BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KAITHAL.
Complaint no.243/14.
Date of instt.: 20.11.2014.
Date of Decision: 08.01.2016.
Ramesh S/o Sh. Ditta Ram@ Ram Ditta, age 56 years, resident of House No.809/12, Gali No.6, Amargarh Gamri, Kaithal, Tehsil & Distt. Kaithal.
……….Complainant.
Versus
1. Kotak Mahindra Old Mutural Life Insurance Ltd., Central Processing Centre,GodrejColiseum, 8th Floor, Lokmanya Pan Bazar,Behind Everard Nagar,Sion Tombay Road, Sion (E), Mumbai-400022 through its Director.
2. Kotak Mahindra Life Insurance Co., MCK No.1025/11, Dhand Road, Kaithal, through its Branch Manager.
3. The Chairman Insurance Regularity & Development Authority (IRDA) Basheer Bagh, Hyderabad.
..……..Opposite Parties.
COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.
Before: Sh. Jagmal Singh, President.
Sh. Rajbir Singh, Member.
Smt. Harisha Mehta, Member.
Present : Sh. Gian Chand Gupta, Advocate for complainant.
Sh. Hardeep Rana, Advocate for the opposite parties.No.1 & 2.
Op No.3 already exparte.
ORDER
(JAGMAL SINGH, PRESIDENT).
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that he purchased an insurance policy No.02158140 dt. 16.11.2010 by paying of Rs.2,00,014/- annual premium under the plan KOTAK ENDOWMENT PLAN LTD. from the Ops. It is alleged that the annual premium of Rs.2,00,014/- was to be paid for five years i.e. w.e.f. 16.11.2010 to 16.11.2014 and the sum assured was Rs.11,47,000/-. It is further alleged that the complainant could not pay the further annual premium till date and he approached the Ops for refund of Rs.2,00,014/- but they refused it on flimsy ground. It is further alleged that the complainant also issued legal notice upon the Ops but the Ops did not refund the amount. This way, the Ops are deficient in service. Hence, this complaint is filed.
2. Upon notice, the opposite parties No.1 & 2 appeared before this forum, whereas Op No.3 did not appear and opt to proceed against exparte vide order dt. 08.01.2015. Ops No.1 & 2 filed written statement raising preliminary objections with regard to maintainability; cause of action; locus-standi; that the present complaint is not maintainable under Section 24-A of Consumer Protection Act being barred by time. The subject policy was issued in November, 2010 to the complainant and now after the expiry of more than 4 years, the complainant has approached this Forum seeking refund of the premium, which is barred by limitation; that in the instant case, the complainant has himself admitted in para No.3 of the complaint that due to financial and economical crises, he could not pay the premiums. The self admission of the complainant clarifies the fact that the complainant himself has not paid the premiums to keep the policy alive thereby breaching the terms and conditions of the policy; that the complainant has raised some very serious allegations against the answering Ops without substantiating with any documentary proof. The entire complaint is based on surmises and conjectures and thus, deserves no other fate but an outright dismissal. There is no deficiency in service on the part of answering Ops. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
3. In support of his case, the complainant tendered in evidence affidavit Ex.CW1/A and documents Ex.C1 to Ex.C3 and closed evidence on 28.09.2015. On the other hand, the Ops No.1 & 2 tendered in evidence affidavit Ex.RW1/A and documents Annexure R1 to Annexure R7 and closed evidence on 26.10.2015.
4. We have heard ld. counsel for both the parties and perused the case file carefully and minutely and have also gone through the evidence led by the parties.
5. From the pleadings and evidence placed on the file, it is clear that the complainant had purchased an insurance policy No.02158140 by paying annual premium of Rs.2,00,014/-. The annual premium of Rs.2,00,014/- was to be paid for five years i.e. w.e.f. 16.11.2010 to 16.11.2014 and the sum assured was Rs.11,47,000/-. The complainant had admitted in his complaint that he paid the first premium of Rs.2,00,014/- on 16.11.2010 but due to ill luck, the business of complainant was collapsed due to economically crises and the complainant could not pay the further annual premium till the filing of the complaint. The Ops have forfeited the amount of Rs.2,00,014/- and the complainant made the prayer for refund of Rs.2,00,014/- along with interest and compensation. The Ops No.1 and 2 have stated that the complainant had admitted in his complaint that due to financial and economical crises, he could not pay the premium and this fact clarifies that the complainant himself has not paid the premium to keep the policy alive and thereby breaching the terms and conditions of the policy. The Ops have also stated that as per the terms of the policy contract if the policy is not suitable, the policy-holder may get his policy reviewed by returning the policy and policy documents within 15 days (Free Look Period) from the day the policy-holder received the policy. The Ops have further stated that the complainant had enjoyed the benefit under the subject policy, so, he is not entitled for the refund of premium deposited by him. The complainant answered the question in the proposal form after having fully understanding the nature of question and after going to the terms and conditions of policy. It is further stated by the Ops that the Ops had received only the subscription premium amount and thereafter, the renewal premium which was due on 16.11.2011 had remained unpaid. The Ops had written a letter Ex.R4 to the complainant but the complainant has not paid the renewal premium within due date and as a result of which, the said policy was entered into the lapsed mode w.e.f. 16.11.2011. The Ops have further stated that a letter Ex.R5 was also sent to the complainant wherein he was informed that the said policy can be revived by paying the outstanding premium and charges on the same. Since the said policy had not been revived before the end of the revival period, the same had been foreclosed on 15.11.2013 and the complainant was informed vide letter Ex.R6.
6. From the facts and circumstances of the case, it is clear that the complainant had not paid any further premium after the subscription premium. The complainant even had not got revived the policy by paying the outstanding premium and charges before the revival period i.e. 15.11.2013. The policy has been terminated by the Ops No.1 & 2 vide letter Ex.R6 at the end of revival period. The Ops have brought a citation 2008 (4) CPJ page 156 (NC), wherein it has been held by Hon’ble National Commission that Life Insurance-Refund of Premium-Policy lapsed for non-payment of premium-Refund of premium paid with interest directed by Forum-Order upheld in appeal-Hence revision-Premium given by insured to cover risk for given period-Insurer covers risk for period for which premium paid-Policy if lapsed after that, no Fora could direct refund of premium-Risk stood covered for period for which premium had been paid-No provision exists for refund of premium of lapsed policy-Order of lower Fora set aside. This authority is fully applicable to the facts of present case. In view of this authority, the complainant is not entitled to any refund of premium of the lapsed policy.
7. Thus, as a sequel of aforesaid discussion, we find no merit in the present complaint and we hereby dismiss the complaint with no order as to costs. A copy of this order be sent to both the parties free of costs. File be consigned to the record room after due compliance.
Announced.
Dt.08.01.2016.
(Jagmal Singh),
President.
(Harisha Mehta), (Rajbir Singh),
Member. Member.
