Harish Kumar Chadha vs Manager M/S. Bajaj Allianz Life Insurance Co Ltd

REVISION petition no. 3271 of 2013 has been filed under section 15 of the Consumer Protection Act, 1986 against the order dated 28.05.2013 of the Delhi State Consumer Disputes Redressal Commission, Delhi ( ''the State Commission '') in First Appeal no. 76 of 2013.

THE brief facts of the case as per the petitioner/ complainant are that the petitioner/ complainant took three life insurance policies which were purchased from M/s Bajaj Allianz Life Insurance Co. Ltd., having their office at that time at Pitampura, later on shifted to Rohini. The policies were purchased in the name of his son Ankit Chadha, his wife Premlata Chadha. All the three policies were sold by Mr Rahul Manchanda, the agent of M/s Bajaj Allianz Life Insurance Company Ltd., from Pitampura. The purpose of purchasing the above said policies was for the higher education of his son, who was studying in Hindu College at that time. Petitioner was assured by the agent - Mr Rahul Manchanda, if the payment of the premium discontinues, the entire payment made by the petitioner will be refunded along with the premium after three years in any case. No Brochure or policy was issued by the agent at the time of registration.

THEREAFTER , the petitioner suffered a heavy loss in his business and could not make the payment of the second installment of the premium and the policies lapsed. The company had shifted their office from Pitampura to Rohini, without giving any intimation, neither by phone nor by mail. It was a heavy loss of Rs.60,00,000/ so it was not possible for the petitioner to make the payment of remaining installments of premium.

IT was very difficult to find out the new office of the Company from Pitampura because nobody was known to them. Finally, the petitioner got the address from some one of their Rohini office and contacted the Manager of the company Mr Sharma and the petitioner explained him the problem for the refund of the money, but he did not show any kind of sympathy and told the petitioner to come after the maturity of the policies after three years. After three years, when the petitioner again visited the office of the Bajaj Allianz Life Insurance Co. Ltd., at Rohini and met Shri Sharma, Manager of the Company and again he behaved rudely and informed me that he cannot have a refund of his money and the same has been forfeited by the Company as per rules laid down in their policy. Petitioner was not told anything of this kind of rules by Mr Rahul Manchanda, who has not contacted him after the issuance of the policies. It was a case of cheating as well as fraud by way of misdeclaration of hiding the facts.

THEREAFTER , he wrote a letter to the Grievance Redressal Officer at their head office for settlement of the dispute in Pune. The letter was written to the Grievance Redressal Officer on 14.05.2010 but nothing has been heard from him till date, as they had not responded to his letter till date and it was an indication of bad intention of the company.

WHEN he did not get any reply from the office of Grievance Redressal Officer, he also made a complaint to the office of the Life Insurance Ombudsman, Life Insurance Building, 2/2A Asaf Ali Road, New Delhi - 110002. Thereafter a format was sent by them and the same was sent after filling the same on the very same day on 09.08.2010, but he had not heard anything from them also. Thereafter, he have decided to approach the District Consumer Disputes Redressal Forum (V) (North West District), Shalimar Bagh for the refund of my valuable money as Bajaj Allianz Life Insurance Co. Ltd., wanted to grab his valuable money by way giving the reference of their untold policy. Petitioner has prayed that the respondent company may kindly be directed to pay the principal amount of all three policies - Rs.95,000/ ; Pay Rs.75,000/ as yearly premium on all the three policies to the petitioner; Pay Rs.50,000/ to the petitioner for the mental as well as physical harassment and causing severe damage to the health of the petitioner.

IN their reply on behalf of the respondents/ opposite parties it has been denied that all the three policies were sold to the petitioner by the same person, i.e., Rahul Manchanda. It was quite evident from the documents of the policy that was issued by the respondent no. 1 that only one policy no. 73116273 has been sourced by the above said person and the remaining two policies, i.e., 0032083435 and 0039891782 have been sourced by Mr Varun Gupta who is an insurance agent of the said insurance company therefore, the averment made by the petitioner is false, wrong and has concocted a misleading storyline to eye wash the Forum.

IT was vehemently denied that the agent of the respondent assured the petitioner, that if the payment of premium of the policy discontinues, the entire amount will be refunded along with the premium after three years. The petitioner purchased three policies, i.e., policy no. 0039891782 dated 21.02.2007 for Rs.5,00,000/ in the name of Mr Ankit Chadha (son) of the petitioner and the policy that was issued by the respondent no. 1 was a ''Capital Unit Gain Size One '' plan, policy no. 0073116273 dated 28.10.2007 for Rs.2,00,000/ again in the name of Mr Ankit Chadha (son) of the petitioner and the policy that was issued was a (Unit Gain Plus Gold) Policy, and the policy no. 0032083435 dated 05.12.2006 for Rs.2,50,000/ in the name of Mrs Prem Lata Chadha (wife) of the petitioner and the policy that was issued was a (New Unit Gain). It was further denied that no ''brochure '' or ''policy '' format was shown at the time of registration. It was stated that every term and condition was thoroughly explained by the agent of the opposite party to the petitioner and after accepting all those terms and conditions, the petitioner filled the proposal form and deposited the proposal deposit amount. The plea of not knowing the policy format or conditions was baseless and a concocted story, as before signing all the documents the petitioner was explained each and every term of the policy. The proposal of the petitioner was accepted as proposed and the policies were issued to him. The original policy bond containing terms and conditions of the insurance were duly received by the petitioner and this fact of having received the policy bond has not been disputed by the petitioner. The petitioner was given 15 days free look cancellation period from the date of receipt of the policy body by the petitioner to review the terms and conditions of the contract as per the Policy Holders '' Protection Regulation, 2002 and if he was dissatisfied with the said terms and conditions of the policy, he would have given written notice to opposite parties to cancel the policy within the said period of 15 days from the date of receipt of the policy bond. The petitioner, however, being fully satisfied with the proposed plan and the terms and conditions of the policy bond never approached the opposite parties to cancel the policy within 15 days free look cancellation period and did not return the policy bond seeking refund of premium permissible as per terms of the meaning there by that he was fully satisfied with the terms and conditions of the policy and terms and conditions are deemed to be admitted on the part of the petitioner and that the petitioner was fully satisfied with the policy conditions and has concocted a false story just to mislead the Forum due to some ulterior motives to raise illegal financial gains against the spirit of the contract of insurance and has filed a complaint after expiry of about 4 years from the commencement of the policy on vague and frivolous grounds. Moreover, there is no cutting on the proposal form duly signed by the petitioner in English which proves that the policy in question was issued as proposed by him. It was vehemently denied that the insurance agent named Mr Rahul Manchanda from M/s Bajaj Allianz Life Insurance Company Ltd., put any extra efforts to convince the petitioner to purchase the said policies by explaining his poor financial situation. All these averments are false, wrong and concocted. The petitioner purchased all the three policies of his own free will and by keeping in mind the future of his son and for his higher education as explained by the petitioner himself in the complaint.

ON 05.12.2006 a proposal form was filed by petitioner for life insurance policy vide proposal no. 0032083435. It is further submitted that petitioner opted for a New Unit Gain Plan for a sum assured upto Rs.2,50,000/ by signing the said proposal form. The premium of Rs.25,000/ was paid by the petitioner in lieu of the said policy on 05.12.2006 via cheque and hence policy was issued. The policy was a New Unit Gain Policy with a fixed premium amount of Rs.25,000/ . The premium was for 10 terms. The petitioner was given an option to withdraw by way of partial or complete surrender of units after three years from the date of commencement of the policy (provided premiums had been paid for all the three years).

ANOTHER policy was purchased by the petitioner on 21.02.2007. A proposal form was filled by petitioner for life insurance policy vide proposal no. 0039891782. Petitioner opted for a Capital Unit Gain Size One plan for a sum assured upto Rs.5,00,000/ by signing the said proposal form. The premium of Rs.50,000/ was paid by the petitioner in lieu of the said policy on 21.02.2007 via direct debit and hence policy was issued. The policy was a Capital Unit Gain Size One policy with a fix premium amount of Rs.50,000/ annually the premium was for 20 terms. The petitioner was given an option to withdraw by way of partial or complete surrender of units after three years from the date of commencement of the policy (provided premiums had been paid for all the three years). A third policy was again purchased by the petitioner on 28.10.2007. A proposal form was filled by the petitioner for life insurance policies vide proposal no. 0073116273. Petitioner opted for a Unit Gain Plus Gold plan for a sum assured upto Rs. 2,00,000/ by signing the said proposal form. The premium of Rs.20,000/ was paid by the petitioner in lieu of the said policy on 28.10.2007 and hence policy was issued. The policy was a Unit Gain Plus Gold policy with a fixed premium amount of Rs.20,000/ annually. The premium was for 20 terms. The petitioner was given an option to withdraw by way of partial or complete surrender of units after three years from the date of commencement of the policy (provided premiums had been paid for all the three years).

THE respondents denied that the office of the respondent no. 1 was shifted without giving any intimation as to every customer a mail was issued and was also informed telephonically about the change of office address from Pitampura to Rohini by the customer care executive from the respondent no. 1 company.

ALL the three policies that the petitioner opted for are different from each other in every aspect and the said proposal, declaration along with the statement leading to the issuance of the policies referred had been agreed to and accepted by the petitioner, as on the basis of the contract the parties had entered into an agreement after considering all the terms of the policies. Further, a free look period of 15 days was also given to the petitioner for cancellation of the policy. During this period, the petitioner was at liberty to consult with anyone or scrutinize the policy contract himself. The first policy which was purchased by the petitioner was a New Unit Gain Plan and it commenced from 05.12.2006 and sum assured in the policy was Rs.2,50,000/ with a premium amount of Rs.25,000/ and the premium term of the policy was 10. In this policy, i.e., (New Unit Gain), if any regular premium is not paid before the expiry of grace period, after three policy years, provided premiums for three full years have been paid, the policy shall be kept in force for full sum assured including additional benefits by cancellation of units at the prevailing unit price to recover all charges including charge for insurance covers. The policy will be terminated and fund value would be paid to the policy holder as and when Fund Value becomes equal to the amount of one annual premium.

SIMILARLY a second policy was purchased by the petitioner, i.e., 0039891782 on 21.02.2007 for a sum of Rs.5,00,000/ with a premium of Rs.50,000/ for the policy terms of 20.

POLICY Number - 0039891782 was issued based on the proposal form filled and signed by the policy holder where the policy holder has opted for Capital Unit Gain Size only with a regular mode and frequency selected as yearly, which was a market linked policy and the value of the policy was dependent on the unit prices. As per the policy condition the surrender value, if any, is payable only after first three policy years and non payment of premium will be processed as per the clause mentioned below. If the unpaid regular premium was due during the first three policy years and the policy holder failed to make the payment before the expiry of the aforesaid grace period: (i) The policy shall immediately lapse along with all insurance covers. (ii) The policy holder may revive the policy within a revival period of two years from the due date of first unpaid regular premium subject always to revival conditions, failing which the contract shall be terminated and 100% of the value of accumulation units in respect of regular premiums as on date of lapse, and the top up premium fund value, if any shall be paid at the end of the third policy year or at the expiry of the revival period, which is ever is later. (iii) If policy is lapsed and the death of the life assured happens, the existing fund value would be paid and the policy will terminate immediately.

THEREAFTER , another policy was purchased by the petitioner with policy no. 0073116273 on 28.10.2007. The policy holder was assured for a sum of Rs.2,00,000/ with a regular premium of Rs.20,000/ annually. The policy was (Unit Gain Plus Gold) where in case the policy holder has failed to pay the regular premium the policy shall lapse along with all the insurance cover. However, the fund will continue to participate in the market. The policy holder shall have an option to review the policy within the revival period of two years on failing to do so the policy shall be foreclosed. If regular premiums due during the first three policy years had not been paid, surrender value, if any, was payable only after the expiry of the revival period or at the end of the third policy year, whichever was later. The surrender charges applicable incase the regular premium had not been paid within the grace period in the first three policy years, would be 60% of the first years '' Annualized premium.

THE District Consumer Disputes Redressal Forum (V) (North West District), Shalimar Bagh, Delhi ( ''the District Forum '') vide their order dated 06.11.2012 has observed that "a perusal of the record shows that the policies purchased by the petitioner had lapsed due to non payment of the yearly premium. The respondent has explained that as per the terms and conditions of the policy the amount payable has already been refunded to the petitioner. The petitioner on his part has not denied that the respondent had acted in accordance with the terms and conditions of the policies purchased by the petitioner. In the case of United India Insurance Company Ltd., vs Harchand Rai Chandan Lal, the Hon ''ble Supreme Court has held that the terms and conditions of the contract entered into between the parties have to be strictly construed and no deviation can be made there from. In view of this we hold that there are no merits in the complaint. The same is accordingly dismissed ". Aggrieved by the order of the District Forum, the petitioner filed an appeal before the State Commission. The State Commission vide order dated 28.05.2013, while dismissing the appeal in limini, noted that the appellant/ complainant has no case at all, "the duty of the courts towards an agreement is to ensure that the parties to an agreement abide by the terms and condition of the contact between them. A perusal of the terms and conditions of each policy unravels that the OP strictly adhered to, and acted in accordance with the terms and conditions of the policies as held by the trial Forum above. The OP cannot therefore be faulted on this court. The two earlier policies lapsed due to non payment of the yearly premiums and there remained nothing to be paid towards these two policies and whatever was due for the third policy, was paid through a cheque by the OP to the petitioner ". Hence, the present revision petition. We have heard the petitioner in person and have gone through the records of the case carefully. In the revision petition no cogent grounds have been given to show that the State Commission has exercised a jurisdiction not vested in it by law or has failed to exercise a jurisdiction so vested or has acted in the exercise of its jurisdiction illegally or with material irregularity. Further, his prayer in the revision petition is the same as his prayer in the complaint except that he has prayed for a further amount of Rs.5,00,000/ due to loss of income of his son because he could not enter any higher education due to lack of funds. He has not prayed for setting aside the order of the State Commission.

HE has admitted that he had taken three policies and due to problems in his business he could not pay the second premium for all the three policies. He, however, stated that he had been advised by the agent that if the payment of premium discontinued, the entire payment made by him will be refunded along with the premium after three years in any case. He could not support this statement with any evidence. It is also an admitted fact that the policies with the terms and conditions were received by him. He had been given a 15 days free look cancellation period from the date of receipt of policy bond to review the terms and conditions of the contract and return the same if he was dissatisfied. He has admitted that he failed to pay the second installment of the premium of the three policies due to heavy loss of his business. He was also aware of the terms and conditions of the policy which had been issued to him. He was also issued with the premium reminders, as per the reminders placed on record at pages 49 & 50.

IN view of the above, we find that there is no jurisdictional error, illegality or infirmity in the order passed by the State Commission as also the District Forum warranting our interference. The revision petition is accordingly dismissed with cost of Rs.5,000/ (Rupees five thousand only). Petitioner is directed to deposit the cost of Rs.5,000/ by way of demand draft in the name of ''Consumer Legal Aid Account '' of this Commission, within four weeks. In case the petitioner fails to deposit the said amount within the prescribed period, then it shall be liable to pay interest @ 9% per annum till its realization. List on 22nd November 2013 for compliance. CDJLawJournal