ORDER

04.07.2024

Sh. Sanjay Kumar, President

1. The factual matrix of the present case is that in July 2013, the authorized representative of OP approached the complainant and induced to take a policy of Kotak Mahindra Old Mutual Life Insurance Ltd. and to pay Rs.24,000/- yearly premium and after 45 days of taking the policy, the company will grant loan for Rs.1,50,000/-. It is stated that as per assurance of representative of OP the complainant taken the said policy and paid Rs.24,000/- in July 2013. It is stated that representative of OP took signatures of the complainant on proposal form and some other documents and also filled up some entries/columns.
2. It is stated that after one month of taking policy the complainant received the policy bond and came to know that many entries filled in the policy bond were incorrect i.e phone number, email id and home address etc. It is stated that complainant approached officials of OP for rectification of wrong entries and issuance of fresh policy bond but no proper assurance  given for sanction of  loan of  Rs.1,50,000/-. It is stated that complainant came to know that OPs have cheated him. It is stated that thereafter complainant contacted officers of OP on various occasions and requested for refund of the money but no heed paid to the request of complainant. It is stated that OPs have  also committed criminal breach of trust and caused wrongful loss to the complainant.
3. The complainant is seeking refund of Rs.24,000/- alongwith 18% interest per annum till realization, compensation of Rs.2,00,000/- for misleading the complainant for sanction  of loan of Rs.1,50,000/- after 45 days of taking policy and to  pay  litigation charges of Rs.11,000/-.
4. OP filed detailed reply and taken preliminary  objections  that OP1 is the branch office and there is no conflict of  interest  among OP1 and 2. It is stated that complaint is false, frivolous, vexatious and gross misuse of  process of  law, therefore, liable to be dismissed. It is stated that there is no consumer dispute between the parties. It is stated that the alleged serious dispute is of misselling of policy which cannot be adjudicated under the summary proceedings and can be adjudicated by only Civil Court.
5. It is stated that complaint is bad for non joinder of necessary party the agent/advisor as alleged. It is stated that the said agent/advisor is necessary and proper  party in adjudication of the present dispute. It is further stated that the agent/insurance broker is an independent  person/entity licensed by Insurance Regulatory and Development Authority, who advised their customer on their insurance needs and thereafter arrange insurance  policies from insurance company as per their own judgment and customer choice. It  is stated that for any act on the part of any agent/insurance broker, the insurance company  cannot be made liable or accountable in any manner, therefore, present complaint is not maintainable.
6. It is stated that the complainant for the first time raised this objection of getting the  signatures on  proposal form and other documents and filling of entries/columns. It is stated that the allegations regarding non  filing of application form and nearly signing the same is false, frivolous, untenable and concocted story. It is stated that principle of law is settled that at the time of filling up the proposal form the agent acts as agent of insured and not of insurance company and any statement contained in the proposal form does not become the  knowledge of insurer. It is stated that if any  person signed any document, it is presumed that he signed the same after reading and understanding it properly, therefore, present complaint is not maintainable and liable to be dismissed.
7. It is stated that as per clause 4 (1) and 6 (2) of the IRDA Regulations 2002 the policy  documents alongwith the copy of proposal form sent to the complainant giving opportunity to review/cancel the policy within 15 days i.e “Free Look Period”. It is stated that the policy documents were dispatched and the same were received at the address of complainant, despite receipt of the policy and policy documents, the complainant failed to approach the OP within free look period making any grievance with respect to the policy, its terms and conditions, implying the policy and its terms and  conditions but duly accepted by the complainant were in order. It is stated that now complainant is stopped  from raising any grievance or issued relating to the policy or its terms and conditions or any information given in the proposal form or seek refund of the  premium of the subject policy. It is stated that now complainant  is bound by the policy contract and waived his right by exercising free look provision.
8. It is stated that the proposal  form signed  by the complainant would specifically reveal as mentioned in clause 3 of the proposal form that he opted for insurance plan named Kotak Surakshahit Jeevan which had coverage for 10 years and premium for the same would be Rs.24,000/- which would be paid annually for a period of ten years so that the complainant gets the full benefits as mentioned in the terms and conditions of the  policy. It is stated that complainant is estopped from pleading that he was unaware about the terms and conditions of the  policy at the time of signing  the proposal form without any undue influence and with his free will and consent. It is stated that complainant is not entitled for  refund of the premium as complainant continues to avail the benefit of the subject policy  till date. The OP referred the judgment of LIC of India & Ors. Vs. Siba Parsad Das & Ors. IV (2008) CPJ 156 NC.
9. It is stated that after receipt of the policy documents, as per records of OP company the complainant never approached the OP regarding any discrepancies in the subject policy and for the  first time approached via email from his email id
10. On merit  all the allegations and denied  and contents of preliminary  objections  reiterated. It is stated that OP did not adopt any unfair trade practice and there is no deficiency of service. It is stated that OP duly discharged its duty by covering the risk on the life of complainant after receiving the premium from the complainant. It is stated that at the most the complainant after surrendering the policy be entitled for surrender amount after deducting the  surrender charges as per the terms and conditions of the policy. It is stated that complainant is not  entitled to  any relief claimed in the complaint.
11. Complainant  filed rejoinder to the WS and denied all the allegations made  therein and contents  of  complaint are reiterated.
12. Complainant filed evidence by way of affidavit. In the affidavit contents of complaint are  reiterated.
13. OP filed evidence by way of affidavit of Shakil Ahmed Senior Manager Legal. In the affidavit contents of WS reiterated. OP relied on copy of proposal  form Ex.R1, copy of benefit illustration form Ex.R2, copy of  policy documents Ex.R3 and copy of letter dated 28.10.2013 Ex.R4.
14. Written arguments  filed by complainant as well as by OP.
15. We  have heard Sh. D.K Sinha  counsel for complainant and Sh. Taufiq Ahmad counel for  OP. We have also  gone through the record.
16. It is admitted case of the parties that complainant got issued a policy from OP insurance company. The complainant alleged that authorized representative of OP induced him to take a policy and to pay Rs.24,000/- yearly premium and after 45 days of taking the policy the company will grant loan of Rs.1,50,000/-. The OP discloses the fact that the complainant availed the services of insurance agent namely SPA Insurance Broking Services Ltd. which is an independent entity licensed by IRDA. According to OP the policy and policy documents alongwith proposal  form were sent to complainant with an opportunity to review/cancel the policy within 15 days i.e “free look period” as per clause 4 (1) and 6 (2) of IRDA (protection of policy holders interest) regulations 2002. The OP alleged that for the first time complainant approached via email dated 10.10.2013 for refund of premium but the request was declined by OP vide letter dated 28.10.2013. According to OP, the risk on the life of complainant has already taken by the OP company and cannot refund the premium as complainant failed to exercise his right to review/cancel the policy within free look period. The OP referred the judgment of LIC of India Vs. Siba Parsad Das & Ors. IV (2008) CPJ 156 (NC). We have gone through the judgment. The complainant signed the proposal form and all other requisite documents through insurance agent and after signing and submitting the documents the policy was issued. The complainant has never disputed that he has any objection to the policy after receiving the documents and failed to exercise the valuable  right within free look period. The OP has admitted that the life  risk covered by the insurer, therefore, in these circumstances the premium deposited by the complainant cannot be refunded and policy cannot be cancelled. It is pertinent to mention that complainant has not mailed M/s SPA Insurance Broking Service Ltd. who is a necessary party. In case there is any deficiency of service i.e on the part of this company not on OP insurance company. The complainant failed to establish deficiency of service or unfair trade practice against the OP insurance company.
17. On the basis of above observation and discussion present complaint is dismissed. No order as to cost. File be consigned to record room.
18. Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving an application from the parties in the registry. The orders be uploaded on www.confonet.nic.in.

Announced in open Commission on  04.07.2024.

     SANJAY KUMAR                 NIPUR CHANDNA                       RAJESH

       PRESIDENT                             MEMBER                                MEMBER