DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (CENTRAL)ISBT KASHMERE GATE DELHI

COMPLAINT CASE NO.  324/13

No. DC/ Central/2021/

vs.

Coram:       Ms. Rekha Rani, President

                    Shri Vyas Muni Rai, Member

                   Ms. Shahina, Member (Female)

ORDER

Ms. Rekha Rani, President

1. Ms. Jasleen Kaur (in short the complainant) filed the instant complaint under section 12 of the Consumer Protection Act, 1986 against ICICI Prudential Life Insurance (in short OP) pleading therein that complainant got issued one ICICI Prudential life time gold policy on 26.06.2009 vide Policy No. 12114177 and she paid a sum of Rs. 1,50,000/- to the OP for the said purpose and first premium was accepted by OP vide receipt no. 75943562 dated 26.06.2009.  It is further pleaded that on 29.09.2012 OP sent her a letter that they had foreclosed the policy with effect from 28.06.2012 for the value of units as on date for Rs. 1,37,974.27/- and a cheque bearing no. 884946 dated 28.06.2013 for a sum of Rs. 34,493.57/- drawn on ICICI Bank was also sent with the letter.  Complainant did not encash the cheque as the same was not proper payment.  Complainant did not receive any satisfactory response from the OP as to why she was paid only Rs. 34,493.57/-.  She sent a legal notice dated 11.03.2013 to the OP.  The said legal notice was not returned so it can be presumed that the same was served on the OP but OP did not reply to the same.  Hence, the instant complaint was filed seeking direction to the OP to pay her a sum of Rs. 1,50,000/- with interest at the rate of 12% p.a., with effect from 26.09.2009 till payment and Rs. 50,000/- for deficiency in service.
2. OP filed reply. It is pleaded that the complaint is barred by limitation under Section 24A of the Consumer Protection Act, 1986. It is stated that the subject Policy was issued to the complainant on 28.06.2009 and now after expiry of more than five years, complainant has approached this Forum for seeking refund of the premium.  It is also stated that complainant paid only one premium till 28.06.2010 and thereafter she failed to pay renewal premiums and also failed to revive the subject policy within two years from the due date of first unpaid premium and accordingly the Policy was foreclosed on 28.06.2012 as per clause 9 of the Policy and after deducting surrender charges as per clause 2.2 of the Policy surrender value was paid to the complainant vide cheque bearing no. 892189 dated 28.06.2012 for Rs. 34,493.57/- but complainant did not encash the cheque.  It is further pleaded that OP as per clause 4(1) and 6(2) of the IRDA (Protection of Policy Holder’s Interest) Regulations, 2002, sent the policy and policy documents along with the copy of the proposal form to the complainant giving her opportunity to review/ cancel the policy within freelook period.  The policy documents were dispatched on 31.07.2009 and the same were received by the complainant.  Despite receipt of the policy and policy documents, the complainant allegedly failed to approach the OP within freelook period making any grievance with respect to the policy or its terms and conditions, implying that the policy and its terms and conditions were duly accepted by the complainant and were in order. Further It is submitted that the complainant is now stopped from raising any grievance or issue relating to the policy or its terms and conditions or any information given in the proposal form or seek refund of the premium.
3. Parties filed their affidavits in support of their cases. They also filed written arguments.  We have heard Adv. Advedh Sethi, Counsel for the OP.
4. It is not in dispute that complainant paid only first premium and failed to pay renewal premium thereafter. In her written arguments, she has stated that at the time of issuing the policy OP told her that she was required to pay only one premium and thereafter she had nothing to pay so she did not approach OP and was under the impression that her deposit of Rs. 1,50,000/- will be released after maturity of the subject policy.
5. There is nothing on record on the basis of which complainant could infer that she was required to pay only one premium and thereafter she had nothing to pay. She herself has placed on record at Page 11 of the case file, the subject policy document sent to her by the OP.  The said document clearly mentions that the said document contained key feature documents, policy certificate and the Terms & Conditions of the subject policy. She was advised to read the same carefully to fully understand the working and benefits of the Policy,

She was also intimated that her LifeTime Gold Policy No. 12114177 had a term of 10 years and will require yearly premium payment of Rs. 1,50,000/-. The document also reads:-

We have set up an exclusive SMS helpline for Elite customers- just SMS ‘INFO’ to 56767 and your Elite Service Team will contact you, to attend to your queries.Alternatively, you can e-mail us at

6. The said document placed on record by the complainant herself clearly shows that the document itself stated that the said policy was for a term of 10 years and she was required to pay yearly premium. Nowhere it is mentioned that she was required to pay one premium and nothing else thereafter.
7. The document further provided that she had Freelook period of 15 days from the date of receipt of the policy during which she could got through the terms and conditions of the policy and request for any changes or discontinue the policy altogether.

The complainant neither suggested any changes in the terms and conditions of the policy nor requested for its cancellation within Freelook period of 15 days period from the date of receipt of the subject policy.

8. Hon’ble National Commission in Shrikant Murlidhar Apte Vs. Life Insurance Corporation of India, Revision Petition No. 634 of 2012 vide its order dated 03.05.2013 held that once 15 days of cooling period is over, policy becomes binding on both the parties. Since complainant did not raise any objection during the Freelook Period of 15 days from the date of receipt of policy documents, it means that she agreed to the terms and conditions of the policy.
9. In Life Insurance Corporation of India and Another vs Sunita, Special Leave Petition(Civil) No. 13868 of 2019 facts of the case were that Husband of the complainant had taken Life Insurance Policy on 14.04.2011 and next premium had fallen due on 14.10.2011 but was not paid by him. Her husband met with an accident on 06.03.2012 and thereafter premium was paid on 09.03.2012 and he expired on 21.03.2012. It was not disputed that at the time of making payment of premium on 09.03.2012 It was not disclosed by the complainant or her husband to the insurer about the accident which had taken on 06.03.2012.

Hon. Apex Court by its order dated 29.10.2021 observed that an insurance claim can be denied if the policy has lapsed due to non-payment of premium and that condition of an insurance policy must be carefully construed and it is not permitted to rewrite the contract while reading the policy’s terms.

10. Complainant has no document to substantiate her allegations of misrepresentation or fraudulent inducement against OPs. Having failed to approach OP1 for cancellation of subject policy within freelook period and having paid only first premium of the subject policy and due to non-payment of further premiums on due time for the said policy, complainant is not entitled to the relief prayed for.

11. The complainant is dismissed. Copy of this order be sent to the parties as statutorily required. File be consigned to record room.

Announced on this 13^th March of 2022.