Order by:
Sh.Amrinder Singh Sidhu, President.
1. The complainant has filed the instant complaint under section 12 of the Consumer Protection Act, 1986 (as amended upto date) on the allegations that in the month of December, 2017 the Complainant received a telephonic call wherein one Mr.Sumit Malhotra alleging himself as a Senior Manager of Opposite Parties asked the Complainant that their company wanted to install a tower of Reliance Jio 4G for which 15 square feet land is required and the company will pay Rs.35,000/- per month on account of rent for the said purpose. The policy term is 12 years for sum assured of Rs.4,72,847/- and the date of commencement of policy is March 5, 2008 with maturity date march 03, 2030. Said representative of the company stated that the Complainant has to invest Rs.40,000/- in Bhaarti AXA company for one year which will be returned alongwith interest after one year. Thereafter, the officials of the Opposite Parties told the Complainant that his plot is a very big plot and another tower was also installed there and they told that another tower known as High Extension has also installed for which 25 square feet land is required and for this purpose Rs.65,000/- per month as rent will be paid to the Complainant and also told that the Complainant has to invest another sum of Rs.65,000/- in their company for one year which was invested by the Complainant as per the requirement of the Opposite Parties. Thereafter, the Opposite Parties also demanded Rs.85,000/- from the Complainant being the security amount of first tower and said amount of Rs.85,000/- was paid vide two cheques. After receiving the amount, the Opposite Parties assured that said tower will be installed within one month. After one month, the Complainant received a call of Opposite Parties and told that Head Office has made some doubt that we have received graft from the Complainant for doing the said work so early and as such, Head office has now rechecked the account of the Complainant and told that now the Complainant has to send Rs.2 lakhs for one year and on believing the words of the Opposite Parties, the Complainant sent four cheques amounting to Rs.49,999/- each to the Complainant. After about one week, the Complainant had received another call from the office of Opposite Parties that we are talking from Finance Department of Opposite Parties and told to the Complainant that his amount becomes Rs.18 lakhs and the Complainant has to pay Rs.1 lakh as tax and on this, the Complainant also sent Rs.1 lakh through cheque for an amount of Rs.99,000/- from his account in favour of India First Life Insurance Company. The Opposite Parties told the Complainant that after about one month, said towers will be installed at his plot and the payment of rent of both the towers, bond papers will be sent to the Complainant. Thereafter, no call was made by Opposite Parties to the Complainant and the Complainant after about one month, called the above said Sumit Malhotra and Rajeev Gupta, but they never picked up the phone and one other person namely Chattneya Reddy contacted the Complainant and told that now he is working at the file of the Complainant and he told that said Sumit Malhotra and Rajeev Gupta had installed a cold in his account and the said code will be opened if the Complainant deposit Rs.50,000/- in India First Insurance Company and accordingly the Complainant made the payment of Rs.50,000/- through online from his account. Thereafter, the Opposite Parties did not pay any heed to the request of the Complainant. In this way, the Complainant came to know that the Opposite Parties have cheated and grabbed his hard earned money by disclosing wrong averments. The Complainant then requested the Opposite Parties to refund his amount alongwith interest, but the Opposite Parties flatly refused to extend any help. In this way, the Opposite Parties have played a fraud with the Complainant and grabbed his amount on account of withdrawing amount of old policy of his father. As such, there is deficiency in service on the part of the Opposite Parties. Vide instant complaint, the complainant has sought the following reliefs.
a) To direct the Opposite Parties to refund the amount of Rs.3,80,000/- alongwith interest @ 9% per annum from the date of investment and to pay Rs.2 lakhs on account of compensation for causing mental tension, harassment and deficient service and Rs.11,000/- as costs of litigation or any other relief to which this District Consumer Commission, may deem fit be granted.
Hence, the present complaint is filed by the Complainant for the redressal of his grievances.
2. On notice, Opposite Parties No.1, 2, 4 appeared through counsel and contested the complaint by filing the written version taking preliminary objections therein inter alia that the complaint is not maintainable; that the complainant has got no locus standi to file the present complaint; that the complaint is absolutely false and frivolous. Further alleges that the present complaint is liable to be dismissed on ground that the allegations are without any proof and are not supported by any evidence whatsoever. It is submitted that the complainant has cooked a false story to mislead this District Consumer Commission and to extort money from the respondent company. That the complainant has raised some very serious allegations in the complaint without substantiating with any documentary proof. The entire complaint is based on surmises and conjectures and thus deserves no other fate but an outright dismissal. It is further submitted that this Hon’ble Court has no jurisdiction to entertain the present Complaint. That in the present Complaint the Complainant has alleged Cheating, Misselling and Misrepresentation in the Garb of installation of a Mobile Tower of RELIANCE JIO Company and has further alleged that he paid a particular sum for the installation of the same but the same was not installed and a policy was issued. He has further alleged that time and again he has paid certain amounts as different occasions and has also named many people in the complaint like one Sumit Malhotra, Rajeev Gupta, Chattenya Reddy etc but non have been made a party in the complaint. Such serious allegations require a proper trial by a civil/criminal court and evidence has to be taken which is not possible in a summary trial. It is clear from the averments made in the Complaint that the Complainant has made such allegations; such matter in question involves complicated questions of facts and law as well as voluminous evidence, which can only be dealt with by a civil court. This District Consumer Commission has no jurisdiction to entertain the present complaint. The Complainant has failed to demonstrate any deficiency in service on the party of the replying Opposite Party. Deficiency is defined under section 2(g) of the Consumer Protection Act which means any fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance; which is required to be maintained in pursuance of a contract. In the present case, the OP has strictly acted as per the terms and conditions of the policy contract. That the terms of the policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion or substitution. That the Forum cannot pass any order in contravention to the terms and conditions of the policy contract. That the present complaint is not maintainable. As per the terms of the policy contract if the policy is not suitable, the policy holder may get his/her policy reviewed by returning the policy and policy documents within 15 days (Free Look Period) from the day the policy holder received the policy. The insurance company will return the premium paid to the complainant after making certain deductions specified therein. In the present case, The Policy No. 501-6549742 was sent on 27.01.2018 vide Speed Post AWB No. – EA173322928IN, and the same was delivered on 05/02/2018, the Policy No. 501-6742305 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814247IN, and the same was delivered on 24/02/2018, the Policy No. 501-6742370 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814264IN, and the same was delivered on 24/02/2018, the Policy No. 501-6820218 was sent on 06.03.2018 vide Speed Post AWB No. – EA173865204IN, and the same was delivered on 14/03/2018, the Policy No. 501-6828294 was sent on 08.03.2018 vide Speed Post AWB No. – EA175325913IN, and the same was delivered on 14/03/2018, the Policy No. 501-6951146 was sent on 26.03.2018 vide Speed Post AWB No. – EA175383607IN, and the same was delivered on 10/04/2018, the Policy No. 501-7080259 was sent on 02.04.2018 vide Speed Post AWB No. – EA175416720IN, and the same was delivered on 16/04/2018. The complainant after the receipt of the subject policies and policy documents did not approach the replying OP and got his subject policies reviewed/cancelled within Free Look period implying that the complainant duly accepted the subject policies and its documents with its terms and conditions. The complainant never approached the replying opp. party with any grievance pertaining to the subject policies and its terms and conditions and straight away filed the present complaint. The complainant is now estopped from raising the issues/ grievances with respect to refund of premium of the subject policies. The complainant is bound by the policy contract and given up /relinquish / waved his right by not exercising the Free look Provision. Thus, the complaint is devoid of any merit and is liable to be dismissed. That the opposite party as per clause 4(1) and 6(2) of the IRDA (Protection of Policy Holder’s Interest) Regulations, 2002, sent the policies and policy documents along with the copy of the proposal forms to the complainant giving him opportunity to review/cancel the policy within freelook period. The policy documents were dispatched to the complainant on at the address of the complainant and same was received by the complainant, which is also not disputed in the present complaint. Despite receipt of the policies and policy documents, the complainant failed to approach the opposite party within freelook period making any grievance with respect to the policy or its terms and conditions, implying the policy and its terms and conditions were duly accepted by the complainant and were in order. The complainant is bound by the policy contract and given-up/relinquish/waived his right by not exercising the freelook provision. The complainant is now estopped from raising the issues / grievances with respect to refund of premium of the subject policies. The applicant is bound by the policy contract and given up / relinquish / waved his right by not exercising the Free look Provision. Thus, the application is devoid of any merit and is liable to be dismissed. Furthermore it has been determined through catena of judgments passed by the Hon’ble National Consumer Disputes Redressal Commission New Delhi, in Mohan Lal Benal v/s ICICI Prudential Life Insurance Co. Ltd. and Harish Kumar Chadha v/s Bajaj Allianz Life Insurance Co. Ltd. that if the insured/Applicant is not satisfied with the policy taken, then he/she should avail the option of returning the policy within 15 days of receipt i.e. within “the Free-look Period”. The said proposition has also been clearly laid down in the case Shrikant Murlidhar Apte vs. Life Insurance Corporation of India, Revision Petition no. 634 of 2012 decided on 02.05.2013. Further, the National Commission concurred with the findings of Maharashtra State Consumer Disputes Redressal Commission, Mumbai that “Once 15 days ‘cooling off’ period is over, policy documents become binding on both the parties and the contents therein are also biding on both of them.” That the Complainant has raised some very serious allegations against the Answering O.P. without substantiating with any documentary proof. The entire complaint is based on surmises and conjectures and thus deserves no other fate but an outright dismissal. Submitted that Bharti AXA Life Insurance Company is a Life Insurance company which issues life insurance policies. Also Bharti AXA Life Insurance Company is not a financial institution which provides loan, bonus, etc. Further, the Complainant was taking policy from the Company which is altogether independent of other life insurance companies or Reliance Jio has no tie up or collaboration with the said company and would thus not have been misled. It is submitted that Bharti Axa Life Life Insurance Company is a separate entity legally as well as otherwise and has nothing to do with the business conducted by other institutions or agents. That it is further submitted that Bharti Axa Life Insurance Company Ltd has a separate legal, financial and administrative set up from that of other institutes, insurance companies and doesn’t deal with Installation of Reliance JIO Mobile Towers. That it is a settled principle of law that if any person signs a document, it is presumed that he/she has signed the same after reading and understanding it properly. That it is further submitted that it is a well settled principle of law that person who fills up anything on a signed document has status of ‘amanuensis’ only and cannot be treated as author of document. At the time of scribing (without admitting) the person who scribes (amanuensis) is treated as representative of person who has signed document and not the representative of the Company, thus after signing the document the person cannot release from signed document and lead anything which is contrary to terms stated in written document. It is submitted that the complainant is not entitled to any refund of the premium under the subject policies. The complainant enjoyed the benefit under the subject policy and now seeks to wriggle out from the same and also claiming the refund of the premium paid under the policy. The complainant continued to enjoy the benefit under the subject policy. The Hon’ble National Commission in the case titled “LIC of India & Ors. Vs. Siba Prasad Das &Ors.” reported in IV(2008) CPJ 156 (NC) has held that: “We are unable to appreciate as to on what ground the District Forum and State Commission could direct refund of premium? The premium is given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period of which the premium has been paid. It is not the case of the complainant that the risk was not covered for the period for which the premium was given. If after that the policy lapsed, under no provision of terms of the policy or law, could any court/forum direct for refund of any premium for the simple reason, as already stated, that the risk stood covered for the period of which premium had been paid.” That, the Complainant has sought a relief from this District Consumer Commission which he is not entitled to get under the terms and conditions of the subjected Life Insurance Policy and as such no deficiency in services on the part of the answering OP have been demonstrated by the Complainant. The answering OP submits that these are serious allegations of misrepresentation which may not be decided under section 12 of the consumer Protection Act 1986. Hence it is prayed that the District Consumer Commission may be pleased to dismiss the present complaint as against the answering respondent. The Complaint deserves to be dismissed on this count alone.That it is further submitted that the Opposite Party Company after the receipt of the proposal forms, and supporting documents life age proof, address proof etc issued the policies to the complainant. Additionally the complainant signed the documents containing the premium rates for the policy and made declaration that the complainant had read and understood the contents of the document and accepted the same. Furthermore, it is submitted that the complainant has received the policy documents and now with the intention to wriggle out of his contractual obligation and with a view to take undue advantage of the company he has filed the present complaint. Further more the complainant has also put his signatures on the application form on the declaration and authorization para where it is stated that he has understood the nature and contents of questions asked in the proposal forms. Further, in light of the Judgement passed by the National Commission in Life Insurance Corporation of India vs. Siba Prasad Dash, IV (2008) CPJ 156 (NC), since risk was covered for the period for which premium was paid, hence there is no question of a premium refund after the policy has lapsed. Section 64VB of the Insurance Act, 1938 too does not permit extending insurance coverage where premiums have not been duly paid. Further, since the complainant is an educated individual, it is presumed that he would have gone through the contents of the proposal form before signing on the same. Further, a bare perusal of the policy terms and conditions, would clearly demonstrate that no such policy benefits are contained therein as have been alleged by the complainant to have been promised to him. The complainant sought a relief from this District Consumer Commission which he is not entitled to get under the terms and conditions of the subject Life Insurance Policy and as such no deficiency in services on the part of the answering respondent have been demonstrated by the Complainant. The complainant has not paid the due premiums for all the policies. The premiums due for Policy No. 501-6549742 which was to be paid on 24.01.2019, for Policy No. 501-6742305 which was to be paid on 14.02.2019, Policy No. 501-6742370 which was to be paid on 14.02.2019, for Policy No. 501-6820218 which was to be paid on 28.02.2019, Policy No. 501-6828294 which was to be paid on 05.03.2019, Policy No. 501-6951146 which was to be paid on 24.03.2019, Policy No. 501-7080259 which was to be paid on 30.03.2019 were not paid and accordingly the policies have lapsed and in case he doesn’t pay further premiums the policies will be terminated as per policy terms and conditions. It is submitted that the complainant has not obtained the policies through any of agents/employees of answering respondents. For obtaining the policies in question, the policy holder had availed the services of an independent Broker i.e. SRIDHAR INSURANCE BROKER. An Insurance Broker is an independent entity licensed by Insurance Regulatory & Development Authority (IRDA), who advise their customers on their insurance needs and thereafter arrange insurance policy from any insurance company as per their own judgment and as per the customer’s choice. It is to be noted that the Insurance Companies do not enjoy any administrative control over the Insurance Brokers. All Insurance brokers are governed by the provisions of IRDA (Insurance Brokers) Regulations, 2002 and IRDA also entertain applications against Insurance Brokers. It is a settled principle of law that at the time of filling-up the proposal form, the agent acts as agent of insured and not of insurance company. No agent can be assumed to have authority from the insurer to write the answer in the proposal form. If an agent nevertheless does that, he becomes merely the amanuensis of the insured and his knowledge of the untruth or inaccuracy of any statement contained in the proposal form does not become the knowledge of the insurer. Further, it is also a settled principle of law that if any person signs any document, it is presumed that he/she has signed the same after reading and understanding it properly. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. The Supreme Court has held in Sitaram v/s Santanu Prasad, AIR 1966 SC 1697, that a master is vicariously liable for the acts of the servant acting in the course of his employment. For the master’s liability to arise, the act must be a wrongful act done through a mode authorized by the master, or a wrongful or unauthorized mode of doing some act authorized by the master. The act must be done only in the course of employment or in the scope of the agent’s authority. The Respondent Company does not authorize any of its agents to offer any such false promises or benefits to its customers, which are at variance with its product features, and assuming without admitting, that such false promises were made by any agent of the Company, the same would fall beyond the scope of the agent’s authority, and the Company would not be vicariously liable for the same. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. That, the Complainant has sought a relief from this Hon’ble Forum which he is not entitled to get under the terms and conditions of the subjected Life Insurance Policy and as such no deficiency in services on the part of the answering respondents have been demonstrated by the Complainant. The Answering respondent submits that these are serious allegations of misrepresentation which may not be decided under section 12 of the consumer Protection Act 1986. Hence it is prayed that the District Consumer Commission may be pleased to dismiss the present complaint as against the answering respondent. The Complaint deserves to be dismissed on this count alone. That there is no deficiency in service rendered by the answering respondent in present case, and the answering respondent is not a necessary or a proper party to present dispute, accordingly present complaint ought to be dismissed against the answering respondent. The Answering Respondents submit that the complainant had submitted Seven proposals for Insurance along with the customer declaration form, details of which are given below: -
Policy No. | 501-6549742 | 501-6742305 | 501-6742370 | 501-6820218 |
Proposal No. | 10284138 | 10284197 | 10284196 | 10506858 |
Name of the Policyholder/ Life Insured | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh |
Proposal date | 26.12.2017 | 09.02.2018 | 09.02.2018 | 26.02.2018 |
Insurance Plan | Elite Advantage | Elite Advantage | Elite Advantage | Elite Advantage |
Issuance date | 24.01.2018 | 14.02.2018 | 14.02.2018 | 28.02.2018 |
Premium | Rs. 39,999.44 | Rs. 35,033.74 | Rs. 30,029.49 | Rs. 44,999.79 |
Frequency of premium | Annual | Annual | Annual | Annual |
Delivery Details | Speed Post AWB No. EA173322928IN | Speed Post AWB No. EA173814247IN | Speed Post AWB No. EA173814264IN | Speed Post AWB No. EA173865204IN |
Policy document dispatched on | 27.01.2018 | 17.02.2018 | 17.02.2018 | 06.03.2018 |
Policy document received on | 05.02.2018 | 24.02.2018 | 24.02.2018 | 14.03.2018 |
Term | 12 years | 12 years | 12 years | 12 years |
Premium Payment Term | 12 years | 12 years | 12 years | 12 years |
Premium paid till date | Rs. 39,999.44 | Rs. 35,033.74 | Rs. 30,029.49 | Rs. 44,999.79 |
Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker |
Policy No. | 501-6828294 | 501-6951146 | 501-7080259 |
Proposal No. | 10506853 | 10506812 | 10506802 |
Name of the Policyholder/ Life Insured | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh |
Proposal date | 27.02.2018 | 14.03.2018 | 16.03.2018 |
Insurance Plan | Elite Advantage | Elite Advantage | Elite Advantage |
Issuance date | 05.03.2018 | 24.03.2018 | 30.03.2018 |
Premium | Rs. 39,999.42 | Rs. 99,997.08 | Rs. 99,997.08 |
Frequency of premium | Annual | Annual | Annual |
Delivery Details | Speed Post AWB No. EA175325913IN | Speed Post AWB No. EA175383607IN | Speed Post AWB No. EA175416720IN |
Policy document dispatched on | 08.03.2018 | 26.03.2018 | 02.04.2018 |
Policy document received on | 14.03.2018 | 10.04.2018 | 16.04.2018 |
Term | 12 years | 12 years | 12 years |
Premium Payment Term | 12 years | 12 years | 12 years |
Premium paid till date | Rs. 39,999.42 | Rs. 99,997.08 | Rs. 99,997.08 |
Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker |
The answering after receipt of duly filled proposal form along with the other requisite documents and the amount of first yearly premiums deposit had issued the subject Policies. That the Complainant had him self opted for Yearly/Annual premiums for all the policies which clearly indicated in the proposal forms. The policy term has been clearly shown as 12 Years and Premium Payment term of 12 Years as per proposal forms submitted by the complainant himself. That the OP Company further states that it has put in place a mechanism namely Pre Issuance Verification Call (hereinafter referred to as “PIVC”) prior to issuing the policy and the core objective of this exercise is to confirm and satisfy at the Company’s end that the policyholder has understood the key features of the policy without any ambiguity and has no grievance in this regard. In the present case as well, the Company had affected PIVC for police and in the said call, the Complainant/policyholder did not raise any concern or issue and was in complete agreement with the terms and conditions of the policy. That in accordance to Clause 6 (2) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations, 2002 every policy document sent by it is accompanied by a forwarding letter which clearly mentions that in case Policyholder is not satisfied with the features or the terms and condition of the policy he can withdraw/ return the policy within 15 days i.e. under the “Free Look period” provision. The respondent further submits that as per Regulation 4(1) of the IRDA Regulation a copy of the proposal form duly signed by the Policy holder is also sent to the policy holder and was duly received along with the policy document thereby giving an opportunity to the Policyholder to understand the terms and conditions and approach the company if any discrepancy. It is pertinent to bring to the notice of the Hon’ble Court that the complainant retained the policy documents and did not raise any objection towards the policy. It is submitted that the complainant/ policyholder had not approached the respondents during the free look period or even after that with any of his grievance regarding the policy or its terms and conditions. Meaning thereby that the complainant/ policyholder agreed to the policy and its terms and conditions. The Policy No. 501-6549742 was sent on 27.01.2018 vide Speed Post AWB No. – EA173322928IN, and the same was delivered on 05/02/2018, the Policy No. 501-6742305 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814247IN, and the same was delivered on 24/02/2018, the Policy No. 501-6742370 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814264IN, and the same was delivered on 24/02/2018, the Policy No. 501-6820218 was sent on 06.03.2018 vide Speed Post AWB No. – EA173865204IN, and the same was delivered on 14/03/2018, the Policy No. 501-6828294 was sent on 08.03.2018 vide Speed Post AWB No. – EA175325913IN, and the same was delivered on 14/03/2018, the Policy No. 501-6951146 was sent on 26.03.2018 vide Speed Post AWB No. – EA175383607IN, and the same was delivered on 10/04/2018, the Policy No. 501-7080259 was sent on 02.04.2018 vide Speed Post AWB No. – EA175416720IN, and the same was delivered on 16/04/2018. The Opposite Parties submit that in this case also a copy of proposal forms was sent along with the policy documents to the Complainant. It is pertinent to bring to the notice of the District Consumer Commission that the Complainant/policyholder retained the policy documents and did not raise any objection towards the policy. That it is submitted that the Policy holder had not approached the answering Op’s party during the free look period with any grievance regarding the policy or its terms and conditions. Meaning thereby that, the Policy holder agreed to the policies and its terms and conditions. That a bare perusal of the policy terms and conditions would clearly demonstrate that they contain no such benefits as have been alleged by the complainant to have been promised to him, and the policy has been issued strictly in accordance with the proposal form and CDF duly signed by the Complainant. That the complainant/policyholder only paid only one premium under the policy and he has not paid the due premiums. The premiums due for Policy No. 501-6549742 which was to be paid on 24.01.2019, for Policy No. 501-6742305 which was to be paid on 14.02.2019, Policy No. 501-6742370 which was to be paid on 14.02.2019, for Policy No. 501-6820218 which was to be paid on 28.02.2019, Policy No. 501-6828294 which was to be paid on 05.03.2019, Policy No. 501-6951146 which was to be paid on 24.03.2019, Policy No. 501-7080259 which was to be paid on 30.03.2019 were not paid and accordingly the policies have lapsed and in case he doesn’t pay further premiums the policies will be terminated as per policy terms and conditions. That Insurance being a contract between the Policyholder and the Company and both are governed by the Terms and Conditions mentioned in the Policy Document and all the benefits are payable strictly as per the policy terms and conditions. In view of the above the present complaint is liable to be dismissed. In view of the above the present complaint is liable to be dismissed. On merits, Opposite Parties No.1, 2, 4 took up the same and similar pleas as taken up by them in the preliminary objections and hence, it is prayed that the complaint of the complainant is liable to be dismissed against Opposite Parties.
3. Opposite Party No.3 appeared separately and contested the complaint and submitted that answering Opposite Party No.3 having no knowledge about the contents of the complaint. Further submitted that Opposite Party No.3 is engaged insurance broking business and all the polices in question are issued to the complainant after due verification and obtaining proper consent of the complainant. It is however denied that any demand was ever made by Opposite Party No.3 to deposit security amount for installation of any mobile tower. The complainant has averred in the complaint that he has not received any policy bond/ documents from Opposite Parties whereas the complainant has annexed several policy documents alongwith the complaint and hence, it is prayed that the complaint of the complainant is liable to be dismissed against answering Opposite Party.
4. In order to prove his case, the complainant has tendered into evidence his affidavit Ex.C1 alongwith copies of documents Ex.C2 to Ex.C35, additional affidavit Ex.C36 alongwith CD Ex.C37 and closed his evidence.
5. On the other hand, to rebut the evidence of the complainant, Opposite Parties No.1, 2, 4 also tendered into evidence affidavit of Sh.Sandeep Kumar Ex.OP1,2,4/1 alongwith copies of documents Ex.OP1,2,4/2 to Ex.OP1,2,4/17. Similarly, Opposite Party No.3 tendered into evidence the affidavit of Sh.Mudit Kaushik Ex.OP3/1 alongwith CD Ex.OP3/2 and thereafter, the Opposite Parties closed their respective evidence.
6. We have heard the ld.counsel for the parties, perused the written submissions filed by the complainant and also gone through the documents placed on record.
7. Ld.counsel for the Complainant has mainly reiterated the facts as narrated in the complaint and contended that in the month of December, 2017 the Complainant received a telephonic call wherein one Mr.Sumit Malhotra alleging himself as a Senior Manager of Opposite Parties asked the Complainant that their company wanted to install a tower of Reliance Jio 4G for which 15 square feet land is required and the company will pay Rs.35,000/- per month on account of rent for the said purpose. The policy term is 12 years for sum assured of Rs.4,72,847/- and the date of commencement of policy is March 5, 2008 with maturity date march 03, 2030. Said representative of the company stated that the Complainant has to invest Rs.40,000/- in Bhaarti AXA company for one year which will be returned alongwith interest after one year. Thereafter, the officials of the Opposite Parties told the Complainant that his plot is a very big plot and another tower was also installed there and they told that another tower known as High Extension has also installed for which 25 square feet land is required and for this purpose Rs.65,000/- per month as rent will be paid to the Complainant and also told that the Complainant has to invest another sum of Rs.65,000/- in their company for one year which was invested by the Complainant as per the requirement of the Opposite Parties. Thereafter, the Opposite Parties also demanded Rs.85,000/- from the Complainant being the security amount of first tower and said amount of Rs.85,000/- was paid vide two cheques. After receiving the amount, the Opposite Parties assured that said tower will be installed within one month. After one month, the Complainant received a call of Opposite Parties and told that Head Office has made some doubt that we have received graft from the Complainant for doing the said work so early and as such, Head office has now rechecked the account of the Complainant and told that now the Complainant has to send Rs.2 lakhs for one year and on believing the words of the Opposite Parties, the Complainant sent four cheques amounting to Rs.49,999/- each to the Complainant. After about one week, the Complainant had received another call from the office of Opposite Parties that we are talking from Finance Department of Opposite Parties and told to the Complainant that his amount becomes Rs.18 lakhs and the Complainant has to pay Rs.1 lakh as tax and on this, the Complainant also sent Rs.1 lakh through cheque for an amount of Rs.99,000/- from his account in favour of India First Life Insurance Company. The Opposite Parties told the Complainant that after about one month, said towers will be installed at his plot and the payment of rent of both the towers, bond papers will be sent to the Complainant. Thereafter, no call was made by Opposite Parties to the Complainant and the Complainant after about one month, called the above said Sumit Malhotra and Rajeev Gupta, but they never picked up the phone and one other person namely Chattneya Reddy contacted the Complainant and told that now he is working at the file of the Complainant and he told that said Sumit Malhotra and Rajeev Gupta had installed a cold in his account and the said code will be opened if the Complainant deposit Rs.50,000/- in India First Insurance Company and accordingly the Complainant made the payment of Rs.50,000/- through online from his account. Thereafter, the Opposite Parties did not pay any heed to the request of the Complainant. In this way, the Complainant came to know that the Opposite Parties have cheated and grabbed his hard earned money by disclosing wrong averments. The Complainant then requested the Opposite Parties to refund his amount alongwith interest, but the Opposite Parties flatly refused to extend any help and in this way, the Opposite Parties have played a fraud with the Complainant and grabbed his amount on account of withdrawing amount of old policy of his father. As such, there is deficiency in service on the part of the Opposite Parties.
8. On the other hand, ld.counsel for Opposite Parties No.1,2, 4 has repelled the aforesaid contention of the Complainant and contended that the complainant has cooked a false story to mislead this District Consumer Commission and to extort money from the respondent company. That the complainant has raised some very serious allegations in the complaint without substantiating with any documentary proof. The entire complaint is based on surmises and conjectures and thus deserves no other fate but an outright dismissal. It is further submitted that this Hon’ble Court has no jurisdiction to entertain the present Complaint. That in the present Complaint the Complainant has alleged Cheating, Misselling and Misrepresentation in the Garb of installation of a Mobile Tower of RELIANCE JIO Company and has further alleged that he paid a particular sum for the installation of the same but the same was not installed and a policy was issued. He has further alleged that time and again he has paid certain amounts as different occasions and has also named many people in the complaint like one Sumit Malhotra, Rajeev Gupta, Chattenya Reddy etc but non have been made a party in the complaint. Such serious allegations require a proper trial by a civil/criminal court and evidence has to be taken which is not possible in a summary trial. It is clear from the averments made in the Complaint that the Complainant has made such allegations; such matter in question involves complicated questions of facts and law as well as voluminous evidence, which can only be dealt with by a civil court. This District Consumer Commission has no jurisdiction to entertain the present complaint. The Complainant has failed to demonstrate any deficiency in service on the party of the replying Opposite Party. Deficiency is defined under section 2(g) of the Consumer Protection Act which means any fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance; which is required to be maintained in pursuance of a contract. In the present case, the OP has strictly acted as per the terms and conditions of the policy contract. That the terms of the policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion or substitution. That the Forum cannot pass any order in contravention to the terms and conditions of the policy contract. That the present complaint is not maintainable. As per the terms of the policy contract if the policy is not suitable, the policy holder may get his/her policy reviewed by returning the policy and policy documents within 15 days (Free Look Period) from the day the policy holder received the policy. The insurance company will return the premium paid to the complainant after making certain deductions specified therein. In the present case, The Policy No. 501-6549742 was sent on 27.01.2018 vide Speed Post AWB No. – EA173322928IN, and the same was delivered on 05/02/2018, the Policy No. 501-6742305 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814247IN, and the same was delivered on 24/02/2018, the Policy No. 501-6742370 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814264IN, and the same was delivered on 24/02/2018, the Policy No. 501-6820218 was sent on 06.03.2018 vide Speed Post AWB No. – EA173865204IN, and the same was delivered on 14/03/2018, the Policy No. 501-6828294 was sent on 08.03.2018 vide Speed Post AWB No. – EA175325913IN, and the same was delivered on 14/03/2018, the Policy No. 501-6951146 was sent on 26.03.2018 vide Speed Post AWB No. – EA175383607IN, and the same was delivered on 10/04/2018, the Policy No. 501-7080259 was sent on 02.04.2018 vide Speed Post AWB No. – EA175416720IN, and the same was delivered on 16/04/2018. The complainant after the receipt of the subject policies and policy documents did not approach the replying OP and got his subject policies reviewed/cancelled within Free Look period implying that the complainant duly accepted the subject policies and its documents with its terms and conditions. The complainant never approached the replying opp. party with any grievance pertaining to the subject policies and its terms and conditions and straight away filed the present complaint. The complainant is now estopped from raising the issues/ grievances with respect to refund of premium of the subject policies. The complainant is bound by the policy contract and given up /relinquish / waved his right by not exercising the Free look Provision. Thus, the complaint is devoid of any merit and is liable to be dismissed. That the opposite party as per clause 4(1) and 6(2) of the IRDA (Protection of Policy Holder’s Interest) Regulations, 2002, sent the policies and policy documents along with the copy of the proposal forms to the complainant giving him opportunity to review/cancel the policy within freelook period. The policy documents were dispatched to the complainant on at the address of the complainant and same was received by the complainant, which is also not disputed in the present complaint. Despite receipt of the policies and policy documents, the complainant failed to approach the opposite party within freelook period making any grievance with respect to the policy or its terms and conditions, implying the policy and its terms and conditions were duly accepted by the complainant and were in order. The complainant is bound by the policy contract and given-up/relinquish/waived his right by not exercising the freelook provision. The complainant is now estopped from raising the issues / grievances with respect to refund of premium of the subject policies. The applicant is bound by the policy contract and given up / relinquish / waved his right by not exercising the Free look Provision. Thus, the application is devoid of any merit and is liable to be dismissed. Furthermore it has been determined through catena of judgments passed by the Hon’ble National Consumer Disputes Redressal Commission New Delhi, in Mohan Lal Benal v/s ICICI Prudential Life Insurance Co. Ltd. and Harish Kumar Chadha v/s Bajaj Allianz Life Insurance Co. Ltd. that if the insured/Applicant is not satisfied with the policy taken, then he/she should avail the option of returning the policy within 15 days of receipt i.e. within “the Free-look Period”. The said proposition has also been clearly laid down in the case Shrikant Murlidhar Apte vs. Life Insurance Corporation of India, Revision Petition no. 634 of 2012 decided on 02.05.2013. Further, the National Commission concurred with the findings of Maharashtra State Consumer Disputes Redressal Commission, Mumbai that “Once 15 days ‘cooling off’ period is over, policy documents become binding on both the parties and the contents therein are also biding on both of them.” That the Complainant has raised some very serious allegations against the Answering O.P. without substantiating with any documentary proof. The entire complaint is based on surmises and conjectures and thus deserves no other fate but an outright dismissal. Submitted that Bharti AXA Life Insurance Company is a Life Insurance company which issues life insurance policies. Also Bharti AXA Life Insurance Company is not a financial institution which provides loan, bonus, etc. Further, the Complainant was taking policy from the Company which is altogether independent of other life insurance companies or Reliance Jio has no tie up or collaboration with the said company and would thus not have been misled. It is submitted that Bharti Axa Life Life Insurance Company is a separate entity legally as well as otherwise and has nothing to do with the business conducted by other institutions or agents. That it is further submitted that Bharti Axa Life Insurance Company Ltd has a separate legal, financial and administrative set up from that of other institutes, insurance companies and doesn’t deal with Installation of Reliance JIO Mobile Towers. That it is a settled principle of law that if any person signs a document, it is presumed that he/she has signed the same after reading and understanding it properly. That it is further submitted that it is a well settled principle of law that person who fills up anything on a signed document has status of ‘amanuensis’ only and cannot be treated as author of document. At the time of scribing (without admitting) the person who scribes (amanuensis) is treated as representative of person who has signed document and not the representative of the Company, thus after signing the document the person cannot release from signed document and lead anything which is contrary to terms stated in written document. It is submitted that the complainant is not entitled to any refund of the premium under the subject policies. The complainant enjoyed the benefit under the subject policy and now seeks to wriggle out from the same and also claiming the refund of the premium paid under the policy. The complainant continued to enjoy the benefit under the subject policy. The Hon’ble National Commission in the case titled “LIC of India & Ors. Vs. Siba Prasad Das &Ors.” reported in IV(2008) CPJ 156 (NC) has held that: “We are unable to appreciate as to on what ground the District Forum and State Commission could direct refund of premium? The premium is given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period of which the premium has been paid. It is not the case of the complainant that the risk was not covered for the period for which the premium was given. If after that the policy lapsed, under no provision of terms of the policy or law, could any court/forum direct for refund of any premium for the simple reason, as already stated, that the risk stood covered for the period of which premium had been paid.” That, the Complainant has sought a relief from this District Consumer Commission which he is not entitled to get under the terms and conditions of the subjected Life Insurance Policy and as such no deficiency in services on the part of the answering OP have been demonstrated by the Complainant. The answering OP submits that these are serious allegations of misrepresentation which may not be decided under section 12 of the consumer Protection Act 1986. Hence it is prayed that the District Consumer Commission may be pleased to dismiss the present complaint as against the answering respondent. The Complaint deserves to be dismissed on this count alone.That it is further submitted that the Opposite Party Company after the receipt of the proposal forms, and supporting documents life age proof, address proof etc issued the policies to the complainant. Additionally the complainant signed the documents containing the premium rates for the policy and made declaration that the complainant had read and understood the contents of the document and accepted the same. Furthermore, it is submitted that the complainant has received the policy documents and now with the intention to wriggle out of his contractual obligation and with a view to take undue advantage of the company he has filed the present complaint. Further more the complainant has also put his signatures on the application form on the declaration and authorization para where it is stated that he has understood the nature and contents of questions asked in the proposal forms. Further, in light of the Judgement passed by the National Commission in Life Insurance Corporation of India vs. Siba Prasad Dash, IV (2008) CPJ 156 (NC), since risk was covered for the period for which premium was paid, hence there is no question of a premium refund after the policy has lapsed. Section 64VB of the Insurance Act, 1938 too does not permit extending insurance coverage where premiums have not been duly paid. Further, since the complainant is an educated individual, it is presumed that he would have gone through the contents of the proposal form before signing on the same. Further, a bare perusal of the policy terms and conditions, would clearly demonstrate that no such policy benefits are contained therein as have been alleged by the complainant to have been promised to him. The complainant sought a relief from this District Consumer Commission which he is not entitled to get under the terms and conditions of the subject Life Insurance Policy and as such no deficiency in services on the part of the answering respondent have been demonstrated by the Complainant. The complainant has not paid the due premiums for all the policies. The premiums due for Policy No. 501-6549742 which was to be paid on 24.01.2019, for Policy No. 501-6742305 which was to be paid on 14.02.2019, Policy No. 501-6742370 which was to be paid on 14.02.2019, for Policy No. 501-6820218 which was to be paid on 28.02.2019, Policy No. 501-6828294 which was to be paid on 05.03.2019, Policy No. 501-6951146 which was to be paid on 24.03.2019, Policy No. 501-7080259 which was to be paid on 30.03.2019 were not paid and accordingly the policies have lapsed and in case he doesn’t pay further premiums the policies will be terminated as per policy terms and conditions. It is submitted that the complainant has not obtained the policies through any of agents/employees of answering respondents. For obtaining the policies in question, the policy holder had availed the services of an independent Broker i.e. SRIDHAR INSURANCE BROKER. An Insurance Broker is an independent entity licensed by Insurance Regulatory & Development Authority (IRDA), who advise their customers on their insurance needs and thereafter arrange insurance policy from any insurance company as per their own judgment and as per the customer’s choice. It is to be noted that the Insurance Companies do not enjoy any administrative control over the Insurance Brokers. All Insurance brokers are governed by the provisions of IRDA (Insurance Brokers) Regulations, 2002 and IRDA also entertain applications against Insurance Brokers. It is a settled principle of law that at the time of filling-up the proposal form, the agent acts as agent of insured and not of insurance company. No agent can be assumed to have authority from the insurer to write the answer in the proposal form. If an agent nevertheless does that, he becomes merely the amanuensis of the insured and his knowledge of the untruth or inaccuracy of any statement contained in the proposal form does not become the knowledge of the insurer. Further, it is also a settled principle of law that if any person signs any document, it is presumed that he/she has signed the same after reading and understanding it properly. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. The Supreme Court has held in Sitaram v/s Santanu Prasad, AIR 1966 SC 1697, that a master is vicariously liable for the acts of the servant acting in the course of his employment. For the master’s liability to arise, the act must be a wrongful act done through a mode authorized by the master, or a wrongful or unauthorized mode of doing some act authorized by the master. The act must be done only in the course of employment or in the scope of the agent’s authority. The Respondent Company does not authorize any of its agents to offer any such false promises or benefits to its customers, which are at variance with its product features, and assuming without admitting, that such false promises were made by any agent of the Company, the same would fall beyond the scope of the agent’s authority, and the Company would not be vicariously liable for the same. Further, it is a settled principle of law that a principal can be held vicariously liable for the acts of an agent, only where such act was within the scope of the agent’s authority. That, the Complainant has sought a relief from this Hon’ble Forum which he is not entitled to get under the terms and conditions of the subjected Life Insurance Policy and as such no deficiency in services on the part of the answering respondents have been demonstrated by the Complainant. The Answering respondent submits that these are serious allegations of misrepresentation which may not be decided under section 12 of the consumer Protection Act 1986. Hence it is prayed that the District Consumer Commission may be pleased to dismiss the present complaint as against the answering respondent. The Complaint deserves to be dismissed on this count alone. That there is no deficiency in service rendered by the answering respondent in present case, and the answering respondent is not a necessary or a proper party to present dispute, accordingly present complaint ought to be dismissed against the answering respondent. The Answering Respondents submit that the complainant had submitted Seven proposals for Insurance along with the customer declaration form, details of which are given below: -
Policy No. | 501-6549742 | 501-6742305 | 501-6742370 | 501-6820218 |
Proposal No. | 10284138 | 10284197 | 10284196 | 10506858 |
Name of the Policyholder/ Life Insured | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh |
Proposal date | 26.12.2017 | 09.02.2018 | 09.02.2018 | 26.02.2018 |
Insurance Plan | Elite Advantage | Elite Advantage | Elite Advantage | Elite Advantage |
Issuance date | 24.01.2018 | 14.02.2018 | 14.02.2018 | 28.02.2018 |
Premium | Rs. 39,999.44 | Rs. 35,033.74 | Rs. 30,029.49 | Rs. 44,999.79 |
Frequency of premium | Annual | Annual | Annual | Annual |
Delivery Details | Speed Post AWB No. EA173322928IN | Speed Post AWB No. EA173814247IN | Speed Post AWB No. EA173814264IN | Speed Post AWB No. EA173865204IN |
Policy document dispatched on | 27.01.2018 | 17.02.2018 | 17.02.2018 | 06.03.2018 |
Policy document received on | 05.02.2018 | 24.02.2018 | 24.02.2018 | 14.03.2018 |
Term | 12 years | 12 years | 12 years | 12 years |
Premium Payment Term | 12 years | 12 years | 12 years | 12 years |
Premium paid till date | Rs. 39,999.44 | Rs. 35,033.74 | Rs. 30,029.49 | Rs. 44,999.79 |
Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker |
Policy No. | 501-6828294 | 501-6951146 | 501-7080259 |
Proposal No. | 10506853 | 10506812 | 10506802 |
Name of the Policyholder/ Life Insured | Ranjodh Singh | Ranjodh Singh | Ranjodh Singh |
Proposal date | 27.02.2018 | 14.03.2018 | 16.03.2018 |
Insurance Plan | Elite Advantage | Elite Advantage | Elite Advantage |
Issuance date | 05.03.2018 | 24.03.2018 | 30.03.2018 |
Premium | Rs. 39,999.42 | Rs. 99,997.08 | Rs. 99,997.08 |
Frequency of premium | Annual | Annual | Annual |
Delivery Details | Speed Post AWB No. EA175325913IN | Speed Post AWB No. EA175383607IN | Speed Post AWB No. EA175416720IN |
Policy document dispatched on | 08.03.2018 | 26.03.2018 | 02.04.2018 |
Policy document received on | 14.03.2018 | 10.04.2018 | 16.04.2018 |
Term | 12 years | 12 years | 12 years |
Premium Payment Term | 12 years | 12 years | 12 years |
Premium paid till date | Rs. 39,999.42 | Rs. 99,997.08 | Rs. 99,997.08 |
Broker | Sridhar Insurance Broker | Sridhar Insurance Broker | Sridhar Insurance Broker |
The answering Opposite Parties after receipt of duly filled proposal form along with the other requisite documents and the amount of first yearly premiums deposit had issued the subject Policies. That the Complainant had him self opted for Yearly/Annual premiums for all the policies which clearly indicated in the proposal forms. The policy term has been clearly shown as 12 Years and Premium Payment term of 12 Years as per proposal forms submitted by the complainant himself. That the OP Company further states that it has put in place a mechanism namely Pre Issuance Verification Call (hereinafter referred to as “PIVC”) prior to issuing the policy and the core objective of this exercise is to confirm and satisfy at the Company’s end that the policyholder has understood the key features of the policy without any ambiguity and has no grievance in this regard. In the present case as well, the Company had affected PIVC for police and in the said call, the Complainant/policyholder did not raise any concern or issue and was in complete agreement with the terms and conditions of the policy. That in accordance to Clause 6 (2) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations, 2002 every policy document sent by it is accompanied by a forwarding letter which clearly mentions that in case Policyholder is not satisfied with the features or the terms and condition of the policy he can withdraw/ return the policy within 15 days i.e. under the “Free Look period” provision. The respondent further submits that as per Regulation 4(1) of the IRDA Regulation a copy of the proposal form duly signed by the Policy holder is also sent to the policy holder and was duly received along with the policy document thereby giving an opportunity to the Policyholder to understand the terms and conditions and approach the company if any discrepancy. It is pertinent to bring to the notice of the Hon’ble Court that the complainant retained the policy documents and did not raise any objection towards the policy. It is submitted that the complainant/ policyholder had not approached the respondents during the free look period or even after that with any of his grievance regarding the policy or its terms and conditions. Meaning thereby that the complainant/ policyholder agreed to the policy and its terms and conditions. The Policy No. 501-6549742 was sent on 27.01.2018 vide Speed Post AWB No. – EA173322928IN, and the same was delivered on 05/02/2018, the Policy No. 501-6742305 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814247IN, and the same was delivered on 24/02/2018, the Policy No. 501-6742370 was sent on 17.02.2018 vide Speed Post AWB No. – EA173814264IN, and the same was delivered on 24/02/2018, the Policy No. 501-6820218 was sent on 06.03.2018 vide Speed Post AWB No. – EA173865204IN, and the same was delivered on 14/03/2018, the Policy No. 501-6828294 was sent on 08.03.2018 vide Speed Post AWB No. – EA175325913IN, and the same was delivered on 14/03/2018, the Policy No. 501-6951146 was sent on 26.03.2018 vide Speed Post AWB No. – EA175383607IN, and the same was delivered on 10/04/2018, the Policy No. 501-7080259 was sent on 02.04.2018 vide Speed Post AWB No. – EA175416720IN, and the same was delivered on 16/04/2018. The Opposite Parties submit that in this case also a copy of proposal forms was sent along with the policy documents to the Complainant. It is pertinent to bring to the notice of the District Consumer Commission that the Complainant/ policyholder retained the policy documents and did not raise any objection towards the policy. That it is submitted that the Policy holder had not approached the answering Op’s party during the free look period with any grievance regarding the policy or its terms and conditions. Meaning thereby that, the Policy holder agreed to the policies and its terms and conditions. That a bare perusal of the policy terms and conditions would clearly demonstrate that they contain no such benefits as have been alleged by the complainant to have been promised to him, and the policy has been issued strictly in accordance with the proposal form and CDF duly signed by the Complainant. That the complainant/policyholder only paid only one premium under the policy and he has not paid the due premiums. The premiums due for Policy No. 501-6549742 which was to be paid on 24.01.2019, for Policy No. 501-6742305 which was to be paid on 14.02.2019, Policy No. 501-6742370 which was to be paid on 14.02.2019, for Policy No. 501-6820218 which was to be paid on 28.02.2019, Policy No. 501-6828294 which was to be paid on 05.03.2019, Policy No. 501-6951146 which was to be paid on 24.03.2019, Policy No. 501-7080259 which was to be paid on 30.03.2019 were not paid and accordingly the policies have lapsed and in case he doesn’t pay further premiums the policies will be terminated as per policy terms and conditions. That Insurance being a contract between the Policyholder and the Company and both are governed by the Terms and Conditions mentioned in the Policy Document and all the benefits are payable strictly as per the policy terms and conditions. In view of the above the present complaint is liable to be dismissed and as such, the present complaint is liable to be dismissed. Ld.counsel for Opposite Party No.3 also contended that Opposite Party No.3 having no knowledge about the contents of the complaint. Further submitted that Opposite Party No.3 is engaged insurance broking business and all the polices in question are issued to the complainant after due verification and obtaining proper consent of the complainant. It is however denied that any demand was ever made by Opposite Party No.3 to deposit security amount for installation of any mobile tower. The complainant has averred in the complaint that he has not received any policy bond/ documents from Opposite Parties whereas the complainant has annexed several policy documents alongwith the complaint and hence, it is prayed that the complaint of the complainant is liable to be dismissed against answering Opposite Party.
9. We have perused the rival contentions of the parties. In this contention, the Complainant has nowhere denied the
10. The main plea raised by the Opposite Parties is that after admitting the terms and condition the Complainant has purchased the insurance policies in question. On the other hand, the Complainant has nowhere denied this factum of knowledge of the terms and conditions and hence at this stage, the Complainant can not wriggle out from its agreement. Moreover, the complainant was given the entire knowledge about the terms and conditions and that being happily agreed and purchased the product, wherein it was clearly agreed upon that once the product is sold, can not be returned back and as such there will be no refund and this version has nowhere denied by the Complainant by filing any cogent and convincing evidence to prove that the Complainant never accepted such terms and conditions of the Opposite Party while purchase the policies in question. In this regard, we find force in the judgment of Hon’ble Supreme Court in the case of Grasim Industries Ltd. Vs. Agarwal Steel, 2009(4) CCC598 (SC), wherein it was observed that the person who signed the documents, there is presumption that he understood the document and only then he signed it specifically he is an educated person unless contrary is proved that it was obtained under some threat, pressure or coercion. It is well settled principle of law that the parties are bound by the terms and conditions of the Insurance Policy, and none of the parties can seek any relief beyond those terms and conditions. In this regard reference may be made to the observation made by the Hon’ble Apex Court in case cited as Suraj Mal Ram Niwas Oil Mills (P) Ltd. Versus United India Insurance Co. Ltd and another, 2011 CTJ 11 (Supreme Court) (CP) wherein the Division Bench of the Hon’ble Apex Court consisting of Hon’ble Mr. Justice D.K. Jain and Hon’ble Mr. Justice T.S. Thakur, held that:-
“22. Before embarking on an examination of the correctness of the grounds of repudiation of the policy, it would be apposite to examine the nature of a contract of insurance. It is trite that in a contract of insurance, the rights and obligations are governed by the terms of the said contract. Therefore, the terms of a contract of insurance have to be strictly construed, and no exception can be made on the ground of equity………..”
“24. Thus, it needs little emphasis that in construing the terms of a contract of insurance, the words used therein must be given paramount important, and it is not open for the Court to add, delete or substitute any words. It is also well settled that since upon issuance of an insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risk covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavour of the court should always be to interpret the words in which the contract is expressed by the parties.”
The facts and circumstances of the instant case are fully attracted to Suraj Mal Ram Niwas Oil Mills (P) Ltd case (Supra). Same view has also been expressed by Hon'ble State Consumer Disputes Redressal Commission, Punjab at Chandigarh in First Appeal No.485 of 2019 in case Reliance Nippon Life Insurance Company Limited, Versus Atma Singh, decided recently on 11.11.2021.
11. Moreover, there was sufficient time with the Complainant to get cancel the policies in question within free look period of 15 days after the receipt of the policies. As per the terms of the policy contract if the policy is not suitable, the policy holder may get his/her policy reviewed by returning the policy and policy documents within 15 days (Free Look Period) from the day the policy holder received the policy. The insurance company will return the premium paid to the complainant after making certain deductions specified therein. In the present case, The Policies were sent to the complainant and the same was delivered on The complainant after the receipt of the subject policies and policy documents did not approach the replying OP and got his subject policies reviewed/cancelled within Free Look period implying that the complainant duly accepted the subject policies and its documents with its terms and conditions. The complainant never approached the replying opp. party with any grievance pertaining to the subject policies and its terms and conditions and straight away filed the present complaint. The complainant is now estopped from raising the issues/ grievances with respect to refund of premium of the subject policy. The complainant is bound by the policy contract and given up /relinquish / waved his right by not exercising the Free look Provision. Thus, the complaint is devoid of any merit and is liable to be dismissed. That the opposite party as per clause 4(1) and 6(2) of the IRDA (Protection of Policy Holder’s Interest) Regulations, 2002, sent the policies and policy documents along with the copy of the proposal forms to the complainant giving him opportunity to review/cancel the policy within freelook period. The policy documents were dispatched to the complainant on at the address of the complainant and same was received by the complainant, which is also not disputed in the present complaint. Despite receipt of the policy and policy documents, the complainant failed to approach the opposite party within free look period making any grievance with respect to the policy or its terms and conditions, implying the policy and its terms and conditions were duly accepted by the complainant and were in order. The complainant is bound by the policy contract and given-up/relinquish/waived his right by not exercising the freelook provision. In view of the Judgements passed by the Honourable National Commission in Prema & Ors. Vs. Life Insurance Corporation of India, IV (2006) CPJ 239 (NC) and in Kishore Chandrakant Rathod v. Managing Director, ICICI Prudential Life Insurance Co Ltd and Ors, (Revision Petition No. 3390 of 2013, NCDRC), the onus was on the Complainant to read the contents of both the documents.The applicant is now estopped from raising the issues / grievances with respect to refund of premium of the subject policies. The applicant is bound by the policy contract and given up / relinquish / waved his right by not exercising the Free look Provision. Thus, the application is devoid of any merit and is liable to be dismissed.That in the case titled as “Pramod Kumar vs. SBI Life Insurance Co.” decided by DCDRF, (North-West) New Delhi, on 18/02/2014 (Case No.-935/2012) it has been held as under : -“…We have heard arguments advanced at the bar and have perused the record. The applicant has admitted that he had received the policy bond from which he had learned that he has being issued with another policy rather than the one for which he had made an application. If it was so the applicant had the option to reject the policy bond received by him within the Free Look period of 15 days. Since the applicant didn’t exercised the said option he cannot now raise a grievance about the same. In view of the judgement cited above we hold that there is no deficiency of service on the part of the OP…”. Furthermore it has been determined through catena of judgments passed by the Hon’ble National Consumer Disputes Redressal Commission New Delhi, in Mohan Lal Benal v/s ICICI Prudential Life Insurance Co. Ltd. and Harish Kumar Chadha v/s Bajaj Allianz Life Insurance Co. Ltd. that if the insured/Applicant is not satisfied with the policy taken, then he/she should avail the option of returning the policy within 15 days of receipt i.e. within “the Free-look Period”. The said proposition has also been clearly laid down in the case Shrikant Murlidhar Apte vs. Life Insurance Corporation of India, Revision Petition no. 634 of 2012 decided on 02.05.2013. Further, the National Commission concurred with the findings of Maharashtra State Consumer Disputes Redressal Commission, Mumbai that “Once 15 days ‘cooling off’ period is over, policy documents become binding on both the parties and the contents therein are also biding on both of them.”
12. Furthermore, the Complainant in his complaint has time and again pleaded that the Opposite Parties have played a fraud with him by misspelling the product by way of misrepresentation. In this regard, Hon’ble National Commission in case Reliance Industries Ltd. Vs. United Insurance Co. (1998) CPJ 13 has held that when the questions of fraud and cheating are involved, in regard to the claim of the Complainant, which require thorough scrutiny, including the examination of various documents and supporting oral evidence, the Consumer Fora cannot adjudicate upon the matter. Further in case Jayantilal Keshavlal Chauhan Vs. The National Insurance Co. Ltd.[1994 (1) CPR 396]: The Hon’ble National Commission held that if “fraud” is alleged, it is desirable that the complainant should be directed to Civil Court as investigation about such fraud is required to be done.
13. The nature of the dispute, in the present complaint, is squarely covered by the law laid down by their lordships of the Hon'ble Supreme Court in the judgement supra. A similar view has been taken by the Hon'ble National Consumer Disputes Redressal Commission in 1(2004) CPJ page 101 wherein it has been held by the Hon'ble National Commission in a revision petition titled as R.D. Papers Ltd. Vs. New India Assurance Co. Ltd. & Ors. in para No.7 of the judgement which reads as under:-
“After going through the complaint and the written version, it appears to us that the complaint raises complicated questions of facts which cannot be decided by us in our summary jurisdiction. It may be though the amount in this case is in few lacs and when we are receiving complaints involving crores of rupees, but then enormous evidence would be required in the present case especially in respect of allegation of forgery made by the complainant and denied by the Insurance Company.”
14. Keeping in view the aforesaid facts and circumstances of the case, the instant complaint is not maintainable in this District Consumer Commission for its proper adjudication and the same stands dismissed. However, the complainant can get redressal of his grievance from the Civil Court/ or any other competent authority, in accordance with law, for which the time spent before this District Commission shall stand excluded under Section 14 of the Limitation Act in the light of the judgment of the Hon'ble Supreme Court in case titled 'Lakshmi Engineering Works vs PSG Industrial Institute reported in 1995(3) SCC 583'. However, keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.
15. Reason for delay in deciding the complaint.
This complaint could not be decided within the prescribed period because the State Government has not appointed any of the Whole Time Members in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.
Announced in Open Commission.
Dated:08.03.2022.