Kerala

StateCommission

A/12/774

BIRLA SUN LIFE INSURANCE CO.LTD - Complainant(s)

Versus

DR.VINESH SENAN - Opp.Party(s)

A.G.SYAM KUMAR

31 Jul 2015

ORDER

KERALA STATE CONSUMER DISPUTES REDRESSAL COMMISSION

SISUVIHAR LANE, VAZHUTHACADU, THIRUVANANTHAPURAM

APPEAL NO. 774/12

JUDGMENT DTD:31/07/2015

(Against the order in CC No.363/11 on the file of CDRF, Ernakulam dtd.29/3/12)

PRESENT

SHRI.K. CHANDRADAS NADAR. JUDICIAL MEMBER

SHRI. V.V. JOSE, MEMBER

 

APPELLANT

 

          Birla Sun Life Insurance Company Ltd.,

          Sahana Towers,

          Opp. Hotel Avenue Regent,

          M.G. Road, Ernakulam,

          Pin – 682016

 

          (By Adv. Sri. A.G.Syamkumar & Sri. K.R. Mahesh Kumar)

 

                                                                             Vs.

 

RESPONDENT

 

          Dr. Vinesh Senan,

          Dhanush Kallampally,

          Medical College P.O.,

          Thiruvananthapuram.

 

          (By Adv. Sri.Tom Joseph)

 

 

 

 

 

 

JUDGMENT

 

          SHRI.V.V. JOSE, MEMBER

 

          This is an appeal filed by the opposite party in CC 363/2011 in the file of CDRF, Ernakulam dated 29/03/2012 directing the opposite party to refund the insurance premiums with 12% interest.  The case of the complainant is as follows:

          2.      The complainant availed a Saral Jeevan Birla Sunlife policy of the opposite party on 28/11/2007 with an annual premium of Rs.1,36,000/- for a sum assured Rs.15,00,000/-.  A break occurred from November, 2008 onwards for remitting premium.  The policy was revived in October, 2009.  Due to the lapsed condition of the policy, opposite party informed that there will be no life cover and no growth in complainant’s investment.  Complainant came to know the deduction of Rs.4,260/- per month towards mortality charge, which is illegal since no life cover for the lapsed period.  As per the information of the opposite party the annual mortality charge is only Rs.4,260/-, whereas they deducted Rs.4,260/- per month.  This amounts to unfair trade practice and deficiency in service.  Complainant is entitled to get refund of the premium paid by him to the opposite party that is Rs.273360/- with 12% from 28/11/2009 till realization along with cost of these proceedings.  Hence the complaint.

          3.      According to the version filed by the opposite party, the complaint is barred by limitation, as it was after two years of cause of action.  The deduction of mortality charges cannot be challenged as per the policy contract.  The complainant was free to withdraw the policy within 15 days, under the free book period, if he is not satisfied with the policy conditions.  As per the terms of the policy reinstating is subject to recovery of all outstanding due.  The policy was not in force with effect from 29/12/2009 due to non-payment of premium from 28/11/2009.  Further to that the complainant approached the Ld. Ombudsman, Kochi for the redressal of his grievance in which the Ombudsman passed an award in favour of the opposite party hence prayed for a dismissal of the complaint.  Exts. A1 to A3 and B1 to B10 were marked by complainant and opposite party respectively.  No oral evidence was adduced by either parties. 

4.      Both parties were heard.  The Lower Forum framed two issues.  Whether the complaint was barred by limitation and entitlement of the complainant for refund of the premium amount paid.  The policy was admitted by the opposite party, which matures on 28/11/2027.  Since the maturity of the policy is in 2027 the contention of the opposite party of barred by limitation is unsustainable and hence rejected by the Lower Forum.

          5.      Even according to the opposite party as per clause 6 (2) of the Insurance Regulatory and Development Authority (Protection of policy holder interest) Regulations 2002, every policy documents sent by the company to the policy holder is accompanied by a forwarding letter by which the policy holder can withdraw or return the policy within 15 days that is “the free look period” if he is not satisfied with the policy conditions.  In the instant case no evidence is on record to prove that the opposite party has forwarded or dispatched such a forwarding letter to invoke his right under the free look period.  Opposite party also failed to produce the terms and conditions of the policy in the Lower forum also.  According to the forum opposite party failed to produce the terms and conditions and also they have failed to prove that they have gone by the terms and conditions of the policy, which amounts deficiency of service on their part.  So the contract entered into between complainant and opposite party is void abinitio.  Thereby the terms and conditions of the insurance contract if any is not binding on the complainant.  In the above circumstances the Lower Forum was of the firm view that the complainant is entitled to get refund of the insurance premium from the opposite party with interest at 12% from the date of each payment till realization and ordered accordingly.

          6.      The opposite party filed this appeal with the various contentions, almost similar to the contentions they have taken in the version.  They content that the evidence adduced by them was not properly appreciated.  But they have no specific case that the specific evidence under which document is not appreciated by the Learned forum.  So this contention does not appear to be correct.  Heard both counsels.  In fact the opposite party / appellant not seriously produced any documents to show that the policy holder will be deprived of refund of the amount remitted by them, with such deductions if any permitted by law.  No one can take unlawful enrichment under the pretext of vague conditions which are against public policy.  Their claim that they have obtained an order in their favour from the insurance Ombudsman was also not produced by the appellants.  The claim of appellant that on taking the policy they have given blanket authority to deduction of charges etc. appears to be unfounded.  We don’t find any useful and meaningful ground to consider their contentions and sustain the appeal.  The Lower Forum has only directed to refund the amount with interest lawfully remitted by the complainant does not have any legal infirmity.  There is no ground to interfere in the order of the Lower Forum.    We are constrained to upheld the order of the Lower Forum and dismiss the appeal without cost.  We are doing so.

          In the result, the appeal is dismissed.  The order of the Lower forum is upheld and we direct the appellant to comply the order of the Lower Forum in CC 363/11dated 29/03/2012 within a period of 60 days from the date of receipt of the copy of this order.

 

V.V. JOSE, MEMBER

 

 

K. CHANDRADAS NADAR, JUDICIAL MEMBER

 

 

 

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KERALA STATE

 CONSUMER DISPUTES

REDRESSAL COMMISSION

SISUVIHAR LANE, VAZHUTHACADU,

THIRUVANANTHAPURAM

 

APPEAL NO. 774/12

JUDGMENT DTD:31/07/2015

 

 

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