DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BATHINDA
CC.No.418 of 25-09-2013
Decided on 09-01-2014
Pankaj Kumar aged about 30 years S/o Pawan Kumar R/o House No.16697, Harpal Nagar, Ward No.5, Bathinda.
........Complainant
Versus
1.DLF Pramerica Life Insurance Company Ltd., 3rd floor, Sardar Guljar Singh Walia Complex, Above V Mega Mart, Near Bus Stand, Bathinda, through its Manager.
2.DLF Pramerica Life Insurance Company Ltd., 4th floor, Building No.9B, Cyber City, DLF City, Phase-III, Gurgaon-122002, through its M.D/Chairman.
.......Opposite parties
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM
Smt.Vikramjit Kaur Soni, President.
Smt.Sukhwinder Kaur, Member.
Sh.Jarnail Singh, Member.
Present:-
For the Complainant: Sh.Vinod Garg, counsel for the complainant.
For Opposite parties: Sh.N.K Batta, counsel for the opposite parties.
ORDER
VIKRAMJIT KAUR SONI, PRESIDENT:-
1. The instant complaint has been filed under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act') by the complainant. Briefly stated the case of the complainant is that on the allurement/assurance of the opposite parties the complainant deposited the amount of Rs.80,000/- as single premium with the opposite parties vide cheque bearing No.139326 dated 19.3.2012 drawn on Vijaya Bank, Bathinda, but the same has been dishonoured, he paid the amount of Rs.80,353/- vide DD No.324099 that has been encashed from his account in Vijaya Bank, Bathinda and the opposite parties intimated him that the policy bearing No.000130473 has been allocated to him and its terms and conditions would be sent to him shortly. The complainant approached time and again to the opposite parties for supplying the original policy alongwith its terms and conditions so that he could examine the same and exercise the option to seek its cancellation within 15 days after receiving the policy, in case its terms and conditions are not acceptable to him. The complainant submitted a written representation dated 12.1.2013 with the opposite party No.1, but the opposite parties were adamant not to supply the policy without getting indemnity bond and other formalities completed which are not reasonable and they have no right to get any indemnity bond as they are bound to supply the abovesaid policy alongwith its terms and conditions, copy of the proposal form with the option of free look period as per the guidelines of IRDA. In the first week of April, 2013, the complainant approached the opposite parties to seek the refund of the amount of the premium alongwith return of 20% to 25% as assured by them at the time of issuing of the insurance policy, but they have neither returned the amount of the first premium nor have supplied the policy, its terms and conditions and the copy of proposal form to him, rather they intimated him that they had issued him a ten years policy and no amount is payable before the expiry of 10 years and he is bound to pay Rs.79,924/- per annum till its expiry. Hence the present complaint filed by the complainant to seek the directions of this Forum to the opposite parties to refund the amount of Rs.80,000/- alongwith interest, cost and compensation.
2. The opposite parties after appearing before this Forum have filed their joint written statement and pleaded that the complainant submitted the application form with the opposite parties company for 'Assure Money +', a plan offered by the opposite parties company and approved by the Insurance Regulator-Insurance Regulatory & Development Authority (IRDA), a statutory body created by an Act of Parliament. The features of the above mentioned plan have been explained to the complainant and only after understanding the same in entirety, he opted the said plan. The complainant being an educated person must have gone through the terms and conditions of the application form and must be aware of the terms and conditions of the abovesaid policy at the time of filling of the application form as the same has been filled and signed by him. There is a Free Look Period option in which the policyholder has the right to review the policy terms and conditions and cancel the policy within a period of 15 days from the date of receipt of the policy documents if he/she is not satisfied with its terms and conditions. The complainant had voluntarily applied for the insurance policy after fully knowing about the terms and conditions of the abovesaid policy. The complainant after completely understanding the terms and conditions of the product 'DPLI Assure Money + Plan' had voluntarily filled up the proposal form bearing No.AF000538221, signed it on dated 19.3.2012, wherein Mrs.Neelam Rani wife of the complainant was proposed as a nominee. In the proposal form, the complainant had given all the relevant details and information in the prescribed form, for sum assured amounting to Rs.5,06,000/- and an annual premium amounting to Rs.79,924/- was proposed to be paid for the period of 10 years. The complainant submitted the various documents i.e. copy of pan card, driving licence etc. alongwith the application form, which itself shows that he after duly understanding the terms and condition, opted for the abovesaid policy. Thereafter the opposite parties issued the policy bearing No.000130473 with the commencement date of 29.3.2012 to the complainant and the policy documents, schedule, terms and conditions thereto alongwith a welcome letter have been dispatched to his mailing address by them on dated 31.3.2012 through the Overnite courier AWB No.6809799990 that were duly delivered to his address on dated 4.4.2012. As per the procedure on dated 15.4.2012, the opposite parties made the welcome call to the complainant as mentioned in the application form to check the status of the policy document, wherein he was informed about the policy details like policy name, policy term, sum assured, premium amount, duration, mode and next due date etc. The abovesaid policy has been issued to the complainant in the month of March, 2012 and the same has been delivered to him on his address as provided by him. The opposite parties have neither received any query or complaint during the free look period with respect to the non-receipt of the abovesaid policy. It was therefore presumed that the complainant was satisfied with the policy so issued to him. On 12.1.2013, the opposite parties received a letter from the complainant requesting him for the issuance of the policy documents and the same has been replied by them on dated 20.1.2013 and he was informed by them that the request for issuance of the the new policy pack would require indemnity bond. The opposite parties would issue the new policy pack on receiving the indemnity bond, but till date the complainant has not complied with the requisite formality, hence the duplicate policy pack could not be issued to him by them. If the complainant would not have received the policy documents, he should have approached the opposite parties earlier, whereas he has approached them in the month of January, 2013 i.e. after the lapse of 10 months from the date of issuance of the abovesaid policy, which shows his malafide intention.
3. The parties have led their evidence in support of their respective pleadings.
4. Arguments heard. The record alongwith written submissions submitted by the parties perused.
5. Admittedly, the complainant has purchased one insurance policy and deposited the premium of Rs.80,000/- with the opposite parties vide cheque bearing No.139326 dated 19.3.2012 drawn on Vijaya Bank, Bathinda, but the same was dishonoured, he paid the amount of Rs.80,353/- vide DD No.324099 that has been encashed from his account in Vijaya Bank, Bathinda and the opposite parties intimated him that the policy bearing No.000130473 has been allotted to him.
5. The disputed facts of the parties are that the complainant submitted that the opposite parties informed him that they would shortly supplied him the policy terms and conditions. The complainant approached time and again to the opposite parties for supplying the original policy alongwith its terms and conditions so that he could examine the same and exercise the free look option to seek its cancellation within 15 days after receiving the policy in case the terms and conditions of the policy would not be acceptable to him. The complainant has submitted a written representation on dated 12.1.2013 with the opposite party No.1, but the opposite parties asked him to give the indemnity bond and to fulfill the other formalities to get the policy terms and conditions. At the time of issuing of the abovesaid policy the opposite parties assured the complainant that only a single premium of Rs.80,000/- is required to be paid by him and he can seek the refund of the premium amount alongwith return of 20% to 25%, but they have neither returned the amount of the first premium nor have supplied him the policy terms and conditions.
6. On the other hand the opposite parties submitted that after completely understanding the terms and conditions of the product 'DPLI Assure Money + Plan', the complainant filled up the proposal form bearing No.AF000538221, signed it on dated 19.3.2012, wherein Mrs.Neelam Rani wife of the complainant was proposed as a nominee. The complainant was assured for the amount of Rs.5,06,000/- for which an annual premium paying amount of Rs.79,924/- was proposed to be paid for the period of 10 years. The complainant submitted the various documents i.e. copy of pan card, driving licence etc. alongwith the application form. Thereafter the opposite parties issued the policy bearing No.000130473 with the commencement date of 29.3.2012 to the complainant and the policy documents, schedule, terms and conditions thereto alongwith a welcome letter have been dispatched to his mailing address on dated 31.3.2012 by the Overnite courier AWB No.6809799990 that were duly delivered to his address on dated 4.4.2012. On receiving the letter dated 12.1.2013 from the complainant, the opposite parties have replied it on dated 20.1.2013 and informed him that the request for issuance of the the new policy pack would require the indemnity bond, but he has not complied with the requisite formalities, hence the duplicate policy pack could not be issued to him by them.
7. The complainant has given a written representation on dated 12.1.2013 to the opposite parties, which is duly admitted by them. The opposite parties have specifically submitted that the policy documents alongwith terms and conditions have been sent to the complainant vide Overnite courier AWB No.6809799990 on dated 31.3.2012 on his mailing address which was duly delivered to his address on dated 4.4.2012. To support their version the opposite parties have not placed on file any dispatch register or postal receipt or the affidavit of any officials of the Overnite courier company that the policy documents alongwith the policy terms and conditions and welcome letter have been delivered to the complainant. No name of the person is mentioned by whom the courier containing the policy documents has been received or whose signatures have been obtained on the courier delivery sheet. Thus the opposite parties have miserably failed to prove that they have ever sent the policy documents and policy terms and conditions alongwith the welcome letter to the complainant. Thus the version of the complainant seems to be true that he again and again approached the opposite parties to give him the policy documents alongwith the policy terms and conditions so that he can avail the free look period option of 15 days to reconsider the terms and conditions of the abovesaid policy and if he is not satisfied, he can get his policy cancelled under that option. Thereafter the complainant requested the opposite parties through a written representation on dated 12.1.2013 to provide him the policy documents alongwith policy terms and conditions and free look period option, but his letter has been replied by them on dated 20.1.2013, asking him to give the indemnity bond to this effect, but he has not given the indemnity bond, so they have not sent him the policy terms and conditions.
8. From the facts, circumstances and evidence placed on file we are of the considered opinion that the version of the complainant seems to be is true that no policy terms and conditions are given to him. The support can be sought by the precedent laid down by the Hon'ble State Commission, Punjab in case titled O.I.C. Vs. M/s Puneet Pasricha, FAO No.1579 of 2004, decided on 05.03.2010.
In the case in hand the terms and conditions are nowhere signed by the Insured nor it is proved that this was made a part of Insurance Policy. If the terms and conditions had been explained to insured at the time of insurance cover, these could have been given to them at the same time or at least these could have been got signed from them. Therefore, the oral version of the opposite parties that these terms and conditions were duly explained to the insured cannot be believed.
The documents/terms and conditions which are not supplied to the complainant or got signed by him or either by the parties, are not binding on the complainant. Regarding the contention of the complainant that the policy is single premium, the opposite parties have not specifically denied this fact. Moreover the opposite parties have themselves failed to place on file the copy of the policy issued to the complainant, which shows that no policy has been generated or issued to him till date by them. Furthermore no terms and conditions are placed on file by the opposite parties which are applicable in the case of the complainant.
9. Therefore in view of what has been discussed above this complaint is accepted with Rs.3500/- as cost and compensation against the opposite parties. The opposite parties are directed to refund the amount of Rs.79,924/- after deducting the proportionate amount of the premium of risk cover till 12.1.2013, medical expenses and stamp duty charges, if any and to furnish the detail of the deductions made by them from the amount of Rs.79,924/- to the complainant.
10. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.
11. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.
Pronounced in open Forum:-
09-01-2014
(Vikramjit Kaur Soni)
President
(Sukhwinder Kaur)
Member
(Jarnail Singh)
Member
