Order No. 8 Date: 24-07-2017
Sri Shyamal Gupta, Member
This Appeal is directed against the Order dated 08-01-2016 passed by the Ld. District Forum, Kolkata – I (North) in C.C. No. 189/2013.
Case of the Complainant, in short, is that on going through the brochure containing details of life insurance scheme of the OP Insurance Company, he opted for the same by paying necessary premium. He also paid renewal premiums for the 2nd and 3rd consecutive years. However, because of some personal predicaments, he could not pay the 4th premium and requested the OP Nos. 1 and 2 to return the entire deposited money along with interest. However, in turn, the OP Insurance Company sent a cheque for a sum of Rs. 44,941.31 without any clarification. Thereafter, all on a sudden, on 05-06-2012, one Mr. Sandip Gupta introducing himself as a representative of the OP Insurance Company asked him to pay Rs. 17,550/- to facilitate refund of rest of the deposited sum in respect of the first insurance policy. Believing such representation, he opted for a new policy and paid due premium of Rs. 17,550/-. However, as no fruitful result emerged despite such payment, the Complainant filed the instant complaint.
OP Nos. 1&2 contested the case by filing WV wherein they have stated that the Complainant, after understanding the pros and cons of the policy in question, opted for it and paid only 3 premiums out of 15 installments. In a paid-up policy, if the value of accumulated units goes below the minimum paid-up value as specified in the policy schedule of the document, then the policy gets cancelled. In a paid-up cancelled policy, the net asset value as on the date of the cancellation is paid to the policyholder. In case of the Complainant, the policy in question attained paid-up status due to non-receipt of renewal premiums. Subsequently, the policy was cancelled. As such, as on the date of cancellation, the fund value of the Policy being Rs. 44,941.31 was refunded to the Complainant.
Decision with reasons
Admittedly, the Respondent No. 1 received a brochure of the Appellant Insurer containing details of “Life insurance scheme”. There is no dispute either as to the fact that policy bond containing details terms and conditions of the policy in question was received by the Respondent No. 1. Also not in dispute is the fact that the Respondent No. 1 paid three premiums in respect of the said policy.
In such circumstances, it cannot be said that the Respondent No. 1 was not aware of the grey areas of the said policy. While the policy conditions did not permit so, it was futile on his part to expect that the Insurer would refund the entire deposited money in contravention of the terms and conditions of the insurance policy which is otherwise equally binding on both sides. It cannot be anybody’s case that by acting strictly in accordance with the terms and conditions the Appellant committed any breach of policy conditions or it was an act of deficiency in service and/or unfair trade practice on its part.
Another issue raised by the Respondent No. 1 is that one Mr. Sandip Gupta misled him by promising him to arrange refund of residual money in respect of the lapsed policy in case he took another policy by paying a sum of Rs. 17,550/-. It betrays our conviction how a sensible and literate person could act believing in such an absurd proposition, if at all any such proposal was ever made to the Respondent No. 1. In fact as to whether or not Mr. Sandip Gupta was at all an agent of the Appellant Insurer, no cogent documentary proof is forthcoming before us to draw such conclusion.
Be that as it may, fact remains that he has not made said Sandip Gupta a party to the case although he was a necessary party in order to unearth the truth. Wittingly or otherwise, we find that the Respondent No. 1 did not pose a single question before the Appellant about said Mr. Sandip Gupta in his seet of questionnaire consisting of 22 questions.. We also notice that the Respondent No. 1 has not claimed refund of Rs. 17,550/- from the Appellants. Normally, whenever a person falls prey to the sinister designs of crooked agents, he tends to claim refund of the policy amount.
Basically, the allegation of the Respondent No. 1 about wrongdoing of Mr. Sandip Gupta remains unproven. We afraid, wild allegation counts nothing before any Court of Law.
It is quite baffling that despite there being no tangible proof to show that the Respondent No. 1 was misrepresented by one Mr. Sandip Gupta, simply on the basis of averment of the Respondent No. 1 the Ld. District Forum decided the case in his favour.
Further, even if it is assumed for argument’s sake that said Mr. Sandip Gupta indeed impressed upon the Respondent No. 1 to make a new policy in the name of his daughter having annual premium for a sum of Rs. 17,550/-, how come the same be a valid reason to ask the Appellant to refund Rs. 45,059/- defeats our common sense.
It is the settled principle of law that disputes cannot be decided purely on surmises and conjecture. As long as the burden of proof is not discharged by the person responsible or circumstantial evidence suggests so, it is always better to steer clear of drawing any adverse opinion about the sincerity of purpose of any person/organization.
In the light of our foregoing discussion, it seems to us that by allowing the complaint, the Ld. District Forum committed a jurisdictional error. As such, the same cannot be upheld. It is quashed as such.
In the result, the Appeal succeeds.
Hence,
O R D E R E D
That A/156/2016 be and the same is allowed on contest. The impugned order is hereby set aside.
