Order No. 23 dt. 23/06/2017
The case of the complainant in brief is that the complainant was approached by representative of o.p. with the proposal to make investment in one of the schemes of o.p. company. The complainant no.1 was assured that the complainants’ capital will remain intact and the complainant will make a good profit after about 3 years, accordingly the complainants invested the amount. The complainants were not in need of any policy but she invested the amount with the assurance of the representative of o.p. company that there will be good return by investment of the said amount to o.p. The complainants were informed that there was no risk of capital in the insurance policy but was only a safe and secured short term investment. The complainant no.1 was not informed that the said policy was unit linked policy and was subject to market risk as is usually done in mutual fund. The complainant on faith invested the amount for 3 years and after expiry of 3 years the complainant no.1 wrote to o.p. for refund of the amount and o.p. after obtaining necessary documents from the complainant no.1 refunded an amount of Rs.1,89,632.29 as surrender value. The complainants on receiving the said amount became astonished and requested the o.p. for balance amount but no action was taken on the part of insurance company for which the complainants filed this case praying for direction upon the o.p. for refund of the amount of rs.3,01,254/- and compensation of Rs.5 lakhs and also for interest.
The o.p. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the complainants are educated persons and belong to a highly educated family and the complainants were aware of the features of the insurance policy, they are going to take in respect of the said policy. The complainants gave blame upon the agent but if there would have any ambiguity the complainants could have contacted the company officials directly. The complainants have not made the agent as a party in this case in order to bring the truth before this Forum. The o.p. filed a common application form along with sales illustration with w/v. The complainants received the policy on 28.9.09 and they had 15 days time within free look period for cancellation of the policy but the complainants did not take any action. It was further stated that Hon’ble National Commission had categorically laid down that after expiry of the free look period the insured will be eligible to get what has been provided for in the policy terms and conditions. The o.p. further stated that the policy was unit linkd insurance plan was directly related to the performance of the market and daily fluctuation of NAV. The complainants were informed regarding the policy condition at the time of taking the policy and when the request for surrender was made the same was processed within a reasonable time and the entire money which was payable was paid to the complainants by making RTGS transfer. There was no deficiency or unfair trade practice on the part of o.p. thereby o.p. prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant obtained the policy from o.p.?
- Whether the policy was unit linked insurance plan?
- Whether the complainant no.1 was provided with the surrender value?
- Whether there was any unfair trade practice or deficiency in service on the part of o.p.?
- Whether the complainant will be entitled to get the relief as prayed for?
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainants argued that the complainants being a housewife of a retired judge of Hon’ble Supreme Court of India and they had no such occasion for getting medical insurance policy since they are entitled to get the medical reimbursement from the Supreme Court. The complainant no.2 is a married daughter of the complainant no.1 and she lives in Delhi and she was not in need of any insurance policy at all. The complainant no.1 for the purpose of a short term investment and for a safe and secured return invested the amount and after investment for 3 years when she wanted to surrender the policy she was informed that the policy issued to the complainants was a unit linked insurance policy and was subject to market risk as is usually done in mutual fund. The complainants no.1 paid an amount of Rs.3,01254/- and she received only Rs.1,89,632.29 i.e. the complainants sustained the loss of Rs.1,11,621.71. The complainants had no such intention to invest the amount for purchasing the policy with the unit linked insurance policy and she was totally misled by the agent of the insurance company, therefore ld. lawyer for the complainant prayed for the balance amount as well as other reliefs.
Ld. lawyer for the o.p. argued that the complainants are educated persons and were fully aware regarding the terms and conditions of the policy. In the application for the policy it was specifically stated that the policy was unit linked insurance plan. Apart from the said fact the complainants after receiving the policy within free look period i.e. 15 days had the opportunity to read the policy terms and conditions along with illustration which was given by o.p. to demonstrate the financial benefit the complainant / insured will be getting. Ld. lawyer also stated that as per IRDA regulation the complainants could have returned the policy within 15 days from the receipt of the policy for any reason o.p. would have returned the premium amount subject to deduction of normal stamp duty charges and expenses incurred for medical test of the complainants as per law. The complainants did not take any action after the expiry of 3 years when the complainants wanted to cancel the policy as per NAV the amount was returned to the complainants. There was no deficiency in service on the part of o.p. or o.p. committed any unfair trade practice upon the complainants. On the basis of the fact and circumstances as stated above o.p. prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the complainants are well educated persons and they applied for the policy and the policy was received by them. They had the opportunity to go through the terms and conditions of the policy as well as example given in the terms and conditions of the said policy even after receiving the policy the complainants did not take any action for cancellation of the policy within free look period i.e. within 15 days from the date of receipt of the policy. It is also an admitted fact that the complainant no.1 in the evidence admitted that in order to have the safe investment she invested the amount with o.p. It is pertinent to mention here that the complainants after receiving the policy failed to exercise the option within free look period for cancellation of the policy, on the contrary paid the policy premium for 3 years, subsequently raised her objection regarding the lesser quantum of amount refunded to her after her surrender. In this respect we can also rely on the decision as disposed of by Hon’ble National Commission in respect of R.P. No.2356 of 2013 wherein it was held by Hon’ble National Commission that on perusal of the record it clearly reveals that the complainant purchased freedom life plan in unit link plan for a period of 10 years and Rs.25,000/- to be paid by her. The complainant paid premium only for a period of 4 years and as per Article 5 of the freedom life plan on surrender of policy the surrender value was returned by o.p. to the complainant and the Hon’ble National Commission held that the insurance company did not commit any wrong and also relied on a decision in respect of Appeal No.385/2012 Shelly Sharma and another vs. M/s Aviva life Insurance Co. Ltd. On the basis of the said judgment as well as since the policy was unit linked and the surrender value was returned to the complainants on the basis of NAV there was no deficiency in service on the part of o.p. insurance company and we also further hold that no unfair trade practice was adopted by o.p. Accordingly we hold that the complainants will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC NO.495/2013 is dismissed on contest without cost against the o.p.
Supply certified copy of this order to the parties free of cost.
