STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
U.T., CHANDIGARH
First Appeal No. | : | 218 of 2013 |
Date of Institution | : | 28.5.2013 |
Date of Decision | : | 12.09.2013 |
Sh. Tapesh Sharma son of Sh. Har Prasad Sharma, r/o H.No.1311, Sector 15-B, Chandigarh.
……Appellant(s)---
V e r s u s
1] Max Life Insurance Company Ltd., SCO No.36-37-38, Second Floor, Sector 8-C, Madhya Marg, Chandigarh, through its Branch Manager.
2] Max Life Insurance Company Ltd., 11th Floor, DLF Square, Jacaranda Marg, DLF Phase II, Gurgaon, Haryana, through its Managing Director.
....Respondent(s)---
Appeal under Section 15 of the Consumer Protection Act, 1986.
BEFORE: JUSTICE SHAM SUNDER (RETD.), PRESIDENT.
SH. DEV RAJ, MEMBER.
Argued by: Sh. Tapesh Sharma, appellant in person.
Sh. Rajneesh Malhotra, Advocate for the respondents.
PER DEV RAJ, MEMBER
1. This appeal is directed against the order dated 16.4.2013, rendered by the District Consumer Disputes Redressal Forum-I, UT, Chandigarh (hereinafter to be called as the District Forum only) vide which, it dismissed the complaint, filed by the complainant (now appellant).
2. The facts in brief, are that the complainant, being allured by the false assurances and promises made by the agent of the Opposite Parties, about their lucrative plans, agreed to buy four insurance policies from the Opposite Parties on single premium payment basis in the name of his daughters and wife. The complainant relied upon them and in good faith signed the blank proposal forms and paid a total premium of Rs.1,75,000/- towards single premium of the insurance policies. Accordingly, four insurance policies, as detailed in Para No.1 of the complaint, were issued. It was stated that on receipt of the policy documents, the complainant found that out of four policies, only one policy was of Single Term Plan and the remaining three policies were issued for annual premium payment basis for 15 years and 25 years. It was further stated that the Opposite Parties manipulated the income of the complainant, in the proposal forms, mentioning it to be Rs.4.50 lacs instead of Rs.2.00 lacs. The complainant visited the Opposite Parties, to correct the insurance policies and making them single premium plan. The Opposite Parties informed the complainant that the policies were converted into single term in the computer system and thereby no need to pay more premiums now. It was further stated that despite all that, the complainant received premium demand letters from Opposite Parties against the three policies. The matter was again taken up with the Opposite Parties, but they did not pay any heed and instead sent letters about the policies being lapsed on account of non-payment of premium. It was further stated that ultimately, on the complaint made by the complainant, the Opposite Parties appointed Ms.Jyoti Randhawa to hear the grievance of the complainant, who assured him to get refund of all his policies, subject to purchase of two more policies from her. On the assurance of Mr.Joyti Randhawa, the complainant purchased two more policies Ann.C-8 & C-9 by paying premium of Rs.75,000/-. Thereafter, the complainant visited Ms.Joyti Randhawa after a year, and requested her to refund the amount of premium paid towards all the policies, but she refused to help. Accordingly, the complainant wrote letter to the Opposite Parties on 17.2.2012 (Ann.C-10) requesting them to return his amount of Rs.2.00 lacs, with profit, but the they expressed their inability to do so vide reply Ann.C-11. It was further stated that the Opposite Parties, in their reply, wrongly stated that the complainant had taken surrender value of two policies, whereas only one policy No.428392195 (Ann.C-12) was surrendered. This matter was also brought to the notice of the Opposite Parties, and they were also requested that the entire premium paid by him towards all the policies be refunded, but the same was refused vide Ann.C-14. It was further stated that the aforesaid acts of the Opposite Parties, amounted to deficiency, in rendering service, as also indulgence into unfair trade practice. When the grievance of the complainant, was not redressed, left with no alternative, a complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter to be called as the Act only), was filed.
3. The Opposite Parties failed to file reply & evidence before the District Forum despite availing of a number of opportunities. As such, it (District Forum) proceeded to settle the consumer dispute, on the basis of the evidence already on record and the case was listed for arguments vide order dated 29.11.2012.
4. The complainant led evidence, in support of his case.
5. After hearing the Counsel for the parties, and, on going through the evidence and record of the case, the District Forum dismissed the complaint, as stated above in the opening para of the instant order.
6. Feeling aggrieved, the instant appeal, has been filed by the appellant/complainant.
7. We have heard the Counsel for the appellant in person and Counsel for the respondents, and, have gone through the evidence, and record of the case, carefully.
8. During the course of hearing of part arguments, it came to our notice that in all, six policies were taken by the appellant/complainant, out of which, surrender value of one policy i.e. 428392195 stood already paid to the appellant/complainant. Out of the remaining five Policies, three Policies related to the year 2006 and two were of the year 2010. As the complete Policy documents were not available on record, the Counsel for the respondents was asked to submit the surrender value of these Policies. The Counsel for the respondents submitted a copy of the email dated 08.06.2013 showing that the Policies at Serial Nos.1, 3, 4 and 5 of the application viz. Policies No.429795248, 428392187, 769930504 and 769930488 did not acquire any surrender value. Since the terms and conditions of the Policies were also not available, on record, the Counsel for the respondents was also asked to submit the copies of Policies alongwith terms and conditions thereof. The copies of the Policies, in dispute, were produced, on record, vide application dated 14.08.2013 of the respondents. The relevant facts with regard to the five policies, in dispute, vis-à-vis the surrender value thereof had been culled out from the application submitted by the respondents and the Policies brought on record.
Sr. No. | Policy No. | Annual Premium | Amount Received | ATP required | Surrender Value |
1 | 429795248 | Rs.75,000.00 | Rs.75,000.00 | 3 | NA |
2 | 428392179 | Rs.25,000.00 | Rs.75,000.00 | 3 | Rs.66,476.07 |
3 | 428392187 | Rs.25,000.00 | Rs.25,000.00 | 3 | NA |
4 | 769930504 | Rs.25,000.00 | Rs.12,500.00 | 2 | NA |
5 | 769930488 | Rs.50,000.00 | Rs.50,000.00 | 2 | NA |
9. In all the above Policies, except Policy No.428392179, only one year premium in respect of Policies at Serial Nos.1, 3 & 5 and half yearly premium for Policy at Serial No.4 was paid against the requirement of payment of three/two ATPs.
10. The relevant clause in respect of each Policy is extracted below:-
Policy No. | Surrender Clause |
429795248 (at Page 135) 428392179 (at Page 193) 428392187 (at Page 218) | 4. SURRENDER 4.1 You may be giving us a prior written request, surrender this Policy, at any time after the third policy anniversary, provided an amount equal to three ATPs has been paid by You. 4.2 We shall endeavour to pay the guaranteed surrender value within 10 days of Our receipt of Your request. |
769930504 (at Page 237) 769930488 (at Page 38) | 4. SURRENDER You may be giving a written request, surrender this Policy, at any time after the first Policy Anniversary, provided an amount equal to two ATPs have been paid by You. Upon the Company’s receipt of Your request to surrender the Policy, this Policy will immediately terminate and the Unit Account shall be closed. However, the Surrender Value if any prevailing at the time of effecting the surrender shall be paid only after the completion of third Policy Anniversary. |
11. Clause 14.2(a) from the terms and conditions of the Insurance Policies Nos.429795248, 428392179 and 428392187, is extracted below:-
“14.2 Discontinuance of premiums within three years of inception of the policy:
a) If all the ATP’s have not been paid for at least 3 consecutive years from the effective date of coverage, the insurance cover under the Policy and applicable Riders, if any shall cease immediately on expiry of the grace period.”
12. Clause 12(2), as it existed in the terms and conditions of Insurance Policies No.769930504 and 769930488, is extracted hereunder:-
“12.2 Discontinuance of Premiums within three years of inception of the Policy:
a)If all the due Premiums have not been paid for at least 3 consecutive years from the Effective Date, the insurance cover under the Policy and the Rider (if any) shall cease immediately on expiry of the grace period and the Unit Account will be closed.”
13. In fact, out of the aforesaid five Policies, the effective dates of coverage in respect of three Policies were as under:-
Policy No. | Effective Date of Coverage. |
428392179 | 04.12.2006 |
429795248 | 30.11.2006 |
428392187 | 13.12.2006 |
14. The respondents/Opposite Parties vide their letter dated 23.09.2008 (Annexure C-7), had rejected the refund of the initial premium paid towards these policies. The relevant portion of the said letter is extracted below-
“We regret to inform you that we are unable to cancel your policy and refund the initial premium paid towards the same since the free look period has expired.”
15. Section 24A of the Act, reads as under: -
“24A. Limitation period—(1) The District Forum, the State Commission or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.
(2) Notwithstanding anything contained in Sub-section (1), a complaint may be entertained after the period specified in Sub-section (1), if the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be, that he had sufficient cause for not filing the complaint within such period:
Provided that no such complaint shall be entertained unless the National Commission, the State Commission or the District Forum, as the case may be, records its reasons for condoning such delay.”
16. Thus, the complaint qua these three policies was barred by limitation. The District Forum was right in holding that the complaint qua these three Policies, was not maintainable being barred by time.
17. Out of the above five Policies, the surrender value to the tune of Rs.66,476.07 in respect of Policy No.428392179 had already been paid to the appellant/complainant and this fact was admitted by the appellant/complainant. The remaining four Policies were sent to the appellant/complainant vide the following letters:-
Policy No. | Date of Proposal | Effective Date of Coverage | Letter dated |
429795248 | 18.11.2006 | 30.11.2006 | Year 2006 (exact date not available on record) (Annexure B-1) |
428392187 | 18.11.2006 | 13.12.2006 | 14.12.2006 (Annexure B-4) |
769930504 | 22.02.2010 | 03.03.2010 | 03.03.2010 (Annexure B-5) |
769930488 | 25.02.2010 | 07.03.2010 | 07.03.2010 (at page 31 of appeal paperbook) |
18. In all the above letters, under which the Policies were sent, there was a stipulation that in case the appellant/complainant was not satisfied with the terms and conditions of the policy, he could surrender the same within 15 days from the date of receipt. The said stipulation, being relevant, is extracted below:-
“Please go through the enclosed Policy, which explains all the features, benefits and terms of your Max New York Life Policy, in as simple a manner as possible. In the unlikely event of your not being completely satisfied with the policy, you have the option to cancel it by returning the original Policy with a written request to us within 15 (fifteen) days from date of receipt. In such a case, the Premiums paid will be returned to you without interest, less proportionate risk premium for the period of cover and any medical fees and expenses that we may have incurred on stamp duty.”
19. Once the appellant/complainant did not avail of the option of returning the Policies, during the free-look period of 15 days, he was bound by the terms and conditions stipulated in the Insurance Policies. Since, the appellant/complainant had paid only one/single premium in respect of the three Policies and half yearly premium in respect of another Policy as indicated in Para 8 above, the same did not acquire any surrender value, in view of the terms and conditions of the Insurance Policies, as extracted above.
20. In the face of evidence, aforesaid, the pleas of the appellant/complainant viz. that he wanted to have only one time premium Policies, his income was Rs.2 Lacs only and blank forms were got signed from him, do not stand to logic and, therefore, not sustainable, in the eyes of law.The District Forum, was, thus right, in holding that the Opposite Parties, were neither deficient, in rendering service, nor indulged into unfair trade practice. The order of the District Forum, being legal and valid, is liable to be upheld. The pleas of the appellant/complainant regarding selling of Policies by misrepresentation and misleading assurances were also not proved.
21. No other point, was urged, by the appellant, in person and the Counsel for the respondents.
22. In view of the above discussion, it is held that the order passed by the District Forum, being based on the correct appreciation of evidence, and law, on the point, does not suffer from any illegality or perversity, warranting the interference of this Commission.
23. For the reasons recorded above, the appeal, being devoid of merit, must fail, and the same is dismissed, with no order as to costs. The order of the District Forum is upheld.
24. Certified copies of this order, be sent to the parties, free of charge.
25. The file be consigned to Record Room, after completion.
Pronounced.
12th September 2013.
Sd/-
[JUSTICE SHAM SUNDER (RETD.)]
PRESIDENT
Sd/-
[DEV RAJ]
MEMBER
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STATE COMMISSION
(First Appeal No.218 of 2013)
Argued by: Sh. Tapesh Sharma, appellant in person.
Sh. Rajneesh Malhotra, Advocate for the respondents.
Dated the 12th day of September, 2013
ORDER
Vide our detailed order of the even date, recorded separately, this appeal filed by the appellant/complainant, has been dismissed, with no order as to costs. The order of the District Forum has been upheld.
(DEV RAJ) MEMBER | (JUSTICE SHAM SUNDER (RETD.)) PRESIDENT |
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