Delhi

New Delhi

CC/27/2016

Ashok Kumar Jain - Complainant(s)

Versus

Max Life Insurance co Ltd - Opp.Party(s)

30 Nov 2017

ORDER

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI),

‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

NEW DELHI-110001

 

 

Case No.CC/27/2016                                                                                   Dated:

In the matter of:

Ashok Kumar Jain

D-10-C Ganesh Nagar-2 Extension

Shakar Pur Near Krishna Nagar,Near Choudhary Dairy

East Ganesh Nagar Delhi

 

……..complainant

 

VERSUS

1. M/S Max Life Insurance Company Ltd.
2.  
6.  

Karakardum Delhi-110092.

 

2. M/S Max Life Insurance Company Ltd.

Regd. Office DLF Sequire Building

Jakarnda Marg/DLF City Phase-II

•  

 

3. M/S Max Life Insurance Company Ltd.
1.  

New Delhi-110001

 

 

                                                                        ...........Respondent

 

 

 

 

 

 

PRESIDENT: S.K. SARVARIA

ORDER

Complainant   purchased   Life Insurance Policy bearing no. 261016109 and 261016125 from the OP securing his life for the period of 7 years with the guaranteed death benefits from the issuing and effective date of the policies. It is stated by the complainant that total premium of Rs. 35,542.56/- was paid to OP. It is alleged by the complainant that the policy term and conditions were withdrawn unilaterally and the same has been replaced by introducing a new table of contract by OP vide their letter dt. 18.05.2015 and as such vide his email dt. 01.08.2015 and 30.08.2015, he protested the same. It is further alleged by the complainant that despite his repeated requests OP neither allowed him  for the cancellation of the policies, nor settle the dispute arising due to change in terms and conditions of the policy, well knowing the fact that the complainant had already completed the required formalities as desired by it. The complainant therefore approached this Forum for the redressal of his grievance.

Complaint has been contested by OP. OP Insurance Company denied any deficiency in services on its part, and prayed for the dismissal of the complaint on the grounds that the complaint is a frivolous one, complainant had failed to pay the premium due on the alleged policies, the policies in question is in lapsed status, and as such complainant is not entitled for any relief as prayed.

Both the parties have filed their evidence by way of affidavit.

We have heard the arguments advanced at the bar and have perused the record.

It is stated on behalf of the complainant that OP Insurance Co. as per  its own sweet will had replaced the existing benefit clause by introducing a new clause, the information regarding the same was given to him by OP vide its  letter dt. 08.05.2015. He has taken us through the contents of letter dt. 08.05.2015 which reads as under :-

“ There is a minor printing error in the table provided in section 8.4.1 of your policy. To rectify, the table in the current contract is replaced by the table provided in the Annexure attached herewith.

This correction will make the content of the table consistent with section 8.1 and 8.2 of the policy, Benefit, Illustration and the policy contract as approved by IRDA of India. “

            It is argued by the complainant that when he asked the OP Insurance CO. about the replaced benefit clause and to satisfy him that  as to how it will not affect the benefit assured  to him at the time of issuance of the policy, nothing has been heard from OP. Being, aggrieved by the conduct of the OP, he requested  OP Insurance Co. to either settle the dispute or to refund the amount, since nothing has been done by OP, he approached this forum for redressal of his grievance, and prayed for the refund of the money.  

            Counsel for OP on the other hand had argued that the complainant is well aware about the terms and conditions of the policy, and if he had any issue regarding any clause of the policy terms and conditions then the same should be raised by him during the “Free Look in period” which had already been expired.

            We are not agree with this contention of the OP , as the policy in question was issued in the year 2014 and the replacement in  benefit  clause is made  in the year 2015 , hence, the question of Free look in period does not arise. Moreover, vide its letter dt. 18.052015, OP had intimated the complainant regarding the replacement in the benefit clause, but had not given him any opportunity to raised any objection regarding the same. Hence, we are of the considered opinion that the replacement in the benefit clause of the policy terms and conditions was  done without obtaining the consent of the complainant and as such the policy terms and condition are not binding on the complainant.

            In view of the above, we are of considered opinion, that the OP had made the changes in the benefit clause of the policy terms and conditions without the consent, this act of OP amounts to Unfair Trade practice. We, therefore, hold OP guilty of Unfair Trade practice  and direct it as under:-

 

1. Refund to the complainant a sum of Rs. 35,543/- along with interest @ 10% from the date of filing of complaint till payment.

 

2. Pay to the complainant a sum of Rs.10,000/- on account of pain and mental agony suffered by him which will also include cost of litigation.

 

 

The order shall be complied by the OP within 30 days of the receipt of the copy of the order. If the said amount is not paid by the OP within a period of one month from the date of receipt of this order, the same shall be recovered by the complainant along with simple interest at the rate of 10% per annum from the date of this order till recovery of the said amount of Rs.10,000/-. This final order be sent to server (www.confonet.nic.in ). A copy each of this order be sent to both parties free of cost by post.

Pronounced in open Forum on ___________________

 

             (S K SARVARIA)

      PRESIDENT

 

 

 

  (H M VYAS)                                                                (NIPUR CHANDNA)

                                       MEMBER                                                                             MEMBER