Complainant by filing this complaint has submitted thatcomplainant is the holder of one Insurance Policy vide No. 000289710 taken from op with the condition that the op will give him a loan of Rs. 10 lakhs against that policy and complainant gave one premium of Rs. 34,500/- deposited in the bank by cash on 08.02.2014 and complainant received the policy certificate on 28.02.2014 from a neighbour who said that a person from the Insurance Company came in the neighbouring area and asked the name and address of the complainant from him and when the neighbour told that he knew the complainant and the person to whom the Insurance Company handed over the certificate and went away without taking any signature of the complainant.
But in the meantime from the agent Mr. Rajat (Mob No. 7278001252) created pressure upon the complainant to take the policy and complainant came to know that op is unwilling to give him the above mentioned loan. But as per Section 6(2) of IRDA Regulation 2002, a policy holder can surrender his policy within 15 days from the date of receiving the policy certificate if he is dissatisfied with the policy. So the complainant went to the Insurance Company and surrendered the policy/certificate on 10.03.2014 i.e. within 15 days from receiving the certificate with a letter regarding surrender marked as Exhibit .B. and op gave a stamp in which it is written that .policy bond is attached. and op promised to complainant on the same day that he shall have to get the amount of Rs. 34,500/- but in reality they did not take any step for which complainant sent a letter to IRDA being Complaint No. 04-14-012572 but they did not respond and in the above circumstances, this complaint is filed for directing the op to refund the same along with interest and for compensation for harassment. Hence, the complaint is filed.
Fact remains that the notice was served upon the op at their Kolkata office from where they purchased it and also the office of the op at Gurgaon. But both the notices were served to Gurgaon address on 17.02.2014 but op did not turn up. But anyhow op changed the office address of Kolkata and ultimately the case is heard exparte on the ground that op did not take though appeared to contest the case. But Kolkata office/op by filing written statement submitted that op’sSmart Cash Protect Plan is approved by the IRDA and complainant with best knowledge purchased the same fully knowing well about the terms and conditions of the policy and fact remains that the sum assured amount is Rs. 3,44,160/- and premium is Rs. 34,500/- which was paid along with application form for premium payment term of 15 years and the policy term is 47 years and complainant submitted all documents. But complainant did not file any cancellation prayer within free look period of 15 days as per by IRDA guidelines and op neither received any query nor a complaint along with the document within the Free Look period for cancellation of the same. So, complainant is completely debarred to get any relief as per terms and conditions of the policy and the entire allegation of the complainant is completely false and fabricated and truth is that the policy document along with schedule of terms and conditions were despatched to the policy holder on 12.02.2014 through Speed Post being AWB No. ED249726845IN which was duly delivered to the address of the policy holder on 17.02.2014 and complainant has admitted that he received the documents and policy document was duly delivered to the policy holder as per address given in the application.
But the complainant suppressed all those facts and tried to create a story that he received from someone is completely false. But complainant for the first time contacted with op through a letter dated 10.03.2014 for cancellation of the policy which is after lapse of 15 days from the Free Look Period for which there is no scope to allow this prayer and complainant was informed that the request of cancellation of the policy cannot be accepted since the same is made outside the Free Look period as per provision and for which there is no question of deficiency and negligence on the part of the op and truth is that the written version was submitted along with Notarial Affidavit before this Forum on 22.11.2014 and it was notarized at the office of New Delhi.
From the said written version it is clear that complainant’s Head Office is at 4th Floor Building, 9B, Cyber City, DLF City, Phase-3, Gurgaon – 122002 and written version was filed by Amit Raheja, AVP – Company Secretary and Legal and duly constituted Attorney of DHLF Pramerica Life Insurance Co. Ltd. and they have prayed for dismissal of this case.
Decision with reasons
On proper study of the complaint and written version and also considering the entire material on record it is proved that complainant being allured by the agent Rajat of the op Company purchased one policy of DHLF Pramerica Life Insurance Co. Ltd. and deposited the first premium of Rs. 34,500/-. But complainant has submitted that he received that policy just 7/8 days prior to 10.03.2014 from another person who received the same and on receipt of the same he went to the agent of the op Mr. Rajat who stated that there is no scope to give loan at this stage. So, he sent the said surrender letter of the policy on 10.03.2014 and op’s authority at Kolkata asked him to wait for refund of the money but practically op is unwilling to refundof the same amount.
But truth is that on actual receipt of the policy by the complainant, he forthwith submitted the same for cancellation on 10.03.2014 and in fact this Rajat the agent of the op managed to receive of the said policy from the postal authority by putting such signature and handed over it to the complainant subsequent to that, but that is not the fault of the complainant. Because actual receipt of the policy document from the agent of the op was just 7/8 days prior to 10.03.2014 and complainant invariably within 15 days submitted it for cancellation of the same and in fact complainant had been deceived by the agent of the op and for which we find that there is no other alternative on the part of the op but to refund of the said deposited amount treated it as cancelled within time.
Another factor is that no insurance company has his legal right to grab the entire deposited premium amount when the insured is unwilling to continue with the said policy and in fact the policy is lapsed if anyone prays for cancellation of the policy and after one year the policy is automatically lapsed for non-payment of further premium and in that case the risk of life of the insured is not covered by the policy when it is dead. and in the present case that has happened. So in the above circumstances, we are convinced to hold that as per IRDA guideline 2010-2012 in case of lapsed policy it is the legal and bounden duty on the part of the insurance company to refund premium amount to the insured after deducting 5 percent as service charge but there is no legal authority on the part of the insurance company to grab the entire amount when the policy is dead, premium amount shall be returned to the insured forthwith after deducting 5 percent as service charge and in the present complaint complainant is entitled to get back the said amount of Rs. 34,500/- after deducting 5 percent by the op and op is bound to refund it and truth is that the insurance company’s office at Kolkata has been somehow or otherwise changed the address but changed addressed has not been sent by the Register office for some obvious reason and for which the complainant is being harassed and harassment is of such a nature that the present op company has no moral, social and corporate responsibility to inform to the complainant to meet at their office at Kolkata in this regard. But they submitted a written version which is the common expression of all the private Insurance Companies in all the cases and their only plea is the entire amount is forfeited though private insurance company is run by agent/consultant etc. and corporate office only for the purpose to somehow grab first premium and it is true that it is not their capital but that but it is proved beyond any manner of doubt that op insurance company has adopted unfair trade practice and they are squeezing money from the poor and middle class family members giving some hopes through agent and the brokers and for which the op is bound to refund the said amount treating it as cancelled within time after deducting 5 percent and same shall invariably be paid along with litigation cost and compensation etc.
Thus the complaint succeeds against the op.
Hence, it is
ORDERED
That the complaint be and the same is allowed on contest with cost of Rs. 5,000/- against the op.
Op is directed to release and pay a sum of Rs. 34,500/- after deducting 5 percent as service charge and also to pay compensation of Rs. 5,000/- for causing harassment to the complainant and also for selling such policy by mis-representation to the complainant by their agent and touts and amount of Rs. 5,000/- litigation cost + Rs. 5,000/- compensation + Rs. 34,500/- premium amount after deducting 5 percent of the premium amount as service charge to the complainant within one month from the date of this order failing which for non-compliance of the Forum’s order and for disobeyance of the Forum’s order, op shall have to pay penal damages at the rate Rs. 200/- per day till full satisfaction of the decree and for non-compliance of the Forum’s order, op may be prosecuted u/s 27 of C.P. Act 1986 for which further penalty and fine may be imposed.
