Delhi

North East

CC/372/2015

Rameshwar Kaushik - Complainant(s)

Versus

HDFC Life Insurnace - Opp.Party(s)

15 Mar 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 Case No. 372/15

In the matter of:

N.K. Sharma, President

Ms. Sonica Mehrotra, Member

Ravindra Shankar Nagar, Member

Order Passed by Ms. Sonica Mehrotra, Member

ORDER

1. In this complaint filed by the complainant he has stated that on 01.10.2015, he had taken a HDFC Life Insurance Policy vide distance calling medium being telephonic conversation which he had with Executive Ms. Nisha Yadav and Shri Ravindra Jain on their respective mobile phones and had taken insurance policy No. 17319845 effective 26.12.2014 onwards and for which he had submitted a cheque of              Rs. 10,000/- which was cleared from his SBI A/c to the HDFC Life Insurance Co. It has been submitted by him that he was promised by the above mentioned Executive  that policy premium would be                Rs. 50,000/- annual and 20% discount therein would be given to him and as such, he shall pay only Rs. 40,000/- annually. Further an amount of Rs. 7.5 lacs to 10 lacs would be the total maturity amount of the policy and it would be mentioned on printed policy document, which shall be sent to him afterwards. According to the complainant, he received the policy documents on 13.01.2015 which to his surprise, vide covering letter dated 05.01.2015 showed the annual premium amount of Rs. 38,800/- and there was no column of 20% discount as promised earlier, and Rs. 9,700/- was the quarterly premium payable for 07 years for a term of 10 years. Further, the maturity amount was mentioned in the policy as Rs. 1,80,987/- commencing from 26.12.14 which was nowhere near to Rs. 7.50 lacs to 10 lacs as promised to him by the OP executives. The complainant has submitted that he was not satisfied with these policy conditions and discrepancies therein and as such, he made calls to HDFC Executives Ms. Nisha Yadav who assured the complainant that within 20 days, he will receive a second kit of policy documents which shall be as per terms and conditions as promised to him. Further, complainant stated that he was advised to report his satisfaction for the policy to the verification department. Believing upon the executive Ms. Nisha Yadav, the complainant said as much to the verification department. According to complainant, Ms. Nisha Yadav and Shri Ravindra Jain made false promise of second kit of policy documents so that his free look period of 15 days to return the policy would lapse. Thereafter, the complainant made complaint to Customer Care of OP which advised him to make complaint in such a case of fraud / mis-sale and that is why he made online complaint on 03.03.2015 at 11:15 a.m. on website www.service@hdfclife.com and also vide letter to Grievance Redressal Officer of OP. However, the complainant was reportedly informed by Ms. Zahara Rizvi, Customer Relation Manager vide letter dated 21.03.2015 that nothing will be refunded to him and he should continue his policy. The complainant, thereafter, approached IRDA Department / IGMS in March 2015 and submitted on line complaint vide emails dated 25.03.2015, 06.04.2015, 23.06.2015, 30.06.2015 & 30.07.2015 but no response was received by him from OP to any of his emails for the refund of Rs. 10,000/- and solving the issue. The complainant has attached copies of these emails alongwith complaint to OP requesting the OP for refund of his life insurance policy premium from HDFC Life Insurance in response to his letter dated 20.03.2015 for cancellation of his policy, wherein it was intimated that since his request was received after expiry of 15 days free look cancellation period, the OP was unable to process a refund of the premium paid towards the policy. However, due to no action taken by OP, the complainant vide the present complaint has prayed for directions to OP to refund of Rs. 10,000/- with 12% interest from the date of purchase of policy till its realization and Rs. 25,000/- as compensation for mental agony, harassment, damages suffered by complainant on account of fraud, mis-sale, unfair trade practice and deficiency in service and Rs. 15,000/- as litigation charges borne by the complainant to be payable by OP.
2. The above complaint was admitted and notices were issued to OPs who filed the written statements. However OP3 did not appear and as such was proceeded ex parte.
3. OP1 & OP2 took preliminary objection in their written statement that allegation of fraud falls outside the scope of adjudication of this Forum in view of settled law by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi in the case of Reliance Inds Ltd. V/s. United India Insurance Company Ltd. Reported as (1998) CPJ 13 (NC). Hence, the present complaint does not qualify as a valid complaint as envisaged in section 2(1)(c) of the CPA 1986 and as such the complaint is liable to be dismissed. Further OP1 & OP2 stated in their reply that the present complaint involves complicated and complex questions of fact which cannot be adjudicated under the summary jurisdiction exercised by this Hon’ble Forum in disposal of the cases filed under the provisions of the CPA 1986 in view of the settled law on the subject by the Hon’ble Supreme Court in the case of Oriental Insurance Company Ltd V/s. Munimahesh Patel reported as (2006) 7 SSC 655 in para 10 whereof the Hon’ble Supreme Court, held that “proceedings before the Commission are essentially summary in nature and adjudication of issues which involve disputed factual questions should not be adjudicated…” and in that view of the matter, the present complaint deserves to be dismissed. Further OPs in their defence stated policy was issued to complainant without any ambiguity or miss-selling that as per regulation of IRDA and vide terms and conditions of the said Policy the policy could be returned within the free-look period of 15 days but the complainant has not returned the said policy within the stipulated period, hence, it can be assumed that complainant was satisfied with the said policy. OP also stated that cancellation request in respect of the subject policy came to be made by the complainant only after lapse of nearly one 1 & ½ years after delivery of the subject policy, hence as per the clause under the head “Cancellation in the Free-Look Period” the policy cannot be cancelled by OPs. OPs further stated that complaint devised the false allegation to create an impression that the subject policy was mis-sold and to impute blame of deficiency in service on OP to which false allegation get rebutted in the threshold since the subject policy came to be issued based on duly signed proposal form and other documents leaving no question for any ambiguity. OPs further stated that after expiry of said period of 15 days, the subject policy cannot be cancelled and the premium paid cannot be refunded and in that regard that there is no deficiency in service on the part of the OPs as held by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi in the case of OPs titled as Gurinder Kaur Vs. HDFC Standard Life Insurance Co. Ltd & Anr (Revision Petition No. 4463 of 2014, date of decision 23.02.2015) wherein the Hon’ble Commission has held that …   “the fact remains that the Petitioner having failed to exercise her option within the stipulated free look period of 15 days, it cannot be held that there was any deficiency in service on the part of the Insurance Company in declining accede to the prayer for foreclosure of the policy.” OP further took the plea that since the policy has been lapsed due to non-payment of premium by the complainant, hence there is nothing that is payable to the Life Assured. For ready reference OP mentioned the clause 5 of the Policy Terms and Conditions which says “In the event that any premium remains unpaid 15 days after the due date and your Policy has either, at our discretion, acquired surrender value, or has acquired a guaranteed minimum surrender value, your Policy will be altered to a paid-up Policy, subject to any terms and conditions, which we may specify from time to time. These terms will involve a reduction in benefits and you will be informed accordingly…….If, however, any premium remains unpaid 15 days after the due date and your policy does not have a surrender value, the basic benefit will lapse and no benefit will be payable to you….”. OP stated that the subject policy in which the premium was paid only once i.e. at the time of issuing the policy, no surrender value has been accrued in respect of the said policy, hence, as per the clause reproduced above, nothing is payable to the complainant. Apart that, OP totally denied of any assurance having been given by its Executives to complainant regarding printed policy documents about getting total sum assured of Rs. 7.5 lacs to 10 lacs which shall be payable to complainant by OP after maturity of policy. The OP stated that the policy documents were duly received by the complainant on 13.01.2015 and therefore if he was not satisfied with the terms and condition mentioned therein, he was at liberty to return the policy within the next 15 days i.e. 28.01.2015 which he did not.  OP further denied allegation of complainant that the complainant made a call to its executive or made complaint about the same or that the premium and maturity amount is totally different from that promised to the complainant or that the complainant wanted to return the policy as alleged. OP also denied that the Executives again called the complainant or said that within 20 days, the complainant will receive a second kit of policy documents in which all terms and conditions will be same as promised to the complainant or insisted complainant to tell the verification department that the complainant is satisfied with the policy as alleged. OP also denied any fraud or miss-sale by its executives name by the complainant or any alleged phone call made to Shri Prashant, Executive of OP by the complainant who told the complainant that this is a case of fraud/mis sale or that the complainant should file a written complaint to the nearest branch of OP. OP admitted that the first ever complaint lodged by the complainant with OP was on 03.03.2015 regarding the subject policy i.e. after almost ½ months of receipt policy document kit. OP, while admitting refusal to complainant for any refund, denied the allegation by complainant that OP asked him to go anywhere or make a complaint, as nothing will happen or then the complainant made a complaint or no reply is received till date as alleged.
4. In the rejoinder to written statement, the complainant denied that he was provided with the detailed and adequate information in respect of the policy under reference. Although he signed the proposal form but it doesn’t mean that customer will be bound to accept all the terms and conditions of the policy as terms and conditions of the policy are never mentioned on proposal form and therefore on being dissatisfied, he had full right of refund of premium. Since the proposal form was signed by the complainant having faith on terms and conditions described to him on telephonic conversation by HDFC executives but the terms and conditions, discount and maturity amount was totally different in printed policy document kit. Complainant denied the statement of OP in its reply that policy was not mis-sale. In support of his contents complainant states the terms and conditions described in policy telephonically by Executives of OP Nisha and Ravindra were totally different from that in the policy document kit hence the same is clear case of mis-sale of the policy by adopting unfair trade practice. Complainant further stated in Para 3 in his rejoinder that ECS option was not opted for by him but was still activated in his policy by OP to draw further premium from his account. The complainant further stated in his rejoinder that this is not merely a case of fraud but also involves un-satisfactory services, mis-guidance and suppression of facts by OP. Further, the complainant denied the allegation by OP of belated complaint on grounds that the complainant had telephonically contacted the executives on the same date of receipt of policy i.e. 13.01.2015 for cancellation of the same but the OP did not cancel his policy but misguided complainant by saying that “you will receive a 2^nd policy kit within next 20 days, in which all terms & conditions, discount and maturity amount will be the same as promised to you and your free look in period will start from the date of receipt of 2^nd policy kit” alleging the same to be suppression of facts. After that OP executives stopped receiving the calls made by complainant and period of free look in period had lapsed. Complainant further mentioned that in reference to the “free look in period” of policy kit, it is clearly mentioned that free look in period is of 30 days in case of distance marketing and not 15 days. Complainant has also taken objection of OP’s statement that complainant submitted the cancellation request after 1 & ½ years when actually the complainant had lodged a complaint telephonically with the OP on 13.01.2015 on same of receiving policy, and despite trying hard to connect with OP executives telephonically but unsuccessfully, the complainant had lodged the complaint with OP customer care on 01.03.2015 and online complaint at OP website
5. Evidence by way of affidavit were filed by complainant as well as OP1 & OP2 exhibiting relevant documents evidence in support of the case/ defence. OPs exhibited proposal form and policy documents issued to the complainant.
6. Written arguments were filed by both the parties and addressed orally as well. Written arguments filed by the complainant were a comprehensive amalgamation of his complaint, rejoinder and evidence reiterating his grievance against the OP. OP in its written arguments placed on record judgment in support of his defence in particular on ‘free look issue’.
7. We have heard the arguments forwarded by the complainant and OP1 & OP3. We have also gone through pleadings, documentary evidence and judgment filed by the parties in support of their contentions. On careful perusal of the same, our observations are as under :

1. The complainant failed to submit any documentary evidence by way of transcript of voice recordings of telephonic conversation held allegedly between him and Ms Nisha Yadav and Mr. Ravindra Jain Executives of the company to substantiate his contentions that he was promised a different policy with different set of terms and condition therein as also sum assured as well as discount on quarterly premium payable by him to HDFC Life Insurance Co. This was a very vital lacuna left by the complainant in this case.
2. The complainant had signed the proposal form after understanding the contents, terms & conditions of the policy wherein an amount of Rs. 1,80,987/- has been mentioned as sum assured which was filed by OP before this Forum which the complainant failed to disprove / rebut with cogent proof/substance.
3. The complainant had received the policy documents on 13.01.2015 as admitted by him and it was clearly mentioned in the covering letter dated 05.01.2015 that in case he is not satisfied with the policy, he had the option to return the policy within free look period of 30 days of receipt of policy by a written complaint to OP i.e. on or before 13.02.2015 but the complainant did not make the request for cancellation within stipulated period so as to press the claim for refund of premium amount deposited by him with OP with supporting evidence.
4. Even if it is presumed that the above policy was purchased through distance marketing and as such as per the clause, the complainant was eligible to cancel the policy within a period of 30 days from the date of receipt of policy i.e. 13.01.2015, the complainant did not make the cancellation request to OP within that stipulated period also with relevant proofs.
5. The complainant failed to submit any proof/ documentary evidence that he had requested for cancellation of the policy and refund of premium in writing to the OP within the stipulated “free look” period of 30 days in case of distance marketing. The OP on the other hand cited various case laws in support of rejection of complaint on ground of disputed / complicated facts (Reliance Industry Ltd Vs United India Insurance Co. ltd passed by Hon’ble NCDRC), summary trial process of consumer Forum (Oriental Insurance Co Vs Munimahesh Patel passed by Hon’ble Supreme Court) and most importantly on ‘free look option’ for cancellation of policy within 15 days / 30 days of receipt of same as passed by Hon’ble NCDRC in Gurinder Kaur Vs HDFC Standard Life Insurance passed on 23.02.2015 whereby the Hon’ble NCDRC held that be that as it may, the fact remains that the petitioner having failed to exercise her option within the stipulated free look period of 15 days, it cannot be held that there was any deficiency in service on the part of insurance company in declining to accede to the prayer for foreclosure of the policy. Thus, we do not find any material irregularity or illegality in the impugned order, warranting are interference in exercise of Revisional Jurisdiction. The revision petition is dismissed accordingly.

8. Keeping in view the above observations, lack of evidentiary proof to substantiate the case of the complainant and settled provision of law, we do not find any deficiency in service of unfair trade practice on the part of OP in not refunding the premium paid by the complainant towards the policy taken by the complainant from the OP. The complainant has failed to establish/ substantiate his contentions in the matter due to lack of documentary evidence placed on record by way of telephonic recording transcript since the entire case of the complainant is based on telephonic conversation alleged to have been held by the complainant between himself and executives Nisha and Ravinder as alleged executive of OP by the complainant. Accordingly, the complaint is dismissed as devoid of merits with no order as to cost on either sides.
9. Let a copy of this order be sent to each party free of cost as per regulation 21 of the Consumer Protection Regulations, 2005.
10.   File be consigned to record room.
11.   Announced on  15.03.2018