FINAL ORDER
SRI R. DEY. MEMBER
The present case is filed by the complainant praying for direction upon OP no. 1 & 2 to cancel the schedule policies and to return back the deposited amount of Rs. 1.50.000. after deducting the processing fees. to give the compensation of Rs. 50.000. to the complainant and others.
The complainant.s case. in a nutshell. is that the complainant had a savings account no. 110101502147 and two Jewellery Bank Loan vide account nos. 110105081916 as well as 110105028869 in ICICI Bank Ltd.. Haldia branch. Having known about the time deposit scheme for a period of 1000 days and being assured by OP no. 1 the complainant put a signature on some printed forms and agreed to deposit a maximum sum of Rs. 1.50.000. which would be paid from his said savings account. Thereafter. the complainant came to know on 15.02.2013 by letter from OP no. 2 that the four ICICI Prudential Life Insurance policy having nos. 17177906 dt. 19.11.2012 of amount Rs. 30.000.. 17173201 dt. 19.11.2012 of amount Rs. 30.000.. 17177310 dt. 21.11.2012 of amount of Rs. 35.000. and 17195995 dt. 27.11.2012 of amount Rs. 50.000. had been operated in the complainant.s name. Having known about the insurance policies the complainant sent a letter to OP no. 2 stating his unwillingness to continue the said policies and requested the OP no. 2 to cancel the aforesaid policies and to return back the deposited amount to the complainant. Next. the OP no. 2 informed the complainant that he can change the policies from ICICI Bank Guaranteed Savings Insurance Plan to ICICI Bank Super Single Premium Plan. But the complainant wanted to get back the said deposited amount after deducting the processing fees and for the very reason the complainant sent notice to OP no. 2 on 2.8.2013 and to the OP no. 1 on 10.10.2013 which were received by both the Ops. The complainant never wished to deposit the said amount in ICICI Prudential Life Insurance Policy and according to the complainant for such dealings of the OP the complainant has been passing the days with mental agony.
The OP no. 1 has appeared in the present case and contested the same by filing a written statement wherein the OP no. 1 has mentioned about reported decisions to establish that OP no. 1 is not a necessary party regarding the instant case and also made his prayer to expunge its name with cost to the complainant. The OP no. 1 has also prayed to expunge the name of the OP no. 1 from the present case by a separate petition on the ground that the OP no. 1 is wrongly impleded by the complainant. The OP no.1 has not submitted WNA.
The OP no. 2 has appeared in the instant case and contested the same by filing WV as well as WNA wherein the OP no. 2 stated that according to clause 6(2) of the Insurance Regulatory and Development Authority (Protection of Policy holders interest) Regulations. 2002 every policy has been sent to the complainant along with a forwarding letter which clearly mentions that in case the policy holder is not satisfied with the terms and conditions of the policy. the same one can withdraw or return the policy within 15 days i.e. under the .Free Look Period. provision. As per the OP no. 2. as stated in WV. that as per regulations 4(1) of IRDA Regulation. a copy of the proposal form duly signed by the policy holder was also sent to the policy holder along with the policy document to give an opportunity to the policy holder to re.examine the replies made by the same policyholder in the said proposal form. According to the aforesaid system of insurance company. the OP no. 2 sent a copy of the proposal form along with the policy document to the complainant which was admittedly received by the complainant in time. According to the OP no. 2 that the complainant after retaining the document did not raise any objection regarding the policy during the Free Look Period with regard to the policies and its terms and conditions. It is also stated that the said policies were issued after receipt of the duly filled in and signed applications form and other documents submitted by the complainant. The OP no. 2 also informed the complainant through SMS regarding the issuance of policy and other features of the policy and the complainant became silent at that time and did not say about his dissatisfaction regarding the said policies. The complainant paid premium only for the first time and failed and neglected to pay the second premium which fell due in November 2013. It is also submitted by OP no. 2 in WV that the complainant. after passing of almost 7 months from the date of receipt of documents. approached the OP no. 2 for the first time on 1.7.2013 to cancel the said policies. As the Free Look Period was over. so. for the customer satisfaction the OP no.2 by the letter dt. 15.7.2013 offered the complainant an opportunity to change the policy product to Pinnacle Super Single premium plan by clubbing 4 policies mentioning a 15 days time for giving reply otherwise it would be constructed that the complainant wants to continue with the Guaranteed Savings Assurance Plan. According to the OP no. 2 as the insurance is a contract between the company and the policy holder. so the parties.policy holders are bound to abide by the terms and conditions of the insurance policy. As per the OP no. 2 that the complainant for paying the initial premium in each policy. issued cheques in name of ICICI Prudential Life Insurance Co. Ltd. and from this it is evident that the complainant was well aware that he applied for insurance policies.
None of the parties adduced any evidence but they have relied upon the averments in their respective pleadings which were supported by affidavit and the documents submitted by them before this forum. But both the parties submitted their WNA except the OP no. 1.
We have gone through the pleadings of the parties. the documents including the WNA submitted by them. We also perused and considered the applications dt. 5.2.2014 filed by the OP no. 1 for expunging its name from the cause title of the case.
Points for consideration
- Is there any deficiency in service on the part of the OPs?
- Whether the complainant is entitled to get any relief or compensation as prayed for?
With an eye to the above two points for consideration. the discussions are mentioned below.
Decision with reasons
Point nos. 1&2:
Having perused the pleadings of the parties and documents filed on the record it appears that the complainant had signed on the proposal forms regarding the insurance policies of OP no. 2 and made payment to OP no. 2 through cheque in respect of the said policies. Though the complainant alleged the OP no. 1 for misguiding him for doing such policies. but the complainant has not submitted any written supported and authentic documents which can prove that OP no. 1 misled the complainant to do the insurance policies. so. the complainant.s allegation against OP no. 1 has not been substantiated. But it is evident from the documents submitted by the OP no. 2 that the complainant started four policies by filling proposal forms and paying the premiums. After payment of first premium the complainant failed to pay the next premium and became defaulter. As per policy document . Terms and Conditions of Policy if a policy holder fails to pay first three premiums in three consecutive years. then the respective policy of the policy holder will be lapsed. Here in this case. the complainant has become defaulter after payment of first premium. therefore. as per policy terms and conditions the complainant is not entitled to get back the money which he paid to OP no. 2. The OP no. 2 received the letter dt. 1.7.2013 of the complainant for returning back the money which the complainant had deposited for four insurance policies and after receiving of the letters. the OP no. 2 informed the complainant vide letter dt. 15.7.2013 giving him an option to change the existing policy ICICI Pru Guaranteed Savings Insurance Plan to ICICI Pru Pinnacle Super Single Plan. But surprisingly. the complainant has not responded to the letter of the OP no. 2 though the complainant had admitted about the receiving of such letter in his petition. As according to the terms and conditions of the insurance policy. which the complainant committed to abide by. the deposited amount in respect of insurance policy cannot be refunded. then when OP no. 2 offered an alternative opportunity to the complainant to convert or to change the existing policy to another policy which may be suitable to the complainant. then the complainant has not responded to the OP no. 2. rather made allegation against both Ops for not returning the deposited money. In this particular point we feel it is not the right and authentic way of the complainant to fulfil his claim. Having perused the documents filed by the OP no. 2 it is clear to us that the complainant.s claim regarding the insurance policies is not sustainable. As OP no.2 has no negligence in issuing insurance policy paper after receiving the insurance premium from the complainant and also informed the complainant the details about the policies and the OP no. 1 as a Marketing Official of OP no.2 has not been proved negligent in any respect rather as per statement of transaction in savings account of the complainant. OP no. 1 has done its duty in respect of banking transaction. hence. we find no deficiency in service on the part of the both OPs. As the complainant signed on the proposal forms and the relevant documents or papers of the said insurance polices as well as issued four nos. of cheque after putting self signature. raised no objection during five months after receiving the four policies and did not respond or reply to the letter dt. 15.7.2013 of OP no. 2. hence. the complainant is not entitled to get any compensation or relief and as such. the instant complainant.s case is liable to be dismissed against the OPs.
Both the two points are. thus. disposed of accordingly and the said applications dt. 5.2.2014 of the OP no. 1 is also disposed of with the above observations and findings.
Hence. it is
ORDERED
That the instant case no. 98.2013 be and the same is dismissed on contest against the Ops. The parties do bear their own respective costs.
