PER MR.B.S.WASEKAR, HON’BLE PRESIDENT

1)                The present complaint has been filed by the complainant under section 12 of the Consumer Protection Act, 1986.  According to the complainant, he is the insurance policy holder of Policy No.WLG 1793570.  He was introduced with the opponent by the Agent Mr.Vijay Malhotra.  It is Lifelong Unit Linked Policy. The complainant was told about deducting premium allocation charges once in a year and policy administration charges.  The complainant was not satisfied with response from the opponent during the year 2008 to 2011.  The opponent convinced the complainant and assured not to worry about the policy.  The complainant was shocked in the year-2012 when he came to know that the opponent charged two unknown charges which was not disclosed to him.  Therefore, the complainant demanded balance policy amount.  The opponent forced the complainant to surrender the policy.  The complainant suffered loss therefore he has filed this complaint to recover Rs.63,828/- instead of Rs.24,488/- along with interest.  He has also claimed compensation of Rs.20,000/- for mental harassment. 

2)                The opponent appeared and filed the written statement.  It is submitted that the complainant is not the consumer. The complainant received the policy along with terms and conditions.  He has not cancelled the policy within free look period of fifteen days.  The complainant is entitled for surrender value only and not the entire premium paid by him.  The complainant has enjoyed coverage for several years. Therefore, he is not entitled for the entire premium amount.  As per proposal form, the complainant assured sum of Rs.1,65,375/- and the annual premium was of Rs.15,000/-.  The date of commencement was 18^th January, 2008.  The policy was delivered to the complainant on 23^rd January, 2008. The complainant has not exercised his right within free look period of fifteen days.  The complainant failed to pay the premium for Janaury-2013.  On 13^th December, 2012, the opponent received written request for surrender of the policy from the complainant. Accordingly, the policy was surrendered as per the terms and conditions and surrender value was calculated at Rs.24,488/-.  As he has enjoyed coverage for several years, he is not entitled for the entire premium amount. 

3)                After hearing both the parties and hearing both the parties, following points arise for our consideration.

POINTS

REASONS

4) As to Point No.1 & 2 :- The proposal form, policy and terms and conditions are produced on record.  Those are not disputed by the parties.  According to the opponent, the policy was issued on 18^th January, 2008.  It was dispatched on 21^st January, 2008 and it was delivered to the complainant on 23^rd January, 2008.  It is not challenged by the complainant.  In the policy, free look period for fifteen days was given to the complainant to cancel the policy.  The complainant has not exercised his right.  As per complaint, the complainant was not satisfied with response from the opponent but he was convinced by the opponent during the period 2008 to 2011.  As per complaint, he demanded balance amount in December-2012.  Thus, he paid premium amount for three years and continued the policy.  As per policy, the complainant has enjoyed the coverage for this period.  As per terms and conditions of the policy, the complainant is entitled for the surrender value only and not the entire premium amount paid by him.  The learned advocate for the opponent has placed reliance on the judgment of Hon’ble National Commission in Revision Petition No.663 of 1994 in the case of Life Insurance Corporation of India –Versus- Anil P.Tadkalkar, decided on 8^th November, 1995.  In para 4 of the judgment, the Hon’ble National Commission has held as under.

Moreover, we have not been able to understand how the complainant can claim refund of all the premia paid by him during the period of the policies remained alive and the LIC had covered the risk.  If during this period the complainant had died (an event which did not occur) the insurer i.e. LIC would have had to pay the full amount due under the policies even though only some fraction of the premia would have been realized by that time by the insurer.  Hence on canceling the policies the complainant is only entitled to the surrender values of the two policies.  It is immaterial what circumstances prompted him to cancel the policies. 

In the instant complaint before us also, the complainant has enjoyed coverage for this period therefore the complainant is not entitled for the entire premium amount. The complainant has alleged cheating at the hands of the Agent of the opponent.  The learned advocate for the opponent has submitted that the complaint before this Forum is summary proceeding and allegations of cheating can not be decided by this Forum. For this purpose, he has placed reliance on the judgment of Hon’ble Supreme Court reported in (2006) 7 SCC 655 in the case of Oriental Insurance Company Limited –Versus- Munimahesh Patel, decided on 12^th September, 2006. In para 7 of the judgment, the Hon’ble Supreme Court has held as under :

The nature of the proceedings before the Commission as noted above, are essentially in summary nature. The factual position was required to be established by documents. Commission was required to examine whether in view of the disputed facts it would exercise the jurisdiction. The State Commission was right in its view that the complex factual position requires that the matter should be examined by an appropriate Court of Law and not by the Commission

In view of this judgment, this Forum can not decide the allegation of cheating as it requires detailed investigation. 

5)                Thus, the complainant is not entitled for the entire premium amount. The opponent has paid surrender value to the complainant.  There is no deficiency on the part of the opponent. Therefore, the complainant is not entitled for the relief as prayed.  Hence, we proceed to pass the following order.

ORDER

1. Complaint stands dismissed.
2. Parties are left to bear their own costs.
3. Inform the parties accordingly.

Pronounced on 16^th October, 2104