DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I,

U.T. CHANDIGARH

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Jenny Lee, House No.153, Sector 35-A, Chandigarh.

…..Complainant

                                      V E R S U S

1.       Aviva Life Insurance Company India Limited, Head Office, Aviva Tower Sector Road, Opp. Golf Course, DLF, Phase V, Sector 43, Gurgaon, through its Managing Director.

2.       Assistant Manager branch Customer Service Aviva Life Insurance Co. India Limited, SCO No.181-183, Ground Floor, Madhya Marg, Sector 9-C, Chandigarh.

          ……Opposite Parties

QUORUM:   P.L.AHUJA                                                  PRESIDENT

                   RAJINDER SINGH GILL                                MEMBER

                   DR.(MRS) MADANJIT KAUR SAHOTA         MEMBER

Argued by: Sh.Vinay Guleria, Counsel for complainant.

                     None for OPs No.1 and 2.

PER P.L.AHUJA, PRESIDENT

1.                Ms.Jenny Lee, complainant has filed this consumer complaint under Section 12 of the Consumer Protection Act, 1986, against Aviva Life Insurance Company India Limited - Opposite Parties (hereinafter called the OPs), alleging that she purchased a product/policy namely Life Long Unit Linked Fund vide policy No. WLG1387824 through agent of OP No.2 on 22.12.2006 amounting to Rs.54,000/-. The copy of cover note of the policy is Annexure C-1. It has been contended that OP No.2 promised for good return except (apart ?) from the principal amount of Rs.54,000/- plus other benefits. After three years, the complainant visited the office of OP No.2 for withdrawal of the amount but OP No.2 requested her to wait for another two years. After five years, the complainant went to the office of OP No.2 on 29.9.2011 for refund of the money and she was told that the fund value of the deposited amount was Rs.42,000/- and the surrender value will be only Rs.20,000/- against the amount deposited by her i.e. Rs.54,000/-. The complainant visited the office of OP No.2 a number of times but the official of OP No.2 put up the matter on one pretext or the other. Then the complainant sent a letter dated 21.9.2011, copy of which is Annexure C-2 and OP No.2 sent a reply, copy of which is Annexure C-3. After a few months, the OP sent a cheque dated 23.12.2011 amounting to Rs.18,372/- only. The complainant sent a legal notice dated 3.5.2012 to OP No.2. Since the cheque amount was inadvertently mentioned as Rs.20,000/- instead of Rs.18,372/- which was sent by OP No.2 to the complainant, the complainant also sent a corrigendum to OP No.2. Copies of legal notice, postal receipts, cheque and corrigendum are annexed at Annexures C-4 to C-7. It has been alleged that OP No.2 is committing day-light fraud by returning an amount of Rs.18,372/- to the complainant instead of principal amount of Rs.54,000/- plus the promises and other benefits. The complainant has made a prayer for a direction to the OPs to refund the amount of Rs.54,000/- along with interest @ 18% p.a., apart from making payment of compensation and litigation expenses.

2.                OPs No.1 and 2 in their written reply have pleaded that as required under the IRDA Regulations 2002 the policy terms and conditions specifically provide for a free look period of 15 days from the date of receipt of the policy document. It has been stated that refund of the amount paid as premium cannot be sought as the request for the same was made beyond the free look period of 15 days. It has been averred that after duly deliberating and understanding all the terms and conditions of the Life Long Unit Linked Plan, the complainant had signed the proposal form dated 15.11.2006 and paid initial premium amounting to Rs.18,000/-, which was to be paid annually, for which, the sum assured was Rs.1,44,000/-. Copies of the proposal form and key features document are annexed at Annexure R-1 and R-2. It has been stated that a policy bearing No.WLG1387824, copy of which is Annexure  R-3 was issued to the complainant having a date of commencement as 22.11.2006. The complainant is an educated (person) and had signed the proposal form after duly understanding the terms and conditions. The standard terms and conditions along with the policy documents were dispatched to the mailing address of the complainant through courier and were duly received on 27.12.2006. It has been averred that as per the terms and conditions of the said policy, the complainant was provided a period of 30 days but she failed to pay the amount within that period and the said policy lapsed on 22.1.2010. As per article 15.3.1 of the policy, if within reinstatement period i.e. two years from the unpaid due date, the policy surrender value of units attributable to regular premium fell below the initial premium i.e. Rs.18,000/- then the said policy would be automatically terminated and the policy holder would be paid surrender value. Accordingly a surrender value cheque of Rs.18,372/- was rightly sent to the complainant. It has been stated that the OPs received a complaint in the month of September, 2011, which was duly replied on 27.9.2011. Copies of the complaint and reply are Annexure R-5 & R-6.

3.                In her rejoinder, the complainant has averred that the representative of OPs assured her that the policy was for a term of three years only and the complainant had to pay Rs.18,000/- annually for three years only. It has been averred that the proposal form was filed and submitted on 15.11.2006, whereas, the policy was received by her in the month of January, 2007 much after expiry of 15 days from the date of submission of the forum.

4.                The parties led evidence in support of their contentions.

5.                After going through the evidence on record and hearing the arguments of the learned Counsel for the parties, we find that the complaint merits dismissal.

6.                Though as per case of the complainant, the representative of OPs assured her that the policy was for a term of three years only and she had to pay an amount of Rs.18,000/- annually for three years only, yet a perusal of the copy of cover note – Annexure C-1 produced by the complainant itself shows that the regular premium amount was Rs.18,000/-, premium frequency was annual and the date of last payment of premium was 22.12.2033. Had the agent of OPs assured the complainant that premium was to be paid in three annual installments only, then the date of last payment of premium would not have been mentioned as 22.12.2033 in the cover note. The copy of first premium receipt at page No.5 of Annexure C-1 also shows the frequency of premium as annual and the date of last payment is shown to be 22.12.2033. The complainant is an educated person, therefore, it cannot be stated that she was told to pay annual premium @Rs.18,000/- per year for three years only.

7.                It is the admitted case of the complainant that she received the policy document from the OPs. According to the averments in the rejoinder of the complainant, the policy document was received in January, 2007. Even if it is assumed that the same was received in January, 2007, yet the complainant did not make a prayer for cancellation of the policy within 15 days free look during the period starting from January, 2007.

8.                It is true that the complainant sent a letter dated 21.9.2011, copy of which is Annexure C-2 demanding back her amount of Rs.54,000/-, yet the copy of letter dated 27.9.2011 – Annexure C-3 sent by the OPs to the complainant shows that she had specifically demanded the product Life Long Unit Linked Plan with annual premium of Rs.18,000/-. The premium payment term was also mentioned in the policy schedule, which was enclosed with the long term contract. Since the policy was a Unit Linked Insurance Policy the performance of the fund depended upon the fund option chosen and the fund performance was directly related to the performance of the market and daily fluctuations of NAV. It is noteworthy that as per Article 15.3.1 of the standard terms and conditions of the policy, the policy holder may exercise any of the three options during the two years reinstatement period. If the said option is not exercised the policy surrender value of the units attributable to regular premium fell below the initial premium i.e. Rs.18,000/- then the said policy would be automatically terminated and the policy holder would be paid surrender value as per Article 14. Accordingly a surrender value cheque of Rs.18,372/- was sent to the complainant. Obviously, the complainant can recover the amount, if any, in accordance with the terms and conditions of the agreement only howsoever harsh the same may be. Hence, we do not find any deficiency in service on the part of OPs.

9.                We may mention that the complainant has alleged in para No.8 of the complaint that OP No.2 is committing day-light fraud by returning an amount of Rs.18,372/- only to her. The complainant has also alleged in her letter dated 21.9.2011 – Annexure C-2 that it is a sheer case of cheating and day light looting. The allegations regarding the cheating and fraud are serious in nature, which require detailed evidence. Fraud is to be proved like a criminal charge. Such type of allegations cannot be decided by way of summary adjudication by this Forum.

10.              For the reasons recorded above, we do not find any merit in the complaint and the same is dismissed with liberty to the complainant to take recourse to the proceedings before the Civil Court.               

11.              The certified copies of this order be sent to the parties free of charge. The file be consigned.