West Bengal

South 24 Parganas

CC/126/2015

Prabir Khan. - Complainant(s)

Versus

1. Aegon Religare Life Insurance Co. Ltd. - Opp.Party(s)

Bimalendu Chakraborty.

07 Jan 2016

ORDER

sa  DISTRICT CONSUMER DISPLUTES REDRESSAL FORUM

SOUTH 24 – PARGANAS ,

AMANTRAN BAZAR COMPLEX, BARUIPUR, KOLKATA – 144                                                                                                                                                                                                                                                                                                                                                                                                                                                            

 

C.C. CASE NO. ___126  OF ___2015___

 

DATE OF FILING : 12.3.2015     DATE OF PASSING JUDGEMENT:_7.1.2016           __

 

Present                        :   President       :   Sri Udayan Mukhopadhyay

 

                                        Member(s)    :  Smt.  Sharmi Basu                                            

 

COMPLAINANT                  :  Prabir Khan, Vill. & P.O Ram Chandra Nagar, P.S. Bishnupur, South 24-Parganas, Pin-743 503.

 

-VERSUS  -

 

O.P/O.Ps                                :    1. Aegon Religare Life Insurnace Co. Ltd. Building no.3, 3^rd Floor,

Unit No.1, NESCO IT Park, Western Express High Ways, Goregaon (East), Mumbai – 400 063.   

 2.    AEGON RELIGARE, Life Insurance Co. Ltd. 57H/1, Kasba, K.N. Sen Road, P.S. Kasba, Kolkata – 42.

3.   Amit Singha, Vill Sulantu, P.O Parulia, P.S. Purbasthali, Dist. Burdwan, Pin – 713513.

________________________________________________________________________

 

                                                            J  U  D  G  E  M  E  N  T

            Smt. Sharmi Basu, Member

            The petition of complaint made under section 12 of the C.P Act ,1986 has been filed by complainant  against the O.Ps on the ground of deficiency in service on the part of  the O.Ps .

             It is the short case of the complainant that being convinced from the version of Amit Singha, the O.P-3 complainant purchased Insurance Policies totaling to Rs.1,85,000/-. At the time of taking the policy the complainant was given to understand that it was one time payment policy and premium would be refunded after three years from the date of purchase of the policy. The complainant being a semi-literate person could not fill up the Form the same was filled up by the agent of the O.Ps.

            After receipt of the policy document complainant was surprised to see that mode of payment is annual and policy will be matured after 16 years from the dte of purchasing the policy. Immediately after receipt of the policy complainant contacted the O.P-3 for cancelling the policy and for refund the money paid by him but O.P-3 requested to wait for three years for getting refund of the total premium paid by the complainant. Inspite of several requests followed by letters dated 9.9.2013 and 26.9.2013 and demand notice dated 4.8.2014 , it yielded no result and hence this case, praying for refund of Rs.1,85,000/- and compensation, cost etc.

            O.P nos. 1 and 2 appeared and contested the case by filing reply against the complaint filed by the complainant  and denied all the material allegations  leveled against them contending inter alia that as formulated and mandated by  Insurance Regulatory Development Authority (“IRDA”) regulations, each policy holder is apprised about the option of Free Look Period   of fifteen days through a Welcome Letter sent along with the Policy contract documents. If the policyholder finds any discrepancy in the policy terms and condition sent to him, he may exercise the Free Look Option by informing the ARLIC’s concerned department in writing. But the complainant did not avail the Free Look Option within the stipulated period . So, it can be deemed that the complainant had accepted the said policy . The O.P nos. 1 and 2 prayed for dismissal of the case.

            The O.P-3 also filed written version denying all the allegations leveled against him contending inter alia that he is not the authorized of O.P-3 for whose effort complainant purchased the policy. He has prayed for dismissal of the case.

 

Points for Decision

1. Whether the complainant is a Consumer or not.
2. Whether there is any deficiency in service on the part of the O.Ps or not.
3. Whether the complainant is eligible to get relief as prayed for partly or fully.

Decision with reasons

            All the points are taken together as they are interlinked.

            This is the case of the complainant against the O.Ps on the allegation of deficiency in service where O.P-1 and O.P-2 are Insurer and O.p-3 is agent of Insurer.

            On several evaluation of the argument as advanced by the Ld.  Advocates of both the parties and also considering the entire materials of the complaint and written version of the parties including the documents it is proved that complainant entered into a contract of insurance policy by paying premium of Rs.1,85,000/- As per the complainant O.P-3 misguided him that he had to pay one time premium and he signed in the policy paper on good faith but lateron he came to know that he has to pay premium several times and policy will mature after 16 years. Thereafter, he requested O.Ps to refund the total premium paid by him as he did not want to continue the same. But O.Ps((Insurer) denied to return the amount in question as the complainant was apprised about the option of FREE LOOK PERIOD  of fifteen days through a welcome letter sent along with the policy contract documents. But the complainant did not inform his unwillingness to continue the policy within the stipulated period. Therefore, the crux of the case is whether the complainant is entitled for refund of amount of premium in question by the O.Ps or not.

            From the record, it is crystal clear that complainant sent two letters on 9.9.2013 and 6.9.2013 and also demand notice to the O.Ps on 4.8.2014. But it is also fact that he receipt the letters of O.Ps mentioning about the option of FREE LOOK PERIOD within the stipulated period as per Regulation of I.R.D.A  but he did not inform his inability and/or unwillingness to the O.Ps within the stipulated period. In this context Ld. Advocate for the complainant and also the complainant in person on the date of hearing argument have submitted that the complainant is literate but not much educated and so he could not understand that it was mandatory to disclose his unwillingness to continue the policy within fifteen days to the O.Ps. In this regard it is needed to be mentioned that in a similar case Hon’ble State Commission, Maharastra has been pleased to observe that “The respondent has signed the proposal Form. When the proposal Form is signed, it cannot be said that the respondent was not aware about the nature of the policy. No doubt, within 15 days of free look period, he has cancelled the policy. The appellants have filed a copy of Notification dated 26.04.2002 issued by the Insurance Regulatory and Development Authority . In the said Notification at regulation 6(2) , it is stated that “while acting under regulation 6(1) in forwarding the policy to the insured, the insurer shall inform by the letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms or conditions, he has the option to return the policy stating the reasons for his objection, when he shall be entitled to a refund of the premium paid, subject only to a deduction of a proportionate risk premium for the period or cover and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges”.

The regulation 6(3) of the said Notification states that “In respect of a unit policy, in addition to the deductions under sub-regulation (2) of this regulation, Insurer shall also be entitled to repurchase the unit at the price of the units on the date of cancellation”. Accordingly, the appellants have refunded the amount to the respondent.

            The Forum below without considering IRDA guidelines has come to the conclusion that there is deficiency in service on the part of the opponent/appellant and passed impugned order which cannot stand in eyes of law and IRDA guidelines. The respondent is a renowned academician. However, in the written submission filed during the hearing of the appeal, he has stated that if the order passed by the District Forum is set aside, he will lose confidence in the judicial system. However, we cannot overlook the IRDA guidelines. The learned District Forum without considering the IRDA guidelines arrived at the conclusions which are erroneous. Looking into the facts of the case, there is no deficiency in service on the part of the appellants”.

             

            We have considered the  “Reply” of the complainant  filed by the O.P-1 and all the documents filed by both the parties and it appears that admittedly the complainant paid Rs.99,990/- as premium towards the Life Insurance Policy under the O.P nos. 1 and 2 . The complainant has submitted an application for Insurance bearing no.0866738  proposing for Educare Advantage Insurance Plan and the base sum proposed was Rs.8,20,860/- , policy term was 16 years and period of  premium to be paid was 12 years. It is also fact that date of the proposal form was 16.4.2014. The policy was issued on 28.4.2014 and the same was delivered to the complainant on 30.4.2014. It is also beyond doubt that complainant has signed the relevant application where it is clearly mentioned “Declaration- I/(we) declare that the sales literature and illustrations in relation to the product proposed to be purchased by me/us have been provided and explained to me/us and I /we have understood the same”.

It is also appearing from the record  that the O.P informed the complainant about the option of Free Look Period of 15 days through welcome letter sent under Policy Contract Document as per mandate by the Insurance Regulatory Development Authority (IRDA). Under the Free Look Period if the policy holder find any discrepancy in the policy terms sent to him ,he may exercise Free Look option by informing the concerned Department in writing. In the instant case the complainant has not informed anything within the aforesaid Free Look Period of 15 days. The complainant requested the O.Ps to refund the amount of Policy as he did not want to continue the policy after that period on 22.7.2014. Therefore, the crux of the case is whether the O.Ps are liable for deficiency in service as they have not refunded the amount allowing the complainant to cancel the policy.

                        We are also highlighting the remarkable judgement of Hon’ble National Commission vide RP no. 555/2011 pronounced on 21.1.2015 . “…. As complainant himself obtained policy with yearly premium and after receiving policy, he did not avail free look period for cancellation of policy, after lapse of one year, he was not entitled to cancellation of the policy and get refund of premium. Learned State Commission wrongly observed that in the application form that complainant opted for single premium whereas proposal form clearly reveals that payment was to be made regularly on yearly basis.

            In the light of above discussion, it becomes clear that Learned District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal and revision petitions are to be allowed”.

            Therefore, in light of the above discussion and also keeping in mind the legal maxim “Ignorance Juris non-excusat” i.e. ignorance of law is not an excuse, we have found no deficiency in service on the part of the O.Ps and this Forum has no alternative but to dismiss the case against the O.Ps without cost.

            Hence,

                                                                                    Ordered

That the complaint case is dismissed on contest against all the O.Ps  without cost.

 

Let a plain copy of judgement be supplied to the parties free of cost as per rule.

 

 

                                    Member                                                                                               President

 

 

Dictated and corrected by me

 

 

 

                        Member

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The judgement in separate sheet is ready and is delivered in open Forum. As it is ,

 

Hence,

                                                                        Ordered

That the complaint case is dismissed on contest against all the O.Ps without cost.

 

Let a plain copy of judgement be supplied to the parties free of cost as per rule.

 

 

                                    Member                                                                                               President