Sunandan Sharma complainant has filed this complaint U/s 12 of the Consumer Protection Act of 1986 against the opposite parties praying that opposite parties be directed to pay Rs.1,00,000/- alongwith interest @ 24% P.A. from the date of deposit till its realization in full and final payment. Opposite parties be further directed to pay Rs.10,000/- as compensation alongwith Rs.5,000/- as litigation expenses.
2. The case of the complainant in brief is that he is running an Institute of Computer Education. He has purchased two Life Insurance policies from HDFC Standard Life Insurance Co. Ltd., from Opposite party no.2 in the year 2013 for a premium amount of Rs.1,00,000/- p.a. each. However, he received a Policy document bearing Policy no. 16380239 dated 12.11.2013 in which he found that the information filled in the policy document was incorrect i.e. Nominee was wrongly filled as his father who has already expired on 07.11.2004, his signature was not on the policy, the benefits mentioned in the above said policy were not according to what was explained to him and the second policy purchased was never received by him. Thereafter he went to the office of opposite party no.1 on dated 15.11.2013 and enquired about the other policy which he did not receive and contacted the Operation Manager Mr. Shashikant about the free look of both the policies and after fulfilling all the requirements and depositing the Policy document no. 16380239 regarding free look of policies the Operation Manager Mr. Shashikant gave the acknowledgement slip regarding free look dated 18.11.2013 (wrongly) however he went to the office of opposite party no.1 on dated 15.11.2013. Thereafter Branch Manager Mr. Shelendar Sood opposite party no.2 contacted him and he met him at his Institute on dated 19.11.2013 accompanied with Mr. Raghunandan Babbar Branch Manager opposite party no.1 and requested him to create New Policy and transfer the funds of the free looked Policy to him after correcting all the wrongly filled information in the above said policy and Branch Manager Mr. Shelender Sood of opposite party no.2 taken request letter from him to apply for the new policy and transfer the funds of the free looked policy no. 16380239 to the new policy and Mr. Shelender Sood called to his branch through his own Mobile phone and dictated all his personal information regarding the new policy and brought the new application form of the new policy to his email ID and using his computer, Mr. Shelender Sood took out the print of the application form of the new policy and got his signature on the application form and then assured him that he had filled the new application form and the new policy document will be received by him within 2 months, however, after lapse of 2 months no policy documents was received by him. Thereafter he went to the office of opposite party no.2 but no satisfactory reply was received by him. Thereafter he had filed complaint through email to Sh.Manik B. Sonawane, Office of the Insurance Ombudsman, SCO No. 101, 102 & 103, 2nd floor, Batra Building, sector 17-D Chandigarh-160017 regarding miss selling of the policy no. 16380239 and the said Ombudsman replied him in respect of the policy no. 16380239 that “this is with reference to you e-mail communication, we would like to inform you that as per our records free look cancellation request was denied as request was not permissible as free look request was received beyond 15 days. Therefore, we request you to kindly check the same.” His policy no.16380239 is neither free looked nor received the new policy generated by Mr.Shelender Sood Branch Manager of opposite party no.2. By doing the abovesaid act the opposite party no.1 and 2 have committed deficiency in services and caused the loss. Hence this complaint.
3. Upon notice, opposite parties appeared and filed their joint written reply through their counsel by taking preliminary objections to the effect that the complaint is not maintainable; the complaint is filed on mere conjectures and surmises. The complaint is false and frivolous allegations made against the opposite parties and are clearly an afterthought. There is no deficiency in service on the part of the opposite party and therefore, no case is made out against the opposite party under the provisions of the Act. On merits, it was submitted that the complainant has concealed the premium paid by him covered under policy bond no.16400412 was refunded to him under the free look option which was well within time. It was denied that the particulars in the policy no.16380239 were wrong. It was further submitted that the particulars in the insurance policy bond were wrong and as such even otherwise, complainant was not entitled to exercise the option of free look which is applicable only where the policy holder is not satisfied with the terms and conditions of the policy and benefits covered therein but the complainant has nowhere alleged any such reservations about the policy terms and conditions. It was however submitted that the request for cancellation of policy bond no.16380239 was beyond the free look period of 15days as per the said benefit given to the policy holder and as such the request for cancellation of the said policy bond no.16380239 was rightly declined by the opposite party and the said decision was duly conveyed to the complainant vide e-mail dated 19.2.2014. The complainant has in fact cooked up a concocted story to get benefit of his own wrong. The complainant was never promised for creation of a new policy by transferring of funds of one policy to other policy nor there is any such provision in the insurance business for transferring funds of one policy to the other policy. In fact the complainant submitted request for cancellation of policy no.16380239 at a belated stage i.e. beyond the period of 15 days and knowing well that the said request cannot be entertained, has made out this false story to give a wrong twist to the case. It has been further submitted that the Ombudsman rightly decided the matter, rightly confirmed the decision of the opposite party to decline the request of free look option with respect to the policy in question. Thus, there is no deficiency in service on the part of the opposite parties. All other averments made in the complaint has been vehemently denied and lastly prayed that the complaint may be dismissed with costs.
4. Complainant has tendered into evidence his own affidavit Ex.C-1 and of Raghunandan Babbar Ex.Branch Manager, HDFC Life Insurance Ex.C7, alongwith other documents Ex.C-2 to Ex.C-6 and closed the evidence.
5. Counsel for the opposite parties tendered into evidence documents Ex.OP-1 to Ex.OP7 and closed the evidence.
6. We have carefully examined all the documents/evidence produced on record and have also judiciously considered and perused the arguments duly put forth by the learned counsels along with the incidental scope of adverse inference for some documents ignored to be produced by the contesting litigants. We find that the OP insurers have duly admitted the receipt (Ex.C2) of the Policy # 16380239 for refund but the same was denied on strict technical grounds alleging that the return was beyond the IRDA mandated free look in period of 15 days by 2-3 days or so. However, the complainant’s allegation of issuance of the Policy with inadvertent ‘terms and conditions’ (including particulars etc) still stands un-rebutted and even no attempt has been made by the OP insurers to produce any cogent evidence in its defense and that amounts to implied admission of the complained of imputations/ aspersions etc. The Policy document (Ex.OP3) vividly shows Mr. Balkrishan Sharma (the Complainant’s father) as ‘nominee’ who is alleged to have expired ten years ago on 07.11.2004 and that speaks low of the working standard of the OP insurers. Further, the complainant alleges not to have signed the related ‘proposal-form’ and thus the OP should have produced the same in evidence to discharge its onus of proof but it opted/ chose otherwise to the best of its knowledge. Somehow, we are neither pleased with nor we approve the OP insurers’ counsels’ pleadings (naturally on the OP’s behalf) and insistence in the absence of any cogent evidence that the impugned Policy was issued with the express consent and at the instance of the complainant as expressed verbally and also in writing on the proposal form etc. The authorities that be at the OP insurers need to know that all their decisions are open to judicial-review and any arbitrariness shall certainly meet an embarrassing but judicious reversal.
7. In the light of the all above, while partly allowing the complaint we hold the OP insurers guilty of arbitrariness amounting to deficiency in service and thus ORDER them to refund the full amount of premium received in the account of the impugned Policy # 16380239 to the complainant besides Rs.5,000/- as compensation for the undue harassment and Rs.3,000/- as cost of litigation within 30 days of the receipt of the copy of these orders, otherwise the aggregate awarded amount shall attract an interest @ 9 % PA form the date of filing of this complaint till actually paid.
8. Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.
(Naveen Puri)
President
ANNOUNCED: (Jagdeep Kaur)
September, 23 2015. Member
*MK*
