DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II U.T. CHANDIGARH [Complaint Case No:770 of 2010] Date of Institution :30.11.2010 Date of Decision :13.02.2012 -------------------------------------------- Smt. Anita Rani Sharma wife of Sh. R. K. Sharma resident of House No.696, Sector 7, Panchkula. ….Complainant. (VERSUS) [1] I.C.I.C.I. Prudential Life Insurance Co. Ltd. through C.E.O and Managing Director, ICICI Prulife Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai-400025. [2] I.C.I.C.I. Prudential Life Insurance Co. Ltd. through Branch Manager, S.C.O. No.9-10-11, First Floor, Sector 9-D, Chandigarh. ---Opposite Parties. BEFORE: SHRI LAKSHMAN SHARMA PRESIDENT MRS. MADHU MUTNEJA MEMBER SHRI JASWINDER SINGH SIDHU MEMBER Argued By: Sh. I.S. Pabla, Advocate for the complainant. Sh. Gaurav Bhardwaj, Advocate for the OPs. PER LAKSHMAN SHARMA, PRESIDENT 1. Smt. Anita Rani Sharma has filed this complaint under section 12 of the Consumer Protection Act, 1986 praying therein that OPs be directed:- i) To pay a sum of Rs.8,69,461/- along with interest @18% per annum from the date of deposit; ii) Any other relief, which the Forum deems fit in the facts and circumstances of the case. 2. The case of the complainant is that on 06.09.2008, she filled in a proposal form for buying a policy from I.C.I.C.I Prudential Life Insurance Company Limited in the name of her daughter Miss Aditi Sharma. She opted to purchase policy known as ‘Premier Life Gold’. The sum assured was Rs.3,75,00,000/-. The complainant was required to pay five premiums of Rs.75,00,000/- each. The complainant paid the first annual premium on the same day. She was assured that the policy document will be issued to her very soon. However, she did not receive any policy till the filing of the present complaint. According to the complainant, after a few days, she approached the Advisor of OPs to know about the status of the policy. She was told that the insurance company had issued the policy to her on 16.09.2008 and as per the record maintained in the Office Call Centre, the said policy has been delivered to her on 23.09.2008. According to the complainant, despite the fact that she had not received the said policy till then, she decided not to continue with the policy and to get the same cancelled. So, the complainant approached the Branch Manager of OPs on 07.10.2008 at Manimajra with the request to cancel the policy. However, he refused to do so. So, on 08.10.2008, she approached the Senior Manager of Chandigarh Regional Centre of OPs with a request to cancel the policy. The said Manager also refused to do so. So, ultimately she sent the request for cancellation of the policy through FAX to the Company’s Call Centre at Mumbai and also sent the request to M.D/C.E.O of the Company as well as Ms. Anita Pai, head of Operations of OP Insurance Company via Email. All the above requests were made on 08.10.2008 itself. She did not get any response of the above said e-mails for about 15 days. Thereafter, she received a scanned image of two pages of her Proposal Form. After going through the same, she was shocked to know that the forms were of a policy, which was not opted by her. She intimated about it to the concerned officer of OPs. Ultimately, she received a refund of Rs.66,30,539/- pertaining to Policy No.09916632. The said amount was accepted by the complainant under duress as she was left with no other option other than to accept the said amount under protest. Thus, according to the complainant, OPs deducted a sum of Rs.8,69,461/- unauthorisedly, which amounts to deficiency in service and unfair trade practice. According to the complainant, she is entitled to the above said amount along with interest @18% per annum from the date of deposit till the date of its payment. In these circumstances, the present complaint has been filed seeking the reliefs mentioned above. 3. In the joint written statement filed by OPs, it has been averred that the OPs received duly filled proposal form from the complainant for issuance of policy known as ‘Premier Life Gold’. With Rich Fund (50%) and Flexi Growth Fund (50%) for her daughter Aditi Sharma (Life Assured). The policy was sourced by Aditi Sharma herself, who is the agent/advisor for the said policy. According to OPs, they cannot be made liable for the acts of the agent in mis-selling the features of the policy. It has further been pleaded that the policy documents were duly dispatched on 18.09.2008 vide Express IT Courier Airway vide Bill No.2667440845 and was received by the complainant on 23.09.2008. It has further been pleaded that after receiving the said policy, a request for refund of the amount was received from the complainant within the free-look period. The said request was acceded and a sum of Rs.66,30,539/- was refunded to the complainant being the N.A.V at the relevant time. It has further been pleaded that as per the terms and conditions of the policy, only N.A.V price was to be refunded at the time of cancellation of the policy during the free-look period. In these circumstances, according to OPs, the amount of Rs.8,69,461/- has been deducted in accordance with the terms and conditions of the policy and there is no deficiency in service on the part of OPs. A specific preliminary objection has been raised by the OPs as regards the maintainability of the complaint. According to OPs, the present complaint is time barred as the same has been filed by the complainant after two years from the date of accrual of cause of action. It is asserted that as the amount refunded was calculated on N.A.V basis on 08.10.2008, the cause of action accrued to the complainant on that day whereas she has filed the present complaint in the month of November 2010. So, it is barred by limitation. 4. We have heard the learned counsel for the parties and have perused the record. 5. Admitted facts are that on the basis of the proposal made by Smt. Anita Rani Sharma, the life of her daughter Miss Aditi Sharma was insured for an assured value of Rs.3,75,00,000/-. The complainant paid the first premium of Rs.75,00,000/-, which was duly accepted by the OPs. On the basis of the said premium, policy (Annexure R-3) was issued in the name of Miss Aditi Sharma. The OPs have admitted that they had received the request for cancellation of the policy within the free-look period. Relying on the clause of the application for Free-look Pre-cancellation, which read as under: – “In case of freelook refunds, NAV fluctuation (if any) will be passed on to the policyholder.” it was argued by the learned counsel for the OPs that as per the above said clause, OP is entitled to pass on the NAV fluctuation to the Policyholder. So, the amount of Rs.8,69,461/- has been rightly deducted and a sum of Rs.66,30,539/- rightly paid being the N.A.V as on 08.10.2008. Whereas, on the other hand, the case of the complainant is that the above said amount has been deducted illegally and against the terms and conditions of the policy. 6. Annexure R-3 is the Policy Document wherein the Freelook period has been defined as under: - “Freelook period: A period of 15 days is available to the Policyholder during which the Policy can be reviewed. If the Policy is not suitable, this booklet should be returned within 15 days from the day the Policyholder receives the Policy. The Company will return the Premiums paid subject to the deductions as follows “ a. Proportionate Mortality and rider charges. b. Insurance stamp duty on the Policy. c. Any expenses borne by the Company on the medicals.” 7. From the bare perusal of this clause, it is apparent that the period of 15 days shall be available to the Policyholder during which the Policyholder can review his options. In case, the Life Assured opts to cancel the policy, he/she can make such a request within 15 days of the issuance of the policy. Once the request for cancellation is received within the stipulated period, the Company will refund the premium paid subject to the following conditions: - “a. Proportionate Mortality and rider charges. b. Insurance stamp duty on the Policy. c. Any expenses borne by the Company on the medicals.” 8. In the present case, admittedly no stamp duty on the policy has been paid nor any expenses were borne by the Insurance Company for medical tests of the Life Assured. In these circumstances, the Insurance Company could deduct only the proportionate mortality and rider charges. So, the refund on the basis of Net Asset Value (N.A.V) is not in consonance with the terms and conditions of the policy. Therefore, deduction of Rs.8,69,461/- is against the terms and conditions of the Policy Document, which amounts to deficiency in service on the part of OPs. 9. So, far as the preliminary objection as regards the complaint being time barred is concerned, the learned counsel for the OPs argued that the complaint is barred by limitation, so, it be dismissed on this very score. It was further argued that the amount was refunded to the complainant on the basis of N.A.V as calculated up to 08.10.2008. So, the cause of action had accrued to the complainant on 08.10.2008. To our mind, this argument of learned counsel for the OPs is without any force. Annexure A-4 is letter dated 06.12.2008 whereby the complainant was intimated that the OPs have processed the refund for an amount of Rs.66,30,539/-, which would be credited to her account within six working days. Thus, in our opinion, the cause of action arose to the complainant from the date of this letter i.e.06.12.2008, when she was informed by the OPs for the first time that they have processed her claim to the tune of Rs.66,30,539/-. Hence, the present complaint has been filed by the complainant within the prescribed period of limitation of two years from the date the cause of action having accrued to her. 10. In view of the foregoing observations, we allow the present complaint and the OPs are directed to refund the premium collected at the time of subscription, after deducting the proportionate mortality and rider charges as per the terms and conditions of the Policy Document (Annexure R-3). The order be complied with by the OPs jointly and severally within 30 days from the date of receipt of certified copy of this order failing which the amount payable shall carry interest @18% per annum from 06.09.2008 till actual payment. 11. Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room. Announced. 13th February, 2012 Sd/- (LAKSHMAN SHARMA) PRESIDENT Sd/- (MADHU MUTNEJA) MEMBER Sd/- (JASWINDER SINGH SIDHU) MEMBER Ad/-
C.C.No.770 of 2010 Present: None. --- The case was reserved on 08.02.2012. As per the detailed order of even date recorded separately, this complaint has been allowed. After compliance file be consigned. Announced. 13.02.2012 Member President Member
| | MRS. MADHU MUTNEJA, MEMBER | HONABLE MR. LAKSHMAN SHARMA, PRESIDENT | MR. JASWINDER SINGH SIDHU, MEMBER | | 
