Delhi

North East

CC/352/2014

Balbir Chand Sandhu - Complainant(s)

Versus

HDFC Life Ins. Co. Ltd. - Opp.Party(s)

04 Dec 2018

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

 

Complaint Cases No.s 352/14 & 353/14

 

In the matter of:

 

	Balbir Chand Sandhu Force No. 001403029 C-103, BN, RAF/CRPF Wazirabad, Delhi-110094.	Complainant
	Versus
1.           2.	HDFC Life Insurance Co.Ltd 1st Floor, 1/A, Mayur Palace Star City Mall, Mayur Vihar, Phase-1 Near Mayur Vihar Extn. Metro Station,                Delhi-110091 (Through its Manager).   Sh. Sandeep Aggarwal Agent, HDFC Life Insurance Co. Ltd  1st Floor, 1/A, Mayur Palace Star City Mall, Mayur Vihar, Phase-1 Near Mayur Vihar Extn. Metro Station,              Delhi-110091	Opposite Parties

 

DATE OF INSTITUTION:     JUDGMENT RESERVED ON:               DATE OF DECISION      :

10.09.2014 04.12.2018 04.12.2018

 

 

N.K. Sharma, President

Ms. Sonica Mehrotra, Member

 

 

 

 

 

 

Order passed by Ms. Sonica Mehrotra, Member

 

ORDER

1. Vide this order the two connected complaints bearing numbers 352/14 & 353/14 shall be disposed off by a common order. The factual matrix of the cases as narrated by the complainant in the present complaints are that he was contacted by OP2 telephonically on 25.12.2013 when he introduced himself as agent of OP1 and explained “HDFC Life Classic Assure Plus Policy” (hereinafter referred to as the Policy) features of OP1 and promised a tour coupon and a gold coin to be delivered by OP1 if the complainant buys the said policy but told the complainant not to disclose about such benefits on telephonic verification call owing to unnecessary percentage demand by such verification agents. The OP2 further assured the complainant of maturity amount of       Rs. 4.20 lacs on the said policy. The complainant believing in the assurances and promised made by OP2, purchased the said policy bearing no.16578514 on payment of premium of Rs. 30,000/- vide cheque cheque no. 675955 dated 20.01.2014. The policy was received by the complainant on 22.01.2014. After few days, OP2 contacted complainant again and informed him that he was selected in top 10 of OP1 and if he buys another policy worth annual premium of Rs. 70,000/-, he would earn lot of benefits. The complainant refused for the same stating that he is a mere Sepoy in the Army with limited means and cannot afford such a hefty premium of Rs. 1,00,000/- every year for both policies to which the OP2 assured the complainant that he will not have to wait for release of maturity benefits which he would receive by August 2014 when OP1 shall pay him an amount of Rs. 1,80,000/- (Rs. 30,000/- paid for earlier policy + Rs. 70,000/- if paid for 2^nd policy + Rs. 80,000/- as bonus) apart from annual tour package of anywhere in India. The complainant again getting lured by promises of huge benefits and tour package from OP2 on behalf of OP1 paid another cheque bearing no. 675957 for Rs. 70,000/- to OP1 through OP2 and a policy no. 16678376 dated 28.02.2014 was issued by OP1 to complainant. Therefore, the first complaint pertains to 1^st policy no. 16578514 dated January 2014 against premium of Rs. 30,000/- paid by complainant to OP and the 2^nd complaint pertains to 2^nd policy no.  16678376 dated February 2014 against premium of  Rs. 70,000/-. The complainant had submitted that after receipts of above mentioned policies, he noticed that none of the benefits promised by OP2 were mentioned therein and he felt cheated by the collusive and conspirational act of OPs having indulging in unfair trade practice. However, the complainant had to leave for his home town Jammu due to sudden death in the family and therefore could not contact OP2 for the said reason. On return to Delhi after 45 days, he tried to contact OP2 and other collection agents of OP1 for refund but to no avail. On 30.06.2014, the complainant received a call from Income Tax Department inquiring about the policies and after hearing the plight of the complainant, advised him for cancellation of policy on “swithing” by paying additional amount of Rs. 40,000/- after which only he would be able to withdraw his entire amount that to after three months. The complainant, being aggrieved with collusion and conspiracy of OPs of depriving him of his hard earned money by making false assurances and promises, wrote a letter dated  09.07.2014 to OP1 requesting for refund of his premium amount, to which letter the OP vide letter dated 16.07.2014 refused to cancel the policies and refund the premium amount without any specific denial of the allegations leveled by complainant in his complaint letter dated 09.07.2014. The complainant wrote another letter to OP1 at its Mumbai office reiterating his request for cancellation of policies and refund of premium but no action was taken by OP1 in this regard. Therefore, finding no other recourse, the complainant was constrained to file present complainants praying for issuance of directions to the OP1 jointly or severally to cancel the policy no. 16578514 and refund Rs. 30,000/- as premium paid their against and cancel the policy  no. 16678376 and refund Rs. 70,000/- as premium paid their against. The complainant also prayed for compensation Rs. 25,000/- and Rs. 50,000/- towards mental and physical harassment and torture and Rs. 11,000/- & 22,000/- towards litigation cost in each of the two complaints respectively.
2. Notices were issued to OPs on 22.09.2014. Written statements were filed by OP1 on 09.12.2014 in which it took the preliminary objections that the present complaints involved complicated and complex questions of fact which cannot be adjudicated under summary jurisdiction exercised by Consumer Forums under Consumer Protection Act, in view of settled law by Hon’ble Supreme Court in the case of Oriental Insurance Co. Ltd. V/s. Muni Mahesh Patel (2006) 7 SCC 655. OP1 further took the objection that since the complainant has alleged cheating, the complaint was outside the purview of the Forum placing relying on Judgment of Hon’ble NCDRC in Reliance Industries Limited V/s United India Insurance Co. Ltd. (1998) I CPJ 13 (NC) in which the Hon’ble National Commission has held that for question of fraud, cheating and conspiracy, proper forum of dealing would be competent civil court. The OP1 denied the allegations of mis-selling of policies on ground that complainant had applied for the same which had been issued based on duly signed proposal form and stood delivered on respective dates through First Flight Courier and as per regulation of IRDA and terms & conditions of said policies, the complainant was given an option called “Cancellation in the Free Look Period” to cancel the policies in question in case he was not agreeable to any of the provisions of the policy. The said option read as under “In case you are not agreeable to any of the provisions stated in the Policy and the details in the proposal form, stated in the policy and the details in the proposal form, you have the option of returning the policy to us stating the reasons thereof, within 15 days from the date of receipt of the policy. On receipt of your letter along with the original policy documents, where the reasons stated thereof are found valid, we shall arrange to refund the premium paid by you, subject to deduction of the proportionate risk premium for the period on cover and the expenses incurred by us on medical examination and stamp duty. A policy once returned shall not be revived, reinstated or restored at any point of time and a new proposal will have to be made for a new policy which contents mentioned in the letter of OP dated 16.07.2014, the complainant had himself filed alongwith his complaint. The OP1 urged that the complainant neither raised any concern regarding the policies features and terms & conditions within the said period of 15 days nor exercised free look cancellation period which was demonstrative of the fact that he was fully satisfied with the policies and suddenly raised concerns about the discrepancies therein in July 2014 alleging mis-sale and claiming cancellation & refund which act of complainant get rebutted at the threshold as he had signed the proposal form, printed illustrations and MID leaving no scope for ambiguity. In this regard OP1 relied on judgment of Hon’ble Supreme Court  in the case of Grasim Industries Ltd. V/s. Aggarwal Steel (Civil Appeal No. 5994/ 2014) in which the Hon’ble Supreme court vide order dated 20.10.2009 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 has affixed his signatures thereon, otherwise no signature on document can ever be accepted.” OP1 further denied any tour coupon and gold coin promised by OP2 to the complainant as benefits / complements of the said policies in question. The OP1, while admitting and acknowledging the receipts of premium of Rs. 1,00,000/- towards both the policies, stated that the complainant had opted for the policies on his own volition and voluntarily signed the proposal form and there was no promise of any maturity benefits of Rs. 1,80,000/- as alleged by complainant to have been made by OP2. The OP1 denied the complainant allegation of cheating, collusion or conspiracy of Op2 or indulgence unfair trade practice and denied the complainant inability to contact OP1 for cancellation of policy in view of his Jammu visit or any Income Tax call received by the complainant for want of sufficient knowledge and lack of cogent proof placed on record by the complainant submitting that these are make believe allegations/ averments. Lastly, OP1 submitted that the complainant had failed to prove OP1’s indulgence in unfair trade practice or deficiency in service and therefore, the complaint merit dismissal under provision of section of 26 of CPA.
3. Rejoinder was filed by the complainant in rebuttal to the defence taken the OPs in which he reiterated his grievance of false promises and assurances given by OP1 through OP2, its agent as also mis-selling of policies with false and frivolous assurances and that the present complaints were not that of cheating. The complainant submitted that when he found discrepancies in the sale of polices, he rightly raised objections in this regard in July 2014.
4. Evidence by way of affidavit was filed by complainant in reiteration of his grievance as narrated in his complaint.
5. Evidence by way of affidavit was filed by OP exhibiting authorization of deponent, Shri Yogesh Kumar, Associate Manager (Legal), policy documents alongwith proposal forms etc. and letter dated 16.07.2014 to the complainant, rejecting his request for cancellation and refund of premium.
6. Written arguments were filed by both the parties summarizing their respective grievance / defence.

The complainant in his written arguments reiterated his grievance of wrongful inducement/allurement by OP2 in coercing the complainant in to taking the policies of OP1 in question by paying a premium of Rs. 1Lac by making false promises of tour package and gold coin and other benefits which were never a part of the policies documents when actually received by the complainant for which he had lodged complaints with the OP1 on 09.07.2014 but the OP1 had refused to cancel the policies and refund his premium amount giving rise to the present complaints.

The OP1 in its written arguments placed on record the judgments relied upon by it on defence taken by it of judgment dated 23.02.2015 in Revision Petition No. 4463/2014 titled Gurinder Kaur Vs HDFC Standard Life Insurance Co. Ltd & Anr. passed by Hon’ble NCDRC in which the Hon’ble NCDRC held that the petitioner having failed to exercise her option of cancellation of policy within the stipulated free look period of 15 days, the same cannot be held as deficiency of service on the part of insurance company in declining to accede to the prayer for foreclosure of the policy as also judgment of Hon’ble Delhi SCDRC dated 04.05.2017 in FA No. 222/2014 titled Surender Kumar Vs SBI Life Insurance Co. Ltd in which the Hon’ble Delhi State Commission, after perusal of records specifically letter dated 04.06.2010 of OP1 sent to complainant with the policy specifically mentioning that the complainant had option of returning the policy to OP and cancel the same within 15 days of receipt of the said document, in terms of the law laid by Hon’ble Supreme Court in United India Insurance Co. Ltd Vs Harchand Rai Chandan Lal and Suraj Mal Ram Nivas Oil Mils (Pvt Ltd) Vs United India Insurance Co. Ltd, held that complainant was not entitled to any relief having failed to exercise his option of cancellation of policy within 15 days of receipt of policy document. The OP further relied upon the Judgment of Hon’ble Delhi State Commission dated 27.01.2017 in FA No. 902/2014 in MD Max Life Insurance Co. Ltd Vs Chand Kishore Nanda in which the Hon’ble Delhi State Commission set aside the order passed by District Forum which had allowed the present complaint and allowed the appeal of the insurance company in light of aforementioned Hon’ble Supreme Court judgment and law laid down therein of ‘terms and conditions of a contract have to be strictly read and natural meaning be given to it in strict compliance with terms and conditions of insurance policy since in a contract of insurance, rights and obligation are strictly governed by the term of the policy and no exception of relaxation can be given on the groundof equity.’

To buttress his arguments on the ground of the complainant being bound by duly signed proposal form and other policy documents, the counsel for OP placed on record the judgment of Hon’ble Supreme Court in the case of Grasim Industries Ltd and Anr. Vs Aggarwal Steel 2009 (13) SCALE 374 in which the Hon’ble Supreme Court 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. We have carefully considered the arguments advanced by the learned counsels for the parties and have examined the documentary evidence and the judgment placed on record by counsel for OP1. Counsel for OP1 categorically stated that he had instruction to appear only for OP1 and his defence in confined to that of OP1 and complainant made no efforts to have OP2 produced before the court despite his grievance solely against OP2 for inducement into buying the policies in question of OP1. Counsel for complainant argued that the deponent of OP1 Sh. Yogesh Kumar- Associate Manager Legal was authorized to appear and depose on behalf of OP1 vide authority letter dated 26.06.2014 and deposed in his affidavit by way of evidence that he was conversant and familiar with the facts of the case whereas the policies question pertain to the period January-February 2014 for which reason this Forum in proceedings dated 30.01.2015 had directed the said officer of OP1 to appear in person but the order was not complied with.  However on perusal of documents it has been seen that authority letter exhibit OP/1 is pursuant to the resolution passed in Board of Directors meeting of OP1 held on 03.02.2012 appointing the AR for OP1, the time being relevant and same for the issuance of policies in question and in subsequent hearing dated 26.02.2015, both parties had given a joint statement for exploring possibility of settlement which remained inconclusive due to subsequent renovation in the Forum and Quorum not complete after which written arguments filed and matter was posted for oral arguments. 

In our view since the complainant has himself admitted in Para 6 of his rejoinder to the written statement filed by OP1 that the present case is not that of cheating but that of false promises and assurances given by OP2 on behalf of OP1 and of mis-selling of the policies in question, the reliance placed by the counsel for OP1 of the judgment of Hon’ble Supreme Court in Oriental Insurance Co. Ltd Vs Muni Mahesh Patel (2006) 7 SCC 655 of complaints involving disputed factual question should not be adjudicated by consumer Forums where proceedings are of summary nature is not applicable.

8. Two key issues therefore have arisen in the present complaint for consideration/adjudication of the present complaints.

1. The first issue is whether the policies of OP1 in question were sold by OP2 to the complainant under the inducement / promise of tour package, gold coin and other benefits to the complainant and the determination of the same. In this regard the complainant has not placed any documentary proof on record of any such telephonic conversation held between himself and OP2 alongwith the complaint despite the same being the basic premise and foundation of his complaints for admissibility which was conspicuously missing in the present case in as much as the complainant failed to place the same on record to corroborate his allegation of inducement / allurement by OP2 in to taking two policies by payment of premium of              Rs. 1 Lac to OP1 only to find none of the promises made to him featuring in any of the policies. On the contrary, what is placed on record before us are duly signed proposal forms and policies documents bearing signature of complainant.  Even otherwise, the complainant had duly signed the policy Proposal Form and policy documents in which it was clearly mentioned the standard policy provisions and no such benefit of tour package or gold coin etc. Therefore, the plea or ground for deficiency of service or inducement by OPs as alleged by the complainant is non maintainable and is therefore decided against the complainant. The judgments filed by counsel for OP1 of Hon’ble Supreme Court in Grasim Industries clearly has laid down the law on the said issue.

We are in agreement with the objection raised by the OPs that thepolicy contract is binding on both the parties putting their signatures and no deviation from the terms and conditions thereof is permissible in view of the settled law by the Hon’ble Apex Court in Export Credit Guarantee Corporation India Vs Garg Sons International 2013 (1) Scale 410, Suraj Mal Ram Niwas Oil Mils Pvt Ltd Vs United India Insurance Co. Ltd (2010) 10 SCC 567 and United India Insurance Co. Ltd. Vs Harchand Rai Chandan Lal V (2004) SLT 876 in which the Hon’ble Supreme Court held that there must be strict compliance with the terms and conditions of an insurance policy vide which the rights and obligations are strictly governed and no exception or relaxation can be given on the ground of equity howsoever liberally we may construe the policy, but we cannot take liberalism to the extent of substituting unintended words.

In light of judgments filed by OP1, OP1 submitted that the complainant having failed to deposit subsequent premium towards the policies in question, resulting in lapsed status of policies, the complainant is not entitled to any benefits arising thereof in view of the expressed terms and conditions of the policy documents which stipulated that if any premium remains unpaid 15 days after the due date during the first three years of the policy, the policy will be altered to lapsed status and no benefits would be payable.

 

2. The second issue arises whether the complainant was well within his rights to get the policies cancelled / premium refunded as asked for by him from the OPs in July 2014.  It is not in dispute that the HDFC Standard Life Insurance bearing polices no. 16578514 and 16678376 were issued to the complainant by OPs on 22.01.2014 and 28.02.2014 respectively on payment of premium of Rs. 30,000/- and 70,000/- respectively. The version of complainant for taking the policies was the assurance of tour package and gold coin and other benefits given by OP2 on behalf of OP1 given to him. However since the said benefits in question never got provided to him, the complainant asked for cancellation of policy and refund of premium vide letter dated 09.07.2014 to corroborate / substantiate the allegation of inducement / allurement by the OP2 in to the complainant taking the polices.

Per contra, the OPs have taking the defence that the policies were taken by the complainant being fully aware of the contents of proposal form and covering letters which had been duly read and signed by him. The defence of OP1 on the aspect of Free Look placing reliance upon the aforementioned judgment in which the Hon’ble NCDRC and Hon’ble Delhi SCDRC had held that premium for the policy period covering the risk cannot be refunded for a lapsed policy under any provision of terms of policy or law and if the insured/complainant was not satisfied with the terms and conditions of the policy, he had an option to return the policy within 15 days of receipt i.e. within “Free Look Period”. We find force in the argument put forth / defence taken by the OPs on this ground on the basis of settled law and the factum that the complainant did enjoy the complete risk cover for six months from issuance of policies without demur / protest and did not raise any objection for cancellation / revocation of the policy during that period and admittedly the objection was raised for the first time as per documentary evidence filed by the complainant in July 2014 for policies taken in January – February 2014 i.e. after 6-7 months. This issue is therefore also decided against the complainant in view of settled proposition of law and documentary evidence placed on record by both the parties. 

9.  Having considered the instant case on the touch stone of the settled provisions of law and the strict adherence of policy terms and conditions and clear observations of the Hon’ble National Commission in judgments pertaining to “Free Look Period”, we are of the considered opinion that the claim of the complainant must fail to the effect of alleging deficiency of service which it has failed to prove beyond reasonable doubt against the OPs given the onus of proving the same on him as per the settled law in the case of Ravneet Singh Bagga Vs K L M Royal Dutch Airlines (2000) 1 SCC 66 in which Hon’ble Supreme Court held that the burden of proving deficiency of service is upon the person alleging it. The rendering of deficient service has to be considered and decided on the basis of inefficiency, lack of due care, absence of bonafides, rashness, haste or omission, none of which ingredients is present or attributable in the present case against the OPs.
10. We therefore, conclude that the present complaints as devoid of merits and are therefore dismissed accordingly, leaving the parties to bear their own costs.       
11.  Let a copy of this order be sent to each party free of cost as per regulation 21 of the Consumer Protection Regulations, 2005.
12.   File be consigned to record room.
13.   Announced on 04.12.2018. 

 

(N.K. Sharma)     President

(Sonica Mehrotra)  Member