Orissa

Cuttak

CC/140/2023

Shaikh Jalal - Complainant(s)

Versus

Futura Generali India Insurance - Opp.Party(s)

B Kar

20 Feb 2024

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.140/2023

Shaikh Jalal,

Samantray Road,Buxi Bazar,

Nima Sahi,Ward No.16,Cuttack Municipality,

Cuttack.                                                                                   ... Complainant.

 

          Vrs.

 

Future Generali India Insurance Co. Ltd.,

Unit-801 and 802, 8^th Floor,Tower-C,

Embassy 247 Park,L.B.S. Marg,

Vikhroli (W), Mumbai-400083.… Opp. Party.

 

 

Present:         Sri Debasish Nayak,President.

                      Sri Sibananda Mohanty,Member.

 

Date of filing:    03.05.2023

Date of Order:  20.02.2024

 

For the complainant:           Mr. R.K.Pattnaik,Adv. & Associates.

For the O.P                :           Mr. C.Patra,Advocate.   

 

Sri Debasish Nayak,President          

Case of the complainant as made out from his complaint petition in short is that he had obtained a Insurance Policy from the O.P bearing No.01319174 on dated 21.11.2016 and had paid cash of Rs.49,900/- towards premium through it’s Broker.  The said Broker had told that only one premium is required for the said insurance policy but after receiving the insurance policy bond, the complainant could know that it is a 10-year premium for which he had contacted the Customer Care of the O.P and had requested to return his money by cancelling the policy.  The Broker of O.P had assured the complainant for its rectification and when the matter remained unsolved  even after several efforts made to that effect, the complainant had sent a legal notice also to the O.P on 11.4.2023 and ultimately had to file this case before this Commission seeking direction to the O.P in order to refund him the premium cost of Rs.49,900/- as paid alongwith bank interest thereon and further has prayed for compensation of Rs.90,000/- towards his mental agony and harassment.  He has also prayed for the cost of his litigation.

Alongwith his complaint petition, the complainant has filed copies of several documents in order to prove his case.

2.       The O.P has contested this case and has filed written version wherein the O.P has questioned the maintainability of the complaint petition and has urged therein to dismiss the same.  According to the O.P, the complaint petition is also barred by limitation.  The O.P ofcourse admits to have issued a policy bearing No. 01319174 to the complainant after receiving the initial premium from him to the tune of Rs.49,900/-.  The O.P has relied upon catena of decisions of the Hon’ble higher courts which are as follows:

i.        In the case of V. N. Shrikande Dr. Vs. Anita Sena Fernandas: IV 2010 CPJ 27(SC) wherein the Hon’ble Supreme Court has observed that Section 24 A contains negative legislative mandate against admission of a complaint which has not been filed within two years from the date of accrual of the cause of action.

ii.       The Hon’ble Supreme Court has held in Kandimalla Raghavaiah & Co. Vs. National Insurance Co. Ltd & Anr. (2009) CPJ 75 (SC) that: Section 24A bars any Fora set up under the Act from admitting a complaint, unless the complaint is filed within two years from the date on which the cause of action has arisen.  Same view was also taken in the case of State Bank of India Vs. B.S.Agriculture Industries reported in (2009) 5 SCC 121=II(2009) CPJ 29 (SC) and Kandimala Raghaviah and Co. Vs. National Insurance Company Ltd. reported in III(2009) CPJ 75 (SC),   In Champaben Atmaram Thakron Vs. Regional Provident Fund Commissioner & Anr (I) 2015 CPJ 131 (NC), the Hon’ble National Commission.

iii.      In the case of M/s. Grasim Industries Ltd. & Anr. Vs. M/s. Aggarwal Steel 2010 (1) SC 33: it is held that “When a person signs a document, there is a presumption, unless there is proof of force or fraud, that he has read the document properly and understood it and only then he has affixed his signatures thereon, otherwise, no signature on a document can ever be accepted”.

iv.      In Kishor Chandrakant Rathod Vs. The Managing Director, ICICI Prudential Life Insurance Co. Ltd & Anr. Decided by Hon’ble National Commission on 21.5.2014 in R.P No.3390 of 2013 it is held that “It must be borne in mind that the petitioner is an educated person.  He was supposed to read each and every term and condition of the policy.  There are no oral rules and conditions of the policy.

V.       Shrikant Murlidhar Apte Vs. Life Insurance Corporation of India decided by the N.C.D.R.C on 2.5.2013 in R.P. No.634 of 2012 has held that ‘The Insurance Agent is a Facilitator between the Insurance Co and the prospective policy purchaser.  He is an agent of consumer as well as Insurance Co.  He is not exclusive agent of Insurance Co.  Moreover, he cannot bind the Insurance Co. if he gives quotation of any policy at monthly or early premium than prescribed by the underwriting Insurance Co.

vi.      Prema & Ors. Vs. Life Insurance Corporation of India Ltd. IV (2006) CPJ 239(NC) :  In so far as the filing of the proposal forms is concern it may be mentioned that in terms of LIC V. M. Gowri’s Ors, the judgment referred to by the State Commission that the agent who got the proposal form could be an agent of the person seeking insurance policy,  The plea that the insured was not aware of the requirement to give correct answer and about contents of the answers given cannot be accepted.

vii.     The Hon’ble National Commission in the case titled “LIC of India & Ors. Vs. Siba Prasad Das & Ors. reported in IV(2008) CPJ 156(NC) has held that: “we are unable to appreciate as to on what ground the Dist. Forum and State Commission could direct refund of premium.

It is also urged by the O.P that the complainant had alleged against a broker but the said broker is not made a party here in this case for which the complaint petition is also liable to be dismissed on the ground of non-joinder of necessary party.   The O.P has relied upon a decision of the Hon’ble National Commission decided on 16.10.2012 in R.P. No.2870/2012 in the case of Mohan Lal Benal Vs. ICICI Prudential Life Insurance Co. Ltd. and Harish Kumar Chadha Vs. Bajaj Allianz Life Insurance Co. Ltd. decided on 7.10.2013 in R.P No.3271 of 2013 wherein it is held that if the Insured/Complainant is not satisfied with the policy taken, then he/she should avail the option of returning the Policy within 15 days of receipt i.e. within the “Free-look Period”.  It is thus urged that the complainant could have withdrawn himself from the policy within the said “Free-look Period” i.e. within 15 days from the receipt of the policy document but he had not done so.  The complainant had not opted for cancellation of the policy within the “Free-look Period” and had not sent any intimation nor had he made any correspondence with the O.P to that effect.  Accordingly, it is prayed by the O.P to dismiss the complaint petition as filed by the complainant.

          The O.P has also annexed copies of several documents alongwith it’s written version in order to support it’s stand.

3.       Keeping in mind the averments as made in the complaint petition and the contents of the written version of the O.P, this Commission thinks it proper to settle the following issues in order to arrive at a proper conclusion here in this case.

i.          Whether the case of the complainant is maintainable?

ii.         Whether there was any deficiency in service on the part of the O.P ?

iii.        Whether the complainant is entitled to the reliefs as claimed by him?

 

Issue no.ii.

Out of the three issues, issue no.i & ii being the pertinent issues, are taken up first to be considered here in this case.

After perusing the complaint petition, the written version, the written notes of submissions as filed from either sides as well as the documents available in the case record, it is noticed that the complainant had availed the insurance policy from the O.P on 21.11.2016 and had paid a sum of Rs.49,900/- to that effect.  The policy schedule as filed by the complainant clearly reflects that the said policy which was obtained by the complainant from the O.P on 29.11.2016 on annual premium basis and the term of premium was for 10 years. This goes to show that as per the policy schedule terms and conditions, the complainant was to pay nine more number of annual premiums for the said insurance policy as obtained by him from the O.P.  From his proposal form it is also noticed that the premium paying term as reflected therein was for 10 years.  The complainant had remained silent after receiving the insurance policy bond and had not opted to rescind the policy contract within the “Free-look Period”.  But has preferred to file this case before this Commission on 3.5.2023.  As per the terms and conditions of the Insurance Policy he could have availed the facility of terminating the policy within the “Free-look Period” which he had not opted.  Thus, the decisions as cited by the O.P in this regard when perused, it is noticed that the complainant has been estopped from rescinding the policy contract after elapse of the “Free-look Period”.  Moreso, there is inordinate delay in filing this complaint petition and the plea taken in this regard is of no help to the complainant.  Accordingly, considering the facts and circumstances of this case, this Commission comes to a conclusion that the case of the complainant is not at all maintainable and the O.P is not at all found to be deficient in it’s service in any manner.  Accordingly, these two important issues are answered against the complainant and in favour of the O.P.

Issue no. iii.

From the discussions as made above, it is held that the complainant is not entitled to any relief as claimed by him.  Hence it is so ordered;

                                              ORDER

Case is dismissed on contest against the O.P and as regards to the facts and circumstances of the case without any cost.

  Order pronounced in the open court on the 20^th day of February,2024 under the seal and signature of this Commission.         

                                                                                                                                                                                            

                                                                                  Sri Debasish Nayak

                                                                                              President

                                                                                             Sri Sibananda Mohanty

                                                                                                      Member