Punjab

Ludhiana

CC/14/716

Mrs.Sukhwinder Kaur - Complainant(s)

Versus

M/s Aegeon Religare Life Ins.Co. - Opp.Party(s)

S.K.Pathak

28 Apr 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, LUDHIANA.

                                                          C.C.No.716 of 15.10.2014

                                                          Date of Decision:28.04.2015

Mrs.Sukhwinder Kaur w/o S.Amandeep Singh s/o S.Sant Singh r/o 35-G, B.R.S.Nagar, Ludhiana. 

                                                                                      … Complainant.

                                             Versus

1.M/s Aegon Religare Life Insurance Company Limited., Building No.3,  Third Floor, Unit No.1, Nesco IT Park, Western Express Highway, Goregaon (East), Mumbai-400063, through its Managing Director/Chairman.

2.M/s Aegon Religare Life Insurance Company Limited., TF 9&10,3^rd Floor, Kunal Tower, 88- Mall Road, Ludhiana-141001 through its Manager.

3.Sh.Navjit Singh Gujral c/o Religare Finvest Limited-B-19-89, Lodhi Tower, 4^th Floor, The Mall, Ludhiana.

4.Sh.Gagan Arora c/o Religare Finvest Limited, B-19-89, Lodhi Tower, 4^th Floor, The Mall, Ludhiana.

                                                                             …       Opposite Parties

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

Quorum     Sh. R.L. Ahuja, President            

                   Sh.Sat Paul Garg, Member.

                   Ms.Babita, Member.

 

Present       Sh.S.K.Pathak, Adv. for complainant.

                   Sh.J.S.Mann, Adv. for OP1 and OP2.

                   OP3 and OP4 ex-parte.

 

                                                ORDER

R.L. AHUJA, PRESIDENT

1.                Complainant Mrs.Sukhwinder Kaur, has filed the present complaint u/s 12 of the Consumer Protection Act, 1986 (herein-after referred to as ‘the Act’) against M/s Aegon Religare Life Insurance Company Limited and others(herein-after in short to be referred as ‘OPs’)- directing them to refund the amount of Rs.1 lakh paid by the complainant and to pay an amount of Rs.25,000/- as damages and interest @24% p.a. on the amount paid till the amount is actually received by the complainant alongwith Rs.10,000/- as litigation costs to the complainant.

2.                Brief facts of the complaint are that the OP1 and OP2 through its agents/employees i.e.OP3 and OP4 approached the complainant for taking an insurance policy and allured her to take such insurance policy for one year, as after one year the amount of the policy alongwith interest shall be paid back to the complainant. The complainant agreed to the proposal and paid an amount of Rs.1 lakh vide cheque No.009384 dated 2.4.2013 drawn on Allahabad Bank, BRS Nagar Branch, Ludhiana towards the insurance policy in the names of complainant Mrs.Sukhwinder Kaur and it was assured by the OP3 and OP4 that in case, the complainant was not satisfied with the terms of the insurance policy, then she had the option to refute/reject the policy within 15 days from the date of receipt of the insurance policy and get back the refund of the amount paid. The complainant kept on waiting for the receipt of the insurance policy but no such policy was ever issued by the OP1. Oral queries made in this respect were of no avail and after exhausting her patience, the complainant got issued a notice dated 24.7.2014 requiring the OP1 and OP2 to issue the insurance policy or to pay the complainant, the amount of Rs.1 lakh alongwith interest. Even then the Ops for the reasons best known, paid no heed and with the intention to commit fraud, did not even acknowledge the same. OP3 and OP4 have been working as employees/agents of OP1 and OP2 and OP1 and OP2 are under obligation to comply and or fulfill the assurance given in their name and on their behalf and the complainant, who has paid the heavy amount on such insurance policy is liable to get the relief from all the Ops. The complainant even visited the office of OP2 at Ludhiana and made enquiries but nothing fruitful came out. Such act and conduct of Ops is claimed to be deficiency in service on their part by the complainant.

3.                Upon notice of the complaint, Op1 and OP2 were duly served and appeared through their counsel Sh.J.S.Mann, Advocate and filed their written reply, whereas, despite service through notice, OP3 and OP4 failed to appear and were proceeded against ex-parte vide order dated 2.12.2014 by this Forum.

4.                OP1 and OP2 filed their written reply, in which, it has been submitted in the preliminary objections that the complainant has concealed and suppressed the material and relevant facts of the case as the complainant has with malafide and dishonest intention not only concealed the material facts as enumerated in the present reply of the answering Ops from this Hon’ble Forum but has also twisted and distorted the same to suit her own convenience and to mislead this Hon’ble Forum. No cause of action ever arose in favour of the complainant and against the answering Ops to file the present complaint and the same is nothing but an abuse of the process of law. It is submitted that the complainant has acted in bad faith with respect to subject of this complaint and has approached this Hon’ble Forum with unclean hands and has tried to mislead this Hon’ble Forum by way of fabricating material facts as she is not interested in continuing policy with the company and is resorting to unfair means and unduly pressuring the Ops to cancel her policy and return her premium. Hence, in view of doctrine of clean hands “one who seeks equity must come with clean hands”, the complaint deserves no fate other than outright dismissal. The complainant by her own act and conduct is estopped from filing the said complaint as the complaint is nothing but an abuse of process of law as the complainant is herself at default. The complainant was given a detailed description about the features of the said policy plans including all the charges that shall be levied on the same and was also apprised with its terms and conditions before signing of the said proposal forms/application. It was only after being completely aware as regards the risks and consequences of the said policy and the terms and conditions attached therewith that the complainant applied for the same vide the aforesaid application/proposal forms and the complainant had signed the same on her own will and consent. After the issuance of the insurance policy, the contract was concluded between the complainant and answering Ops and the insurance policy being a legal document its terms and conditions were binding on both the parties. The complainant is alleging that “Fraud and mis-representation” has been committed against her by the answering Ops and as such, the complainant has not approached the right Forum for redressal of her alleged grievances. Thus, the complaint is not maintainable and it should be dismissed at the outset. On merits, it is submitted that Religare Finvest and Aegon Religare Life Insurance Company are separate legal entities and OP3 and OP4 are not the agents or employees of the answering Ops and the answering Ops are not in any way responsible for the acts of the OP3 and OP4. Further, it is submitted that on the basis of the proposal forms submitted by the complainant, the answering Ops issued policy No.130313808593 in favour of the complainant and an insurance contract was executed between the complainant and the answering Ops and the same was governed by the terms and conditions of the policy documents. As per clause 2.5 of the policy contract, in case, the complainant after receiving the said policy was not satisfied with the terms and conditions, she could have asked for the cancellation of the said policy within 15 days of receipt of the policy and could have opted for the free look period. However, the complainant did not opt the “free look option”. The policy was duly delivered on 25.4.2013 and the complainant did not submit any request for cancellation of the said policy within a period of 15 days from the date of receipt of the said policy. Now as the complainant is not interested to continue the policy and hence, is resorting to all kind of unfair means to wriggle out of her contractual obligations. Thus, the policy cannot be cancelled and the complainant is not entitled to the refund of the premium amount. Otherwise, similar pleas were taken as taken in the preliminary objections and at the end, denying any deficiency in service and all other allegations of the complainant being wrong and incorrect, answering OPs prayed for dismissal of the complaint with costs.

5.                Learned counsel for the complainant in order to prove the case of the complainant, tendered into evidence affidavit of complainant as Ex.CA, in which, she has reiterated all the averments made in the complaint.

6.                On the contrary, learned counsel for the OP1 and OP2 in order to rebut the evidence of complainant, adduced evidence by placing on record affidavit Ex.RA of Sh.Jitin Parekh, in which, he has reiterated all the contents of reply filed by OP1 and OP2 and refuted the case of the complainant. Further, learned counsel for the OP1 and OP2 has proved on record the documents Ex.R1 to Ex.R4.

7.                We have heard the learned counsel for the complainant as well as learned counsel for the OP1 and OP2.

8.                Learned counsel for the complainant has contended that it is proved on record that complainant had purchased the policy in question from the Ops and paid Rs.1 lakh to the Ops towards the payment of premium. It was assured by the OP3 and OP4 that in case, the complainant was not satisfied with the terms of the insurance policy, then she had the option to refute or reject the policy within 15 days from the date of receipt of the insurance policy and get back the refund of the amount paid by her. Further, it has been contended that the complainant kept on waiting for the receipt of the insurance policy after payment of premium, but no such policy was ever issued by the OP1 despite repeated requests, approaches and despite issuance of legal notice dated 24.7.2014 requiring the OP1 and OP2 to issue the insurance policy or to pay the complainant the amount of Rs.1 lakh alongwith interest. Such act and conduct of Ops is claimed to be deficiency in service and it has been contended that the complainant is entitled for refund of the amount of Rs.1 lakh alongwith the relief prayed for.

9.                On the other hand, learned counsel for the OP1 and OP2 has filed the written arguments, in which, he has reiterated all the contents of written reply filed by the Op1 and OP2 and further, it has been submitted in the written arguments that in the present case, the Ops are in full compliance of law and regulations and the Ops have duly produced the copies of policy kit clearly stating the free look period of 15 days annexed with the reply. In view of the above, the request for cancellation of policy is filed much after period of 15 days as provided under the regulation and the Ops are fully justified in declining the said cancellation request of the complainant and hence, the Ops have acted as per mandate of law and same cannot be termed as deficiency in service offered by the Ops. The Ops company after issuance of policy has duly assumed and undertaken the risk on life of complainant and in case of any eventuality, the company would have been statutory liable to honour the claim of the complainant, thus the OP had already undertaken the risk on life of complainant and the complainant cannot demand the refund of premium paid, since he failed to exercise her free look period option, thus allowing present complaint will virtually allow the complainant as easy way to wriggle out her contractual obligations merely on her asking which will settle bad precedent and consequently, results in abuse of process of law. Further, it is submitted that jurisdiction of this Hon’ble Forum is barred because the transaction is commercial in nature and hence, the dispute does not come under the umbrella of consumer dispute. Further, learned counsel for the OP1 and OP2 has relied upon judgment titled as Life Insurance Corporation of India and another vs. Mangai & another-2010(2)CLT-562(N.C.)..

10.              We have considered the rival contentions of learned counsel for the complainant and have also gone through the written arguments alongwith judgment filed by the learned counsel for the OP1 and OP2 and have also gone through the record very carefully.

11.              Perusal of the record reveals that there are specific allegations of the complainant that complainant had paid an amount of Rs.1 lakh to the Ops vide cheque No.009384 dated 2.4.2013 drawn on Allahabad Bank, BRS Nagar Branch, Ludhiana towards the insurance policy in question purchased from from the Ops and it was assured by the OP3 and OP4 that in case, the complainant was not satisfied with the terms of the insurance policy then she had the option to refute/reject the policy within 15 days from the date of receipt of the insurance policy and get back the refund of the amount. Further, there are allegations that despite awaiting sufficient time and despite numerous approaches, requests and despite serving a legal notice dated 24.7.2014, the Ops failed to issue the policy in question to the complainant. On the other hand, there is specific plea of the learned counsel for the OP1 and OP2 that on the basis of the proposal forms submitted by the complainant, the Ops had issued policy No.130313808593 in favour of the complainant and an insurance contract was executed between the complainant and the Ops and the same was governed by the terms and conditions of the policy documents. As per clause 2.5 of the policy contract, in case, the complainant after receiving the said policy was not satisfied with the terms and conditions, she could have asked for the cancellation of the said policy within 15 days of receipt of the said policy and could have opted for the free look period. However, the complainant did not opt the “free look option”. The policy was duly delivered on 25.4.2013 and the complainant did not submit any request for cancellation of the said policy within a period of 15 days from the date of receipt of the said policy and now as the complainant is not interested to continue the policy and hence, she is resorting to all kind of unfair means to wriggle out of her contractual obligations. So, the policy cannot be cancelled and the complainant is not entitled to the refund of the premium amount.

12.              Though, the learned counsel for OP1 and OP2 have taken the plea that OP1 and OP2 had sent letter Ex.R2 to the complainant informing her about sending copy of her proposal and other declarations and further, it was informed that in case, she was not satisfied with the terms and conditions of the policy, she can opt to cancel her policy within 15 days from the date of receipt of this policy as per Regulation 6(2) of the IRDA(Protection of Policyholder’s interests) Regulations, 2002.

13.              Perusal of the record further reveals that it is an admitted fact on record that policy which were allegedly issued by the Ops was not received by the complainant. Rather, the same was sent to the financer i.e. Religare Finvest Limited which fact is evident from documents Ex.R3 and Ex.R4 and it is proved on record that neither any intimation was sent to complainant by the OPs nor they sent the insurance policy to the complainant nor the insurance policy was sent by the abovesaid Religare Finvest Limited to the complainant. Though, the complainant had paid the amount of Rs.1 lakh as premium to the OP1 and OP2 through OP3 and OP4 in order to get the policy in question which was not received by him from the Ops, due to which, the complainant was deprived from taking benefit of the policy and also deprived from exercising of her right by using free look period to get cancel the same. So, non-supply of the insurance policy to the complainant by the Ops clearly amount to deficiency in service on the part of the Ops. As such, complaint deserves to be allowed and complainant is found to be entitled for the compensation.

14.              Hence, in view of the above discussion, the present complaint is allowed with the direction to the Ops to send the copy of insurance policy to the complainant and also to extend the period of free look period for another 15 days from the date of receipt of the copy of the insurance policy by the complainant and in case, the complainant is not interested to continue with the insurance policy, the complainant can exercise his option to get the insurance policy cancelled and in that eventuality, Ops shall be liable to pay the whole amount of the premium paid by the complainant towards the insurance policy, within 15 days from the date of request made by the complainant in this regard. Further, Ops are burdened with Rs.10,000/-(Ten thousand only) as compensation to the complainant on account of mental pain, agony and harassment suffered by him due to deficiency in service on the part of the Ops and Rs.2000/-(Two thousand only) as litigation costs to the complainant. Order qua compensation and litigation costs be complied within 30 days of receipt of copy of the order, which be made available to the parties free of costs. File be completed and consigned to record room.

 

(Babita)                (Sat Paul Garg)              (R.L.Ahuja)

           Member                   Member                     President.  

Announced in Open Forum

Dated:28.04.2015

Gurpreet Sharma.