DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I, U.T. CHANDIGARH

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Capt. M.S. Sethi, #2708, Sector 38-C, Chandigarh.

…..Complainant

                 V E R S U S

[1] Max New York Life Insurance Company Ltd., 4^th Floor, DLF Square, Jacarand Marg, DLF Phase-II, Gurgaon – 122002.

[2] Max New York Life Insurance Company Limited, through Mr. Rahul Sharma, Manager, Client Relationship, SCO N. 36-37, Second Floor, Sector 8-C, Chandigarh.

[3] Shree Ganesh Corporate Services Limited, through Ms. Riya Manager, SCO No. 46, NAC, Manimajra, Chandigarh.

                      ……Opposite Parties

CORAM:   SH.P.D.GOEL                    PRESIDENT

         SH.RAJINDER SINGH GILL       MEMBER

         DR.(MRS).MADANJIT KAUR SAHOTA  MEMBER

Argued by: Sh. N.S. Jagdeva, Counsel for Complainant.

           Sh. Varun Chawla, Proxy counsel for Sh.Rajneesh Malhotra,        Counsel for OPs No.1 & 2.

           Sh. B.L. Sharma, Counsel for OP No.3.

PER RAJINDER SINGH GILL, MEMBER

         Concisely put, the Complainant had taken a Policy on 18.12.2007 and paid Rs.12,500/- as half yearly premium. On receipt of policy document, to his shock, the verbal terms and conditions told were entirely different. It was averred that on 22.4.2010, OP No.3 contacted him and informed that the aforesaid policy stood lapsed, which could be restored with all benefits on payment of Rs.30,000/-. It was also told that OP Insurance Company would pay pension @ Rs.1333/- quarterly and principal amount after five years from the date of policy. Accordingly, the Complainant issued cheque dated 23.4.2010 for Rs.30,000/-, but to his shock instead of reviving the old policy, as promised, a fresh policy dated 29.4.2010 was issued. Smelling something fishy, the Complainant brought the said fact to the notice of the OP Insurance Company, vide dated 24.03.2010. In response thereto, the OP Insurance Company replied that the request for cancellation of Policy cannot be accepted since the policy was outside the free look period. Hence, this complaint. 

2.         Notice of the complaint was sent to OPs seeking their version of the case. OP No.3 did not turn up despite service and suffered ex-parte.

3.         The OPs No. 1 & 2 in their joint written statement, while admitting the factual matrix of the case, pleaded that based on the information given in the proposal form, the insurance policy along with complete terms and conditions was issued to the Complainant on 22.12.2007. The premium was to be deposited on semi annual basis. However, when the Complainant did not deposit the next installment after depositing the first installment of Rs.12,500/-, the policy got lapsed. It was pleaded that the Complainant took another new policy and gave a cheque for Rs.30,000/-, dated 22.04.2010, along with the signed proposal form. On the basis of the fresh proposal form, insurance policy along with the terms was issued to him. It was denied that the Complainant had requested that his old insurance policy be restored. While admitting the receipt of letter dated 24.5.2010 written by the Complainant, it was asserted that the same was duly replied, clearly stating that the pre-look period of 15 days has already over and as per the terms and conditions of the insurance policy, the policy could not be cancelled. All other material contentions of the complaint were controverted. Pleading that there was no deficiency in service on their part, a prayer has been made for dismissal of the complaint.

4.         The OP No. 3 in its written statement, while admitting the factual matrix of the case, pleaded that no money was paid by the Complainant in the name of OP No.3, nor there was any document whatsoever showing any transaction between the Complainant and OP No.3. It was asserted that OP No. 3 was only a facilitator and whatever documents were received from the policy holders for onward transmission to OP No.1 Insurance Company, the same were transmitted to it for taking necessary action at its end. Issuing/ cancelling of policies and grant of benefits under the policies are in the domain of Insurance Company and OP No.3 has no role to play in it. All other material contentions of the complaint were controverted. Pleading that there was no deficiency in service on their part, a prayer has been made for dismissal of the complaint.

5.         Parties led evidence in support of their contentions.

6.         We have heard the learned counsel for the parties and have also perused the record.

7.         It is admitted case of the Complainant that he had obtained a Policy No. 451173405, after paying half yearly premium of Rs.12,500/- and in the year 2010, one Ms. Riya informed him that the said Policy had lapsed; therefore, the Complainant had issued a Cheque bearing No. 900891 for a sum of Rs.30,000/- on 23.04.2010 to the OPs. But, to the utter surprise of the Complainant, he had received a new Policy, for which he had never applied.

8.         On the other hand, the OPs contended that the Complainant wanted a new Policy, for which he had filled up fresh proposal form bearing No. 769375874 (Annexure R-3) and he has also signed the said proposal form.  On the basis of the fresh proposal form, insurance policy No. 769375874 along with the terms & conditions was issued to him qua Annexure R-4.  OPs had also denied that the Complainant had requested that his old insurance policy be restored.

9.         The Complainant had himself admitted that he had taken the Policy in the year 2007, which was lapsed, as he could not pay the premium thereof. When the request for cancellation of the new insurance policy No. 769375874 was received by the OPs, the free look period of 15 days was already over and the same was conveyed to the Complainant vide letter dated 25.6.2010 (Annexure R-6). The Complainant could return the policy during the 15 days of “free look period” as per the IRDA Rules.  

10.       Now, it is proved beyond doubt that the Complainant made the request for cancellation of the policy beyond the free look period, therefore, the same could not be cancelled by the OP- Insurance Company. The provision of “Policy Review Period” reads as under:-

         “Policy Review Period:

You may opt to return the original policy document to the company with a written request for cancellation of the policy within fifteen days from the date of receipt of the Policy. In such an event, the premiums paid, adjusted for any adverse movement in fund value less charges incurred on medical examination and on account of stamp duty, will be refunded without interest.”

11.       Since the Complainant was signatory to the proposal form, he cannot wriggle out of the terms and conditions of the policy. The policy can only be cancelled as per the terms and conditions of the insurance policy and not on the whims and fancies of the Complainant.

12.       Judged from any angle, we have no hesitation incoming to the conclusion that the Complainant has not been able to establish any case in his favour or prove any allegation against the OPs. As a matter of fact, it is the OPs which has been able to completely assail and rebut the allegations made by the Complainant against it by producing all relevant documents on record. Therefore, we eventually find that there is no merit, weight or substance in the present complaint and it deserves rejection. Hence, we dismiss the complaint. However, the respective parties shall bear their own costs.

13.       Certified copies of this order be sent to the parties free of charge. The file be consigned.

Pronounced

18.10.2011

[P.D. GOEL]

President

[Rajinder Singh Gill]

Member

[Madanjit Kaur Sahota]

Member