ORDERS:
Charanjit Singh, President
1 The complainant has filed the present complaint by invoking the provisions of Consumer Protection Act under Section 11 and 12 against the opposite party on the allegations that complainant is the consumer of the opposite party, as the complainant is holder of Policy Certificate No. LP-UIN105L114V02 for Rs. 97,000/- dated 19.10.2013 Advisor code No. 00151827 M.No. 98792 45279, issued by the opposite party in favour of complainant. It is averred that the above said policy was to be matured within five years which has been expired. The husband of the complainant has sold some land and the complainant made fixed deposited in the bank ICICI opposite party SDM Office, Tarn Taran and the opposite party by taking information for the amount of the complainant advised to the complainant to make the above said policy and also assured the complainant that the amount deposited by her will be doubled within five years and the complainant paid Rs. 1,00,000/- to the opposite party for the said purpose but the opposite party made the above said policy only for Rs. 97,000/-. After the expiry of maturity date of the above said policy, the complainant approached the branch office of the opposite party for the payment of the amount of the above said policy, so many times but the opposite party without any reason linger on the matter and is not making the payment of the amount of the above said policy to the complainant. Two days ago the complainant lastly approached the office of the opposite party for receiving the amount of above said policy but the opposite party has insulted the complainant instead of making the payment of the amount of the above said policy and finally refused for making the payment of the amount of the above said policy to the complainant. The complainant belongs to poor family and has need for money for house hold needs and due to the above said reason the complainant has caused physical as well as mental torture. The opposite party is liable to pay Rs. 70,000/- as compensation amount to the complainant from the opposite party due to her mental as well as physical harassment by the opposite party. The complainant has prayed that the opposite party may be directed to pay Rs. 2,00,000/- double amount of the deposit amount of Rs.1,00,000/- to the complainant as per the policy issued by the opposite party and the complainant has also prayed Rs. 70,000/- as compensation.
2 Notice of this complaint was sent to the opposite party and opposite party appeared through counsel and filed written version inter-alia pleadings that the present complaint is barred by limitation as enumerated under section 24A of the Consumer Protection Act. The subject policy was issued to the complainant in the year 2012 and the cause of action arose in 2012 itself, he received the policy documents and the present complaint has been filed in 2018 after a span of 6 years which on the face of the record is barred by period of limitation. The limitation period starts from the day of cause of action arose. The present complaint is false, frivolous, vexatious and abuse of the process of this Commission and therefore, same is liable to be dismissed. On the basis of proposal form submitted by the complainant, the subject policy was issued. Thus the allegations herein are false, frivolous and untenable and a concocted story. If any person signs any document, it is presumed that he/ she has signed the same after reading and understanding it properly. The respondent company does not authorize any of its agents to offer any such false promises or benefits to its customers which are at variance with its product features, and assuming without admitting, that such false promises were made by any agent of the company, the same would fall beyond the scope of the agent’s authority and the company would not be vicariously liable for the same. Person who fills up anything on a signed document has status of ‘amanuensis’ only and cannot be treated as author of document. At the time of scribing(without admitting) the person who scribes (amanuensis) as representative of person who has signed document and not the representative of the company, thus after signing the document the person cannot release from signed document and lead anything which is contrary to terms started in written document. This Commission has no jurisdiction to entertain the present complaint. The complainant has failed to demonstrate any deficiency in service on the part of the opposite parties. The terms of the policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract. This Commission has got no jurisdiction to try and entertain the present complaint. In the present complaint, the complainant has alleged fraud and cheatings require a proper trial by a civil/ criminal court and evidence has to be taken which is not possible in a summary trial. The complainant has made allegations, such mater in question involves complicated questions of facts and law as well as voluminous evidence, which only be dealt by the Civil Court. The opposite party after receipt of the proposal form, benefit illustrations and supporting documents age proof, address proof etc. issued the policy to the complainant. Every application form clearly has the logo ICICI Prudential Life Insurance Co. Ltd. hence prima facie it is evident that the opposite party is involved in the business of life insurance and not a bank as alleged by the complainant. Further it is reiterated that the subject policy was issued strictly as per the duly filled in and application form duly filled and signed by the Proposer/ LA for IPru Guaranteed Savings Insurance Plan of the Company for annual premium of Rs. 1,00,000/- payable for a period of 7 years and term of policy being 15 years. On the basis of information provided in the application form the policy bearing No. 17094634 was issued on 19.10.2012 to the Proposer/ LA. In view of the facts and circumstances mentioned hereinabove, the complainant had applied for the subject policy with a clear knowledge and understanding of the terms and conditions of the said policy. It is assumed that she must have definitely read the proposal form properly before signing the same. No prudent person will invest such a big amount in anything without going through its terms and conditions properly. The complainant was required to pay the premiums on a yearly mode for the entire premium paying term of 7 years and the policy opted by the complainant was not single premium policy or a FDR as wrongfully alleged by her in the present complaint. The company was in receipt of only one annual premium and the premium due thereafter have remained unpaid. Subsequently, due to non-payment of renewal premiums, the subject policy was foreclosed on 19.10.2015 as per policy terms and conditions, however, no foreclosure payout was made as per the terms and conditions of the subject policy. The company sent a letter to the complainant dated 20.10.2015 intimating her that the subject policy had been foreclosed due to nonpayment of premium from 19.10.2013 and therefore no benefits were payable under the policy. Any communication was made by the company to the complainant stating that her premium amount would be doubled in 5 years from issuance. The complainant never approached the company before the present complaint. The complainant has also put her signatures on the application form, where it is stated that she has understood the nature and contents of questions asked in the proposal form. There was no deficiency in service or negligence on the part of the opposite party. As per terms and conditions of the policy contract, if the policy is not suitable, the policy holder may get his/ her policy cancelled by returning the policy and policy documents within 15 days (free lock period) from the day the policy holder received the policy. The insurance company will return the premium paid to the complainant after making certain deductions specified therein. The policy was dispatched to the complainant and the same was duly received by her as admitted. The policy holder after the receipt of the subject policy and policy documents did not approach the opposite parties to get her subject policy cancelled within free look period implying that the policy holder duly accepted the subject policy and its documents with its terms and conditions. The complainant slept over her right to free look and now after a period of 6 years has approached this commission to seek equity against her own negligence. The complainant has failed to provide any documentary evidence to show that the policy was sourced to her with any false assurance. The opposite party company sent the policy documents on 26.10.2012 vide speed post AWB No. EW084926856IN, stating the policy terms and conditions alongwith a copy of proposal form on. The complainant retained the policy document and did not approach the company with any discrepancies regarding premium payment, benefits, foreclosure, surrender and the policy terms and conditions, neither did she approach the company for cancellation of the policy during the free look period thereby implying that he had agreed to all the terms and conditions of the policy. The opposite party/ company had sent regular SMS/ letters at the registered mobile number/ address of the complainant informing the premium amount, sum assured, next premium, due date, frequency etc. however, the company did not hear anything from the complainant. The complainant has also admitted the said fact in the complaint. The opposite party company had sent several premium payment reminders at the registered address and several service related SMS on the registered mobile number of the complainant. Despite receipt of the policy documents and receipt of the said communications and SMS, the complainant did not approach the company with her alleged grievances for reasons best known to her. The premiums under the captioned policy were to be paid on a yearly basis the complainant only deposited the first premium valid up to 19.10.2013 and thereafter failed to deposit the renewal premiums payable for the subject policy for a premium payment term of 7 years. The due date for payment of renewal premium was 19.10.2013. Subsequently, due to nonpayment of renewal premiums, the subject policy was foreclosed on 19.10.2015 as per terms and conditions, however, no foreclosure payout was made as per the terms and conditions of the subject policy. Any communication was made by communication was made by the company to the complainant stating that her premium amount would be doubled in 5 years from issuance. The complainant never approached the company before the present complaint. The relevant clauses of the terms and conditions of the policy are given herein below
Clause 3-Payment of Premiums
- Premiums under the Policy can be paid on yearly, half yearly or monthly basis as per the frequency chosen by the policyholder and as mentioned as the Policy certificate
- Premiums as mentioned on the Policy certificate alongwith service tax and education cess is required to be paid on the premium due date.
- A grace period of not more than 30 days, where the mode of premium is other than monthly…. Is allowed from the premium due date for payment of premiums.
- If the premium is not paid within the grace period during the first three policy years, the policy shall lapse and no benefits would be payable….
- We are not under any obligation to remind you about the premium due date, except as required by applicable regulations.
General Conditions
2 Revival of the Policy
A policy which has lapsed, for non payment of premium may be revived subject to the following conditions
- The application for revival is made within two years from the due date of the first unpaid premium and before the date of maturity….”
The opposite party foreclosure has been done in a bonafide manner and strictly as per the applicable terms and conditions. The company states that insurance being a contract between the policyholder and the company both parties are governed by the terms and conditions mentioned in the policy document and all the benefits are payable as per the said policy terms and conditions. The company is not liable to make any payment under the subject policy as demanded by the complainant and make any further payments under the subject policy. Insurance being a contract between the policy holder and the company and both are governed by the terms and conditions mentioned in the policy document and all the benefits are payable strictly as per the policy terms and conditions. In view of the above, the present complaint is liable to be dismissed. The opposite party has denied the other contents of the complaint and prayed for dismissal of the complaint. Alongwith the written version, the opposite party has placed on record documents i.e. proposal form Ex. R-1, Policy Terms and Conditions Ex. R-2, SMS Tracker Ex. R-3, Affidavit of Ms. Monica Giri Ex. R-4, letter dated 20.10.2015 Ex. R-5.
3 The complainant has filed the rejoinder by alleging that no one can bypass the mandatory provisions of law by only making some submissions. The opposite parties have specifically mentioned in Para No. 9 of the preliminary objections that the company sent a letter to the complainant dated 20.10.2015 intimating her that the subject policy had been foreclosed due to the non payment of premium. As such, it becomes clear from this fact that the cause of action has arisen on 20.10.2015 intimating her that the subject policy had been foreclosed due to non payment of premium. As such, it becomes clear from this fact that the cause of action has arisen on 20.10.2015 and further complainant has requested to refund the amount but opposite parties have neither accepted nor refused the claim of the complainant, as such, the complaint was filed in the year 2018 which is well within the period of limitation. The letter dated 20.10.2015 and the decision of the company was never acceptable to the complainant as the company has the arbitrariness, which was not as per the terms and conditions of the policy. The complainant has denied all the allegations of the written version and reiterated the stand as taken in the complaint. Alongwith the rejoinder, the complainant has placed on record her affidavit Ex. C-1, copy of Insurance cover note Ex. C-2, Policy certificate Ex. C-3, Premium receipt Ex. C-4, .
4 We have heard the Ld. counsel for the parties and have carefully gone through the record placed on the file.
5 Ld. counsel for the complainant contended that the complainant is holder of Policy certificate No. LP-UIN105L114V02 for Rs. 97,000/- dated 19.10.2013issued by the opposite party in favour of complainant which is attached herewith as Ex. C-3. It is also contended that the husband of the complainant has sold some land and the complainant made fixed deposited in the bank ICICI opposite party, SDM Office, Tarn Taran and the opposite party by taking information for the amount of the complainant advised to the complainant to make the above said policy and also assured the complainant that the amount deposited by her will be doubled within five years and the complainant paid Rs. 1,00,000/- to the opposite party for the said purpose but the opposite party made the above said policy only for Rs. 97,000/-. After the expiry of maturity date of the above said policy, the complainant approached the branch office of the opposite party for the payment of the amount of the above said policy, so many times but the opposite party without any reason linger on the matter and is not making the payment of the amount of the above said policy to the complainant. Two days ago the complainant lastly approached to the office of the opposite party for receiving the amount of above said policy but the opposite party has insulted the complainant instead of making the payment of the amount of the above said policy and finally refused for making the payment of the amount of the above said policy to the complainant and prayed that the present complaint may be allowed.
6 On the other hands, Ld. counsel for the opposite party contended that the subject policy was issued strictly as per the duly filled in and application form duly filled and signed by the Proposer/ LA for IPru Guaranteed Savings Insurance Plan of the Company for annual premium of Rs. 1,00,000/- payable for a period of 7 years and term of policy being 15 years. On the basis of information provided in the application form the policy bearing No. 17094634 was issued on 19.10.2012 to the Proposer/ LA. In view of the facts and circumstances mentioned hereinabove, the complainant had applied for the subject policy with a clear knowledge and understanding of the terms and conditions of the said policy. It is assumed that she must have definitely read the proposal form properly before signing the same. No prudent person will invest such a big amount in anything without going through its terms and conditions properly. The complainant was required to pay the premiums on a yearly mode for the entire premium paying term of 7 years and the policy opted by the complainant was not a single premium policy or a FDR as wrongfully alleged by her in the present complaint. The company was in receipt of only one annual premium and the premium due thereafter have remained unpaid. Subsequently, due to non-payment of renewal premiums, the subject policy was foreclosed on 19.10.2015 as per policy terms and conditions. This Commission has no jurisdiction to entertain the present complaint. There was no deficiency in service or negligence on the part of the opposite party. As per terms and conditions of the policy contract, if the policy is not suitable, the policy holder may get his/ her policy cancelled by returning the policy and policy documents within 15 days (free lock period) from the day the policy holder received the policy. He further contended that the insurance company will return the premium paid to the complainant after making certain deductions specified therein. The policy was dispatched to the complainant and the same was duly received by her as admitted. The policy holder after the receipt of the subject policy and policy documents did not approach the opposite parties to get her subject policy cancelled within free look period implying that the policy holder duly accepted the subject policy and its documents with its terms and conditions. The complainant slept over her right to free look and now after a period of 6 years has approached this commission to seek equity against her own negligence. The complainant has failed to provide any documentary evidence to show that the policy was sourced to her with any false assurance. The opposite party/ company had sent regular SMS/ letters at the registered mobile number/ address of the complainant informing the premium amount, sum assured, next premium, due date, frequency etc. however, the company did not hear anything from the complainant. The opposite party company had sent several premium payment reminders at the registered address and several service related SMS on the registered mobile number of the complainant. The SMS Tracker is Ex. R-3. Despite receipt of the policy documents and receipt of the said communications and SMS, the complainant did not approach the company with her alleged grievances for reasons best known to her. The premiums under the captioned policy were to be paid on a yearly basis. The premiums under the subject policy were to be paid for 7 years annually however, the complainant herein only paid the first year premium. The due date for payment of renewal premium was 19.10.2013 and subsequently all premiums remained unpaid following which the subject policy was foreclosed on 19.10.2015 as per terms and conditions. He further contended that the opposite party foreclosure has been done in a bonafide manner and strictly as per the applicable terms and conditions. The company states that insurance being a contract between the policyholder and the company both parties are governed by the terms and conditions mentioned in the policy document and all the benefits are payable as per the said policy terms and conditions. The company is not liable to make any payment under the subject policy as demanded by the complainant and make any further payments under the subject policy.
7 The opposite party has taken the plea that the complaint is barred by time. But as per version of the complainant that the perusal of record shows that the opposite party has received the premium amount from the complainant and as per allegations of the complainant, he approached the opposite party after expiry of 5 years from the date of deposit i.e. in the year 2017 and the present complaint has been filed in the year 2018. Hence, the present complaint is well within time.
8 In the present case it is not disputed that the complainant has made the payment of Rs. 97,000/- to the opposite party as per policy certificate Ex. C-3. Further, the complainant alleged that she has given the amount to the opposite party for fixed deposit amount. But the complainant herself has placed on record the documents i.e. Ex. C-2 i.e. policy highlights, Ex. C-3 Policy certificate, terms and conditions of policy, Ex. C-4 First premium receipt and statement of account. All the above said documents which have been produced by the complainant, show that this amount is not deposited in the shape of FDR, rather the complainant has purchased the policy. Ex. C-3 it is clearly written that due date of last premium 19.10.2018 and premium paying term: 7. As such, the complainant has to deposit the amount of Rs. 97,000/- seven times up to 19.10.2018. The Terms and conditions have been supplied to the complainant by the opposite party which has been produced on record as Ex. C-3 in which the opposite party has given 15 days free look period. But the complainant has not approached the opposite party in free look period for cancellation of the policy. Ex. C-4 also shows that this is first premium receipt. On the receipt Ex. C-4 it is also written that ‘Your next premium is due on: 19.10.2013. As such, the complainant cannot say that she has deposited the amount with the opposite party in the shape of fixed deposit amount. On the other hands, the case of the opposite party is that the complainant was required to pay the premiums on a yearly mode for the entire premium paying term of 7 years and the policy opted by the complainant was not single premium policy or a FDR. The premiums due thereafter have remained unpaid by the complainant due to which the subject policy got foreclosed on 19.10.2015 as per policy terms and conditions. The due date for payment of renewal premium was 19.10.2013 and subsequently all premiums remained unpaid following which the subject policy was foreclosed on 19.10.2015 as per terms and conditions. As regards conveyance of terms and conditions of the policy to the complainant, it has been held by the Hon'ble State Commission in case Tarun Bansal & Anr Vs. Reliance General Insurance Company Ltd. & Ors II(2007) CPJ 295 that the terms and conditions are part of the policy. The Hon'ble State Commission has relied upon the ruling of the five judge bench of the Apex Court in general Assurance Society Ltd. Vs. Chandmull Jain and Anr. AIR 1966 Supreme Court 1644. It has been further held by the Hon'ble Apex Court in case M/s Suraj Mal Ram Niwas Oil Mills (P) Ltd Vs. United India Insurance Co.Ltd & Anr that in a contract of insurance the rights and obligations are governed by the terms of the contract. Term of contract of insurance have to be strictly construed. No exception can be made on the ground of equity- in construing the terms of a contract of insurance, the words used therein must be given paramount importance and it is not open for the court to add, delete or substitute any word. In this case also contract of insurance between the parties is based on terms and conditions of the policy and must be followed in letter and spirit. As such, the complainant is not entitled to relief of double amount because the amount of the complainant is not deposited in the shape of FDR.
9 Now the question is that the complainant has made the payment of Rs. 97,000/- to the opposite party which has been admitted by the opposite party. The said amount is lying with the opposite party. The opposite party has failed to place on record any letter and its postal receipt showing that the opposite party has intimated that the policy has been lapsed and money of Rs. 97,000/- has been forfeited. As such, the amount of Rs. 97,000/- is lying with the opposite party of the complainant which is trust of the complainant. The opposite party has not refunded the amount to the complainant for a long time, it constitutes deficiency in service on the part of the opposite party.
10 In view of the above discussion, the present complaint is partly accepted and the opposite party is directed to refund the fund value with interest prevalent time to time. The complainant is also entitled to Rs. 3,000/- (Rs. Three thousand only) as compensation on account of harassment and mental agony and Rs 2,500/- (Rs Two thousand and five hundred only) as litigation expenses. Opposite party is directed to comply with the order within one month from the date of receipt of copy of the order, failing which the complainant is entitled to interest @ 9% per annum, on the awarded amount, from the date of complaint till its realisation. Copy of order be supplied to the parties free of costs as per rules. File be consigned to record room.
Announced in Open Commission.
26.08.2021
