Before the District Consumer Dispute Redressal Commission [Central District] - VIII,      5th Floor Maharana Pratap ISBT Building, Kashmere Gate, Delhi

                                      Complaint Case No.06/2017

Mr. P. Krishnamurthy son of Shri P. Periasamy

r/o P-302, Aupam Apartment, East Arjun Nagar,

Delhi-110032                                                                            ...Complainant

                                                Versus

M/s Future Generali India Life Insurance Co. Ltd.

Unit no. 102A/103, Tiwari House,  Plot no.8 First Floor,

B-11, Pusha Road, Rajendra Nagar, New Delhi-110015        ...Opposite Party                                                

                                                                                    Date of filing:             07.01.2017

                                                                                    Date of Order:            14.11.2023

Corum: Shri Inder Jeet Singh, President

                 Ms. Shahina, Member -Female

Shri Inder Jeet Singh, President

                                                       ORDER

1.1. (Introduction to the case of parties) - The complainant has grievances of deficiency of services, false assurances and harassment against OP. The complainant was lured and assured by OP, thus  he took two insurance policies from OP but the promised LED TV and other  additional bonus/benefits were not given. When he requested to cancel the policies, his valid request was declined. That is why the complaint u/s 12 of the Consumer Protection Act 1986 for refund of paid premium, compensation in lieu of harassment and litigation costs.

1.2.  OP opposed the complaint vehemently that neither there is any deficiency of services nor false assurances nor harassment to complaint nor any LED TV was offered nor other benefits nor such promise was made by or on behalf of OP.  The complainant took policies through a broker but that broker was not made a party to complaint. The complainant is not entitled for any of reliefs claimed.

2.1. (Case of complainant) -  In April, 2015, the complainant received a call from a person representing himself to be an agent of the OP offering to purchase of policy of OP and he assured the complainant that OP’s policy  is more beneficial than policies of LIC of India, since OP's policy gives benefit of composite grant, bonus and LED TV.  He  also told complainant that they have links with LIC of India and they can get refunded complainant’s  money in policy with LIC, the complainant was induced to purchase policy from OP.

2.1. Since the complainant was made repeated calls by representatives of OP for attractive and beneficial policy besides assurances were given, thus complainant bought two policies from OP after completing all formalities viz (i) Policy no. 01255442 dated 30.04.2015 for annual premium of Rs. 1,09,000/- and (ii) Policy no. 01248035 dated 20.02.2015 for annual premium of Rs. 40,000/-.

            Thence complainant remained in regular touch of agents of OP for assured additional offers  of composite grant, bonus and LED TV but they kept on lingering the issue on one pretext or the other. The complainant also visited Delhi office of OP but none bothered to attend him nor gave any satisfactory reply. The complainant being feeling aggrieved and disappointed, wrote request letter dated 20.08.2015 to OP to cancel his policies/bonds and to refund the entire amount, since there was  misrepresentation and fraud to him. There was no response from OP.

2.2. The complainant was constraint to approach Insurance Ombudsman, Delhi but his complaint was dismissed by the Ombudsman  for the reason  request for cancellation  on ground of mis-selling of policies was after the free look period. Thereafter, the complainant approached to IRDA, Delhi, the complainant was informed by letter dated 07.03.2016 to file appropriate complaint before District Forum. Then police complaint dated 03.06.2016 was lodged with P.S. Farsh Bazar, Delhi. The complainant was feeling harassed mentally and physically from the OP besides financially hardship. There is deficiency of service and unfair trade practice on the part of OP; that is why complaint for refund of Rs.1,49,000/- of premium paid with interest @ 24% pa; damages of Rs. 18,00,000/- and costs Rs. 50,000/- in his favour and against OP besides other relief. The complaint mentions names  and contact number of agents of OP.

2.3. The complaint is accompanied with copy of policies, copy of letter dated 20.08.2015, email of OP dated 21.08.2015; copy of order dated 04.01.2016 by Insurance Ombudsman, IRDA’s reply dated 07.03.2016, complaint dated 03.06.2016 to the police.

3.1 (Case of OP)- OP in its reply does not dispute issue of  two policies to the complainant and it gives their details  viz. (i) Policy no. 01255442, w.e.f. 11.04.2015 for sum assured Rs.14,17,800/- against annual premium of Rs. 1,07,940/-, for 20 years tenure and (ii) policy no. 01248035 w.e.f. 20.02.2015 for sum assured Rs. 5,23,914/- against annual premium of Rs. 40,000/- and policy term for 18 years.

3.2.  However, OP denies all allegations against it in the complaint that it is false, frivolous, misleading and abuse of process as well as without cause of action against OP. However, the cause of action, if any, would be against the Insurance Broker namely A.B. Insurance Brokers Pvt. Ltd. who allegedly approached and lured the complainant to purchase the subject policies, inter alia, for earning maturity proceeds on the policies from other insurance companies, bonus, LED-TV etc. The complainant has intentionally failed to array said A.B. Insurance Broking Company  being necessary party to the complaint.  It is only A.B. Insurance Broking Company, who can reveal false allegations leveled by the complainant. The complaint is liable to be dismissed on the ground of non-joinder of necessary party. A.B. Insurance Brokers Pvt. Ltd. (through whom complainant procured two policies), is not agent nor employee of OP but is a licensed and registered with IRDAI and functions independently under IRDA Regulations, 2013. A.B. Insurance Brokers Pvt. Ltd. is independent and OP does not  have any administrative control over  it. The grievances of false promises for benefits of complainant are against employees of A.B. Brokers Pvt. Ltd.

 3.3. The OP was furnished the duly filled in and signed application forms by  complainant (along with supporting documents) containing features and terms and conditions for subject policies to be issued in favour of complainant. Accordingly, the policies were issued in conformity of information  provided in proposal forms. The OP sent a letter with policy bonds, copies of the proposal form  and signed benefit illustrations with policy terms and conditions to complainant. It was also mentioned that in case complainant is not satisfied with the terms and conditions of the policies, he can withdraw/ return the policies within 15 days being free-look period. The complainant had admittedly had received  policies with copy of the proposal forms and signed benefit illustrations, that is why they were produced in the proceedings of this complaint.

3.4  Since,  the complaint involves allegations of fraud and wrong-sale of policy, the issues cannot be adjudicated under summary procedure but it can only be adjudicated in Civil Court after holding a proper trial and leading substantive evidence. Moreover.  the Forum  lacks jurisdiction to entertain the present complaint as there is no deficiency of service or negligence on the part of OP. The  is complainant bound by the contents of polices and  the complainant estopped from raising the issues/grievances of refund of premium of the policies. The complainant is bound by the policies contract and he waived off his right for want of exercising the free look period in time. The complaint is  liable to be dismissed. The OP also refers case law. 

3.5 The reply is accompanied with copies of proposal form, benefits illustrations, CD of pre-issue verification call, copy of letter of forwarding policy, terms and conditions, receipt etc, copy of letter of free look cancellation request dated 20.8.202015, letter dated 27.08.2015 and copy of award dated 4.01.2016 by Ombudsman.

4.1 (Replication of complainant) -  The complainant filed his  detailed rejoinder to the reply of OP. The complainant  denies  of availing services of broker A.B. Insurance Brokers Pvt. Ltd. for the purchasing the policies; rather it were the officials/ agents/ sales Executives of OP, who contacted the complainant on telephonic and they never told of such broker. The OP is trying to shift its liability on broker company. It is denied that complaint is liable to be dismissed for non-joinder A.B. Insurance Brokers Pvt. Ltd as complainant never contacted to such company prior to purchase of policies. The complainant is  a consumer and complaint is maintainable before this Forum. It is also denied that there is no cause of action against OP. The case law cited by the OP in written statement is not applicable to the present case. Since police complaint is of civil nature, FIR was not registered by the police so, there is no question of initiating criminal proceedings. The complainant reiterates the complaint.

5.1. (Evidence) - The complainant led his evidence by filing detailed affidavit of evidence  supplemented with documents filed with the complaint.

5.2. OP also led its evidence by filing affidavit of Sh. Conjeevaram Bhardwaj, Executive Vice-President, Legal & Compliance and Company Secretary. The affidavit is replica of reply with support of documents filed with reply. The OP had also filed CD (but without its transcript) about pre-issue verification call to the complainant.

6.1 (Final hearing)- Both the complainant and the OP filed their written arguments, followed by supplementary written arguments on behalf of complainant. The written arguments  are hybrid of pleadings and evidence of the parties. The parties were given opportunities to make oral submissions, consequently Sh. Sanjay Kumar Tiwari, Advocate for complainant and Ms. Snigtha Bhattacharya Advocate with Ms. Samridhi Puri, Advocate for OP made their respective oral submissions.

6.2. The OP fortifies its contentions by drawing reasons from the following case:-

(i) Srikant Murlidhar Apte vs Life Incoporation of India, RP No. 634/2012 decided on 02.05.2013 it has been held that if the insured/ applicant 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”.

(ii) Surajmal Ramniwas Oil Mills (P.) Ltd. vs. United Insurance of India Co. Ltd. (2010-10 SCC 567) it was held that the words in the insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion or exclusion.

(iii)  LIC of India and Ors. Vs Sitaprasad Das & Ors. IV (2008) CPJ 156 (NC)  held that “we are unable to appreciate as to on what ground the District Forum and State Commission could direct refund of premium? The premium is given by insured, to cover the risk for a given period, and the insurer covers the risk for the period of which the premium has been paid. It is not the case of the complainant that the risk was not covered for the period in which premium was given. If after that the policy lapsed, under no provision of terms of the policy or law, could any Fora direct for refund of any premium for the simple reason, as already stated, that the risk stood covered for the period of which premium had been paid.”

(iv) M/s Grasim Industries Ltd. & Anr. vs M/s Aggarwal Steel 2010(1) SC 33, it was 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.

7.1 (Findings)- The rival contentions are considered, keeping in view the material on record, which is pleadings, oral narration of facts and documents, besides statutory provisions of law and case law. It is undisputed, that the complainant was issued two policies by OP after requisite proposal form and documents viz (i) Policy no. 01255442  and (ii) Policy no. 01248035.

7.2.1 But OP took objections that there is no cause of action against it; the complaint is also bad for non-joinder of A.B. Brokers Pvt. Ltd.  and issues can be adjudicated by a Civil Court by holding proper trial and of leading  detailed evidence and the Consumer Forum  lacks jurisdiction to entertain the present complaint. These issues/objections  are being taken one by one.

7.2.2  The complainant by his letter dated 20.08.2015 requested OP for cancellation of his two policies and refund of paid premium amount. However, OP by its letter dated 27.08.2015 opposed that no such request was not made within 15 days of free look period.  The IRDA by its letter dated 07.03.2016 to complainant informed that it plays only a facilitative role in resolution of complaints by the insurer and does not adjudicate upon individual complaints. The complaint filed by the complainant before Insurance Ombudsman was also dismissed by its order dated 04.01.2016. The circumstances are suggesting that complainant grievances against OP, it constitutes cause of action for determination, therefore, there was cause for filing the complaint. This issue is decided against the OP accordingly.

7.2.3  So far non-joinder of A.B. Bookers Pvt. Ltd. is concerned, it needs look at record. On 17.05.2017 the OP had moved an application u/Order I rule 10 CPC r/w section 151 CPC seeking direction to complainant to implead A.B. Insurance Brokers Pvt. Ltd and the complainant it by reply opposed that application, since Broker was not a necessary party.  Then OP withdrew that application, it was dismissed as withdrawn by proceedings dated 17.05.2018 subject to legal consequences. Otherwise, had the OP is of view that broker was a necessary party, even OP could have filed the application to implead necessary party but no such motion was moved by OP. Therefore, it is held that complaint does not suffer for non-joinder  broker. This issue stand disposed off.

7.2.4  The OP's objection that complaint can  be adjudicated by the Civil Court [by trial and by leading substantive evidence] does  not sustain since OP failed to suggest what are those specific complicated question of law and facts involved to be tried by Civil Court exclusively. There is general plea of OP. All the issues of this complaint can be determined by this Consumer Commission.  Thus, this objection is just for the sake of objections,  it is without merits and it is decided against the OP.

7.2.5  OP has also reservation that complainant is not a consumer, consequently the present Forum has no jurisdiction to entertain the present complaint. It is opposed by the complainant.

            Since the complainant is Insured and OP is Insurer by virtue of insurance policy contract. There is consumer dispute of 'whether or not the complainant is entitled for refund of paid premium amount' or 'whether or not there is deficiency of services'. Therefore, for issues involved of consumer disputes, the present Commission has jurisdiction to try and decide the complaint. This issue is determined against OP and it disposed off accordingly.

7.3. OP  by its letter dated 20.02.2015 informed the complainant that there is period of 15 days from the date of receipt of the insurance policy to seek review of the terms and conditions of the policy, in case complainant is feeling not satisfied, or disagreed,  with any of the terms and conditions of policy, he has the option to get cancelled  the policy., then OP/Future Generali will make refund of the paid premium after the eligible deduction, stamp charges, cost of medical examination, if any, and proportionate cost for the insurance cover period upto the date of cancellation. Further, OP by its letter dated 27.08.2015 informed the complainant that it had reviewed the complainant’s complaint and after necessary evaluations, it did not find merits to refund the amount since OP had made a verification call to complainant and it was completed successfully of complainant having understood all the details of the policies. Since there was agreed period of 15 days of ‘free look period’ to get the policy cancelled and to seek refund of paid premium but he failed to proceed within that period despite receipt of letter from OP. It is undisputed that terms and conditions of policies were sent to the complainant by OP through courier.  There is provision/option to complainant to withdraw/cancel the policies within ‘free look period', if complainant was not in agreement with the terms and conditions of policies. The free look period ended on 11.03.2015 and 21.05.2015 in the policies but complainant made request for cancellation on 20.08.2015,  this request for cancellation of policies was declined by OP on 27.08.2015. All these circumstances  are manifesting that complainant failed to get the policies cancelled within specified duration of ‘free look period of 15 days'.  The complainant failed to establish that his request for cancellation was within the stipulated period vis a vis OP has proved that request made much after free look period of 15 days cannot be invoked and request was properly declined.

7.4.  In view of aforementioned detailed discussion, analysis and conclusions, it is held that the material on record do not establish complainant's case of deficiency of services on the part of OP nor that complainant could establish that he was entitled to get the policy cancelled beyond 15 days free look period. Therefore, complaint fails, the complainant is not entitled for any of the reliefs claimed. The complaint is dismissed. No order as to costs.

8.  Announced on this 14th November, 2023 [कार्तिक 23, साका 1945].

9.  Copy of this Order be sent/provided forthwith to the parties free of cost as per rules for compliances.

                        [Shahina]                                                             [Inder Jeet Singh]

             Member (Female)                                                                               President