DISTRICT CONSUMER DISPUTES REDRESSAL FOR`UM, BATHINDA.
CC.No.348 of 24-07-2012
Decided on 10-12-2012
Paramjit Kaur w/o Harvinder Singh r/o # 116, Phase-2, Model Town, Bathinda.
........Complainant
Versus
Max New York Life Insurance having its office at first floor, The Mall, Bathinda.
.......Opposite party
Complaint under Section 12 of the Consumer Protection Act, 1986.
QUORUM
Smt. Vikramjit Kaur Soni, President.
Sh.Amarjeet Paul, Member.
Smt. Sukhwinder Kaur, Member.
Present:-
For the Complainant: Sh.Sanjay Goyal, counsel for complainant.
For Opposite party: Sh.N.K Batta, 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'). The brief facts of the complaint are that the complainant has purchased the insurance policy bearing No.751214180 and paid Rs.20,000/- in the month of August 2009 and further paid the top up premium of Rs.5000/- and total Rs.25,000/- was paid and she was assured that she is not required to make any further payment, as insurance amount is payable only once and she will be insured for Rs.2,00,000/- and in case she wants to get the refund of the amount then she will be given Rs.20,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and she can claim the refund of the amount anytime. The complainant alleged that the opposite party neither issued any cover note nor separate terms and conditions nor free look period to her. In the year 2010 the complainant wanted to seek the refund of Rs.25,000/- but the opposite party refused to refund any amount and told that she has to make the payment for the period of minimum two years otherwise she will not be entitled to get the refund. Under the compelled circumstances the complainant has paid further premium of 2nd year and she made payment of Rs.30,000/- further as such she paid in total Rs.55,000/- to the opposite party excluding top up premiums. Few days back the complainant requested the opposite party to refund Rs.55,000/- alongwith interest @ 12% p.a. but they conveyed that only Rs.43,000/- the fund value will be paid to her. Hence the complainant has filed the present complaint to seek the refund of Rs.55,000/- and top up premiums alongwith interest, cost and compensation.
2. The opposite party on its appearance before this Forum has filed its written statement and pleaded that upon issuance of the said policy on 11.8.2009, the said policy documents were dispatched to the complainant on 13.8.2009 via XPS courier bearing reference No.934020104822 and the same was delivered to her on 18.8.2009. The complainant inspite of receipt of the said policy documents did not raise any objection or made any complaint during the free look period hence it was presumed that the contract of the insurance with her was legally concluded. On 6.8.2009, the opposite party received a proposal form bearing No.751214180 duly filled and signed by the complainant for a 'Max Life Smart Assure Unit Linked Investment Plan' giving all the relevant details and information in the prescribed form. Under the said policy, an annual target premium of Rs.20,000/- was to be paid semi-annually. In the proposal form the complainant has also given a declaration that she has fully understood the meaning and scope of the proposal form and the contents of the same and only after understanding the same she signed it. Based on the information provided in the Proposal Form after the receipt of the initial premium amount of Rs.12,500/- through cheque, the opposite party issued the policy bearing No.751214180 on 11.8.2009. The said policy documents which consist schedule and terms and conditions of the said policy was sent to the address of the complainant. Under Article 25 of the terms and conditions of the said policy document it was specifically mentioned under the Free Look Period, in case of non-agreement with the terms & conditions of the policy the Customer can return the policy. On 12.1.2010 the opposite party sent a premium reminder notice to the complainant and thereafter on 24.2.2010, they received the renewal premium amount vide cheque No.942567. The opposite party dispatched the premium receipt to the complainant on the same day. The premium reminder letter dated 12.1.2010 and the premium receipt dated 24.2.2010 respectively are given to the complainant. On 12.7.2010 the opposite party sent a premium reminder notice to the complainant and thereafter on 11.8.2010, they dispatched account statement to her. On 13.9.2010 the opposite party received the renewal premium amount of Rs.10,000/- in cash thereafter on 15.9.2010, they issued the premium receipt to the complainant. On 13.1.2011 the opposite party sent a premium reminder notice to the complainant and thereafter on 12.4.2011, they received the renewal premium amount vide cheque No.148486. On 13.4.2011 the opposite party issued the premium receipt to the complainant. On the same day i.e. 13.4.2011 the complainant called on toll free number to check the account value and the opposite party duly informed appropriately. On 12.7.2011 the opposite party sent a premium reminder notice to the complainant and thereafter on 11.8.2011, they dispatched the account statement to her. On 31.8.2011 the opposite party received renewal premium amount of Rs.10,000/- in cash and thereafter on the same day opposite party issued the premium receipt to the complainant. Again on 12.1.2012 the opposite party sent a premium notice to the complainant. Since the complainant has failed to deposit the renewal premium within time even grace period also expired. The said policy lapsed due to the non-payment of the renewal premium and the same was also intimated to the complainant vide letter dated 11.6.2012. The opposite party has denied that it has ever assured the complainant that if she wants to get the refund of the amount than she will be given Rs.20,000/- alongwith interest or the said policy was a single premium policy. The complainant herself opted the said policy for 10 premiums paying terms and the same is duly mentioned in the proposal form. The opposite party denied that it has assured that it is a single premium policy and after first premium there is no need to pay any further premium for the same. The said policy terms and conditions has been supplied to the complainant. The opposite party further pleaded that the said policy terms & conditions are drawn as per the guidelines laid down by the IRDA and before issuance to the general public; each policy format is approved by the IRDA to ensure that the same is in line with the guidelines for the protection of the interest of the policyholders. The complainant being an educated person was not aware of the terms & conditions of the proposal form and she had simply put on her signatures. The complainant has all the means to submit the cancellation request within the statutory limit of 15 days if she has reason to believe that she was miscommunicated about the benefits of the said policy. However having failed to do so despite being informed of the process, the Company was right in declining his request for the cancellation of the said policy as the Company continues to provide him with life cover.
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 purchased the insurance policy bearing No.751214180 and paid Rs.20,000/- in the month of August 2009 and further paid the top up premium of Rs.5000/- and in total Rs.25,000/- was paid. The complainant was insured for a sum of Rs.2 lacs. The complainant paid further premium of Rs.30,000/- as such she paid Rs.55,000/- in total to the opposite party.
6. The disputed facts between the parties are that the complainant submitted that she has purchased the insurance policy on the assurance of the opposite party that she has to make the payment of Rs.20,000/- only once and she will be insured for Rs.2,00,000/- and in case she wants to get the refund of the amount then she will be given Rs.20,000/- alongwith interest @ 12% p.a. and no charges shall be deducted and she can claim the refund of the amount anytime. The complainant further submitted that neither any cover note nor separate terms and conditions nor free look period was given to her. In the year 2010 the complainant wanted to seek the refund of Rs.25,000/- but the opposite party refused to refund any amount and told that she has to make the payment for the period of minimum two years otherwise she will not be entitled to get the refund. Under the compelled circumstances the complainant had paid further premium of 2 years to the tune of Rs.30,000/- as such she has paid in total Rs.55,000/- to the opposite party excluding top up premiums. The complainant requested the opposite party to refund Rs.55,000/- alongwith interest @ 12% p.a. but they conveyed that only Rs.43,000/- the fund value will be paid to her.
7. On the other hand the opposite party submitted that it has duly sent the policy documents on dated 13.8.2009 via XPS courier bearing reference No.934020104822 and the same was delivered to the complainant on 18.8.2009. The complainant despite receipt of the said policy documents did not raise any objection or made any complaint during the free look period hence it was presumed that the contract of the insurance with her was legally concluded. In the proposal form the complainant has also given a declaration that he has fully understood the meaning and scope of the proposal form its contents and after understanding the same she had signed the proposal form. On the receipt of the initial premium amount of Rs.12,500/- through cheque, the opposite party issued the policy bearing No.751214180 on 11.8.2009. The policy documents duly containing schedule, terms and conditions of the said policy was sent to the address of the complainant. On 12.1.2010 the opposite party sent a premium reminder notice to the complainant and thereafter on 24.2.2010, they received the renewal premium amount vide cheque No.942567. The opposite party dispatched the premium receipt to the complainant on the same day. The premium reminder letter dated 12.1.2010 and the premium receipt dated 24.2.2010 respectively are given to the complainant. On 12.7.2010 the opposite party sent a premium reminder notice to the complainant and thereafter on 11.8.2010, they dispatched account statement to her. On 13.9.2010 the opposite party received the renewal premium amount of Rs.10,000/- in cash thereafter on 15.9.2010, they issued the premium receipt to the complainant. On 13.1.2011 the opposite party sent a premium reminder notice to the complainant and thereafter on 12.4.2011, they received the renewal premium amount vide cheque No.148486. On 13.4.2011 the opposite party issued the premium receipt to the complainant. On the same day i.e. 13.4.2011 the complainant called on toll free number to check the account value and the opposite party duly informed. On 12.7.2011 the opposite party sent a premium reminder notice to the complainant and thereafter on 11.8.2011, they dispatched the account statement to her. On 31.8.2011 the opposite party received renewal premium amount of Rs.10,000/- in cash and thereafter on the same day opposite party issued the premium receipt to the complainant. Again on 12.1.2012 the opposite party sent a premium notice to the complainant but she has failed to deposit the renewal premium within time even grace period also expired. Due to this policy lapsed for the non-payment of the renewal premium and the same was also intimated to the complainant vide letter dated 11.6.2012. The opposite party has denied that it has ever assured the complainant that she has to pay the premium only once and she can get the refund of the amount anytime alongwith interest.
8. A perusal of documents placed on file reveals that the policy documents consisting policy schedule and terms and conditions were sent to the address of the complainant via XPS courier bearing reference No.934020104822 and the same was delivered to her on 18.8.2009. The opposite party has placed on file Ex.R4 to support their version i.e. certificate issued by 'TCI XPS, Express Distribution Specialists'. The relevant portion of this is reproduced as under:-
“To Whomsoever It May Concern
This is to certify that to the best of our knowledge we have delivered the shipment no.934020104822 as on 18th Aug 2009 with signature at the below mentioned address:
Mrs.Paramjit Kaur
w/o Harvinder Singh Chahal
No.1012, Model Town Phase III
Arjan Dev Nagar Bathinda-151001”
Ex.R5 is the renewal premium notice that has been sent to the complainant, in this the due date premium is shown as 11.2.2010; the insurance premium receipt has been issued to the complainant on 24.2.2010, again the renewal premium notice was sent by the opposite party vide Ex.R7, in this the due date of the premium shown as 11.8.2010; the statement of account that has been sent to the complainant vide Ex.R8 is also placed on file by the opposite party; the premium renewal Ex.R10 dated 13.1.2011 is also sent to her; thereafter insurance premium receipt has been sent to her on dated 13.4.2011 vide Ex.R11; the renewal premium notice Ex.R12 sent to her on 12.7.2011; the statement of account dated 11.8.2011 Ex.R13 has also been sent to her; Ex.R14 insurance premium receipt has been sent to her and thereafter on 12.1.2012 again the renewal premium notice Ex.R15 has been sent to her; the intimation regarding the lapse of the said policy was also sent to her on dated 11.6.2012 vide Ex.R16.
A further perusal of the evidence placed on file shows that the payment mode was semi-annual and various renewal premium notices were sent to the complainant. If she had not received the terms & conditions or policy documents or free look period option, she should inquire the same from the opposite party as she has been receiving the regular correspondence from the opposite party from time to time. In all the renewal premiums notices, the following details are mentioned:-
“Name of the life insured; Plan Name:-'Smart Assure (Unit Linked Investment Plan)';Policy issue date:-11.8.2009; Payment Mode:- Semi-Annual; Payment Method:-Direct Bill; Model Premium:- Rs.10,000/-; Due Date and Client ID:-0002469728.”
9. Thus from the facts, circumstances and evidence placed on file this Forum concludes that the complainant herself has not approached the opposite party to seek the refund of the amount earlier. According to the complainant's own version when she requested the opposite party to refund the amount of Rs.55,000/-, they conveyed her to refund the amount of Rs.43,000/- as fund value but nothing has been mentioned in their reply that the amount of Rs.43,000/- has been offered by them as fund value.
10. Therefore in view of what has been discussed above there is no deficiency in service on the part of the opposite party. Hence this complaint is dismissed without any order as to cost. However, the complainant is entitled to get the fund value of her amount according to the present market value.
11. 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:- Vikramjit Kaur Soni
10-12-2012 President
Amarjeet Paul
Member
Sukhwinder Kaur
Member
