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-UIN105L121V03 dated 31.7.2012 for Rs. 5,00,000/- i.e. (Rupees Five Lacs only) issued by the opposite party in favour of complainant. it is averred that the complainant has sold his land and the amount of Rs. 5,00,000/- for fixed deposit was given to the opposite party but the opposite party without the consent and information of the complainant issued the above said policy in favour of the complainant. The complainant is illiterate person and does not know whether the opposite party issued the policy or made FDR of the amount of Rs. 5,00,000/-. Thereafter when the complainant came to know that the opposite party has issued above said policy in favour of complainant then the complainant again approached the office of opposite party and requested that the amount of Rs. 5,00,000/- of the complainant was fixed deposited and the opposite party assured the complainant that after the expiry of period of 5 years the complainant will be paid double i.e. Rs. 10,00,000/- to the complainant. After the expiry of period of five years the complainant approached the office of opposite party to take Rs. 10,00,000/- as per assurance of the opposite party then the opposite party made payment of Rs. 5,96,000/- only to the complainant. The complainant is entitled to Rs. 10,00,000/- from the opposite party as per policy instead of Rs. 5,96,000/- but the opposite party is denying to make Rs. 10,00,000/- to the complainant and the opposite party is harassing the complainant unnecessarily without any reason. As such, the complainant is entitled to the compensation for a sum of Rs. 1,00,000/- from the opposite party for the physical, mental and monetary harassment of the complainant by the opposite party and prayed that the opposite party may kindly be summoned and tried and directions be issued to the opposite party to make the payment of Rs. 10,00,000/- as per the policy to the complainant immediately and directions be also issued to the opposite party to pay Rs. 1,00,000/- to the complainant as compensation and harassment may also be awarded.
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 company has covered the life of the complainant until the policy was active and due to nonpayment of premiums the policy got foreclosed and the foreclosure amount of Rs.5,96,527.43 was rightly paid to the complainant as per the terms and conditions. The opposite party after the receipt of 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 company is involved in the business of life insurance and does not deals with Fixed Deposit as alleged by the complainant. The subject policy was issued strictly as per the duly filled in and application form duly filed and signed by the proposer/ LA for IPru Principle Super Plan of the company for annual premium of Rs. 5,00,000/- payable for a period of 5 years and term of policy being years. Bases on the information provided in the application form, the policy bearing Number 16876111 was issued on 31.7.2012 to the proposer/ LA. 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 he must have definitely read the proposal form properly before 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 5 years and the policy opted by the complainant was not single premium policy or a FDR as wrongfully alleged by him in the present complaint. The company was in receipt of only one annual premium and the premium due thereafter have remained unpaid by the complainant due to which the subject policy got foreclosed on 31.7.2017 as per policy terms and conditions and a foreclosure payout of Rs. 5,96,527.43 Paise was directly credited in to the account of the complainant on 31.7.2017 which is also an accepted fact by the complainant in his complaint. 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. 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 him as admitted. The policy holder after the receipt of the subject policy and policy documents did not approach the opposite parties to get his 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 his right to free look and now after a period of 6 years has approached this commission to seek equity against his own negligence. The complainant has failed to provide any documentary evidence to show that the policy was sourced to him 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 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 his alleged grievances for reasons best known to him. The premiums under the captioned policy were to be paid on a yearly basis. The premiums under the subject policy was to be paid for 5 years annually however, the complainant herein only paid the first year premium. The due date for payment of renewal premium was 31.7.2013 and subsequently all premiums remained unpaid following which the subject policy was foreclosed on 31.7.2017 as per terms and conditions and a foreclosure payout of Rs. 5,96,527.43 was directly credited in to the account of the complainant on 31.7. 2017. The relevant clauses of the terms and conditions of the policy are given herein below
Clause 7.10- Foreclosure of the Policy:
For five pay, after five policy years have elapsed, if the fund value falls below 110% of one full year’s premium then the policy will be terminated by paying the Fund Value without levying any charge. For one Pay, after five policy years have elapsed, if the Fund Value falls below Rs. 10,000/- then the policy will be terminated by paying the Fund Value without levying any charge. A policy shall not be foreclosed before completion of five policy year. On termination of the policy all right, benefits and interests under the policy will be extinguished
Clause 8.3: Premium Payment:
- Only annual frequency is allowed for payment of premiums
- You are required to pay premiums on the due dates and for the amount mentioned in the policy certificate.
- A grace period of not more than 30 days from the premium due date is allowed for the payment of premiums.
- You are required to pay premiums for the entire premiums payment term.
- We are not under any obligation to remind you about the premium due date, except as required by applicable regulations.
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, Acknowledgment 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 a foreclosure payout of Rs. 5,96,527.43 was directly credited in to the account of the complainant on 31.7.2017. As such it becomes clear from this fact that the cause of action has arisen on 31.7.2017 when the company has credited the above said amount in the account of the complainant and the complaint was filed in the year 2018 which is well within the period of limitation. The above said amount was never acceptable to the complainant as the company has credited the arbitrary amount which was not as per the terms and conditions of the policy. The amount paid to the complainant was not according to surrender value which was required to be paid to the complainant after the passing of five years from the purchase of the policy. The foreclosure value and the surrender value can be easily assessed by following the product feature attached with 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 his affidavit Ex. C-1, copy of policy highlights Ex. C-2, Policy certificate Ex. C-3, Terms and conditions of policy Ex. C-4, Premium receipt Ex. C-5, Adhar Card of complainant Ex. C-6.
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-UIN105L121V03 dated 31.7.2012 for Rs. 5,00,000/- i.e. (Rupees Five Lacs only) issued by the opposite party in favour of complainant which is attached herewith as Ex. C-3. An amount of Rs. 5,00,000/- for fixed deposit was given to the opposite party but the opposite party without the consent and information of complainant, issued the above said policy in favour of the complainant. The complainant is illiterate person and does not know whether the opposite party issued the policy or made FDR of the amount of Rs. 5,00,000/-. Thereafter when the complainant came to know that the opposite party has issued above said policy in favour of complainant then the complainant again approached to the office of opposite party and requested that the amount of Rs. 5,00,000/- of the complainant was fixed deposited and the opposite party assured the complainant that after the expiry of period of 5 years the complainant will be paid double i.e. Rs. 10,00,000/- to the complainant. He further contended that after the expiry of period of five years the complainant approached to the office of opposite party to take Rs. 10,00,000/- as per assurance of the opposite party then the opposite party made payment of Rs. 5,96,000/- only to the complainant. He further contended that the complainant is entitled to Rs. 10,00,000/- from the opposite party as per policy instead of Rs. 5,96,000/- but the opposite party is denying to make Rs. 10,00,000/- to the complainant and the opposite party is harassing the complainant unnecessarily and without any reason 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 filed and signed by the proposer/ LA for IPru Principle Super Plan of the company for annual premium of Rs. 5,00,000/- payable or a period of years and term of policy being years. On the basis of the information provided in the application form, the policy bearing Number 16876111 was issued on 31.7.2012 to the proposer/ LA. 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 he must have definitely read the proposal form properly before 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 5 years and the policy opted by the complainant was not single premium policy or a FDR as wrongfully alleged by him in the present complaint. The company was in receipt of only one annual premium and the premium due thereafter have remained unpaid by the complainant due to which the subject policy got foreclosed on 31.7.2017 as per policy terms and conditions and a foreclosure payout of Rs. 5,96,527.43 Paise was directly credited in to the account of the complainant on 31.7.2017 which is also an accepted fact by the complainant in his complaint. 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 him as admitted. The policy holder after the receipt of the subject policy and policy documents did not approach the opposite parties to get his 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 his right to free look and now after a period of 6 years has approached this commission to seek equity against his own negligence. The complainant has failed to provide any documentary evidence to show that the policy was sourced to him 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 his alleged grievances for reasons best known to him. 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 5 years annually however, the complainant herein only paid the first year premium. The due date for payment of renewal premium was 31.7.2013 and subsequently all premiums remained unpaid following which the subject policy was foreclosed on 31.7.2017 as per terms and conditions and a foreclosure payout of Rs. 5,96,527.43 was directly credited in to the account of the complainant on 31.7. 2017. 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 perusal of record shows that the instant complaint is within time as cause of action arose in the present case on 31.7.2017 when amount of Rs. 5,96,527.43 was credited in to the account of the complainant.
8 In the present case it is not disputed that the complainant has made the payment of Rs. 5,00,000/- to the opposite party as per policy certificate Ex. C-3. Further, the complainant alleged that he has given the amount to the opposite party for fixed deposit amount. But the complainant himself has placed on record the documents i.e. Ex. C-2 i.e. policy highlights, Ex. C-3 Policy certificate, Ex. C-4 terms and conditions of policy, Ex. C-5 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 31.7.2016 and premium paying option: Five pay. As such, the complainant has to deposit the amount of Rs. 5,00,000/- five times up to 31.7.2016. The Terms and conditions have been supplied to the complainant by the opposite party which has been produced on record as Ex. C-4 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-5 also shows that this is first premium receipt. On the receipt Ex. C-5 it is also written that ‘Your next premium is due on: 31.7.2013. As such, the complainant cannot say that he 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 5 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 31.7.2017 as per policy terms and conditions and a foreclosure payout of Rs. 5,96,527.43 Paise was directly credited in to the account of the complainant on 31.7.2017 and it is admitted by the complainant himself in his complaint. The opposite party/ company had sent regular SMS at the registered mobile number of the complainant informing the premium amount, sum assured, next premium, due date, frequency etc. which is attached herewith as Ex. R-3The due date for payment of renewal premium was 31.7.2013 and subsequently all premiums remained unpaid following which the subject policy was foreclosed on 31.7.2017 as per terms and conditions and a foreclosure payout of Rs. 5,96,527.43 was directly credited in to the account of the complainant on 31.7.2017. .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 . Opposite party has credited the amount of Rs. 5,96,527.43 Paise in the account of complainant as per terms and conditions of the policy which was the base of the contract of insurance between the parties. There is no deficiency in service on the part of the opposite party.
9 In view of the above discussion, the complaint is without merit and the same is hereby dismissed with no order as to costs. Copies of the orders be supplied to the parties as per rules. File is ordered to be consigned to the record room.
Announced in Open Commission.
26.08.2021
