Complainant by filing this complaint has submitted thathe purchased a policy of the op being Policy No. 01751880 which was effective from January-2010 but the company did not issue the original policy deed till December-2013. So, complainant stopped the policy and in January-2014 he approached the Branch Manager and fulfilled all necessary documents to get his original Policy Deed. But ultimately he got it on 17.02.2014 and after that an employee called him on 24.02.2014 and advised him to submit following documents i.e. Cancelledcheque, Proof Identity, Written Application along with original Policy Deed within 15 days in his nearest Branch for Free Look Cancellation pay out. But on 26.02.2014 he submitted all the necessary papers in the said office and got an acknowledgement receipt and he kept in touch with the Insurance Co. but in the meantime an Office employee told him to submit a Specimen Signature form to continue or promote the process. But he did the job on 24.03.2014 and also got an acknowledgement receipt.
After a week he got an email information for non-receipt of Specimen Signature form towards the Policy and also asked to send scanned image of acknowledgement receipt while submitting in the said office.
After that complainant sent it through email on 19.04.2014. The Branch Office assured the complainant the he would get refund within 21 processing days after lapse of due time even after keeping relation in communication with the company he did not get any result from the company. Moreover Insurance Company refused to admit and also denied to get back his refund and after that complainant lodged a written complaint to the Assistant Director, CA&FBP, Kolkata Central Regional Office but they failed to give any solution from then Office and in the above circumstances, complainant has submitted this complaint praying for redressal and for refund of the deposited premium to the extent of Rs. 20,000/- and for negligent and deficient manner of service on the part of the op.
On the other hand op by filing written statement submitted that the cause of action if any arose or arisen was on 04.01.2010 (the date on which he applied for policy). But ultimately complainant filed this complaint in the year 2014. So, it is filed after 4 years from the date of cause of action and it is barred by limitation.
Further it is submitted by the op that the complainant suppressed the material fact and so the complaint is nothing but a vexatious, frivolous complaint.
Fact remains that complainant purchased the policy on the basis of the proposal from filed by the op on 04.01.2010 in ING Prime Life Plan an unit linked insurance product offered by op which was duly approved by the IRDA and detailed of the plan was explained in detail and after understanding the same, complainant opted the said plan and premium opted by the complainant of Rs. 4,000/- to be paid quarterly for a premium paying term of 20 years and sum assured under the said policy was Rs. 80,000/- for tenure of 20 years and the fund chosen by the complainant was ING Preserver- 40 percent and ING Prime Equity – 60 percent and complainant made his wife as nominee under the policy and complainant confirmed those facts in his declaration made in proposal form dated 04.01.2010.
It is submitted that based on the answers, statements, premium amount, premium paying term opted and declarations made in the proposal form duly executed and submitted by the complainant to be true and correct and after receipt of initial premium, the op issued a policy bearing No. 01751880 on 06.01.2010 along with the terms and conditions of the policy and a welcome letter to the complainant and the details of the policy – Name of Life Policy Holder Mr. Milan De, Policy No. 01751880, Product is ING Prime Life Plan, Risk Commencement Date – 06.01.2010, Maturity Date – 06.01.2030 and Policy Term – 20 years, Sum Assured – Rs. 80,000/-, Premium Amount, Mode and Term – Rs. 4,000/- to be paid annually for quarterly and Name of the Nominee & Relationship – Mrs. Pranati De (Wife) and fact remains that the welcome letter terms and conditions was sent to the complainant on 07.01.2010 through Speed Post Courier and it was delivered to the complainant at his address as provided in the proposal form (no such note of date of receipt). Fact remains that because of the name change in the company all the communication including the terms and conditions which was reprinted for the purpose of producing before the Hon’ble Forum from fully loaded computer system capture Exide Life instead of ING Vysya is filed.
Further complainant never raised any objection within 15 days from the date of receipt of the policy, hence contract of life insurance which company had with complainant becoming legally concluded and it was presumed that complainant was satisfied with terms and conditions so issued to him. Therefore, complainant is legally estopped from disputing the terms and conditions regarding and of any negligent and deficient manner of service on the part of the op.
Moreover complainant did not pay refundable premium in the year 2011, 2012 and 2013 for the reasons best known to him. However, the op sent repeated reminder to complainant asking him to pay renewal premium, by way of letter and SMS’s but all such efforts went in vain and consequently policy lapsed on 06.01.2010 and that was not renewed for which it is clear that complainant paid quarterly renewal for the year 2010 one year only after receiving the policy bond and after knowing the policy terms and conditions. But he would have raised the same without any delay but that has not been done. So, the complaint is false and fabricated.
It is admitted that the policy bond was sent to him on 12.02.2014 through Speed Post vide Courier No. AWB. No. EK310717261IN which was delivered to the complainant. Onreceipt of thepolicy bond the complainant had approached the op on 26.02.2014 for Free Look Cancellation of his policy. A copy of the Free Look Cancellation Request is produced. Op no.4 subsequently the op collected the cancelled cheque and specimen signature from the complainant as a process and after ascertaining the record it was duly rejected Free Look Cancellation Request and accordingly intimated the complainant as original policy bond was issued to him on 2010, so same cannot be entertained at this juncture.
Moreover op did not receive any renewal premium for 3 years from last unpaid premium and op had to cease the policy as per clause 5.1 (Discontinuance of Regular Premium within three years of the policy commencement date) of the policy terms and conditions and as per rule and clause of the policy where premiums have been discontinued within three years of policy commencement date as mentioned in this clause and death of the life assured occurs during such period, the company’s liability under this policy shall be limited to payment of Fund Value only. The Policyholder may at any time within 3 years from the date of cessation of the insurance cover, apply to the Company for reinstatement of the insurance cover and the company may at its discretion and subject to fulfillment of the conditions set forth in clause 6 below, allow reinstatement of the insurance cover. Unless the insurance cover is so reinstated within 3 year, the policy shall terminate at the end of such period or at the end of the 3rd policy year whichever is later and the Company shall pay the Surrender value, if any after deduction of surrender charges.
So, under any circumstances, complainant is not entitled to get any benefit of original policy during his Free Look Period Cancellation. Further it is submitted that when the money is investing in the share market, it is no doubt a commercial purpose. So, complainant cannot get any benefit and complaint should be dismissed.
Decision with reasons
On proper appreciation of the complaint including the written version and also considering the entire materials on record, it is undisputed fact that complainant no doubt opened a policy under the op and that policy was issued by the op and complainant paid 4 premiums for one year, thereafter he did not continue. So, it is clear that Rs. 16,000/- was paid by the complainant as premium from January-2010 to December-2010 and this part has been admitted by the op.
Fact remains the complaint is filed against ING Life Insurance Company Ltd. Which has been subsequently renamed as Exide Life Insurance Company Ltd. Complainant has alleged that even after purchasing the said policy, he never received the original policy document since January-2010. But after repeated reminders, complainant got the original policy document on 17.02.2014 and practically op has admitted that complainant received the original policy document on 17.02.2014 and thereafter filed an application form praying for cancellation of the said policy within Free Look Period on 26.02.2014 and it is also admitted that on 26.02.2014 op accepted the said the prayer for cancellation of the policy.
On overall evaluation of the materials on record, we find that complainant even after payment of four premiums did not get the original policy document. But he received the original policy document on 17.02.2014 and within 15 days Free Look Period, he applied for cancellation of the said policy.
On the other hand op has failed to prove that any particular original policy document was sent to the complainant and complainant received the same from the op on 07.01.2010. There is no such document to show that original policy document was served upon the complainant on 07.01.2010. On the contrary it is proved and it is also admitted that on 17.02.2014 that complainant got the same and complainant after receipt of the said original policy document submitted such prayer. So, in the eye of law, it is proved that as per provision of law, complainant on receipt of the original policy document filed prayer for cancellation by filing all documents.
Truth is that op has admitted that they received all those documents etc., but it is their defence that the said policy was issued by ING Life Insurance which was renamed as Exide Life Insurance Company and subsequently Exide Life Insurance Co. sent a fresh original policy document on 17.02.2014 and complainant received that and tried to convince that he never received it earlier. But after overall evaluation of the entire document as produced by the complainant, it is clear that op has failed to prove any cogent materials that on 07.01.2010 any original policy document was delivered to the complainant and fact remains that complainant again and again reported the matter to the op about non-supply of the original policy document. But ultimately he got it on 17.02.2014 that is long after three years.
It is also a fact that complainant in the meantime paid one year quarterly premium at the rate Rs. 4,000/- that means Rs. 16,000/- paid by the complainant as premium against the policy. But policy document was received after repeated reminders and in view of the above findings, we are convinced to hold that from the date of receipt of the original policy document on 17.02.2014 complainant within 15 days submitted that prayer for cancellation of the policy and that was within the condition of the policy and then there was no legal ground to cancel the said policy by the op and to refund the entire amount.
Anyhow ops tried to convince that revised copy of the original policy of ING Life Insurance was merged with Exide Life Insurance Co. and Exide Life Insurance Co. sent this said revised original policy document. But this theory as stated by the ops cannot be believed in view of the fact that ops have failed to produce any paper to show that ING Life Insurance Co. previously sent any original policy document and that is proved beyond any manner of doubt and in this case the written version is filed by the op/Exide Life Insurance Co. Ltd. and they have tried to convince that they sent the revised policy that is not correct.
In view of the fact, op has failed to produce any document to show that the particular original policy document issued by ING Life Insurance Co. Ltd. was sent to the complainant and complainant received it on 07.02.2010 and such a plea cannot be believed by this Forum when no document is produced. Mere sending of document does not ipso fact prove that the document was received by the complainant.
In the light of the above observation and also considering the materials, we are convinced to hold that no doubt complainant filed the Free Look Cancellation Request form being not satisfied with the policy document which was received only on 17.02.2014 and that application was filed on 26.02.2014 and considering all the above fact, we are convinced to hold that complainant filed that application for Free Look Period Cancellation Request in proper form along with all papers and in that case op have no other alternative to entertain the same after deducting 5 percent as service charge for such period and under any circumstances, no other provision can be applied in this case what op has tried to apply to dislodge the claim of the complainant.
In the light of the above observation we are convinced to hold that the claim of the complainant is legally acceptable and his application for Free Look Cancellation Period request in proper form along with all documents is legal and justified when he received the original policy document on 17.02.2014 and that application for Free Look Cancellation Request form other document on 26.02.2014 was admittedly received by the ops. Then op is bound to release the amount after deducting 5 percent but no other deduction can be made by the op and fact remains that all the private insurance companies have adopted some illegal procedure to forfeit the entire amount when the policy is lapsed. But that is not the legal procedure.
Anyhow in this case in the eye of law, it is lapsed. But as per conduct of the op, the original policy document was received by the complainant on 17.02.2014. Though the policy was opened in the year January-2010.
Another factor is that if we believe the ops, then invariably the policy lapsed in the year 2010 then what is the necessity to send another new original policy document by the op that means the policy was not processed by the ops either by ING Life Insurance Co. Ltd. or by merged company Exide Life Insurance Co. at any point of time prior to 17.02.2014 when the policy has been lapsed on 2010 as claimed by the op.
Considering this conduct of the op, it is clear that no policy document was processed by the op since January-2010 to February-2014 and when it was processed that was sent on 17.02.2014 but prior to that complainant never received it on 07.02.2010 and so within Free Look Period he submitted the prayer for cancellation of the said policy on receipt of policy document on 17.02.2014.
In the light of the above observation we are convinced to hold that the defence as taken by the op is no doubt a procured defence only for dislodging the claim of the complainant and to grab the good money paid by the consumer whose policy deed is declared invalid by the op in the year 2010.
In the result the complaint succeeds.
Hence, it is
ORDERED
That the complaint be and the same is allowed on contest with cost of Rs. 5,000/- against the ops.
Ops are hereby directed to refund the entire amount treating it as a cancelled policy within Free Look Period after deducting 5 percent from the total deposit premium amount and it shall be paid to the complainant within 15 days from the date of this order failing which for each day’s delay, op shall have to pay penal damages at the rate Rs. 100/- per day till full satisfaction of the entire decree and if it is collected the said penal damage shall be deposited to the Forum’s account.
Ops are directed to comply the order very strictly within stipulated date in default for non-compliance of the Forum’s order, penal action shall be started against them for which further penalty and fine may be imposed.
