Delhi

New Delhi

CC/1007/2013

Arun Kumar Bahl - Complainant(s)

Versus

M/S. Aviva Life Insurance Company Ltd. - Opp.Party(s)

04 Nov 2019

ORDER

 

 

 

               CONSUMER DISPUTES REDRESSAL FORUM-VI

              (DISTT. NEW DELHI),

            ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

                                               NEW DELHI-110001

 

    Case No.C.C.1007/2013                            Dated:

                In the matter of:

Sh. Arun Kumar Bahl,

S/o Late Sh. Shanti Prakash Bahl,

R/o E-90,Greater Kailash,

New Delhi.

                            ……..COMPLAINANT

VERSUS

1.     Aviva Life  Insurance Co. India Ltd.,

             Through its Managing Director,

            2^nd Floor, Prakash Deep Building,

            7, Tolstoy Marg, Connaught Place,

             New Delhi-110001.

 

2.     Indus-Ind Bank,

Block A, Sushant Lok,

Ph.I, Tower-B,

Mehrauli Gurgaon Road,

            Gurgaon                                                                                                                      ……..OPPOSITE PARTIES

 

NIPUR CHANDNA, MEMBER

ORDER

      

The complainant has filed the present complaint against the OPs under section 12 of Consumer Protection Act, 1986.  The gist of the complaint is that the complainant is having a joint saving account bearing No.0022-641300-001 along with his wife with OP-2. In the month of March, 2010, two officials  of OP-2 solicited to the complainant that if he purchased  the life insurance policy from OP-1, it would earn a return to the extent of 15 to 20% p.a. It was assured that amount has to be paid for a period of three years, after which it can be withdrawn with return of 15%p.a. Thereafter, the  complainant transferred sum of Rs.5 lacs from his saving bank account  to OP-2  and took a policy bearing No.APN2900867.   After expiry of 3 years, when the complainant deposited a total amount of Rs.16.25 lacs upto March, 2013, he approached the OP-1 for getting the deposited amount along with interest against the policy purchased.  OP-1 informed the complainant that he would get an amount of not more than Rs.13 lacs, far below than the amount towards the principle sum paid by him.  The complainant sent a legal notice dt. 29.8.2013 but no reply was received from the OP-1.    The matter was also brought to the knowledge of Insurance Regulatory and Development Authority (IRDA) but all in vain.  Complainant, therefore approached this Forum for redressal of his grievance.

2.     Notices were sent to both the OPs.  Despite opportunity, OP-2  failed to file its evidence,  and not appeared after  8.7.2014, therefore, it was ordered to be proceeded with ex-parte on 26.8.2014 by our predecessor Bench.

 

3.     Complaint has been contested by the OP-1.  In its written statement OP-1 has stated that on the basis of Proposal Form, the complainant was issued a policy bearing No.APN2900867 commencing from 6.3.2010 with premium payable for 20 years.  It is stated that in the policy schedule it was clearly mentioned that the premium was payable from 6.3.2010 and the date of last payment of premium is 6.3.2029 and same schedule was sent to the complainant. It is stated that the policy terms and conditions specifically provides for a Free Look Period of 15 days, during which period the policy owner is entitled to review the policy terms and conditions and request for a cancellation,  if dissatisfied with the terms and conditions of the policy. Admittedly, the complainant received the policy documents in the month of March 2010, he failed to exercise his right and filed the present complaint after expiry of more than 2 years, hence the claim is barred by limitation and be dismissed on the sole ground.

4.     Complainant has filed his evidence by way of affidavit wherein he has corroborated the contents of his complaint.  On the other hand,  OP-1 filed its evidence by way of Affidavits.  

5.     We have heard argument advance at the Bar and have perused the record.

6.     OP has strongly challenged the issue of limitation, hence need to be decided first. The complainant had filed an application for surrender of policy in the year 2013 with OP. The OP neither rejected the request nor had complied with the same, hence, in our view the cause of action for filing the present complaint, if any, arose in the year 2013 and the complainant has filed the present complaint on 13/11/2013 well within the limitation period, hence, the objection of the OP regarding the limitation is rejected.

7.     Some facts are not disputed by the parties such as the policy documents, payment of premiums.    Admittedly, the complainant received the policy in the year 2010.  He has also paid three premiums against the policy in question.  The complainant received the policy documents in the year 2010, if he was not satisfied with the policy than he ought to have approached the OP for the cancellation of the same.  After three premiums, the complainant failed to pay the further premium and as such the policy moved to lapse status.  During the pendency of the proceedings, the OP sent a cheque of Rs.14,69,693/-  to the complainant against the policy in question on account auto foreclosure. 

8.     As per policy terms and conditions, due to non-payment of further premium, policy moved to lapse status and as such the OP cancelled the policy and sent the surrender value to the complainant vide cheque dated 12.6.2015.  The surrender value was calculated by the OP as per the terms and conditions of the policy.   Insurance is a contract between the insured and insurer and both the parties are bound by the terms contained therein. The Hon’ble NCDRC in the matter of National Insurance Co. Ltd. vs. Vinod Puri as reported in I [2014] CPJ 341 (NC) is pleased to hold as under:

Insurance contract has to be construed like any other contract on basis of its terms and conditions and outside aid for construction of insurance policy is impermissible.

9.     The Hon’ble Apex Court in the case of Oriental Insurance Co. Ltd. versus Sony Cheryan reported in (1999) 6 SCC 451 is pleased to hold as under:

The insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. The insured cannot claim anything more than what is covered by the insurance policy.

10.    Similarly in the case of General Assurance Society Ltd. vs. Chandumull Jain and Anr., reported in (1996) 3 SCR, 500, the Constitution Bench has observed that the policy document being a contract and it has to be read strictly. It was observed:

In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties, because it is not for the court to make a new contract, however, reasonable, if the parties have not made it themselves. Looking at the proposal, the letter of acceptance and the cover notes, it is clear that a contract of insurance under the standard policy for fire and extended to cover floor, cyclone etc. had come into being.

11.    The Hon’ble NCDRC in the matter of Ind Swift Ltd. versus New India Assurance Co. Ltd. reported in IV[2012] CPJ 148 (NC) is pleased to rule as under:

Construction of the policy is to be construed strictly as per the terms and conditions of the policy document which is binding contract between the parties and nothing can be added or subtracted by different meaning.

12.    Similarly in LIC versus Banwarilal Yadav reported in IV[2013] CPJ 38 (NC) the Hon’ble NCDRC observed as under:

“Forum has no jurisdiction to go beyond terms and conditions of the Policy.”

13.    The NCDRC in yet another matter in the matter of Morien Chemicals Ltd. versus UCO Bank reported in III [2013] CPJ 261 (NC) is pleased to hold as under:

“Insurance Company is not liable to pay damages which are not covered under the policy.”

 14.   Having regard to the facts and circumstances of the case and  discussion heard, we are of the considered view that there exists no infirmity in the decision of the Insurance Company as the surrender value was calculated as per the terms and conditions of the policy and courts are not meant to add or delete the terms of contract.  The above cited judgments  are squarely applicable in the present case. 

15.    In view of the above discussion, we are inclined to hold that the disbursement of the claim of the complainant to the tune of  Rs.14,69,693/-against the surrender value was justified.  The present complaint is devoid of merit, hence, dismissed.

A copy of this order each be sent to both parties free of cost by post.  This final order be sent to server (www.confonet.nic.in ). File be consigned to Record Room.

Announced in open Forum on 04/11/2019.

 

 

 

(ARUN KUMAR ARYA)

          PRESIDENT

(NIPUR CHANDNA)                                                  (H M VYAS)

       MEMBER                                                                MEMBER