Zain 09 May 2016

Office forcing to buy insurance

Hi LCI,

I've previously posted here with queries and I'm very keen to have another problem resolved by this awesome community;

I work in an IT startup. 1.5 months back we were informed that the company is trying to get insurance for parents at a discounted rate and they wanted to know who all are interested. I gave my name. On 14th March, i got a mail with the following content (bold/underline mine) :

In continuation to the our earlier email regarding the coverage of parents in our group medical insurance plan, we now have the final premium amount from the insurance company. Please find the same below
Cost per Life – Rs XXX
Sum Insured – Part of Employee Floater Policy
The above cost will be completely borne by the employee.
Please provide your final consent for considering the nomination as shared earlier by you. Let us know and reconfirm to add your parents latest by Tuesday, 15-March-2016. In case you do not provide your re-confirmation to include your parents in reply to this email, we will consider them as to be included in the plan.

I did not get time to review this mail properly for a few days and so i replied two days later on 17th March with the following:

Hello Ms HR,
Can you provide the insurance documents so that i may go through them ?

To that the HR replied that "As of now i do not have any documents,plz discuss in person to clarify your doubts"
I told her that i want to know what is covered in the insurance and other details like amount and clauses etc

So she shared an excel file as attachment with details of what is the sum insured for different designations in the company. The body of that email was:

Benefits provided under this plan cannot be accumulated or carried forward to succeeding year and shall automatically lapse at the end of the plan period. The benefits under this plan will cease for an employee, his/her immediate dependent(s) and parent upon cessation of his or her employment with the company. For this purpose, the date of relieving will be deemed to be the cutoff date.
No mid-term inclusions are allowed for an existing employee.
The premium paid by employee for covering parent will be recovered from employees in a period of 3 month (April, May & June payroll).

But still, there was no official policy document. I got that finally on 7th April. But the mail stated that the insurance is in effect from the previous month itself (18th March to be exact).
In this entire month i never gave my express consent or confirmation to be a part of the insurance scheme. In fact, my replies to her were clearly asking for more information, rather than giving my approval.

As this is my first job, i couldnt understand the document very clearly and it took me some time to get to it. I also had to confirm with parents if their existing insurance is better or worse. I had to do some research before i would give my confirmation.

But on 28th April, i got my salary and noticed that a big amount has been deducted as first instalment of Insurance premium. On 29th April, i mailed her saying that i would like to opt out and be given a refund (or pro rata refund). She replied by saying that this is not possible.
I don't understand why it is not possible.
Am i bound to continue even though i did not give confirmation ?
The policy document says that employees who leave the company will be given a pro rata refund. So... why is not possible for me to opt out ?

Any help is greatly appreciated !
I'm totally confused and lost.

Reply Follow

9 Replies

adv.bharat @ PUNE (Lawyer) 09 May 2016

1) A company can not force you to buy particular policy without ur consent.

2) U first read terms of ur appointment i.e. TOR for ur appointment. Whether they have specified that u must purchase the policy as per company explain to u. If u have agreed to the same then u have no solution.

3) iF NO SUCH CONDITION THEN U CAN GET THAT AMOUNT BACK FROM COMPANY..

Thanks

Kumar Doab (FIN) 09 May 2016

The bone of contention is:

In case you do not provide your re-confirmation to include your parents in reply to this email, we will consider them as to be included in the plan.

Your only defence is:

" "As of now i do not have any documents,plz discuss in person to clarify your doubts".

Apply your skills to resolve while in employment.

In future try to send clear messages on acceptance/declinature and in time.

Zain 09 May 2016

@ Bharat,

Thanks for you reply. I have checked the terms of appointment, and there is no such clause.
They are refusing to refund because they automatically enrolled me when idid not reply back in 24 hours.

Is it legal to say to a person that we will enroll you if you dont reply in 24 hours ?

Zain 09 May 2016

@Kumar Doab,

You are right, that is point of contention.

I think they are going to tell me that they have already paid the full amount of this year to the insurance company on my behalf and now they are simply taking it in instalment from my salary.

Is that a valid excuse ? Is it the case that if company has paid full amount of insurance for the next one year then it cannot be refunded ?

Additionally, if the insurance company will not refund the amount of my employer, then i think that should be company's liability. They should have checked all these things while entering into an agreement with this insurance company. Even if the insurer is not refunding my company, i should still be refunded by my employer.

What are your thoughts ?

Kumar Doab (FIN) 09 May 2016

Apply your skills to resolve while in employment.

Build a favorable written record.

Zain 09 May 2016

Yes, you;re right. I'll have to use subtle skills in resolving this. But if you can help me understand the legal nature of such a situation, I'll be better equipped.

Kumar Doab (FIN) 09 May 2016

Harp on deemed acceptance in 24 hrs..................and that NO insurance document (implying T&C) was supplied to you.

Write that in future don't send any communication on deemed acceptance.

Avoid quoting legalities for the time being.

In future try to send clear messages on acceptance/declinature and in time.

Apply your skills to resolve while in employment.

Build a favorable written record.

Zain 16 May 2016

Update: I met the HR today and she said the following:

"Our company was able to negotiate a Corporate plan for insurance of employees based on a commitment of buying insurance for a minimum number of employees. If employees starting opting out, we will not be able to provide this facility to the other employees.

The only way to refund your money is if I cancel the current contract with the insurer. This will cause a cancellation for all other employees also. Therefore i cannot do this. The only way out of this is when an employee leaves the company, then a pro rata refund is given."

What should i do now ?
It is true that initially when they had asked who all are interested, i had given my name. But i NEVER confirmed. In fact, they never provided documents on the basis of which i could make my decision.

In myopinion, if my company did not negotiate a clause of opting out in between, this is not my problem. They should pay me back from their own pocket.

But first of all, enrolling me itself was forceful and without giving documents and on the basis on "deemed" acceptance.

It seems to me to be cheating and fraud.

But i dont know the legal status of this situation. Can anybody guide me here in detail ?