DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (EAST)
GOVT. OF NCT OF DELHI
CONVENIENT SHOPPING CENTRE, FIRST FLOOR,
SAINI ENCLAVE, DELHI – 110 092
C.C. NO. 144/15
Shri Pradeep Kumar Soni
1/3126, First Floor
Ram Nagar Extension
Loni Road, Shahdara
Delhi – 110 032
(Near Indira Piyau & Rahul Dairy) ….Complainant
Vs.
M/s. Kotak Mahindra Old Mutual Life Insurance Ltd.
8th Floor, Roots Tower, Plot No. 7
Laxmi Nagar, Vikas Marg, Delhi – 110 092 ….Opponent
Date of Institution: 13.03.2015
Judgment Reserved for: 02.09.2016
Judgment Passed on: 16.09.2016
CORUM:
Sh. Sukhdev Singh (President)
Dr. P.N. Tiwari (Member)
Ms. Harpreet Kaur Charya (Member)
Order By: Ms. Harpreet Kaur Charya (Member)
JUDGEMENT
This complaint has been filed under Section 12 of the Consumer Protection Act 1986, by complainant Shri Pradeep Kumar Soni against M/s. Kotak Mahindra Old Mutual Life Insuranc Ltd. (OP).
2. The brief facts of the complaint are that the complainant purchased Unit Linked Endowment Assurance Plan (UIN-107L043V01) by the name of ‘Kotak Smart Advantage’ bearing Policy No. 01742673. The complainant was assured that complainant could surrender the policy after 3 completed years and he would get total investment and assured returns. The premium for the said policy was Rs. 15,000/- p.a.
It is the grievence of the complainant that when he surrendered the policy after 3 years, he received only a sum of Rs. 29,073/- as against Rs. 45,000/-, the total premium paid. Thereafter, the complainant approached insurance ombudsman, but his appeal was dismissed vide order dated 30.01.2015. The complainant alleged misrepresentation and concealment on part of OP, thus, prayed for refund of Rs. 15,000/- with interest.
3. OP appeared after the notice of complaint was served on them and filed WS. In their WS, OP had submitted that the complaint was barred by limitation under Section 24 A of CPA. Another plea raised by OP was with respect to the free look period. OP had also submitted that complainant was bound by the terms of contract of insurance, hence, there was no deficiency in service on their part.
4. Thereafter, complainant filed rejoinder to the WS of OP and reiterated the averments made in the complaint.
5. Both the parties filed their evidence, where complainant examined himself and placed reliance on surrender letter showing the break up and first premium certificate dated 20.10.2009.
OP got examined Ms. Priti Sawant, Assistant Vice President (Legal), who had placed the proposal form bearing no. KP386324 (Annex. 1), copy of insurance policy no. 01742673 (Annex. 2), delivery confirmation (Annex. 3), copy of benefit illustrations (Annex. 4), copy of surrender form (Annex. 5), reply to the request of the complainant for return of first premium (Annex. 6), reply of OP in insurance ombudsman and copy of the order of insurance ombudsman (Annex. 8).
6. We have perused the material placed on record. As pleadings were complete and none appeared on behalf of both the parties, the complaint is being decided on merits.
As far as limitation under Section 24A is concerned, the complaint is within limitation. The period of limitation will commence from the date of order, passed by insurance ombudsman.
The proposal form annexed with the complaint reply of OP shows that premium payment term was full policy term i.e. 15 years, schedule also reveals that premium payment term was 15 years.
Surrender charges, as mentioned in the terms and conditions of the policy are:
- “The surrender charge (expressed as a % of fund value) from 2nd policy year onwards is (8 minus N) %.
- N = Policy year of surrender (for policies which are surrendered after 3 policy years and 3 years premiums are paid).
- N = Policy year of first unpaid premium (for policies in lapse mode)
- In addition to the above, for LPP policies, 2% of the fund value will be charged if the policy is surrendered or policy is lapsed in any of the year from year 2-7.
- There are no charges from 8th year onwards.
- For surrender value in the first policy year, please refer clause-4.
- There is no surrender charge on the top up accounts.”
Term and conditions of the policy are also placed on record, in which Free Lock Provision is mentioned as below:
“In case you are not agreeable to any of the provisions stated in the policy, then you have the option of returning the policy to us stating the reasons thereof within 15 days from the date of the receipt of the policy. The cancellation request should be submitted to your nearest Kotak Life Insurance Branch or sent directly to our Head office. On receipt of your letter along with the original policy document we shall arrange to refund the premium paid by you after deducting the proportionate risk premium, medical charges and stamp duty. A policy once returned shall not be revived, reinstated or restored at any point of time and a new proposal will have to be made for a new policy”.
7. It is well settled law that insurance policy between the insured and insurer represents the contract between the parties. The terms of agreement have to be strictly construed. The complainant is educated person who had signed the declaration on the proposal form that he had read and understood the product features, benefits and risk factors, structure of charges, term and conditions etc.
Furthermore, Annex. 2 reveals that the complainant was made aware regarding the free look period. The complainant had every opportunity to return the policy even if we assume that he was induced by the agent at the time of signing proposal form. Not exercising his right and alleging unfair trade practice and deficiency in services cannot be justified on the part of the complainant.
Hence, the present complaint is dismissed being devoid of merits without any orders as to cost
Copy of the order be supplied to the parties as per rules.
File be consigned to Record Room.
(DR. P.N. TIWARI) (HARPREET KAUR CHARYA)
Member Member
(SUKHDEV SINGH)
President
