Haryana

Ambala

CC/9/2018

Balwinder - Complainant(s)

Versus

Max Life Insurance - Opp.Party(s)

30 May 2019

ORDER

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

 

                                                          Complaint case no.        :  09 of 2018

                                                          Date of Institution         :  04.01.2018                                                       

                                                                   Date of decision   :  30.05.2019

 

1.       Balwinder, aged 30 years, son of Sh. Joginder, resident of 195, B.D.Floor Mill, Pragati Vihar, Ambala Cantt.

2.       Rajni, aged  28 years,  wife of Sh. Balwinder, resident of House No.3704/4, Panna Cottage, Ambala Cantt. At present address #195, B.D.Floor Mill, Pragati  Vihar, Ambala Cantt.

…. Complainants.

                                                          Vs.

1.       Max Life Insurance Company Limited through its Chairman, Plot No.90A, Sector-18, Gurgaon-122015, Haryana, India.

2.       Max Life Insurance Company Limited through its Authorized Signatory, near Capital Chowk, Ambala Cantt. 

  ….. Opposite Parties  

Complaint Under Section 12 of the Consumer Protection Act

 

Coram:       Ms. Neena Sandhu, President.

       Ms. Ruby Sharma, Member.

      Sh. Vinod Kumar Sharma, Member.                            

Present:       Sh. Vijay Kumar, Advocate, counsel for complainant.

Sh. Sandeep Kashyap, Advocate, counsel for the OPs.

Order:         Smt. Neena Sandhu, President.

Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties(hereinafter referred to as ‘Ops’) praying for issuance of  following directions to them:-

1. To refund Rs.57,899.98, to the complainant No.1, paid by him for the purchase of policy no. 107998304 dated 14.10.2015 and to refund Rs.58,100/- to complainant No.2, paid by her for the purchase of policy no. 264972050 dated 03.12.2015, alongwith upto date interest.
2. To pay Rs. 50,000/- as compensation for mental agony and physical harassment suffered by them. 
3. To pay Rs.20,000/- as litigation expenses.

Or

any other relief whichthis Hon’ble Forum may deemfit.

 

 

The brief facts of the complaint are that the complainant no.1 had purchased an insurance policy no.107998304 dated 14.10.2015 and complainant no.2 had purchased policy no. 264972050 dated 03.12.2015. The officials of the OPs allured the complainants if both of them, would pay one time premium of Rs.57,899.98 and Rs.58,100/- respectively to the OPs, they would get 10% of the benefit of their policies every year. Accordingly, on the assurance of the officials of the OPs, the complainant no.1 had purchased the policy  no. 107998304 dated 14.10.2015 of Rs. 57,899.98, with death benefit of Rs.10,98,463/-, having maturity date 14.10.2040. The complainant no.2 also had purchased policy no. 264972050 dated 03.12.2015 of Rs.58,100/- with death benefit of Rs.8,35,131/-, having maturity date 03.12.2040. After receiving the policy certificates and other documents, the complainants came to know that a big fraud has been played on them by the officials of the OPs, who had concealed the true facts about the said policies. The complainants approached the OPs and filed an application for withdrawal of the amount but they linger on the matter on one pretext or the other. A legal notice dated 01.04.2019 was served upon the OPs but they did not respond the same. By not refunding the amount, the OPs have committed deficiency in service. Hence, the present complaint.

2.               Upon notice OPs, appeared through counsel and filed written version raising preliminary objections qua complaint is not maintainable being false and frivolous; no jurisdiction; no cause of action; no locus standi and estoppal. On merits, it is stated that the complainant no.1 approached the Ops, for purchase of Max Life Monthly income Advantage Plan and complainant no.2 approached the OPs for purchase of Max Life Life Gain Premier plan and submitted their duly signed proposal forms with the OPs. Thereafter, the OPs issued the policy No.107998304 to the complainant no.1, with effect from 14.10.2015 and also issued policy no.264972050 to complainant no.2, with effect from 03.12.2015. The policy documents comprising of the policy terms and conditions and copy of the proposal forms, were duly delivered to the complainants. It was the basic condition in the policy of insurance regarding free look period which is reproduced as under:-

“You have a period of 15 days from the date of receipt of this policy to review the terms and conditions of this policy. If you disagree to any of the terms and conditions of this policy, you have the option to return the original policy to us, by stating the objections/reasons for such disagreement. Upon return of this policy by you, this policy shall terminate forthwith and all rights, benefits including the death and maturity benefit and interest under this policy shall cease immediately. We will only refund the premiums received by us, after deducting the proportionate risk premium for the period of cover, charges of stamp duty paid and the expenses incurred on medical examination of the Life Insured, if any”.

 

During this free look period of 15 days, complainants did not raise any objections and did not withdraw the policies. Meaning thereby, they have given their consent and accepted the terms and conditions of the policy. There is no mis-representation of concealment of facts, the complaint filed by the complainants may be dismissed with heavy cost.

3.               To prove their version complainant tendered affidavits Annexure C/A & C/B alongwith documents as Annexure C-1 to C-16 and closed the evidence. On the other hand, Counsel for the OPs tendered evidence by way of documents Annexure R-1 to R-14 and closed the evidence on behalf of the OPs.

4.                We have heard the learned counsels for the parties and carefully gone through the case file.

5.                 The learned counsel for the complainant has argued that the complainants were not satisfied with the policies issued by the OPs because they had issued the policies in question by mis-representation and concealing the facts, as such complainants requested the OPs to refund the amount paid by them, however, the OPs refused to pay the said amount. This act of the Ops amounts to deficiency in service.

The learned counsel for the OPs has argued that the question of selling the insurance policies to the complainants by mis-representation does not arise at all because same were issued to the complainants, on receipt of proposal form from them. The said policies were duly received by the complainants. As per the terms and conditions of the policies, free look period of 15 days was given to the complainants to surrender the policies from the date of receipt of the policies documents. But they had not opted to surrender the said policies in question within the free look period of 15 days after receiving the same, which implied that both the complainants accepted the policies. Since the complainants have surrendered the policies in question after expiry of free look period, therefore, as per terms and conditions of the policies, no amount is payable to them. Thus, the present complaint filed by the complainants is liable to be dismissed.

6.                It may be stated here that the parties are bound by the terms and condition of the policy. In column no.4, under the heading ‘Important Notes’ in Annexure C-11/ Annexure R-1, it has been written that if insured is not satisfied, he/she may opt to cancel the policy by returning the original policy to the company with a written request within 15 days, 30 days if policy has been sourced through distance marketing modes, from the date of receipt of the policy. It is not out of place to mention here that if the complainants were not satisfied or were of this apprehension that the OPs have sold the policies in question by mis-representation then they could have surrendered the policies in question within the free look period of 15 days from the date of receipt of the policies documents. Furthermore, there was no question of mis-representation of the facts in respect of the policies in question, especially in the face of the option of the free look period of 15 days, whereby, the complainants were at liberty to exit from the said policies. Once they have not done so, now at this stage they cannot raise such grounds, as such the prayer made for refund of the amount by the complainants cannot be accepted.  

7.                In view of the aforesaid discussion, we do not find any merits in the present complaint, consequently, we dismiss the same without any order as to costs. Certified copy of this order be sent to the parties free of costs under the Rules. File be indexed and consigned to the Record Room.

Announced on : 30.05.2019

 

 

 

 

(Vinod Kumar Sharma)               (Ruby Sharma)      (Neena Sandhu)

            Member                     Member                         President