Ld Advocates are present. Judgement is ready and pronounced in open Commission in 12 pages 6 separate sheet of papers.
BY - SRI ASISH DEB, PRESIDENT
Brief facts of the complainant’s case are that the Complainant is a law abiding citizen of India. The Complainant had obtained a Life Insurance Policy No.345822076 of the aforesaid Max Life Insurance Company Limited under their plan “Max Life Smart Wealth Plan“. Policy Holder being the complainant Mr. Pradip Kumar Jana and the name of the life insured being Ms. Shilpita Jana, daughter of the complainant paid an annual premium of Rs.2,80,000/- only to the said Max Life Insurance Co. Ltd. to the debit of his S.B. A/No. 912010054582803 with Axis Bank Ltd., Tamluk Branch, Dist. Purba Medinipur, West Bengal.The employee of AXIS Bank Ltd., Tamluk Branch, Agent of the Max Life. Ins. Co. Ltd had come to complainant’s residence on 05.10.2020 to get all the formalities fulfilled by him for obtaining the Ins. Policy, “Courtesy Annexure C — running page no. 24.” The complainant had received the speed post delivery envelope, containing the Insurance Policy and related papers on 16.10.2020 evening, “ Courtesy Running Page No. 9 and 10 “Annexure “ A “ and “ B “ respectively. After going through full details of that so obtained Insurance Policy Cover for my 18 years aged daughter that the Complainant had considered full details of the so obtained life insurance policy of Max Life Insurance Co, Ltd, under their scheme “Max Life Smart Wealth Plant“ and had taken decision to cancel the aforesaid Insurance Policy of Max Life Insurance Co. Ltd, under their Free look period of 15 days after receipt of the Insurance Policy Cover normally, and within 30 days from the date of receipt of Insurance Cover Policy if the Policy Cover is sourced through distant marketing mode “ Courtesy Running Page No. 23, Insurance cover. page 12 of 16 - Free look Clause “ , Running Page 11 to 26 “ Annexure” C”, Though the Complainant was quite eligible to cancel the said Insurance Cover within 30 days from 16.10.2020, as the policy cover is sourced through distant marketing mode i.e. from Gurugram, Hayana -122015 to his place of residence at Village Bhagawankhall, P.O. Chaknan, P.S. Chandipur, Distt. Purba Medinipur - 721633, West Bengal, a long distance of more than 1500 K.M. But Complainant had cancelled the said Insurance Policy Cover by sending an E-mail cancellation letter dt. 27.10.2020 at 6:20 P.M. to Max Life Insurance Co. Ltd.’s e-mail Id. account., sufficiently prior to end of normal fifteen ( 15 ) day’s period of cancellation , which specific 15 days period gets ended on 31.03.2020 in the instant case. The Complainant had canceled the Policy vide e-mail dt.27.10.2020 at 6:20P.M. “Courtesy Running Page No. 27“-Having got no acknowledgement of e-mail cancellation letter dt. 27.10.2020 at 6:20 P.M. from Max Life Insurance Co. Ltd., complainant had consecutively sent e-mail cancellation letters dt. 29.10.2020 at 1:35 P.M. dt. 30.10.2020 at 9:30 P.M. and dt. 31.10.2020 at 7:00 P.M. respectively on the same score of cancellation request of said Insurance Policy Cover No. 345822076, “Courtesy Running Page Nos. 28, 29, 30 respectively as Annexure “ E “, “ F “.“G“ respectively. The Complainant had sent a letter dt. 27.10.2022 vide DTDC Courier Service to the Max Life Insurance Co. Ltd. to their address at Gurugram, Haryana 122015, which had duly been received by some Mr, Kuldeep on 30.10.2020, though said Mr. Kuldeep did not put the date under his signature, but from PR/TR of DDTDC it appeared the article had been duly received on 30.10.2026, “ Courtesy running page No.s 31,32,33,34 respectively, as Annexure “H”, “I”, “J”. After a long gap of more than fortnight of his repeated cancellation request letters of the said insurance Cover Policy No.345822076 that too within the normal free look clause of 15 days from the receipt of Insurance Cover Policy Max Life insurance Co. Ltd. on 16.10.2020, though Complainant was entitled to cancel the said Insurance Policy Cover within 30 days of receipt of the said Insurance Policy Cover received as on 16.10.2020, since it is sourced through distant marketing mode i.e. from Gurugram, Haryana 122015 to his P.O. at Norghat, P.S. Chandipur, Distt. Purba Medinipur, West Bengal - 721633, a long distant mode of more than 1500+ K.M., this distantly sourced Insurance Cover where 30 days period is allowed to cancel the insurance Policy Cover of Max Life Insurance Co. Ltd. lies printed exclusively on free look clause of Running Page no.23, Annexure “ C” . Vide their letter Document Code CS008 dt. 17.11.2020. Max Life insurance Co. Ltd, has quoted “ your policy pack including proposal form and benefit illustration was handed over to the Complainant on 09.10.2020 via SPEED POST bill number EH7181147531N “. “ Further, the free look period for the above mentioned policy has already lapsed, therefore, we express our inability to cancel the policy and refund the premium amount. “Page no.35 and 36, as Annexure “ K “. The complainant felt extremely bewildered viewing the contents of this letter dt. 17.11.2020 of Max Life Insurance Co. Ltd., addressed to him, wherein it is clearly stated that “your policy pack including proposal form and benefit illustration was handed over to Complainant on 09.10.2020 via SPEED POST bill number EH7181147531N.” Further in the 2nd paragraph of their letter dt. 17.11.2020 addressed to him it is written “ Further the free look period for the above mentioned policy has already lapsed therefore, we express our inability to cancel the policy and refund the premium amount.” Gist of Max Life insurance Co. Ltd.’s this letter dt. 17.11.2020, addressed to him, are full of blatant lies whose sole aim is to have a scot free run in not to refund him his legally receivable refund amount of entire annual insurance premium amount of Rs,2,80,000/- only. The Running Page No. 9 i.e. Annexure “ A “ is photocopy of the speed post delivery envelope containing Insurance Policy Cover and other papers is crystal clear that it was received on 16/10/20. Annexure “ B “, enclosed therewith the case of complaint is the track record of Indian Postal Department of Speed Post Bill Number EH 718114753IN, exactly the same as quoted by Max Life Insurance Co. in their letter dt. 17.11.2020 addressed to him, but printed contents of that TR of speed post bill number EH718114753IN reveals that the said speed post envelope containing the Insurance Policy Cover and other paper of Max Life Insurance Co. Ltd. was booked from Gurgaon BPC on 10.10.2020 at 15:24:51 and after being transported through several tiers on several days it has reached to Kharagpur NSH on 15.10.2020 at 03: 15: 25 and it was shown that from Kharagpur NSH it had been dispatched, naturally it stood that it had been dispatched to Norghat SO, and Norghat SO on receiving of the said speed post bill numbered EH718114753IN envelope on 16.10.2020. It is candid documentarily proved that the said speed post bill numbered envelope had been booked on 10.10.2020 from Gurgaon BPC by O.P./ Respondent at 15: 24: 51 and which had been received by Norghat SO on 16.10.2020 under whose jurisdiction the complainant resides, hence had got the delivery of that envelope on 16.10.2020 evening from Norghat SO, whereas O.P. / Respondent vide their letter dt. 17.11.2020 had claimed that the said insurance Policy Cover had been delivered to the complainant on 09.10.2020. Respondent’s blatant lie has been caught red handed by claiming “your policy pack including proposal form and benefit illustration was handed over to him on 09.10.2020 via SPEED POST bill number EH7181147530IN. Naturally within the normal limitation period of 15 days after receipt of the insurance Cover policy from Max Life Insurance Co. Ltd. on 16.10.2020 had sent cancellation of the instant Insurance Policy Cover by e-mail request letter on 27.10.2020, on 29.10.2020, on 30.10.2020 and on 31.10.2020 and vide my DTDC Courier Serviced letter dt. 17.10.2020 and poignantly all those requests for the cancellation of the Insurance Policy Cover No. 345822076 had also been duly delivered to O.P timely and last e-mail being delivered on 31.10.2020 i.e. within the Max Life insurance Co. Ltd’s stipulated free look period of normal 15 days, though Complainant was quite eligible to send his cancellation request of the said Insurance Policy Cover within 30 days after receipt of the Insurance Policy Cover on 16. In view of the above facts and circumstances, the complainant has prayed for directing O.P to refund entire annual premium amount of Rs.2,80,000/- only, compensation of Rs. 1,00,000/- only for sustaining unavoidable pecuniary hardship for nearly 2 ( two) years and for harassment, humiliation, mental stress, strain and anxiety , Rs.20,000/- only as towards litigation cost and to levy a sizable punitive cost upon 0.P. to arrest this type of fraudulent, deceitful trend and the punitive cost may be deposited to Consumer Welfare Fund as the District Consumer Disputes Redressal Commission may deem fit and proper.
The op has contested the case by filing written version stating inter alia that the instant complaint does not disclose any cause of action against the answering Opposite Party.The Complainant purchased a policy being No. 345822076 on 3rd of October, 2020 from AXIS BANK LTD., Tamluk having annual mode payment of the premium. The customer initially paid the premium amount of Rs. 2,95,797,80/-. Thereafter the customer wanted to cancel the policy as he was not ok with terms and conditions of the policy. The cancellation request was received in the office of the answering Opposite Party on 10th November, 2020, which was already beyond the free look period. Hence, the request for cancellation was not approved as the policy was beyond the free look period. Since the contractual obligation in between the parties abides upon the both, no cause of action arose against the Opposite Party, the present complaint is liable to be dismissed. As per the Terms and Conditions of the policy the Complainant was provided a free look period of 15 days from the date of receipt of the policy to cancel the policy in case there are any discrepancies in the policy.It is submitted that the Opposite Party as per clause 10(1)(1) and 8(1) of the IRDA (Protection of Policyholder's Interest) Regulations, 2017, at the policy document along with the copy of the proposal forms to the Complainant giving him an opportunity to review/cancel the policy within free look period. In this present case, the complainant purchased a policy being no. 345822076 on 3rd of October, 2020 from AXIS BANK LTD., Tamluk having Annual mode payment of the premium. The customer initially paid the premium amount of Rs.2,95,797.80/-. Despite, receipt of the policy terms, the Complainant failed to approach the Answering Opposite Party within the free look period with any grievances with respect to the terms and conditions of the policy thereby implying that the terms and conditions of the policies were in order. The Complainant is now estopped from raising any grievances or issues relating to the policies seeking refund of the premium paid under the policy. The Complainant is bound by the policy contract and is deemed to have given up/ waived her rights by not exercising the free look provision. It is submitted that after receiving the documents, the Complainant failed to approach the Opposite Party within the free look period of 15 days from the date of receipt of the policy document. Thus, the present complaint deserves outright dismissal. The Hon'ble National Consumer Disputes Redressal Commission New Delhi, in Mohan LalBenal v/s ICICI Prudential Life Insurance Co, Lt and Harish . Kumar Chadha v/s Bajaj Allianz Life Insurance Co. Ltd has heldthat if the insured/applicant is not satisfied with the policy taken, then he/she should have availed the option of returning the policy within 15 days of receipt i.e., within “the Free-look Period". The said proposition has also been clearly laid down in the case Shrikant Murlidhar Apte vs. Life Insurance Corporation of India, Revision Petition no. 634 of 2012 decided on 02.05.2013. Further, the National Commission concurred with the findings of Maharashtra State Consumer Disputes Redressal Commission, Mumbai that "Once 15 days ‘cooling off period is over, policy documents become binding on both the parties and the contents therein are also biding on both of them.” The Hon'ble National Commission in the case titled "LIC of India &Ors. Vs. Siba Prasad Das &Ors." reported in IV (2008) CPJ 156 (NC) has held that: "We are unable to appreciate as to on what ground the District Commission and State Communion could direct refund of premium? The premium given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period of which the premium has been set. It is not the case of the Complainant that the risk was not covered for the period for which the premium was given. If after that the policy lapsed, under no provision of terms of the policy or law, could any Fora direct for refund of any premium for the simple reason, as already stated, that the risk stood covered for the period of which premium had been paid." Since the policy documents were received by the Complainant, it was her duty to read and verify the details stated in the proposal form and approach the Company in case of any discrepancy. The Complainant was duly informed that in case she is not satisfied with the features or the terms and conditions of the policy he can withdraw/cancel the policies under the "Free Look Period” provision that is within 15 days from the date of receipt of policy document. The Complainant herein retained the documents and approached the company after the free look period for the cancellations. This implied that the Complainant had verified and consented to all the details stated in the proposal form. This Hon'ble Commission has no jurisdiction to entertain the complaint. There is no deficiency of service or negligence on the part of the replying Answering Opposite Party. "Deficiency" as defined under Section 2(11) of the Consumer Protection Act, 2019 mean any fault, perfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be maintained by or under any law or has been undertaken to be performed by a person in pursuance of a contract or otherwise in relation to any service. In the present case, the Complainant has failed to approach the Answering Opposite Party for cancellation/refund of the premium within the freelook period of 15 days from the date of receipt of the policy nor he has continued with the payment of premium of the policy. Therefore, there is no deficiency in services or unfair trade practice on the part of the Opposite Party as laid down in the case of Ravneet Singh Bagga v. KLM Royal Dutch Airlines (2000) 1 SCC 66 the Hon'ble Supreme Court has laid down the test of deficiency in service by stating that “The deficiency in service cannot be alleged without attributing fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the complainant who alleges it. The complainant has, on facts, been found to have not established any will fault, imperfection, shortcoming or inadequacy in the service of the Opposite Party. The deficiency in service has to be distinguished from the tortuous acts of the Opposite Party in the absence of deficiency in service, the aggrieved person may have a remedy under the common law to file a suit for damages but cannot insist for grant of relief under the Act for the alleged acts of commission and omission attributable to the Opposite Party which otherwise do not amount to deficiency in service. In case of bona fide disputes, no willful fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance in the service can be informed. If on facts it is found that the person or authority rendering service had taken all precaution and considered a relevant facts and circumstances in the course of the transaction and that their action or the final decision was in good faith, it cannot be said that there had been any deficiency in service if the action of the Answering Opposite Party is found to be in good faith, there is no deficiency of service entitling the aggrieved person to claim relief under the Act. The rendering of deficient service has to be considered and decided in each case according to the facts of that case for which no hard and fast rule can be laid down. Inefficiency, lack of due care, absence of bona fides, rashness, haste or omission and the we may be the factors to ascertain the deficiency in rendering the service.” It is submitted that the Complainant has with mala fide, and dishonest intention twisted and distorted the facts of the case to suit her convenience and to mislead this Hon'ble Commission. The complaint therefore deserves no fate other than outright dismissal. The complaint is devoid of any material particulars and has been filed merely to harass and gain undue advantage and unjustified monies from the Opposite Party. It submitted that the complaint has been filed with ulterior motive and mala fide intention to cause harassment and prejudice to the Oppose Party, which is a Company of long standing and high repute and to extract money from without just cause or valid reason. The Complainant is seeking a relief which is beyond the Jurisdiction of this Hon'ble Commission as this Hon'ble Commission cannot alter the terms of the contract which has been agreed by the parties. It is submitted that the policy contract between the parties and both the parties are bound by the said terms and conditions of the policy. Therefore, as this stage the Complainant cannot be permitted to come forward and may allege mis-selling as there is no provision of refund of premium after the expiry of the free look period. It is stated that the policy a legal contract between the policyholder and insurance company and the parties to the said contract are bound by its terms and conditions. The terms of the policy are in the nature of a contract and their interpretation have to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion of substitution. The law in this regard is very well settled and one may conveniently refer to a recent judgment of the Hon'ble Apex Court in the case of Suraj Mal Ram Niwes Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. [(2010) 10 SCC 567]. The same has been clearly stated in the case of Reliance Life Insurance Co. Ltd V's Madhavacharya (Revision petition no: 211 of 2009), wherein it was held by the National Commission that "Since the insurance between the insurer and the insured is a contract between the parties, the terms of the agreement including applicability of the provision and also exclusion had to be strictly construed to determine the extent of the liability of the insurer" Export Credit Guarantee Corporation of India Ltd. v. Garg Sons International (2013 (1) Scale 410): The Hon'ble Supreme Court held that while construing the terms of the contract of insurance, the court must give paramount importance to the terms used in the said contract. Suraj Mai Ram Niwas Oil Mills (P) Ltd. v. United India Insurance Co. Ltd. (2010-10 SCC 567): The Apex Court held that the words in an insurance contract must be given paramount importance and must be interpreted as expressed without any addition, deletion or exclusion. Reliance General Insurance Madhavacharya (RP No. 211/2009): The Hon'ble National Commission has clearly stated that since the Insurance between the insurer and the insured is a contract between the parties, the terms of the agreement including applicability of the provision and also its exclusion had to be strictly construed to determine the extent of the liability of the insurer. General Insurance Society Limited v. Chandumul Jain & Anr. (1966) 3 SCR 500): The Apex Court has made the following observations that in interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties. Because it is not for the court to make a new contract, however reasonable, if the parties have not made themselves. In United Insurance Co. Ltd. v. HarchandRaichandRaiChandantal (2003) CPG 393 &VikramGreentech (1) Ltd. &Anr. V. New India Assurance Co. Ltd. II (2009) CPJ 34: The Hon'ble Supreme Court has held that an insurance policy is to be construed as per the terms and conditions of the policy document which is a binding contract between the parties, and nothing can be added by giving a different meaning to the words mentioned therein. The instant complaint is false, malicious, vexatious and incorrect and is nothing but an abuse of the process of law and it is an attempt to waste the precious time of this Hon’ble Commission, as the same has been filed by the Complainant just to avail undue advantage and extract monies from the Answering Opposite Party. The Complainant was explained free look clause, whereby complainant can cancel the policy if he is not satisfied with the plan within 15 days from issuance of policy. Complainant confirmed that he has applied for the policy and signed the proposal forms. It is submitted that the Complainant is well aware about the features of the policies more specifically the fact that he will not be entitled for refund at the premiums at this stage therefore to get back the refund of the premiums the Complainant come up with a cooked-up story of deficiency of service. The documents which are sent after signing should also be read thoroughly and approach the concern in case of any discrepancies. No prudent person would have signed any document without understanding the intricacies of the same. The Hon'ble National Commission has held in a plethora of Judgments, the relevant excepts of which have been reproduced herein below, that the onus is on the Policyholder to thoroughly read the contents of the proposal form before signing on the same, and the Policyholder cannot simply place reliance on oral promises and assurances provided by anyone purportedly on behalf of an insurance company. Further, the insurance company is under no obligation to issue a policy in accordance with such oral promises and assurances. Kishor Chandrakant Rathod Vs. The Managing Director, ICICI Prudential Life Insurance Co. Ltd. & Another [Decided by the National Consumer Commission on 21.05.2014 in Revision Petition No. 3390 of 2013) ,Shrikant Muridhar Apte Vs. Life Insurance Corporation of India (Decided by the National Consumer Commission on 02.05.2013 in Revision Petition No. 634 of 2012) , Prema and Ors. vs. Life Insurance Corporation of India Ltd, TV (2006) CPJ 239 (NC), M/S Grasim Industries Ltd. & vs. M/S Agarwal Steel 2010 (1) SC 33. The Opposite Party most humbly pray that this Hon'ble Commission may be pleased to dismiss the Complaint summarily without going into the merits thereof. Thus, the Complainant is liable to be dismissed with exemplary cost.
Both the complainant and the op have filed Written Notes of Arguments; these are the almost replica of the complaint and written version respectively.
Upon reading the pleading of both parties and giving thoughtful consideration to the rival contentions of the Ld Counsel of both parties the following points for determination are framed.
Points for determination are:
- Is the case maintainable in its present form and in law?
2. Is the Complainant entitled to get the relief(s) as sought for?
Decision with reasons
Both the points, being inter related to each other, are taken up together for discussion for the sake of brevity and convenience.
We have carefully perused and assessed the complaint supported by affidavit of the complainant, written version filed by op, evidence of both parties and documents. We have anxiously considered the arguments advanced by the Ld. Counsel of rival parties.
Having evaluated the facts and circumstances of the case, it appears that the Complainant had obtained a Life Insurance Policy No.345822076 of the aforesaid Max Life Insurance Company Limited under their plan “Max Life Smart Wealth Plan“. Policy Holder being the complainant Mr. Pradip Kumar Jana and the name of the life insured being Ms. Shilpita Jana, daughter of the complainant paid an annual premium of Rs.2,80,000/- only to the said Max Life Insurance Co. Ltd. to the debit of his S.B. A/No. 912010054582803 with Axis Bank Ltd., Tamluk Branch, Dist. Purba Medinipur, West Bengal. The op is Max Life Insurance Co. Ltd. The complainant insured , being a consumer had alleged Deficiency of Service and Unfair Trade Practice against the op insurer ; the bundle of facts suggest that the instant case is maintainable in its present form and in law.
On careful analysis of evidence on record, it appears that indisputably Complainant had obtained a Life Insurance Policy No.345822076 of the aforesaid Max Life Insurance Company Limited under their plan “Max Life Smart Wealth Plan“. Policy Holder being the complainant Mr. Pradip Kumar Jana and the name of the life insured being Ms. Shilpita Jana, daughter of the complainant paid an annual premium of Rs.2,80,000/- only to the said Max Life Insurance Co. Ltd.
The crux of the dispute is that the complainant avers that he had received the speed post delivery envelope, containing the Insurance Policy and related papers on 16.10.2020 evening, After going through full details of that so obtained Insurance Policy Cover for his 18 years aged daughter that the Complainant had considered full details of the so obtained life insurance policy of Max Life Insurance Co, Ltd, under their scheme “Max Life Smart Wealth Plant“ and had taken decision to cancel the aforesaid Insurance Policy of Max Life Insurance Co. Ltd, under their Free look period of 15 days after receipt of the Insurance Policy Cover normally, and within 30 days from the date of receipt of Insurance Cover Policy if the Policy Cover is sourced through distant marketing mode .Though the Complainant was quite eligible to cancel the said Insurance Cover within 30 days from 16.10.2020, as the policy cover is sourced through distant marketing mode i.e. from Gurugram, Hayana -122015 to his place of residence situated at more than 1500 K.M. But Complainant had canceled the said Insurance Policy Cover by sending an E-mail cancellation letter dated 27.10.2020 at 6:20 P.M. to Max Life Insurance Co. Ltd.’s e-mail Id. Account sufficiently prior to end of normal fifteen ( 15 ) day’s period of cancellation , which specific 15 days period gets ended on 31.03.2020 in the instant case. The Complainant had sent a letter dated 27.10.2022 vide DTDC Courier Service to the Max Life Insurance Co. Ltd. to their address at Gurugram, Haryana 122015, which had duly been received on 30.10.2020,
On the other hand op has resisted the said averment of the complainant asserting that as per the Terms and Conditions of the policy the Complainant was provided a free look period of 15 days from the date of receipt of the policy to cancel the policy in case there are any discrepancies in the policy.It is submitted that the Opposite Party as per clause 10(1)(1) and 8(1) of the IRDA (Protection of Policyholder's Interest) Regulations, 2017, at the policy document along with the copy of the proposal forms to the Complainant giving him an opportunity to review/cancel the policy within free look period. In this present case, the complainant purchased a policy being no. 345822076 on 3rd of October, 2020 from AXIS BANK LTD., Tamluk having Annual mode payment of the premium. The customer initially paid the premium amount of Rs.2,95,797.80/-. Despite, receipt of the policy terms, the Complainant failed to approach the Answering Opposite Party within the free look period with any grievances with respect to the terms and conditions of the policy thereby implying that the terms and conditions of the policies were in order. The Complainant is now estopped from raising any grievances or issues relating to the policies seeking refund of the premium paid under the policy. But in its letter dated November 17,2020 Annexure-C the op has contended that Policy was handed over to the Complainant on 09.10.2020 via speed post receipt no-EH718114753IN. From scrutiny of the Postal Track Report in connection with speed post receipt no-EH718114753IN, it is evident that the contention of the of op is not true. The said speed post envelope containing the Insurance Policy Cover and other paper of Max Life Insurance Co. Ltd. was booked from Gurgaon BPC on 10.10.2020 at 15:24:51 and after being transported through several tiers on several days it has reached to Kharagpur NSH on 15.10.2020 at 03: 15: 25 .Ultimately it was received by the complainant on 16.10.2020. So the claim of the op that the said insurance Policy Cover had been delivered to the complainant on 09.10.2020 is not at all true.Thus , it is crystal clear that the policy document was received by the complainant on 16.10.2020.The evidence of the complainant to that effect is quit reliable and it should be accepted.
Now , the complainant has proved by annexure-5 ,6 ,7 & 8 that he sent E-mail on 27th Oct,2020 at 6-20 pm with the request for cancellation Life Insurance Policy No.345822076 of the aforesaid Max Life Insurance Company Limited under their plan “Max Life Smart Wealth Plan“ well within the Free Look period i.e. cooling period. Having got no acknowledgment of e-mail cancellation letter dt. 27.10.2020 at 6:20 P.M. from Max Life Insurance Co. Ltd., complainant had consecutively sent e-mail cancellation letters dt. 29.10.2020 at 1:35 P.M. dt. 30.10.2020 at 9:30 P.M. and dt. 31.10.2020 at 7:00 P.M. respectively on the same score of cancellation request of said Insurance Policy Cover No. 345822076, The Complainant had sent a letter dt. 27.10.2022 vide DTDC Courier Service to the Max Life Insurance Co. Ltd. to their address at Gurugram, Haryana 122015, which had duly been received by some Mr, Kuldeep on 30.10.2020. The complainant sent repeated cancellation request letters of the said insurance Cover Policy No.345822076 that too within the normal free look clause of 15 days from the receipt of Insurance Cover Policy Max Life insurance Co. Ltd. on 16.10.2020, though Complainant was entitled to cancel the said Insurance Policy Cover within 30 days of receipt of the said Insurance Policy Cover received as on 16.10.2020, since it is sourced through distant marketing mode i.e. from Gurugram, Haryana 122015 to his P.O. at Norghat, P.S. Chandipur, Distt. Purba Medinipur, West Bengal - 721633, a long distant mode of more than 1500+ K.M. ; In the case of distantly sourced Insurance Cover 30 days period is allowed to cancel the insurance Policy Cover of Max Life Insurance Co. Ltd. So, there can not be any doubt that the complainant submitted his request for cancellation of the policy within the cooling period. Thus the op has issued the repudiation letter basing on misconception and misinterpretation of the glaring facts.
In course of arguments It has been contended by the op that the complainant sent the e-mail to the wrong address , it should not have sent to the helpdesk. We think that such contention has been put forth to avoid the liability of the op only. The help desk number has been reflected in all the documents provided by the op as the means of communication with the op ; any communication lapse ,if any on the part of the helpdesk channel can not absolve the liability on the part of the op. Besides the op has sent the request for cancellation by DTDC Courier service well within the required cooling period of 15 days as per clause 10(1)(1) and 8(1) of the IRDA (Protection of Policyholder's Interest) Regulations, 2017.
It has been stated that the policy a legal contract between the policyholder and insurance company and the parties to the said contract are bound by its terms and conditions. The terms of the policy are in the nature of a contract and their interpretation have to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion of substitution. This position of law can be overlooked. But, in the instant case , the complainant has not derailed from any terms and condition of the insurance policy, a legal contract between the policy holder and insurance company . Rather the op has misinterpreted the date of issuance of the policy as date of receipt or it has falsely taken a defense plea that the policy was received by the op on 10th Oct although the Speed post receipt speaks otherwise. In the facts and circumstances of this case the ratio of the cases cited by the op as in the case of;
Suraj Mal Ram Niwes Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. [(2010) 10 SCC 567].
Reliance Life Insurance Co. Ltd V's Madhavacharya (Revision petition no: 211 of 2009),
Export Credit Guarantee Corporation of India Ltd. v. Garg Sons International (2013 (1) Scale 410):
Reliance General Insurance Madhavacharya (RP No. 211/2009)
General Insurance Society Limited v. Chandumul Jain &Anr.(1966) 3 SCR 500).
IN United Insurance Co. Ltd. v. HarchandRaichandRaiChandantal (2003) CPG393 &VikramGreentech (1) Ltd. &Anr. V. New India Assurance Co. Ltd. II (2009) CPJ 34: will not help the op in the instant case.
As we have hold that the insured/applicant being not satisfied with the policy taken has availed of the option of requesting for cancellation of the policy within 15 days of receipt i.e. on 16.10.2020 within “the Free-look Period". Therefore, the facts and circumstances of this case being different from the facts and circumstances of the referred case , the ratio of the Judgement of the Hon’bleNational Consumer Disputes Redressal Commission New Delhi, in
1.MohanLalBenal v/s ICICI Prudential Life Insurance Co, Lt and Harish . Kumar Chadha v/s Bajaj Allianz Life Insurance Co. Ltd
2.ShrikantMurlidharApte vs. Life Insurance Corporation of India, Revision Petition no. 634 of 2012 decided on 02.05.2013.
3. "LIC of India &Ors. Vs. Siba Prasad Das &Ors." reported in IV (2008) CPJ 156 (NC) are not be applicable in the instant case.
The cumulative effect of our above discussion indicate that the op by its acts and omission has committed deficiency of service and has set an instance of unfair trade practice thereby not settling the genuine claim of the op. The complainant is entitled to get refund of the amount of premium paid, Compensation for harassment and litigation costs.
Accordingly, the points for determination are decided in favour of the complainant.
Thus, the case succeeds.
Hence, it is
O R D E R E D
That CC/125 of 2022 be and the same is allowed on contest against the op.
The op is hereby directed to refund the entire premium amount of Rs.2,80,000/- to the complainant.
The op is further directed to pay simple interest @ 12 % per annum over the said amount of Rs.2,80,000/- from the date of filing of the case till the date of full payment to the complainant in the nature of compensation and to pay litigation cost of Rs.10,000/-.
The op will comply the above direction within 45 days from the date of this order.
In default, the complainant would be at liberty to put the order into execution under section 71 of the C P Act 2019 or to initiate a proceeding under section 72 of the C P Act 2019.
Let a copy of the judgment be supplied to the complainant and the op free of cost.
