Delhi

New Delhi

CC/215/2012

Fakir Chand Sarawagi - Complainant(s)

Versus

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

18 Mar 2020

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. 215/2012                                                             Dated:

    In the matter of:

    Fakir Chand Sarawagi,

    E-890, Saraswati Vihar,

   1^st floor, Pitampura, Delhi                                                      ……..COMPLAINANT

VERSUS

    Aviva Life  Insurance Co.India Pvt. Ltd.

     2^nd Floor, Prakash Deep Building,

      7, Tolstoy Marg, New Delhi-110001.

 

Also at :- 5^th Floor, JMD Regent Square,

Gurgaon-Mehrauli Road,

Gurgaon-122001.                                                          ……..OPPOSITE PARTY     

 

 

ARUN KUMAR ARYA-PRESIDENT

ORDER

The complainant has filed the present complaint against the OP under section 12 of Consumer Protection Act, 1986.  The gist of the complaint is that the complainant had taken Policy bearing No. WLG1497349 with commencement date being 30/05/2007 from the OP. the next annual premium for 2008-09 was paid on 30/05/2008, thereafter the next annual premium of Rs. 90,000/- for the year 2009-10 was duly acknowledged by OP vide letter dated 12/09/2009.

In 2010, due to tragedy, the complainant deposited the 4^th  installment by delay i.e. in August, 2012. Vide letter dated 11/08/2011 the OP  intimated the complainant about the auto foreclosure of the policy in question and also refunded the 4^th premium alongwith it. It is also mentioned in this letter that the previous 3 premium paid by the complainant stands forfeited as the surrender value is less than the first year premium. Complainant requested to the concerned executive and officials of OP, to refund the deposited 3 premium along with interest but no response was given to him till date by OP.  Complainant, therefore approach this Forum for redressal of her grievance.

Complaint has been contested by the OP.In its written statement OP stated that theInsurance policy availed by the complainant is Lifelong unit link plan which is market linked.It has been pleaded that complainant failed to reinstate the said policy with in a prescribed time frame, hence, the status of the policy changed to auto foreclosure and a cheque to surrender value of Rs. 98,000/- dated 11/08/2010 was duly received by the complainant on 13/08/2010. It has been 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. The complainant failed to exercise his right and paid the premium for 3 years, unfortunately the policy moved to the lapse status and as such the surrender value was given to the complainant as per the terms and condition of the policy in question. He further prayed that the present complaint be dismiss as the surrender value against the policy in question was already disbursed.

Both the parties have filed their evidences by way of affidavits.  

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

 

As per policy terms and conditions, due to non-payment of further premium, policy in question was in  lapse status.  The complainant has failed to place on record any document which shows that he requested the OP to continue  the policy during free look period.  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.

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.

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.

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.

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.”

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.”

In view of the above discussion, we find no merit in the present complaint same is hereby 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   18/03/2020.

 

(ARUN KUMAR ARYA)

PRESIDENT

(NIPUR CHANDNA)                                                                                (H M VYAS)

                    MEMBER                                                                                                MEMBER