DISTRICT CONSUMER DISPUTES REDRESSAL FOR`UM, BATHINDA.

CC.No.440 of 06-09-2012

Decided on 29-11-2012

Alka Jain aged about 29 years wife of Manoj Kumar r/o House No.19641, Ward No.6, Bathinda.

........Complainant

Versus

Max New York Life Insurance Company Ltd., through its Manager near Mall Road First Floor Bathinda.

.......Opposite party

Complaint under Section 12 of the Consumer Protection Act, 1986.

QUORUM

Smt. Vikramjit Kaur Soni, President.

Sh.Amarjeet Paul, Member.

Present:-

For the Complainant: Sh.Sanjay Goyal, counsel for complainant.

For Opposite party: Sh.Rakesh Gargi, counsel for opposite party.

ORDER

VIKRAMJIT KAUR SONI, PRESIDENT:-

1. The complainant has filed the present complaint under section 12 of the Consumer Protection Act, 1986 as amended upto date (Here-in-after referred to as an 'Act'). In the instant complaint the complainant alleged that the opposite party approached her for selling the life insurance plan and stated that she has to make the payment of Rs.35,000/- only once and she will be insured for Rs.7 lacs and in case she wants to get the refund of the amount then she will be given Rs.35,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and she can claim the refund of the amount anytime. On the allurement of the opposite party the complainant purchased the insurance policy bearing No.702280793 and paid Rs.35,000/- in the month of December 2011. The opposite party neither issued any cover note nor separate terms and conditions nor free look period option to the complainant. The complainant further alleged that she approached the opposite party regarding the non receiving of the policy and terms & conditions and told that as no policy document has been received by her as such free look period option is still available and she wants to get the refund of the amount of Rs.35,000/- but the opposite party refused to do so. Hence the complainant has filed the present complaint to seek the refund of Rs.35,000/- alongwith interest, cost and compensation.

2. The opposite party has filed written statement and pleaded that the complainant was well aware of the terms of the policy. The said policy was issued on the receipt of duly signed proposal form dated 9.12.2011. The policy cancellation request has been sent by the complainant on 15.5.2012 i.e. after 5 months of the issuance of the said policy. Since the said policy was outside free look period the opposite party could not cancel the policy. The free look period as per the Clause 20 of the policy contract:-

20. Free Look Period

“The policyholder has a period of Fifteen (15) days from the date of receipt of the policy to review the terms and conditions of the policy and where the policyholder disagrees to any of those terms or conditions, the policyholder has the option to return the policy stating the reasons for his/her objections, upon which, he/she shall be entitled to refund of an amount equal to the non-allocated premium plus charges levied by cancellation of units plus fund value as at the date of cancellation of policy less expenses incurred on medical examination and on account of stamp duty.”

The opposite party further pleaded that the complainant after duly understanding the terms & conditions of the 'Max New York Life-Shiksha Plus II' plan submitted the duly signed Proposal Form No.702280793 dated 9.12.2011 pursuant to which the insurance policy bearing No.702280793 was issued on 24.12.2011 for a sum assured of Rs.7 lacs under the plan. On 26.12.2011 the opposite party sent the policy documents to the complainant through first flight courier airway bill No.019625900. On 11.4.2012 the complainant herself went to the branch office of the opposite party and stated that she has not received the said policy pack. On 26.4.2012 a duplicate policy pack was sent to the branch office as requested by the complainant. On 8.5.2012 the complainant received the duplicate policy pack. On 15.5.2012 the opposite party received a letter from the complainant with the request for cancellation of the said policy, the reason was mentioned 'no requirement'. On 28.5.2012 the opposite party sent a reply to the complainant informing her that the said policy being outside the Free Look Period cannot be cancelled. On 12.7.2012 the opposite party again received a letter from the complainant stated that she got her duplicate policy pack on 8.5.2012 and according to this date she is applying for the cancellation of her policy. The opposite party further pleaded that they have not informed the complainant that she would have to pay only a single premium, it is nowhere mentioned that the said policy is a single premium policy. The policy documents were duly delivered to the complainant and she was well aware of the terms of her policy. The complainant did not raise any concern regarding the said policy till the expiry of five months of the issuance of the said policy. The free look period option is applicable from the date when the initial policy pack is received by the complainant. Since the free look period option has expired the said policy cannot be cancelled,

3. The parties have led their evidence in support of their respective pleadings.

4. Arguments heard. The record alongwith written submissions submitted by the parties perused.

5. Admitted facts of the parties are that the complainant had purchased the said policy from the opposite party after filling the Proposal Form No.702280793 dated 9.12.2011 and policy bearing No.702280793 was issued on 24.12.2011 for sum assured of Rs.7 lacs.

6. The disputed facts between the parties are that at the time of purchase of the said policy, the complainant was conveyed by the opposite party that she has to pay Rs.35,000/- only once and she will be insured for Rs.7 lacs and in case she wants to get the refund of the amount then she will be given Rs.35,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and she can claim the refund of the amount anytime. The policy documents/cover note, separate terms and conditions and free look period option has not been provided to the complainant. The complainant has lodged the complaint regarding this with the opposite party that she has not received the cover note, separate terms and conditions and free look period option and requested them to supply the same and told that she wants to cancel her policy. The complainant has not received the said policy documents and still has the free look period option available with her.

7. The submissions of the opposite parties are that after 5 months of the issuance of the said policy the complainant has sent the request for the cancellation of the same on 15.5.2012. The opposite party sent the policy documents on dated 26.12.2011 to the complainant vide first flight courier airway bill No.019625900. On 11.4.2012 the complainant herself approached the branch office of the opposite party and stated that she has not received the policy pack. On 26.4.2012 a duplicate policy pack was sent to the branch office as requested by the complainant. On 8.5.2012 the complainant received the duplicate policy pack. On 15.5.2012 the opposite party received a letter from the complainant with the request for cancellation of the said policy, the reason was mentioned 'no requirement'. On 28.5.2012 the opposite party sent a reply to the complainant informing her that the policy being outside Free Look Period cannot be cancelled. On 12.7.2012 the opposite party again received a letter from the complainant stating that she has received her duplicate policy pack on 8.5.2012 and according to this date she is applying for the cancellation of her policy within 15 days as required under the policy.

8. The opposite party No.1 has argued that the said policy documents were sent to the complainant on 26.12.2011 vide first flight courier airway vide bill No.019625900.

A perusal of documents placed on file shows that no document has been placed on file to show that the said policy has been sent to the complainant and she has received the said policy alongwith terms & conditions. No dispatch register or acknowledgment of receipt of the said policy dated 26.12.2011 is placed on file by the opposite party. Only one acknowledgment of receipt of the said policy Ex.R5 dated 8.5.2012 has been placed on file by the opposite party which shows that the complainant has received the said policy issued to her on 8.5.2012.

9. Thus from the facts, circumstances and evidence placed on file it is concluded that earlier the said policy has not been sent to the complainant. If it would have been sent to the complainant the acknowledgment of the same must have been placed on file by opposite party. Since the complainant has not received the policy earlier and the same has been sent on the request of the complainant on 8.5.2012 as such her free look period option starts from 8.5.2012, as such she has applied for the cancellation of the said policy on 15.5.2012 within the free look period. As per Clause 20 of the policy contract:-

20. Free Look Period

“The policyholder has a period of Fifteen (15) days from the date of receipt of the policy to review the terms and conditions of the policy and where the policyholder disagrees to any of those terms or conditions, the policyholder has the option to return the policy stating the reasons for his/her objections, upon which, he/she shall be entitled to refund of an amount equal to the non-allocated premium plus charges levied by cancellation of units plus fund value as at the date of cancellation of policy less expenses incurred on medical examination and on account of stamp duty.”

10. Thus in view of what has been discussed above the opposite party has failed to prove that it has sent the said policy to the complainant prior to 8.5.2012. The complainant has received the said policy on 8.5.2012, according to the abovementioned Clause 20 of free look period, the complainant has applied for the cancellation of the said policy as such she is entitled to the refund of Rs.35,000/- after deduction of expenses incurred on medical examination and on account of stamp duty.

16. Therefore in view of what has been discussed above this complaint is accepted against the opposite party with Rs.5000/- as cost and compensation and the opposite party is directed to refund the amount of Rs.35,000/- after deducting the expenses incurred on medical examination, if any and on account of stamp duty. The compliance of this order be done within 45 days from the date of receipt of the copy of this order.

In case of non-compliance the interest @ 9% per annum will yield on the refunded amount till realization.

16. A copy of this order be sent to the parties concerned free of cost and file be consigned to the record room.

Pronounced in open Forum:-

29-11-2012

Vikramjit Kaur Soni

President

Amarjeet Paul

Member