Tamil Nadu

South Chennai

CC/143/2013

Yoganandan - Complainant(s)

Versus

Max Life Insurance Co, Ltd., - Opp.Party(s)

Party in Person

06 Oct 2017

ORDER

                                                                        Date of Filing :   29.04.2013

                                                                        Date of Order :   06.10.2017

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM, CHENNAI (SOUTH)

     2^nd Floor, Frazer Bridge Road, V.O.C. Nagar, Park Town, Chennai-3

PRESENT: THIRU. M.MONY, B.Sc., L.L.B. M.L.,                     : PRESIDENT            

                  TMT. K.AMALA, M.A. L.L.B.,                                 : MEMBER I

             DR. T.PAUL RAJASEKARAN, M.A ,D.Min.PGDHRDI, AIII,BCS : MEMBER II

C.C.NO.143/2013

FRIDAY THIS  6^TH DAY OF OCTOBER 2017

 

Yoganandan,

Jagannathan,

Senior Citizen,

No.1A, Chakrapani Road,

Ist Floor, Guindy,

Chennai 600 032.                                                  .. Complainant

 

                                        ..Vs..

 

1.  The Manager,

Max Life Insurance Co. Ltd.,

Chennai Branch – Chennai 005,

Gee Crystal, 8^th Floor,

91/92, Dr. Radhakrishnan Salai,

Opp. Yellow Pages,

Mylapore, Chennai -4.

 

2. Mr. Analjit Singh, Chairman,

Max Life Insurance Co. Ltd.,

1, Dr. Jha Marg, Okhla,

New Delhi 110 020.

 

3. Mr. T.Vijayan, Chairman,

Insurance Regularity Development Authority,

3^rd Floor, Parisharam Bhavanam,

Basheerbagah, Hyderabad 500 004.                 .. Opposite parties.

 

For Complainant                            :    Party in person      

Counsel for opposite parties 1 & 2   :   Tr.Gaurav Chatterjee

For opposite party-3                    :    Appeared in person.

 

 

ORDER

THIRU. M. MONY, PRESIDENT

This complaint has been filed by the complainant against the opposite parties under section 12 of the Consumer Protection Act 1986 seeking direction to cancel the original policy and refund the premium amounts of Rs.60,001/- with interest and also to pay a sum of Rs.3,00,000/- towards mental agony and Rs.1,00,000/- towards cost of the incidental and other legal expenses.

 1. The averment of the complaint in brief are as follows:

         The complainant submit that he availed Max New York policy from the opposite party insurance company, and paid a sum of Rs.20,000/-  drawn on Bank of India, Chennai (Main) Branch,  dated 23.2.2009 vide cheque No.690944  after duly filled up proposal form.    The complainant also state that the agent of the opposite party advised that the original policy document would be sent to him directly by the company within 10 days which never arrived for more than two years.  Now the complainant understands that the Agent had fraudulently missold the policy with an intention to cheat and defraud the complainant.   The opposite party company was also in collusion with the Agent and hence, the original policy document was never dispatched and delivered to the complainant.     Further the complainant state that  he has been deprived of the right of executing the option to reject or accept the policy within 15 days of receipt of the policy document as per IRDA guidelines.    The complainant received an email communication advising that his policy had lapsed for nonpayment of premium for two years.    Hence the complainant issue notice was sent to them  and there was no response from the opposite parties.   The complainant also state that he received the renewal premium information on 12.2.2012.  Immediately after receipt of the duplicate document of policy No.737424325, the complainant  approached the opposite party’s Chennai Office and explained in detail regarding the non receipt of unit account of 1814.05 units which is 240 units less than, the unit available at the time of renewal premium.   The complainant has preferred complaint on 22.1.2013 to the Chairman, Max Life Insurance Co. Ltd  for taking appropriate action, but the opposite party company had failed to comply with the regulation prescribed by IRDA.   As such the act of  the opposite parties amounts to deficiency in service which caused mental agony and hardship to the complainant.  Hence this complaint is filed.

2.      Written Version of opposite party-1 & 2 not filed

3.    The brief averments in Written Version of  the opposite party-3 are as follows:

      The 3^rd  opposite party denies each and every allegations except those that are specifically admitted herein.  The opposite party state that  the complainant is not a consumer vis-à-vis IRDA within the meaning of Sec.2(d) of the  Consumer Protection Act, 1986.  The IRDA in exercise of its statutory duties does not collect any fees or other charges from the policy holders for the performance of functions assigned to it under the IRDA Act.     Further in this case of S.P. Goyal ..Vs.. Collector of Stamps (1996) 2 Company Law Journal 1996 (Supreme Court), it has been held that the officers appointed to implement provision of statutes like Stamp Act, Registration Act are only performing statutory duties and do not render any service within the meaning of the Consumer Protection Act.   Similarly IRDA is also performing statutory duties under the IRDA Act, 1999 and in so doing it does not render any service for consideration.   Further there is no relationship of consumer between the opposite party and the complainant.  Hence there is no deficiency in service on the part of the opposite party and the complaint is liable to be dismissed.

4.     In order to prove the averments of the complaint, the complainant has filed proof affidavit as his evidence and documents Ex.A1 to Ex.A33 marked.  Proof affidavit of opposite parties 1 & 2 filed and Ex.B1 to Ex.B13  marked on the side of the opposite parties 1 & 2.  

5.   The points for the consideration is:  

1) Whether the complainant is entitled to cancel the original policy and to get refund of premium Rs.60,001/- with interest  as prayed for ?

 

2) Whether the complainant is entitled to a sum of R.3,00,000/- towards mental agony and Rs.1,00,000/- towards cost of incidental charges and other legal expenses  as prayed for ?

 

6.  POINTS  1 & 2:

        Heard both sides.  Perused the records.  As per order of the State Commission dated 14.7.2017 this forum is directed to receive proof affidavit of opposite parties 1 & 2.    On verification of notes paper it is seen that written version of opposite parties 1 & 2 filed.   But admittedly in this case, the opposite parties 1 & 2 has not filed any written version.  Learned counsel for the complainant contended that admittedly the complainant availed Max New York policy from the opposite party insurance company.   It is also admitted that the complainant paid a sum of Rs.20,000/-  drawn on Bank of India, Chennai (Main) Branch,  dated 23.2.2009 vide cheque No.690944, after duly filled up proposal form.   The contention of the complainant  that the agent of the opposite party misled the complainant with malafide intention and sold the policy; giving copies of the proposal form, terms and conditions etc., is not acceptable.   Since it is apparently seen from the records that the complainant is a retired Senior Manager bank of India and practicing as an advocate.  

7.     Further the contention of the complainant is that after the issue of cheque dated 23.2.2009 within 15 days the original policy shall reach to the complainant from the opposite parties.  But the complainant has not received any policy till two years is not denied.   Hence the complainant was deprived of the right of exercising the option to reject or accept  the policy  as per I.R.D.A. guidelines within 15 days of receipt of the policy document.    The contention of the opposite parties  that the policy was duly dispatched is not acceptable in the absence of any record. The Ombudsman order Ex.A25 dated 15.2.2013 is also very clear that the opposite party has not proved the due ddespatch of the policy.    Further the complainant contended that immediately after the receipt of the duplicate document of policy No.737424325, the complainant  approached the opposite party’s Chennai Office and explained in detail regarding the non receipt of unit account of 1814.05 units which is 240 units less than, the unit available at the time of renewal premium is also not denied.   The contention of the opposite parties is that complainant  requested  to cancel the policy and demanded the entire premium amount.  But as per the terms and conditions of policy the complainant is entitled for net assess value of Rs.12869.38; if the complainant was given due opportunity to cancel the policy within the free look period the complainant would have cancelled  the policy and the entire amount will be refunded.  As per the order of the Ombudsman the complainant has to cancel the policy within  15 days.    At that time the complainant was paid a sum of Rs.60,000/- towards three premium.   Further the contention of the opposite parties is that the complainant has not submitted the cancellation letter is also not acceptable because it is apparently clear from Ex.B9, dated 31.1.2013 proves the deficiency of service and unfair trade practice of the opposite parties.  

8.     The further contention of the opposite parties is that the request of the cancellation of the policy by the complainant cannot be accepted because the complainant has not approached the opposite parties within the free look period of 15 days from the date of receipt of policy.    But on a careful perusal of entire record it is apparently seen that the complainant paid a sum of Rs.20,000/- on 23.2.2009.  The opposite parties has not issued the policy for two years.   The contention of the opposite parties that the opposite party issued the policy well in advance within the  free look period of 15 days is absolutely false.  It is also proved from Ombudsman order.   The terms and condition of the policy is as follows:

“You may opt to return the original policy/document to the company with a written request for cancellation of the policy within fifteen days from the date of receipt of the policy.  In such an event the premiums paid, adjusted for any adverse movement in Fund Value less charges incurred on medical examination and on account of stamp duty, will be refunded without interest.”    

No proper steps for cancellation also taken by the opposite parties, since the complainant opted for cancellation immediately after the 1^st premium.   Further the contention of the opposite party is that the allegation of unaware of the proposal and terms and conditions of the policy is not acceptable because as per the terms and conditions Ex.A31  the   complainant is not entitled to a sum of Rs.60,001/-  towards the cancellation of policy, since on the date of cancellation i.e. immediately after the payment of three premium and giving effect to the renewal of policy.   Further the learned counsel for the opposite parties contended that the claim of the complainant is imaginary and exorbitant.  Considering the facts and circumstances of the case, this Forum is of the considered view that the opposite parties 1 to 3 are jointly and severally liable to pay a sum of Rs.44,554.51 towards premium amount with interest at the rate of 9% p.a. from 23.2.2009 to till the date of this order i.e. 6.10.2017 and also shall pay compensation of Rs.25,000/- towards mental agony and cost of the Rs.5000/- and the points are answered accordingly.

        In the result, the complaint is allowed in part.  The opposite parties 1 to 3 are jointly and severally liable to pay a sum of Rs.44,554.51  (Rupees Forty Four thousand five hundred and fifty four and fifty one paisa only) towards refund of premium amount with interest at the rate of 9% p.a. from 23.2.2009 to till the date of this order i.e. 6.10.2017  and also shall pay compensation of Rs.25,000/- (Rupees Twenty five thousand only) towards mental agony and cost of Rs.5000/- (Rupees Five thousand only) to the complainant.

The aboveamounts shall be payable within six weeks from the date of receipt of the copy of this order, failing which, the said amounts shall carry interest at the rate of 9% p.a to till the date of payment.    

 

            Dictated by the President to the Assistant, taken down, transcribed and computerized by her, corrected by the President and pronounced by us in the open Forum on this the 6^th day  of  October  2017.  

 

MEMBER-I                        MEMBER-II                             PRESIDENT.

Complainant’s side documents:

Ex.A1- 12.3.2009  - Copy of Life Insurance Policy document.

Ex.A2- 13.3.2009  - Copy of Statement of Account.

Ex.A3- 14.7.2011  - Copy of email from opposite party. 

Ex.A4-18.7.2011   - Copy of cheque for Rs.40,000/-

Ex.A5- 18.7.2011  - Copy of payment receipt.

Ex.A6- 18.8.2011  - Copy of Statement of Account.

Ex.A7- 12.2.2012  - Copy of renewal premium intimation.

Ex.A8- 21.7.2012  - Copy of premium paid certificate.

Ex.A9- 21.1.2013  - Copy of Statement of account.

Ex.A10- 21.1.2013         - Copy of Complainant’s letter.

Ex.A11- 22.1.2013         - Copy of complainant ‘s letter addressed to the opp. party.

Ex.A12- 25.1.2013         - Copy of letter from opposite party.

Ex.A13- 31.1.2013         - Copy of letter from opposite party.

Ex.A14- 1.2.2013  - Copy of email from opposite party.

Ex.A15- 7.2.2013  - Copy of email from the complainant to the opp. party.

Ex.A16-       -       - Copy of email sent by IRDA.

Ex.A17- 14.2.2013         - Copy of complainant letter to Ombudsman, Chennai.

Ex.A18- 19.2.2013 – Copy of letter received from the office of Ombudsman.

Ex.A19- 21.2.2013         - Copy of complainant letter addressed to IRDA. 

Ex.A20- 10.2.2013         - Copy of renewal premium intimation.

Ex.A21-       -       - Copy of email from Max Life Insurance Co Ltd.,

Ex.A22-       -       - Copy of email sent by complainant.

Ex.A23- 25.2.2010         - Copy of press cutting on need for transparency.

Ex.A24- 25.3.2013         - Copy of Statement of Account received.

Ex.A25- 28.3.2013         - Copy of letter from Insurance Ombudsman, Chennai.

Ex.A26- 15.2.2013         - Copy of letter from Insurance  Ombudsman, Chennai.

Ex.A27- 25.3.2013         - Copy of letter from Max Life Insurance Co. Ltd.,

Ex.A28-       -       - Copy of Blank Ack. Of policy.

Ex.A29-       -       - Copy of letter from IRDA.

Ex.A30        -     - Copy of letter from opp. party

Ex.A31-       -       - Copy of terms and conditions  clause-26.

Ex.A32-       -       - Copy of terms and conditions Clause-32.

Ex.A33-       -       - Copy of IRDA 2000.

Opposite parties’ side document: -     

Ex.B1- 23.2.2009  - Copy of Proposal Form.

Ex.B2- 12.3.2009  - Copy of policy documents.

Ex.B3- 12.3.2009  - Copy of Statement of account.

Ex.B4- 18.7.2011  - Copy of Reinstatement request letter.

Ex.B5- 12.2.2012  - Copy of renewal premium notice.

Ex.B6- 12.3.2012  - Copy of Statement of account.

Ex.B7- 12.12.2012         - Copy of Revival period intimation.

Ex.B8- 23.1.2013  - Copy of letter from the complainant.

Ex.B9- 31.1.2013  - Copy of letter from the complainant.

Ex.B10- 10.2.2013         - Copy of Revival Period Intimation letter.

Ex.B11- 22.2.2013         - Copy of letter from the complainant.

Ex.B12- 12.3.2013         - Copy of statement of account.

Ex.B13- 25.3.2013         - Copy of letter from the complainant.

 

MEMBER-I                        MEMBER-II                             PRESIDENT.