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Hdfc Standard Life Insurance Co. Ltd. And Others Petitioner(S) v. Debashish Sanyal And Another (S).
Summary of Opinion: NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION — Revision Petition No. 740 of 2018
Factual and Procedural Background
The complainant (Respondent No.1 before this Commission) purchased a Unit Linked Insurance Policy from HDFC Standard Life Insurance Co. Ltd. (petitioner) through Union Bank of India (Respondent No.2). The policy was for a 12-year term with an annual premium of Rs.10,00,000 and a minimum fund value of Rs.10,00,000 as per the policy schedule. The policy required the first premium with the application and subsequent premiums on scheduled dates; non-payment 15 days after due date could cause lapse or paid-up status.
The complainant paid the first premium (Rs.10,00,000). By letter dated 18.7.2009 he requested reduction of the premium to Rs.2,50,000; the insurer approved that request by letter dated 29.11.2009 effective 30.1.2009, warning that falling below the minimum fund value could lead to cancellation. The complainant paid two premiums of Rs.2,50,000 each but did not pay the renewal premium due on 30.1.2011.
The insurer informed the complainant by letters dated 7.2.2011 and 21.3.2011 that the policy was in paid-up status and advised payment of renewal premium. The complainant, however, asserted in a letter dated 17.8.2011 that he had learned by message on 16.8.2011 that the policy had been cancelled and claimed that Union Bank had told him he could pay Rs.10,000 annually after the first year; he sought refund of Rs.15,00,000 paid to the insurer.
The insurer replied on 25.8.2011 that the policy had become paid-up for non-receipt of the renewal premium and had subsequently been cancelled when the fund value fell below the Rs.10 lakh minimum; a cheque dated 12.8.2011 for Rs.997,246.81 representing the fund value on cancellation was sent to the complainant. The complainant encashed that cheque and filed a consumer complaint seeking refund of the amounts paid with interest or, alternatively, revival of the policy.
The District Forum dismissed the complaint. The complainant appealed to the State Commission. Vide the impugned order dated 11.2.2017, the State Commission allowed the appeal and directed that the appellant (complainant) receive residual amount of Rs.5,02,753.19 from the respondents with 9% simple interest from the date of filing the complaint, along with costs of Rs.10,000.
Aggrieved by the State Commission's order, the insurer filed this revision petition before the National Consumer Disputes Redressal Commission (NCDRC). Oral arguments were heard and a brief written submission by the complainant/respondent No.1 was considered by the NCDRC.
Legal Issues Presented
- Whether the insurer was justified in treating the policy as paid-up and subsequently cancelling it when the unit fund value fell below the minimum fund value specified in the policy schedule.
- Whether the complainant was entitled to refund of the amounts paid (or the residual amount ordered by the State Commission) or alternatively to revival of the policy with benefits, despite non-payment of the renewal premium due on 30.1.2011.
- Whether the complainant's encashment of the cheque representing the fund value on cancellation estopped him from disputing the cancellation and from claiming the relief granted by the State Commission.
Arguments of the Parties
Complainant's (Respondent No.1) Arguments
- The complainant asserted that Union Bank of India (through which the policy was purchased and which was acting as agent) informed him that after the first year he could pay a minimum premium of Rs.10,000 per annum.
- He contended that he was entitled to refund of amounts paid (Rs.15,00,000 as pleaded) or, in the alternative, revival of the policy with all benefits.
- In his communications after cancellation (letter dated 17.8.2011) he sought refund rather than offering to pay the minimum premium or seeking to reinstate the policy by paying the outstanding premium.
Petitioner / Insurer's Arguments
- The insurer contended that the policy document (duly received by the complainant) governed the rights and obligations and contained express provisions relating to paid-up status, surrender, revivals and cancellation when fund value fell below the stipulated minimum.
- The insurer maintained that non-payment of the premium due on 30.1.2011 (and not paying even the claimed minimum Rs.10,000 within 15 days of due date) entitled it to treat the policy as paid-up and later cancel it when the unit fund value fell below the minimum fund value.
- The insurer disputed any contention that the bank (agent) had authority to unilaterally fix the minimum premium; reduction in premium required insurer's approval (which occurred earlier by letter dated 29.11.2009 when the complainant's request for reduction was accepted).
- The insurer also relied on the fact that a cheque representing the fund value at cancellation was sent to and accepted/encashed by the complainant, which, it argued, estopped him from disputing cancellation.
Table of Precedents Cited
No precedents were cited in the provided opinion.
Court's Reasoning and Analysis
The court's analysis proceeded by applying the express terms of the policy, as the complainant had received the policy document and had not returned it during the free-look period (14 days). The consequence was that the complainant was held to have accepted the policy's terms and conditions.
The policy expressly provided that after the first three years if any premium remained unpaid the policy would become paid-up, with unitized funds continuing to be invested and charges being deducted. The policy further provided that where a paid-up policy's unit value fell below the minimum fund value specified in the schedule, the policy would be cancelled and the unitized fund value after deduction of surrender charges would be payable.
Facts the court relied on:
- The renewal premium due on 30.1.2011 was not paid by the complainant within the required 15-day period or at any later point.
- Accordingly, the policy became a paid-up policy and was subsequently cancelled when the unit fund value fell below the stipulated minimum of Rs.10 lakhs (the insurer cancelled the policy on 8.8.2011 and issued a cheque dated 12.8.2011 for Rs.997,246.81 representing the fund value at cancellation).
- The complainant's case that the bank had told him he could pay a minimum of Rs.10,000 yearly did not alter the fact that he did not actually pay even that amount on or before the due date or within the 15-day grace period; the court emphasized that if the complainant believed Rs.10,000 to be the minimum he should have paid at least that amount.
- The complainant never informed the insurer prior to cancellation about the alleged bank representation nor offered to pay the Rs.10,000 renewal for 2011 before cancellation; in his post-cancellation correspondence he sought a refund rather than revival.
The court concluded that given these admitted facts and the contract terms, the insurer was justified in (i) treating the policy as paid-up for non-payment of the premium due within the stipulated time, and (ii) cancelling the policy when the fund value fell below the minimum fund value stated in the policy schedule.
In addition, the court relied on estoppel: having accepted and encashed the cheque representing the fund value on the date of cancellation, the complainant was estopped from disputing the cancellation of the policy. The court treated that acceptance as a further independent ground for dismissing the complaint.
Holding and Implications
DECISION: The order passed by the State Commission was set aside and the consumer complaint was dismissed.
Implications:
- The direct effect is that the complainant's consumer complaint is dismissed and the relief ordered by the State Commission (refund of residual amount with interest and costs) is vacated.
- The NCDRC recorded "no order as to costs" in respect of this dismissal.
- The opinion does not state or announce any broader legal principle or precedent beyond applying the contractual terms of the policy and ordinary principles of estoppel to the admitted facts; accordingly, no new precedent or wider legal consequence is set out in the provided opinion.
Opinion authored by: HON'BLE MR. JUSTICE V.K. JAIN, Presiding Member. Dated: 09 Jan 2020.
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
REVISION PETITION NO. 740 OF 2018
(Against the Order dated 11/12/2017 in Appeal No. 854/2016 of the State Commission West Bengal)
1. HDFC STANDARD LIFE INSURANCE CO. LTD. & 2
ORS.
EREKA TOWERS 5TH FLOOR, MIND SPACE COMPLEX,
LINK ROAD, MALAD (W)
MUMBAI-400064
Maharashta.
2. HDFC STANDARD LIFE INSURANCE CO. LTD.
BRANCH OFFICE GROUND FLOOR, MENAKA ESTATE
3, RED CROSS PLACE, RED ROAD,
KOLKATA-700001
WEST BENGAL
3. BRANCH MANAGER, HDFC STANDARD LIFE
INSURANCE CO. LTD.
1ST FLOOR, 26A, HINDUSTAN PARK GARIAHAT
SHOPPING COMPLEX,
KOLKATA-700029 WEST BENGAL ...........Petitioner(s) Versus
1. DEBASHISH SANYAL & ANR. MAYFAIR ETERNITY F-102, BLOCK B, 256, NETAJI
SUBBHASH CHANDRA BOSE ROAD, ALTAS MORE,
KOLKATA-7000145
WEST BENGAL
2. MR. RANJAN KUMAR
BRANCH MANAGER, UNION BANK OF INDIA,
MACHUATOLI BRANCH MACHUATOLI ARYA KUMAR
ROAD,
PATNA-800004 BIHAR ...........Respondent(s)
BEFORE:
HON'BLE MR. JUSTICE V.K. JAIN,PRESIDING MEMBER For the Petitioner : Ms. Suman Bagga, Advocate For the Respondent : In person
Dated : 09 Jan 2020
ORDER
JUSTICE V.K. JAIN, PRESIDING MEMBER
Oral arguments were heard on 7.1.2020. Thereafter, the complainant submitted brief written
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arguments, which have been considered. The complainant / respondent No.1 obtained a Unit Linked Insurance Policy from the petitioner company through respondent No.2 Union Bank of India. The policy document issued by the petitioner company was duly received by him. The policy was issued for a term of 12 years and the annual premium stipulated in the policy was Rs.10 lakhs. Minimum fund value, as per the Schedule of Benefits incorporated in the policy document, was Rs.10 lakhs. The Premium clause contained in the policy required the first premium to be paid alongwith the application and subsequent premium to be paid, in full, on the dates and at the frequency set out in the policy schedule. It was stipulated that if the premium remained unpaid 15 days after due date, the policy would become lapse or become paid-up. The policy holder could increase of decrease his regular premium amount, subject to discretion of the insurer, subject to deduction of the Premium Reduction Charges from the Unitized Fund Value. It was also stipulated in the policy document that the policy might be surrendered at any time after the completion of three years and the amount payable on surrender would be Unitized Fund Value, arrived at after deduction of surrender charges, and upon payment of such benefit, the policy would terminate. It was also stipulated that if any premium remained unpaid during the first three years of the policy, the policy would lapse but the lapsed policy could be revived any time during the period of two years from the date of lapse of the policy or till the end of three years from inception, whichever was earlier. It was further stipulated that if the policy was not revived, the Unitized Fund Value at the date of lapse, less surrender charges, would be paid to the policy holder at the end of two years from the date of lapse or at the end of three years from the inception whichever was later.
2. The policy document also stipulated that if any premium remains unpaid after the first three years of the policy, the policy would be made paid-up, the unitized funds will continue to be invested, all charges will continue to be deducted and the policy holder will be entitled to all policy servicing. Clause 5(iii)(d) of the policy document provided that if the value of units in a paid up policy fell below the minimum fund value as specified in the policy schedule, the policy would be cancelled and the amount payable on cancellation would the Unitized Fund Value, arrived at after deduction of the surrender charges.
3. The complainant paid first premium of Rs.10 lakhs to the petitioner. Thereafter, he submitted a letter dated 18.7.2009 to the petitioner seeking reduction of the premium from Rs.10 lakhs to Rs.2,50,000/-. The request was granted by the petitioner vide its letter dated 29.11.2009, w.e.f. 30.1.2009. It was reiterated in the said letter dated 29.11.2009 that if fund value of the policy falls below the minimum criteria, it could lead to policy cancellation. The criteria for determining the fund value was also reproduced in the said letter. The complainant paid two premiums of Rs.2,50,000/- each to the petitioner company but did not pay any premium in the year 2011 though the said premium had become due on 30.1.2011. The complainant was informed by the petitioner vide its letters dated 7.2.2011 and 21.3.2011 that the policy was in paid-up status and he was advised to pay the renewal premium. The complainant instead of paying any premium for the year 2011, wrote a letter dated 17.8.2011 to the petitioner company stating therein that he had come to know on 16.8.2011 through a message on his phone that the policy had been cancelled. It was further stated in the said letter, that the policy was taken by him from Union Bank of India which had informed him that he could pay Rs.10 lakhs in the first year and thereafter he could pay Rs.10,000/-. He sought refund of the amount of Rs.15 lakhs which he had paid to the petitioner. He was informed by
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the petitioner company vide its letter dated 25.8.2011 that the policy had attained a paid-up status due to non-receipt of the renewal premium which was due on 30.1.2011. He was further informed that the policy had been cancelled since the fund value had fallen to less than Rs.10 lakhs which was the minimum fund value stipulated in the policy document. It was also informed to him that a cheque dated 12.8.2011 for an amount of Rs.997246.81, which represented the fund value on the date of cancellation of the policy had been sent to him but he did have option to reinstate the policy by paying the outstanding premium alongwith fund value cheque refunded to him. Instead of making any payment to the petitioner, the complainant encashed the cheque of Rs.997246.81 sent to him by the petitioner and thereafter filed a consumer complaint before the concerned District Forum impleading the petitioner company as well as Union Bank of India as the opposite parties in the complaint, seeking refund of the amount which he had paid to the petitioner company alongwith interest @ 12% p.a. or in the alternative revival of the policy with all benefits accruing therefrom.
4. The complaint was resisted by the petitioner company which justified the cancellation of the policy on account of non-payment of the premium due on 30.1.2011.
5. The District Forum having dismissed the consumer complaint filed by him, the complainant approached the concerned State Commission by way of an appeal. Vide impugned order dated 11.2.2017, the State Commission directed as under:-
"The appeal is allowed on contest against the respondents with cost of Rs.10,000/-. The appellant is also entitled to get back, within 45 days from the date of this order, the residual amount of Rs.5,02,753.19 from the respondent Nos.1 to 3 together with simple interest @ 9% p.a. with effect from the date of filing of the complaint before the Ld. District Forum till full and final payment is made. The impugned order is hereby set aside."
6. Being aggrieved from the order passed by the State Commission, the petitioner is before this Commission by way of this revision petition.
7. It is an admitted position that the policy document was duly received by the complainant. Therefore, all the terms and conditions of the policy came to be known to him as soon as the policy document was received. The insurance policy has a free look period of 14 days in which the policy can be returned by the insured if its terms and conditions are not acceptable to him. Admittedly, the policy was never returned by the complainant to the petitioner. The terms and conditions of the policy were thereby accepted by him.
8. As per the terms of the insurance policy noted hereinabove, the policy was to become a paid-up policy if any premium remained unpaid after the first three years of the policy. In that case, the unutilized funds would continue to be invested and the policy holder would be entitled to the benefits available in respect of a paid-up policy. Admittedly, the insurance premium payable on 30.1.2011 was not paid by the complainant at any point of time though it was required to be paid within 15 days of the due date. As a result, the policy taken by him
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became paid-up policy. The case of the complainant is that Union Bank through which the policy was taken by him had told him vide letter dated 4.12.2008, that he could pay a minimum premium of Rs.10,000/- per year. The said letter was given to the complainant by the Branch Manager of Union Bank of India which was acting as an agent of the petitioner company while selling the policy to the complainant. Though the case of the petitioner is that the Bank was not authorized to decide the minimum premium which could be paid by the policy holder and the reduction in the policy premium required approval of the insurer, the fact remains that the complainant did not pay even the minimum premium amounting to Rs.10,000/- on 30.1.2011 or within 15 days thereafter. If the petitioner believed that he was required to pay at least Rs.10,000/- as annual premium, at least that much amount ought to have been paid by him within 15 days of the due date, in order to keep the policy alive. Even that having not been done, the petitioner company, in my opinion, was fully justified in treating the policy as a paid- up policy and later on cancelling the same when the fund value of the policy came below Rs.10 lakhs on account of erosion in the NAV of the units. At no point of time before cancellation of the policy, the complainant informed the petitioner company that the Bank had represented to him that he could keep the policy alive by paying a minimum annual premium of Rs.10,000/-. What is crucial for the purpose of deciding this petition is that even the premium of Rs.10,000/- which according to the complainant was the minimum premium required to be paid by him to keep the policy alive was not paid by him on or before the due date or even thereafter. As noted earlier, the policy was cancelled by the petitioner company on 8.8.2011. Even till that date, no attempt was made by the complainant to pay the premium amounting to Rs.10,000/- to the petitioner company.
9. The first communication after cancellation of the policy was sent by him to the petitioner company on 17.8.2011. Even in the said letter dated 17.8.2011, he did not offer to pay the premium amount of Rs.10,000/- for the year 2011. The petitioner only wanted refund of the entire amount which he had paid to the petitioner company alongwith bank interest on that amount. He never sought revival of the policy or recall of the cancellation on payment of the premium amounting to Rs.10,000/-. It is, therefore, evident that the complainant was not willing even to pay the amount of Rs.10,000/- which according to him was the minimum premium payable by him in order to keep the policy alive. Therefore, the petitioner company, in my opinion, was fully justified in treating the policy as a paid-up policy and then in cancelling the same when the fund value fell below Rs.10 lakhs. The complaint, therefore, merited dismissal.
10. Admittedly, the complainant received payment of Rs.997246.81 representing the fund value as on the date of cancellation of the policy. Having accepted that amount, he is estopped from disputing the cancellation of the policy on account of his failure to pay the requisite premium and the fund value having gone below the required value of Rs.10 lakhs. This is yet another ground justifying dismissal of the complaint.
11. For the reasons stated hereinabove, the order passed by the State Commission cannot be sustained and the same is hereby set aside. The consumer complaint is consequently dismissed, with no order as to costs.
......................J
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V.K. JAIN
PRESIDING MEMBER
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