Delhi

North East

CC/135/2017

Smt. Ritu Jain - Complainant(s)

Versus

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

17 Apr 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION: NORTH-EAST

GOVT. OF NCT OF DELHI

D.C. OFFICE COMPLEX, BUNKAR VIHAR, NAND NAGRI, DELHI-93

 

Complaint Case No. 135/17

 

 

In the matter of:

 

 

	Mrs. Ritu Jain W/o Mr. Amit Jain R/o C-4/181, C-Block, Yamuna Vihar, Delhi-110053	Complainant
	Versus
	MSAB Max Life Insurance Co. Ltd. Having its branch office previously at:- Unit No.1, First Floor, Dilshad Garden Metro Station, Delhi and now at 6th Floor, Nipun Towers, Plot No.15, Community Centre, Karkardooma, Delhi-110092.Having its registered office at:- 3rd Floor, Operation Centre, 90-A, Udyog Vihar,Sector-18, Gurgaon-122015,Haryana, Through its Branch Manager	Opposite Party

 

DATE OF INSTITUTION:   JUDGMENT RESERVED ON:  DATE OF ORDER:

17.04.17 12.01.23 17.04.23

CORAM:

Surinder Kumar Sharma, President

Anil Kumar Bamba, Member

ORDER

Surinder Kumar Sharma, President

The Complainant has filed the present complaint under Section 12 of the Consumer protection Act, 1986.

Case of the Complainant

1.  The case of the Complainant is that she applied for a personal loan to Cholamandalam Finance Co. then Shri Gaurav Gupta Representative of the Opposite Party contacted the Complainant and told that purchasing a policy from the Opposite Party is a pre condition for obtaining the loan. On his persuasion, the Complainant purchased a policy from the Opposite Party and she was assured that the Complainant can surrender the policy at any time after expiry of 3 years. It was also told that in case of the said surrender of her policy the Opposite Party shall refund the total amount of premium paid by the Complainant. Under compulsion, the Complainant purchased policy bearing no. 850138868 from the Opposite Party and the Complainant had paid the premium till June 2016. Due to some personal problem, the Complainant surrendered her policy to the Opposite Party vide request letter dated 06.11.16 and requested for refund of the amount of premium paid by her along with interest etc. The Opposite Party told her that it would pay Rs. 38,198/- as per the surrender value of the policy in terms of the agreement, whereas the Complainant has pay Rs. 95,000/- to the Opposite Party. This offer given by the Opposite Party is in violation of the insurance business. The Complainant lodged the complaint with the Insurance Ombudsman and her claim was rejected. The Complainant sent a legal notice dated 04.03.17 to the Opposite Party but of no avail. The Complainant has prayed for refund of Rs. 95,000/- i.e. the total amount of premium paid by her and Rs. 2 lakh as compensation.

Case of the Opposite Party

2. The Opposite Party contested the case and filed written statement. It is stated by Opposite Party that the complaint is not maintainable as the Complainant has suppressed the material facts. It is stated that the Complainant has duly signed the Proposal Forms and the policy bonds were delivered to the Complainant on 16.07.11. The Complainant did not raise any grievance regarding the terms and conditions of the policy during the free look period of 15 days. The request for cancellation was received on 06.11.16 i.e. after 5 years. The Opposite Party has denied the averments made in the complaint. It has denied the violation of any terms and conditions of insurance policy. The Opposite Party has prayed for dismissal of the complaint.

Rejoinder to the written statement of Opposite Party

3. The Complainant filed rejoinder to the written statement of Opposite Party wherein the Complainant has denied the pleas raised by the Opposite Party and has reiterated the assertions made in the complaint.

Evidence of the Complainant

4. The Complainant in support of her complaint filed her affidavit wherein she has supported the averments made in the complaint.

Evidence of the Opposite Party

5. In order to prove its case, Opposite Party has filed affidavit of Shri Dhiraj Malik, Manager Legal of Opposite Party, wherein the averments made in the written statement of Opposite Party have been supported.

 

 

Arguments and Conclusion

6. We have heard the AR for Complainant and Ld. Counsel for the Opposite Party. We have also perused the file and the written arguments filed by the parties. The case of the Complainant is that she had approached Cholamandalam for obtaining the loan. There she was compelled to purchase the insurance policy by the representative of the Opposite Party. Her case is that under compulsion she had purchased a policy from the Opposite Party in the sum of Rs. 2,54,211/-. At the time of purchasing the policy, she was assured by the Opposite Party that the Complainant could surrender the policy at any time after expiry of 3 years period and in case of said surrender the Opposite Party shall refund the total amount of premium paid by the Complainant along with bonus etc. It is the case of the Complainant that she had paid total amount of Rs. 95,000/- to the Opposite Party as premium and the Opposite Party told the Complainant that it would pay only Rs. 38,198/- as the same was the cash surrender value of the policy in terms of the agreement. It is the case of the Complainant that this amounts to the deficiency of service and unfair trade practice on the part of the Opposite Party. On the other hand, it is the case of Opposite Party that as per the terms and conditions of the policy, the surrender cash value in respect of the policy in question is Rs. 38,198/- . It is also the case of the Opposite Party that the said terms and conditions were given to the Complainant and free look period of 15 days was given to the Complainant for cancellation of the policy. But the Complainant did not opt for the cancellation of the policy.
7. The Complainant has not file any proof that she ever approached Cholamandalam for obtaining the loan nor anything has been brought on record by the Complainant that she had to purchase the policy in question under compulsion. The Opposite Party has led evidence that all the policy bonds and documents in respect of the policy were duly delivered at the address of the Complainant on 16.07.11. The Complainant has not denied this fact nor has controverted this fact in her rejoinder. On perusal of the pleadings, it is revealed that it is not the case of the Complainant that she was not supplied the terms and conditions of the policy. Therefore, the Complainant is bound by the terms and conditions of the policy.
8. As per the terms and conditions of the policy, the Complainant had option to cancel the policy within the free look period of 15 days, the relevant part is reproduced as under:-

“Policy Review Period

Please examine your policy carefully. You may opt to return the Original Policy to the Company with a written request for the cancellation of the Policy within fifteen days from the date of receipt of this policy. In such an event the Premiums paid less proportionate risk premium for the period of cover, any medical fees and expense incurred on stamp charges by the Company will be refunded without interest.

9. Further the cash value and the surrender value of the policy is determined in the following manner as per the terms and conditions of the policy. The relevant part is reproduce as under:-

“Cash Value

This Policy will acquire cash value if it has been in force for at least three years and provided all the Premiums that have fallen due have been paid. The guaranteed cash value in this Policy will be (a) higher of thirty per cent of the Premiums received (excluding the first year’s Premium) accumulated at the compound rate of 1 % p.a. or (b) net level premium reserve as per table filed with IRDA.

Surrender Value

After the Policy has acquired Cash Value, you may opt to surrender this Policy. The Surrender Value payable will be equal to Cash Value. However, one the Surrender Value has been paid in cash, the Policy will terminate and no further benefit under the Policy is payable.”

10. Therefore, in view of the discussion the Complainant is not entitled to the amount paid by her as premium and she is entitled to receive the money in terms of the above procedure as per the terms and conditions of the policy.
11. The Opposite Party has calculated the surrender/ cash value of the policy as Rs. 38,198/-. Therefore, it is ordered that the Opposite Party shall pay the Complainant an amount of Rs. 38,198/- along with interest @ 6 % p.a. from the date of filing the complaint till recovery. No order as to costs.
12. Order announced on 17.04.23.

                           Copy of this order be given to the parties free of cost.

File be consigned to Record Room.

(Anil Kumar Bamba)           Member

(Surinder Kumar Sharma) President