BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KAITHAL.
Complaint no.256/13.
Date of instt.: 19.11.2013.
Date of Decision: 13.01.2015.
Dyal Singh since deceased son of Suraj Bhan Ahluwalia, now represented by his nominees (i) Pankaj (ii) Kapil sons of Sunil Kumar son of Dayal Singh, residents of Nai Wala Mohalla Village and P.O. Fatehpur, District Kaithal (Haryana).
……….Complainant.
Versus
1. Max Life Insurance Company, Kaithal Branch near Chhotu Ram Chowk, Dhand Road, Kaithal, through its Branch Manager.
2. Max Life Insurance Company Ltd., 11th floor DLF Square, Jalaranda Marg, DLF Phase-II, Gurgaon-122002.
..……..Opposite Parties.
COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.
Before: Sh. Rajbir Singh, Presiding Member.
Smt. Harisha Mehta, Member.
Present : Sh. G.S.Virk, Advocate for complainant.
Sh. P.P.Kaushik, Advocate for the opposite parties.
ORDER
(RAJBIR SINGH, PRESIDING MEMBER).
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that he purchased a policy vide proposal No.733902191 GO/CA/Broker Code-RKTHI (Rural) amounting to Rs.2,00,000/-. It is alleged that the complainant had to make payment of the instalments quarterly at the rate of Rs.5,000/- i.e. Rs.20,000/- per year and accordingly, the complainant without any default deposited an amount of Rs.1,00,000/- from 23.04.2009 to 20.05.2013. It is further alleged that neither the complainant ever surrendered the policy nor was defaulter nor shows any intention to close the same. It is further alleged that the complainant received a letter dt. 15.07.2013 issued by the Ops along with cheque amounting to Rs.20,000/- with the endorsement, ‘Please find enclosed for Rs.20,000/- towards service request/refund/policy benefits as per policy term and condition’ upon which the complainant contacted the Op No.1, who told the complainant that refund value of the policy has gone below the annual target premium being, so, thee policy has gone below the annual target premium being, so, policy is terminated with immediate effect and surrender refund amount of Rs.20,000/- has already been paid to him. It is further alleged that neither the complainant surrendered the policy nor showed any willingness to do so. It is further alleged that the Ops without giving any notice to the complainant have issued the cheque and letter, which is against the rules of natural justice. This way, the Ops are deficient in service. Hence, this complaint is filed.
2. Upon notice, the opposite parties appeared before this forum and filed written statement raising preliminary objections with regard to maintainability; cause of action; locus-standi; that the policy issued to the complainant was a market linked/unit linked investment-cum-insurance policy. The policy of complainant was terminated as per terms and conditions of the policy and fund value was accordingly sent to the complainant; that a provision is also provided at page 22 under Clause 25 of the terms and conditions of the policy by the name of “Free look period” under the terms and conditions of the policy as per IRDA rules. It is submitted that the complainant was required to send request for cancellation of policy within 15 days of receipt of the policy document, however, despite clear instruction regarding method, means and time period of cancellation of policy, the complainant did not send any request for cancellation of the policy within 15 days of receipt of the policy. It is, therefore, a concluded insurance policy contract came into existence between the complainant and the Ops and both the parties are bound by the terms and conditions of the policy. Moreover, the complainant kept paying premium under the policy but did not ask for the policy terms and conditions at any point of time. There is no deficiency in service on the part of answering Ops. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
3. In support of their case, both the parties submitted their affidavits and documents.
4. We have heard ld. counsel for both the parties and perused the case file carefully and minutely.
5. We have perused the complaint & reply thereto and also have gone through the evidence led by the parties.
6. Keeping in view the facts and circumstances of the case, we found that the complainant purchased a policy vide proposal No.733902191/GO/Broker Code-RKTHI amounting to Rs.2,00,000/- from the Ops. The complainant paid Rs.1,00,000/- from 23.04.2009 to 20.05.2013 by way of quarterly instalment of Rs..5,000/-. The complainant received a letter dt. 15.07.2013 issued by the Ops along with a cheque of Rs.20,000/- with the remarks ”that refund value of his policy has gone below the annual target premium. Hence, they regret to inform him that as per contract, his policy is being terminated with immediate effect and surrender refund amount of cheque Rs.20,000/- paise is enclosed herewith”. But neither the complainant surrendered the policy nor shows any willingness to do so. On the other hand, the Ops stated that policy issued to the complainant was a market linked/unit linked investment-cum-insurance policy. The policy of complainant was terminated as per terms and conditions of the policy and fund value was accordingly sent to the complainant. The counsel of Ops argued that after understanding the terms and conditions of the policy, the complainant applied for policy namely Max Life Smart Assure (Unit Linked Investment Plan) and signed proposal form bearing No.733902191 on 23.04.2009. Upon issuance of the policy, policy documents including welcome letter, policy schedule containing various charges being levied under the policy, terms and conditions of the policy. The welcome letter i.e. first page of the policy itself contained information about procedure for cancellation of the policy in case of dissatisfaction with the features of the policy. The contents of welcome letter is as under:-
While acting under regulation 6(1) in forwarding the policy to the insured, the insured shall inform by the letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms or conditions, he has the option to return the policy stating the reasons for his objection, when he shall be entitled to a refund of the premium paid, subject only to a deduction of proportionate risk premium for the period of cover and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges.”
As per clause 25 of the terms and conditions of the policy by the name of “Free Look Period”, the complainant was required to send request for cancellation of policy within 15 days of receipt of the policy document, however, despite clear instruction regarding method, means and time period of cancellation of policy, the complainant did not send any request for cancellation of the policy within 15 days of receipt of the policy. It is, therefore, a concluded insurance policy contract came into existence between the complainant and the Ops and both the parties are bound by the terms and conditions of the policy. As the policy was market linked policy and due to uncertainty in the market, the fund value under the policy fall below one annual target premium. Thus, the policy got automatically terminated in July, 2013 as per Clause 13(iv) of terms and conditions of the policy. Upon termination of policy, the Ops sent surrender value cheque of Rs.20,000/- to the complainant. In this case, the Ops acted as per terms and conditions of the policy and not found deficient on their part.
7. Thus, in view of above discussion, we find no merit in the present complaint and dismiss the same. A copy of this order be sent to both the parties free of cost. File be consigned to the record room after due compliance.
Announced.
Dt.13.01.2015.
(Harisha Mehta), (Rajbir Singh),
Member. Presiding Member.
