DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II U.T. CHANDIGARH [Complaint Case No: 457 of 2011] Date of Institution: 28.09.2011 Date of Decision : 26.04.2012 -------------------------------------- Mr. Sanjeev Kumar, R/o 1439, Village Burail, Chandigarh. ….Complainant. V E R S U S [1] M/s Aviva Life Insurance Company India Limited, SCO 180-181-182, Sector 9-C, Chandigarh, through its Manager. [2] M/s Aviva Life Insurance Company India Limited, 2nd Floor, Prakshsdeep Building, 7, Tolstoy Marg, New Delhi, through its Chairman-cum-Managing Director. ---Opposite Parties. BEFORE: SH. LAKSHMAN SHARMA PRESIDENT MRS. MADHU MUTNEJA MEMBER SHRI JASWINDER SINGH SIDHU MEMBER Argued By:Ms. Sonia Gupta, Authorized Agent for the Complainant. Sh. Sandeep Suri, Advocate for the OPs. PER JASWINDER SINGH SIDHU, MEMBER [1] Complainant has filed the present complaint against the Opposite Parties on the grounds that the Complainant had taken an insurance policy from the Opposite Parties in the month of August, 2010 and was told by the Agent that it is a F.D. Plan and only one single premium of Rs.2 Lacs is to be paid. As the Complainant did not receive the policy document after the payment of the premium, he contacted the Agent (Mr. Gurpreet Singh), who had advised the Complainant about the said Policy. The said Agent told the Complainant that the policy is under process, and the Complainant would receive the policy document very soon. Thereafter, the Agent stopped replying to the Complainants queries, and also stopped picking-up the telephone of the Complainant. The Complainant claims that thereafter, he visited the Chandigarh Office of the OPs, to enquire about the Policy document, whereupon, he was told the original policy document has been posted to his address. The Complainant claiming that he did not receive the original policy, till date, requested the Opposite Parties to issue a duplicate copy of the policy document. Having gone through the duplicate policy document, Complainant came to know that the policy is not a F.D. Plan with single premium. The Complainant in order to exercise his right to re-consider requested for the cancellation of the Policy within 15 days of receipt of the duplicate policy document. The Opposite Parties failed to consider the request of the Complainant, claiming that has per their records, they had sent the policy document at Complainant‘s home address, in the month of August, 2010, so the “right to re-consider” is not available to the Complainant. Complainant aggrieved of the actions of the Opposite Parties claims that his right to reconsider only arose on the receipt of duplicate policy document and the same should be entertained. Thus, alleging deficiency in service on the part of the Opposite Parties, the Complainant has sought the following relief: - [i] Direct the Opposite Parties to pay the premium paid i.e. Rs.2Lacs along with interest. [ii] A sum of Rs.10,000/- towards physical strain & mental agony suffered by the Complainant and his family members; [iii] Rs.1000/- towards costs of litigation. [2] On notice, Opposite Parties have filed their joint reply/ version, contesting the claim of the Complainant. [3] Opposite Parties have taken preliminary objections to the effect that the Complainant is seeking benefit on the basis of the duplicate documents taken by him, and issued on his demand. The policy was issued to the Complainant on 6.9.2010, dispatched through Blue Dart and the same was received back as RTO. The policy document was once again re-issued on 16.9.2010 through Speed Post and is claimed to have been delivered and not received back. A specific line is mentioned against the date “21.09.2010, Query raised for contact details, Endorsement issued”. Secondly, the Complainant raised a query on 21.9.2010 which was replied by the Opposite Parties on 23.9.2010. The Opposite Parties claims that no dispute was raised for one full year with regard to, non-delivery of policy. The policy came into force with effect from 31.8.2010 and the Complainant did not raise any dispute regarding the alleged non-receipt of documents with the Opposite Parties for full one year. For the first time, a complaint was made on 22.7.2011 to which a response was sent on 25.7.2011, asking the documents to be dispatched to the Chandigarh Branch. On subsequent request on 09.08.2011, the duplicate policy documents were dispatched to Chandigarh Branch and were finally handed over to the wife of the Complainant on 11.08.2011. While submitting the preliminary objections, a chronological detail of the events is also mentioned. On merits, Opposite Parties have filed its para- wise reply to all the averments of the present complaint, repeating the submissions as mentioned in the preliminary objections. [4] Parties led their respective evidences. [5] Having gone through the entire complaint, version of the Opposite Parties, the evidence of the parties and with the able assistance of the ld. Counsel for the parties, we have come to the following conclusions. [6] In the present complaint, the main allegation of the Complainant against the Opposite Parties is with regard to not having supplied him with the Original Policy Document, till date. This aspect finds repeatedly mentioned in the communication shared between the complainant and the opposite parties, as revealed from the annexures R-2 & R-3 at page #27 to 30. When a duplicate copy of the said policy document was received by him, he had preferred to exercise his “Right To Reconsider” option, and because of being dissatisfied with the policy terms & conditions, requested for the cancellation of the policy, within fifteen days of the receipt of the duplicate copy of the policy document. Thus, the Complainant claims that his “Right To Reconsider” is well within the permitted period of 15 days time, as it is now that he has received the policy document for the first time. This right is enshrined in the policy document. The Opposite Parties while contesting the claim of the Complainant on this particular issue have tendered a detailed chorology of events, starting from 31 Aug. 2010 up to 06 Sept. 2011. From this chorology of events, one aspect has clearly come to light that the Complainant for the first time had enquired about his policy on 21.9.2010. However, the Opposite Parties have confirmed this aspect while making a mention of “POLICY DETAILS“ on page 5 of their reply. But at the same time opposite parties have failed to bring on record as to what was their answer to this particular query which they claimed to have replied on 23.9.2010 as mentioned in para 3 of their preliminary objections. Hence it stands established from the documents of the opposite parties that the complainant repeatedly enquired about his policy documents but the opposite parties have not addressed the grievance of the complainant in a direct and comprehensive manner. At the same time the claim of the opposite parties that the complainant remained silent for more than one year, is falsified, from their own documents, as they have admitted of a query of the complainant dated 21.09.2010 about “POLICY DETAILS”. [7] The Opposite Parties have mentioned the AWB No. EH155647145IN, of the Speed Post, through which, they claim to have dispatched the original policy document to the Complainant. But the Opposite Parties have failed to bring on record, any document from their own records, to establish this aspect in a befitting manner. At the same time, while mentioning that as this document has not been received back at their office, the Opposite Parties claim that the same is understood to have been delivered to the Complainant. However, we feel that the Opposite Parties have presumed that the policy document sent to the Complainant as per their version, has been received by him. But in the eyes of law, presumption can not take the place of a proof. The Opposite Parties have failed to establish the aspect of the delivery of the Original Policy Document to the Complainant by bringing on record any cogent, reliable and trustworthy evidence. Thus, the contentions of the Complainant have remained unaddressed. The Opposite Parties have failed to adhere to the Insurance Regulatory and Development Authority (Protection of Policyholders’ Interests) Regulations, 2002, Clause 4(1) Proposal for insurance, by not supplying the policy document to the complainant. 4. Proposal for insurance (1) Except in cases of a marine insurance cover, where current market practices do not insist on a written proposal form, in all cases, a proposal for grant of a cover, either for life business or for general business, must be evidenced by a written document. It is the duty of an insurer to furnish to the insured free of charge, within 30 days of the acceptance of a proposal, a copy of the proposal form. [8] The Complainant has for the first time tried to exercise his option of surrendering the policy after the receipt of duplicate policy document. We feel that the Complainant on having received these documents was very much entitled to exercise his option of “Right To Reconsider” as provided in the policy document. Thus, the Opposite Parties are bound to consider the request of the Complainant. The refusal to entertain the request of the complainant is a deficiency in service, on the part of the opposite parties. However, the Opposite Parties are free, to exercise their right, of necessary deductions, on such refunds, as applicable under the Rules. [9] In the light of the aforementioned observations, the present complaint succeeds against the Opposite Parties and the same is allowed. The Opposite Parties are directed to refund the amount of premium collected from the complainant within 30 days of the receipt of this order. [10] Finding definite deficiency in service on the part of the Opposite Parties, we also saddle the Opposite Parties with an amount of Rs.10,000/- as compensation. The Opposite Parties are also directed to pay Rs.1,000/- towards costs of litigation, within 30 days of the receipt of this order. Failing which, Opposite Parties shall be liable for an interest @9% per annum on the premium amount since the date of its deposit till it is paid. The compensation of Rs.10,000/- too will attract interest @9% from the date of this order till it is paid, apart from costs of litigation. [11] Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room. Announced 26th April, 2012. Sd/- (LAKSHMAN SHARMA) PRESIDENT Sd/- (MADHU MUTNEJA) MEMBER Sd/- (JASWINDER SINGH SIDHU)
| | MRS. MADHU MUTNEJA, MEMBER | HONABLE MR. LAKSHMAN SHARMA, PRESIDENT | MR. JASWINDER SINGH SIDHU, MEMBER | |
