the policy was surrendered, whereas the complainant has not surrendered the policy and no letter was sent by him to the OPs regarding surrender of the policy. The OPs have wrongly forfeited the premium amount which was deposited by the complainant with OPs. The OPs did not inform any ground for cancellation of the insurance policy, therefore, the OPs committed unfair trade practise and deficiency in service. The complainant is entitled to get reliefs, as prayed by him in the complaint. 7. Shri Sunil Patel, learned counsel appearing for the OPs has argued that the complainant obtained insurance policy from the OPs for commercial purpose, therefore, the complainant is not a consumer under Section 2(1)(d) of the Consumer Protection Act, 1986. The complainant purchased Unit Linked Plan for the investment purpose, therefore, the complainant is not a consumer. The amount deposited by the complainant is investment in stock market which comes within commercial purpose. The terms and conditions of the insurance policy were provided by the OPs to the complainant and the complainant was aware of the terms and conditions of the insurance policy. The complainant has only deposited Rs.25,00,000/- towards premium with the OPs. The plan was market based plan and is depending upon fluctuation (speculations) in the market. The complainant surrendered the policy. On the basis of terms and conditions of the insurance policy, the cheque for appropriate amount was sent to the complainant. The complainant suppressed material facts and filed the instant complaint on malicious ground. The complainant is not entitled to get any reliefs against the OPs. The complaint is liable to be dismissed. He placed reliance on Revision Petition No.658 of 2012 - Ram Lal Aggarwalla v. Bajaj Allianz Life Insurance Company Limited & Others, decided by Hon'ble National Commission vide order dated 23.04.2013, Satish Chander Gupta and Sons v. Klick Nixon Limited & Another, 2010 STPL (CL) 1585 (NC) and Western India State Motors v. Sobhag Mal Meena & Ors. 1989 STPL (CL) 71 (NC). 8. 1989 STPL (CL) 71 (NC). 8. We have heard learned counsels appearing for both the parties and have also perused the documents filed by the OPs in the complaint case. 9. The complainant has filed Annexure A, which is Application Form. In the application form, the policy term is mentioned as 10 years and the amount of insurance is mentioned as Rs.1,00,00,000/-. The complainant has also filed documents Annexure C to E, which are Policy Information Page Policy Data, First Life Insurance Premium Receipt and Renewal Life Insurance Premium Receipt respectively. In Policy Information Page Policy Data it is specifically mentioned that the sum assured is Rs.1,00,00,000/-, the issue date is mentioned 26.03.2009, maturity date/expiry date is mentioned 18.03.2019 and against the column, no. of years premium, 3 years is mentioned. The OPs have also filed document Ex. D/1 which is Application Form. Though, the OPs have filed document Ex.D/2 which is transcript of conversation between the complainant and the employee of OPs. The same is not admissible without examination of the person, who transcript the conversation. Even in same document, it is mentioned that the premium was prescribed for minimum three years. It appears that the complainant was only liable to pay the premium only for three years. On the basis of Policy Information Page Policy Data, First Life Insurance Premium Receipt and Renewal Life Insurance Premium Receipt, it is evident that the complainant deposited Rs.25,00,000/- with the OPs towards premium. 10. According to the OPs, the above transaction is commercial transaction and the plan is investment plan. The above contention is not acceptable. The judgments cited by the OPs are not helpful to the OPs. 11. The complainant filed a document titling Basic Definitions. In the above documents under the head Benefit Provisions - Tata AIG Life Investassure Apex, it is mentioned thus :- (1) Maturity Benefit - If the Insured is then alive on the Maturity Date, We will pay to You the higher of : (i) the Fund Value of this Policy at the applicable Unit Price as specified in the section "Cut-off time for determining the appropriate valuation date" under Fund Provisions. Or (ii) the Guaranteed Maturity Unit Price multiplied by the number of Units of the Apex Lock-in Fund as on the Maturity Date. Or (ii) the Guaranteed Maturity Unit Price multiplied by the number of Units of the Apex Lock-in Fund as on the Maturity Date. Under the head "Termination" it is mentioned thus :- All coverage under this Policy shall automatically terminate on the occurrence of the earliest of the following :- (1) If the Basic Policy matures, lapses or is Surrendered; or (2) Death of the Insured, or (3) In case of discontinuance of Regular Premiums, when the Policy, in Investment-Only status, is terminated or surrendered according to the Grace Period clause of the Premium Provisions. Except specified otherwise in the Policy, any Fund Value remaining after termination will be refunded subject to Surrender Charge and Our minimum refund rules." 12. In the instant case, the complainant deposited regular premium and according to the terms and conditions of the policy, the sum assured is Rs.1,00,00,000/-. The OPs did not file any letter to prove that the complainant surrendered the policy. 13. The complainant filed letter dated 11.06.2014 - Annexure G in which simply it is mentioned thus :- "Dear Sir/Madam, We enclose herewith our Cheque towards the settlement of your payment as per the following details :- Cheque Number : 522122 Cheque Date : 11/06/2014 Cheque Amount : *******2,242.21 Favouring : Arvind Shamji Shah. Reference No. : Payment Details : U015794411 Surrender Payout of Linked POL POS 12 Customer Reference : 2000118607 FT140611442179" 14. The OPs did not file any letter to prove that the complainant sent letter to the OPs to surrender the policy. For want of document, it cannot be held that the complainant had surrendered the policy, therefore, the OPs cannot not forfeit the premium amount. By forfeiting the premium amount Rs.25,00,000/-, the OPs committed deficiency in service. The complainant is entitled for refund of the premium amount deposited by him with the OPs i.e. Rs.25,00,000/-. 15. In the instant case, the OPs have wrongly forfeited the premium amount deposited by the complainant and the only sent cheque of Rs.2,242.21 to the complainant. The above act of the OPs comes in the category of deficiency in service. The complainant suffered pain due to above act of the OPs, but the complainant demanded a sum of Rs.10,00,0000/- towards compensation for mental agony, which is very excessive. The above act of the OPs comes in the category of deficiency in service. The complainant suffered pain due to above act of the OPs, but the complainant demanded a sum of Rs.10,00,0000/- towards compensation for mental agony, which is very excessive. Looking to the facts and circumstances of the case, it is just and proper to award a sum of Rs.50,000/- (Rupees Fifty Thousand) to the complainant towards compensation for mental agony. 16. The complainant also demanded interest @ 12% p.a. on Rs.25.00,000/-, which is on higher side. The complainant is entitled for getting 9% p.a. simple interest on Rs.25,00,000/- from the date of filing of the complaint i.e. 04.07.2016 till realisation. The complainant is also entitled to get Rs.10,000/- (Rupees Ten Thousand) towards cost of litigation. 17. Therefore, we allow the complaint of the complainant and direct that :- (i) The OPs will pay a sum of Rs.25,00,000/- (Rupees Twenty Five Lakhs), which is premium amount deposited by the complainant with the OPs, within a period of one month from the date of order. (ii) The OPs will also pay simple interest @ 9% p.a. on the amount of Rs.25,00,000/- from the date of filing of the complaint i.e. 04.07.2016 till realisation. (iii) The OPs will also pay a sum of Rs.50,000/- (Rupees Fifty Thousand) to the complainant towards compensation for mental agony. (iv) The OPs will also pay a sum of Rs.10,000/- (Rupees Ten Thousand) to the complainant towards cost of litigation.