Before the District Consumer Dispute Redressal Commission [Central District] - VIII, 5th Floor Maharana Pratap ISBT Building, Kashmere Gate, Delhi
Complaint Case No. 416/17.11.2016
Vadhans Singh
S-2/119, Sector-2, Old Mahavir Nagar,
Janakpuri East, West Delhi-1120018 …Complainant
Versus
Bharti Axa Life Insurance Company Limited
Videocon Tower, 6th Floor, Block E-1,
Jhandewalan, Extension, New Delhi-110055
Also at Regd. Office Unit 601 & 602, 6th Floor,
Raheja Titanium of Western Express Highway,
Goregaon (E), Mumbai-400063 ...Opposite Party
Date of filing: 17.11.2016
Coram: Date of Order: 07.03.2024
Shri Inder Jeet Singh, President
Ms. Shahina, Member -Female
ORDER
Inder Jeet Singh , President
1.1. (Introduction to case of parties) –The complainant filed complaint u/s 12 of Consumer Protection Act 1986 against OP with allegations of deficiency of services, and unfair trade practice that he took Life Insurance Policy under the plan “Bharti Axa Child Advantage Plan” against one time premium payment of Rs. 1,20,000/-, which he paid but after receipt of insurance policy, it revealed that what was assured and promised was not there in the policy, that is why he preferred request to surrender/cancel his policy within prescribed time but his request was declined. That is why the complaint for refund of paid premium with cost etc. of Rs. 50,000/- as he was subjected to physical pain, agony, mental torture, embarrassment and financial hardship.
1.2. This complaint is opposed by the OP that neither there is any unfair trade practice nor deficiency of services as the complainant was issued the insurance policy in terms of the signed proposal form for the tenure it was requested vis-à-vis the request for surrender of policy was beyond period of 15 days of free look period, it was not acceptable. The complaint is without cause of action.
2.1. (Case of complainant) –The complainant is working as a melodist/musician/ (रागी) in a Gurudwara, his annual income from all source is Rs. 3 lakhs. The OP is having branch office at Delhi and registered office at Mumbai. The OP through its agent/employees (namely Rawal Dixit, Nisha, Murali, Digvijay Singh, Ram Krishan Gupta from Direct Marketing Division) approached the complainant telephonically to have a life insurance policy and thence there was a meeting with them. The complainant took life insurance policy through authorized representative while assuring that there is coverage of life, return of survival benefit as money back of Rs. 60,000/- within a month from the date of booking of policy. The complainant gave consent by believing such assurance and paid one time single premium of Rs. 1,20,000/- by cheque no. 421369 dated 20.11.2015 and also signed blank proposal form on the same very day on the instructions of representative of OP.
2.2. A policy no. 501-3778245 was issued to the complainant, which is purported to be dispatched by OP on 21.12.2015. On receipt of policy bond, the complainant get explained its features from his well wisher, then it was realized tha the terms and conditions mentioned in the policy document are different as described by the representative of OP at the time of solicitation of policy. The complainant was told that it was one time single premium but policy document was showing that he was required to pay regular annual premium for next 12 years, survival benefit feature after a one month was not there and in this way the policy was sold to complainant fraudulently by cheating him of his hard money. It is unfair trade practice.
2.3 The complainant informed the OP and also wrote email request dated 22.01.2016 for cancellation/surrender of policy within 30 days from the date of receipt of policy, which is prescribed in Part-D/caluse-1 of policy bond being free look period for cancellation of policy within 30 days, e-mail was acknowledged by OP by email dated 22.01.2016. However, OP asked certain details for surrender of policy, which was provided on 27.01.2016, which was replied by the OP vide email dated 04.02.2016. Thence, OP after registering a complaint no. CRU061632, the OP informed the complainant by email that the matter is being looked into and Sh. Hamid Sheikh was appointed for redressal of grievances. The complainant received a mail dated 16.02.2016 from OP while rejecting his the request for cancellation of policy.
2.4 Thence, the complainant sent legal notice to the branch office of OP by speed post on 05.04.2016 for redressal of his grievances but there was no response. Had the complainant been given correct information and disclosed the features of the policy issued before it issue, he would not take the policy on such terms. That is why the complaint.
2.5 The complaint is accompanied with copy of blank proposal form, email dated 22.01.2016, emails dated 27.01.2016 and reply dated 04.02.2016, email dated 16.02.2016, notice and policy bond.
3.1 (Case of OP)- The OP filed its detailed reply by making pick and choose of paragraphs of the complaint instead of responding all the paragraphs of the complaint. The facts and features mentions in paragraph 2 & 3 above are not disputed by the OP in its written statement.
3.2. However, the allegations of complaint are opposed that the complainant had signed the proposal form after understanding the terms and conditions of the policy. The complainant had also understood the tenure of policy and premium payable. But the complainant kept quite till 22.01.2016 after receipt of insurance policy on 24.12.2015. The copy of proposal form and insurance policy document were sent to the complainant at his address on 21.12.2015 through Blue Dart vide AWB no. 44150176394 and it was delivered to the complainant on 24.12.2015. There was free look period of 15 days during which the request can be for cancellation of the policy but the request of complainant was beyond that agreed period, therefore, his request for cancellation was declined properly. The complaint is liable to be dismissed.
3.3 The reply is accompanied with customer declaration form, signed proposal form, copy of cheque of Rs. 1,20,000/- of first premium, terms and conditions of policy.
4.1. (Evidence)-Complainant Sh. Vadhans Singh led his exclusive evidence by filing detailed affidavit with the support of all documents filed with the complaint.
4.2. The OP also led its evidence by filing detailed affidavit of Sh. Sachin Kalra, Head-Legal, which is replica of written statement with the support of documents.
5. (Final hearing)-Both the parties were given opportunity to file written argument and oral submissions. However, the complainant filed the written argument but no written argument on behalf of OP. Similarly, at the stage of oral submission, the complainant requested that written arguments may also be considered as substitute of oral submission but there is no oral submission on behalf of OP.
The written arguments of complainant are blend of pleading and evidence vis-à-vis the case of OP mentioned in the pleading is reiteration in the evidence, therefore, in order to appreciate the case of parties, the entire record will be considered.
6.1 (Findings)-The case of both the sides are considered and in fact it is based on documentary record, which is narrowed down to a particular free look clause 'whether or not the plea of complainant would be tenable?. The insurance policy document is also proved by the OP ] it is Annexure-R2/Exh.DW1]. Therefore, it is a fact in issue and it can be determined with relevant evidence of insurance policy pertaining to free look period, being undisputed aspect the same is reproduced as follows:-
“Free Look Period : if policy holder disagrees with any of the terms and conditions of the policy, there is an option to return the original policy along-with a letter stating reason/s within 15 days of receipt of the policy in case of offline policy and within 30 days of receipt of the policy in case of policy sourced through distance marketing. The policy will accordingly be cancelled and the company will refund an amount equal to the premium paid and may deduct a proportionate risk premium for the period on cover, the medical expenses incurred by the company (if any) and the stamp duty charges. All rights under this policy shall stand extinguished immediately on cancellation of the policy under the free look option.”
It is apparent that there are two free look periods, it is 15 days in case of offline policy and it is 30 days in case of policy source through distance marketing. The next narrow question to be determined is in which time span the case of complainant is covered.
6.2. According to the case of OP the period is 15 days and as per free look period, the 15 days period is for offline policy. But according to complainant, the period of 30 days is available since the matter comes under policy sourced through distance marketing and the proposal form proved by the OP clearly shows that it is online proposal insurance policy of OP.
Since, the signed proposal form proved by the OP clearly mentions being highlighted as submission of 'online proposal for insurance policy', therefore, the case does not fall in the category of offline. There is period of 30 days as free look period for other than offline insurance policy. Therefore, it is held the complainant had period of 30 days from the date of receipt of insurance policy to invoke free look period being online policy.
6.3. The OP has also proved that the policy was dispatched through blue dart and it was sent from Mumbai and delivered to the complainant on 24.12.2016 and the complainant apply for surrender/cancellation of policy on 22.01.2016, therefore, cancellation was sought within 30 days of free look period. However, the complainant was not refunded the policy amount despite request.
6.4 As per free look clause, the OP had right to deduct a proportionate risk premium for the period on cover and to deduct other certain expenses. The period of one month was exhausted till request for cancellation of policy was made but the OP has not established other expenses. Therefore, the proportionate premium amount for one month was Rs. 10,000/- and after deducting this amount of Rs. 10,000/- from total paid premium amount of Rs. 1,20,000/-, the remaining amount comes to Rs;1,10,000/-; the complainant is held entitled for refund of such balance amount of Rs.1,10,000/-.
6.5 The complainant has claimed cost and compensation of Rs. 50,000/- but there is no specified criteria mentioned to make such claim. Therefore, in order to strike the balance that complainant was constraint to issue legal notice and for want of reimbursement of amount, this complaint for refund of the amount was filed; thus, cost and compensation of lump sum amount of Rs. 10,000/- is determined and allowed in favour of the complainant and against the OP.
7. Accordingly, the complaint is allowed in favour of complainant and against OP while directing the OP to refund/pay a sum of Rs. 1,10,000/- besides compensation and cost of Rs. 10,000/- (consolidated) to the complainant, payable within 45 days from the date of this order.
However, in case the OP does not pay (or deposit) the amount within that period, then OP will be liable to pay interest on amount of Rs. 1,10,000/- at the rate of 6%pa from the date of complaint till realization of amount. The OP may deposit the amount [in the name of complainant] with the Registry of this Commission in that period.
8. Announced on this 7th day of March 2024 [फाल्गुन 17, साका 1945]. Copy of this Order be sent/provided forthwith to the parties free of cost as per rules for compliances, besides to upload on the website of this Commission.
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