Tamil Nadu

South Chennai

CC/41/2007

Rajesh thamara - Complainant(s)

Versus

Max New York Life Insurance Co.Ltd., - Opp.Party(s)

A.C.Kumaragurbaran

26 Aug 2015

ORDER

                                                                         Date of Filing :   20.12.2006

                                                                        Date of Order :   26.08.2015.

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM, CHENNAI(SOUTH)

     2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

PRESENT: THIRU. B. RAMALINGAM M.A.M.L.,                      : PRESIDENT

                 TMT. K.AMALA, M.A.L.L.B.,                                   : MEMBER I

                 TR. T.PAUL RAJASEKARAN, M.A PGDHRDI, AIII,BCS : MEMBER II

 

                          C.C.NO.41/2007

WEDNESDAY THIS 26^TH   DAY OF AUGUST 2015

 

Mr. Rajesh Thamara,

S/o. Sri. C.K. Thamara,

Rep. by his Power Agent C.K. Thamara,

S/o. K.P.Damodara Menon,

No.15/62, Vaikasi Street,

Chinmaya Nagar, Stage-II,

Virugambakkam,

Chennai 600 092.                                          ..Complainant

 

                                                 ..Vs..

 

1. Max New York Life Insurance Co. Ltd.,

12^th Floor DLF Square,

Jacarnda Marg, DLF Phase-II,

Gurgaon 122 002.

 

2. Max New York Life Insurance Co Ltd.,

Registered Office, Max House, II Floor,

1, Dr. Jha Marg, Okhla,

New Delhi 110 020,

India.

 

3.  Max New York Life Insurance Co. Ltd.,

Ground Floor, TPL Towers,

Cenotaph Road,

Chennai 600 002.                                           .. Opposite parties

 

For the Complainant                  :  M/s. A.c. Kumaragurubaran & another     

 

For the  Opposite parties 1 & 2   :  M/s.  R.Murari.

For the opposite party-3           :   Exparte.

 

        This complaint is being filed by the complainant u/s 12 of the C.P. Act 1986 for a direction to the opposite parties to return a sum of Rs.86,800/- together with interest and also to pay a sum of Rs.25,000/- as compensation  with cost of the complaint to the complainant.

ORDER

 

THIRU. B. RAMALINGAM PRESIDENT      

         

1.The case of the complainant is briefly as follows:-

        The complainant is a policy holder bearing Policy No.239852791 for the base policy whole life participating to age 100 years and that the said proposal was submitted by the complainant at Chennai to the third opposite party for processing.   The sum insured of Rs.15 lakhs for the base policy and rider of personal accident benefit of Rs.15 lakhs.  The complainant further states that the mode of payment of premium is quarterly at Rs.10,850.75/- for both.  The opposite parties by their letter dated 16.12.2003, informed that they are keen to process the complainant proposal and that by letter dated 25.12.2003, the complainant requested the opposite party to offset the premium at his age of 60 years, which was also agreed by the  opposite parties as evidenced from their letter dated 29.12.2003.  The opposite parties sent a letter dated 30.12.2003 enclosing the policy document without incorporating the changes as requested by the complainant vide his letter dated 25.12.2003.

 

2.  The complainant was under the impression that the opposite parties would carry out the necessary changes in the policy as required by him and paid the periodical premium amount.  The opposite parties made the complainant to believe that this request will be carried out and the opposite parties have also collected the premium amount upto quarterly September 2005.    As the opposite parties failed to carry out the request of the complainant for the changes as stated above, he was forced to stop payment of quarterly premium since December 2005.   The opposite parties informed the complainant that his policy was lapsed in January 2006 which made the complainant to request the opposite parties by his letter dated 28.2.2006 to refund the complainant the sum of Rs.86806/- paid by him as aforesaid after narrating the reasons for his nonpayment and the inaction on the part of the opposite parties in offsetting the maturity period at his age of 60 years instead of 100 years to which the opposite parties by letter dated 23.3.2006 informed that they are unable to refund the premium paid by the complainant stating that the complainant’s request had been received outside the free-look period of 15 days, which allows the policy holders, the option to return the policy, if it does not suit their requirements.  The complainant again wrote a letter dated 22.5.2006 requesting the opposite parties to refund the amount which was of no use.    As such the act of the opposite parties amounts to deficiency of service and which caused mental agony and hardship to the complainant.       Hence the complaint.      

 

Written version of  1^{st &} 2^nd  opposite parties  is  as follows:-

3.      It denies all the averments and allegation contained in the complaint except those that are specifically admitted herein.    The opposite parties are not liable to refund back the premiums because the condition NO.3 of the policy clearly states that the policy can be canceled within 10 days from the receipt of the policy.   The condition No.3 reads as follow:

“3.  Free Look Provision – The policy Holder may cancel this policy by written request to the company within 10 days from the receipt of the policy in which case the premium paid less any medical fees and administration expenses incurred by the company will be refunded without interest.  If the policy is sent by post it shall be deemed to have been delivered and received in the ordinary course of the post within three days of posting. “

In other words, the insurance policy offer a free look period of 10 days which allows the policy owner the options to return the policy if it does not suit their requirements.  It is to mention here that policy was sent vide letter dated 30.12.2003, which was received by the complainant on 17.2.2004 while the complainant opted for the cancellation on 28.2.2006 after receiving the intimation vide letter dated 9.1.2006 about lapse of policy.   The complainant failed to cancel the policy within 10 days as per condition No.3 of the Policy.   In fact the  policy was cancelled by the complainant vide letter dated 28.2.2006 only after receiving the letter dated 9.1.2006, whereby the complainant was informed about the lapse of policy.  

4    The complainant opted for whole life participating to age 100 years policy, are payable only on the occurrence of insured event i.e. on death of life assured or on his survival  to age 100 years.  Moreover neither the terms of the policy contract have stated that the premium of the life assured will be offset at the age of 60 years nor such promise was made by the answering opposite party as alleged by the Life assured.  The whole life participating policy to age 100 years was duly approved by the IRDA and only after that the same was being sold by the opposite parties to its customers.   Since the policy was received by the complainant on 17.2.2004 and  he kept paying the premium upto September 2005.  Without prejudice to the above it is stated that the cause of action  arose on 17.2.2004 when the complainant received the policy.  The complaint has been filed after the prescribed of two years.  The complaint is barred by limitation as per the provisions of section 24A of the Act.  In view of this there is no deficiency of service on the part of the opposite parties.     Hence the complaint is liable to be dismissed.

5.     Even after receipt of the notice, the 3^rd opposite party did not file written version. Hence, the 3^rd opposite party was set exparte on  5.3.2007. 

6.     Complainant has filed his Proof affidavit and  Ex.A1 to Ex.A15 were marked on the side of the complainant.    1^st and 2^nd Opposite parties have filed their proof affidavit and Ex.B1 to Ex.B5 were  marked on the side of the opposite parties 1 & 2.

7.      The points that arise for consideration are as follows:-

1. Whether the complaint filed by the complainant is barred by  

     limitation?

      2. Whether there is any deficiency in service on the part of the  

          opposite parties ?

 

      3 To what relief the complainant is entitled to?

 

8.      POINTS 1  2 & 3 :

        Perused the complaint filed by the complainant, written version filed by the opposite parties,  the  proof  affidavit filed by both sides and Ex.A1 to Ex.A11 filed on the side of the complainant and Ex.B1 to Ex.B5   filed on the side of the  opposite parties and considered both side arguments.   There is no dispute that the complainant has taken the life insurance policy with the opposite parties the policy document which is attached with letter Ex.A5 dated 30.12.2003.   Subsequent to the receipt of the said policy the complainant has paid one quarterly premium for the said policy and subsequently the complainant  has not paid the premium for the said policy.  Further the complainant after proposal of the policy before receipt of the policy document from the opposite parties, the complainant has written a letter Ex.A3, dated  25.12.2003 to the opposite party stating that he has remitted a sum of Rs.1099.75 and also requesting that his proposal may please be made annual and also proposed to offset premiums at his age 60 years and requested to incorporate the such changes in the policy.          Since the said policy by the complainant on his proposal is only the objection raised with regard to the period of coverage i.e. 100 years as in proper and against the opposite party that the said aspect has not been properly enlightened at the time of proposing the policy are all irrelevant and unnecessary and cannot be sustainable as contended by the opposite parties  is acceptable,     since the  life participating policy to age 100 years was duly approved by  the IRDA. 

9.     Though the complainant averred that he has realized about 100 years maturity of policy is not proper instead of he wants to change it as 60 years and have stated that he has sent a letter Ex.A3, dated 25.12.2003 to the opposite party.   The opposite party has replied Ex.A4,  for the said letter dated  29.12.2003 stating that the complainant wants any changes in the policy, approached the official of the opposite parties it will be complied with, and to set off the age is 60 years instead of 100 years the complainant having received the policy document with letter Ex.A5 of the opposite party and the reply letter Ex.A5 sent by the opposite party on 30.12.2003 as mentioned in the reply letter and Clause-3 of the terms and conditions attached with the policy document would have taken steps to amend or to change the said proposed changes he wants in respect of payment of premium as annual and the set off age 60 years immediately and that too within the period in the clause.3 of the conditions mentioned in the terms and conditions of the policy i.e. free look period of 10 days from the date of receipt of the policy document.   There is no evidence of the complainant.   Having failed to take such steps by the complainant.   As per the complainant’s case he has sent a letter Ex.A7 to the opposite party  dt.28.2.2006  stating that the opposite parties have not changed the policy particulars as proposed by him as such the complainant don’t want to continue the payment of premium in future  for the above premium and claim premium already been as to refund. 

10.    The above act of the complainant that though the complainant has proposed changes in the policy and sent letters Ex.A3, Ex.A4 despite of reply letter received by him for non compliance of the changes in the policy by the opposite party the complainant has not taken any legal steps immediately.   Having failed to take such steps the complainant after sending notice dated 28.2.2006 to the opposite party stating that he proposed to discontinue the policy and seeking for refund of the amount and filing this complaint before this forum against the opposite parties for the said grievance on 20.12.2006 is barred by limitation  as per Sec. 24-A of the Consumer Protection Act 1986.  As such the complaint filed before this forum is not maintainable as contended by the opposite parties is acceptable.  Because the complainant having raised grievance for change of particulars of policy the opposite party have not complied the same and subsequent premium was also paid by the complainant after that the complainant remained not paying the premium.   But the complainant has sent letter dated 22.5.2006 and filed this compliant on 20.12.2006 is clearly shows that this complaint filed by the complainant not within two years from the actual cause of action arised for the complaint mentioned grievance as such the complaint is barred by limitation is acceptable. 

11.    However the complainant has requested the opposite parties for change of particulars of policy in respect of payment of premium and period of coverage (i.e. 100 years to 60 years) immediately after proposal and receipt of the policy the opposite party having received the said letter and replied to the complainant for asking him to take necessary steps, the opposite parties has not taken appropriate steps to comply the proposal of the complainant during December 2003 and January 2004 it may amount to deficiency of service on the part of the opposite parties but for non compliance of the proposed changes requested by the complainant by the opposite parties the complainant would have taken legal steps and filed this complaint before this forum within two years from the date of receipt of the policy document.  Whereas the complainant has miserably failed to file this complaint in time as per Sec. 24-A of the Consumer Protection Act 1986.   However the complainant having failed to pay quarterly premium from 2004 onwards has written a letter Ex.A7 to the opposite party stating that he wants to discontinue the payment of premium and seeking refund of the amount paid by him as premium from the opposite parties it may be considered or treated as surrender of the policy and refund amount of payment of premium if any made by the complainant available and permissible under the said policy be may considered by the opposite parties and order to be paid to the complainant on humanitarian ground in the interest of justice. 

12.    Therefore we are of the considered view that this complaint is liable to be dismissed as barred by limitation under section 24-A of the Consumer Protection Act 1986 and no cost.   As such the points 1 to 3 are answered accordingly.

           In the result, the complaint is dismissed  as barred by limitation under section 24-A of the Consumer Protection  Act 1986.  No cost.   However this order not prevent the opposite party to consider on humanitarian ground and good gesture to treat Ex.A7 letter dated 28.2.2006 as proposal for surrender sent by the complainant and to refund amount if any to the complainant for the said order.

Dictated to the Assistant transcribed and typed by her corrected and pronounced by us on this  26^th    day of August  2015.

 

MEMBER-I                                    MEMBER-II                                              PRESIDENT.

Complainant’s Side documents :

Ex.A1- 15.3.1999      - Copy of power of attorney deed.

Ex.A2- 16.12.2003     - Copy of letter of the opposite party.

Ex.A3- 25.12.2003     - Copy of letter of the complainant.

Ex.A4- 29.12.2003     - Copy of letter of the opposite party.

Ex.A5- 30.12.2003     - Copy of letter of opposite party along with policy.

Ex.A6- 9.1.2006        - Copy of letter of the opposite party.

Ex.A7- 28.2.2006      - Copy of letter of the complainant.

Ex.A8- 23.3.2006      - Copy of letter of the opposite party.

Ex.A9- 22.5.2006      - Copy of letter of the complainant.

Ex.A10- 4.9.2006      - Copy of lawyer’s notice.

Ex.A11- 20.9.2006     - Copy of reply from the opposite parties.

 

Opposite parties’ side documents: -    

 

Ex.B1-           -        - Copy of policy documents.

Ex.B2- 9.1.2006        - Copy of letter from opposite party to complainant.

Ex.B3- 9.12.2003      - Copy of proposal form.

Ex.B4- 23.3.2006      - Copy of letter from opposite party to complainant.

Ex.B5- 20.9.2006      - Copy of letter from opposite party to the complainant.

 

 

 

MEMBER-I                                    MEMBER-II                                              PRESIDENT.