Delhi

New Delhi

CC/1212/2012

Hari Singh Verma - Complainant(s)

Versus

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

02 Jun 2017

ORDER

NEW DELHI DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

M BLOCK, 1ST FLOOR, VIKAS BHAWAN, I P ESTATE, NEW DELHI-110002

 

Case No.CC/1212/2012                                                                            Dated:

 

IN THE MATTER OF:-

Mr. Hari Singh Verma

R/O  Flat no. 687,

Sector-37, Arun Vihar

Noida-201303.

                                                                                                   ………………………………………COMPLAINANT

VERSUS

 

1. Aviva Life Insurance Company Ltd.

Through its Chairperson

Registered office,

2^nd Floor, Prajasdeep Building

7 Tolstoy Marg

New Delhi-110001.

 

2. Aviva Life Insurance Company Ltd.

Through its General Manager

General Manager

Heard Office, Aviva Tower,

Sector Road, opp. Golf Course,

Dlf-Phase V, Sector -43,

Gurgaon-122002.

                                                                                                           

……………………………………….OPPOSITE PARTY

 

ORDER

NIPUR CHANDANA MEMBER

 

Complainant was the policy holder of Op CO. vides policy no. WSG 1669780 . It is alleged by the complainant that vide letter dt. 25.06.2012  he was asked by the Op to convey his acceptance to a sum of Rs. 1,24,742  towards full and final settlement of his claim, after five year against the payment of his hard earned money worth Rs. 1,50,000/- . and the same was refused by the complainant vide his letter dt. 5.10.2012.

It is also alleged by the complainant that initially he had deposited with the OP a sum of Rs. 15,000/- in June 2007 , but due to the negligence by the OP, the wrong policy was issued  to him , and the correct policy was issued by the OP in the month of September 2007. It is alleged by the complainant that he is an Ex-serviceman retired from the Army and invested his hard earned money in the policy of op on the assurance of OP that the policy will give him lot of financial benefits. It is further alleged by the complainant that the OP had kept him in dark regarding the maturity amount, even when op asked him to forward all the documents including policy in original vide its  letter dt. 25.06.2012, and arbitrarily transferred the unjustified sum of Rs.1,24,742 /- in his bank account and asked him to give his acceptance  to it as full and final settlement of his claim.

It is alleged by the complainant that he sent legal notice to the Op and called upon him to supply the signed copy of the terms and condition as well as to refund the money deposited with him, but the same was not replied by it.  It is alleged by the complainant that  paying an unjustified amount of Rs. 1,24,000/- against the sum of Rs. 1,50,000/- amounts to unfair trade practice and non providing of policy terms and condition amounts to deficiency in service by op . Hence this complaint.

Complaint has been contested by the OP and written statement has been filed. Para no. 3 ( I, iii, iv) of preliminary submissions are relevant for the disposal of this case and is reproduced as under :-

That the complainant, after going through the key Feature Document and sample illustration of the projected maturity value, submitted the proposal  form bearing no. NUP10818008, dated 10.07.2007 for issuance of an insurance policy namely life sever plus unit linked  policy so as to provide insurance cover as well as investment that
“In unit Linked Plans, the investment risk in the investment portfolio is borne by the policy holder”. Accordingly, on the basis of the proposal from  the Complainant was issued a life saver Policy bearing policy no WSG1669780 by the opposite party commencing from 20.092007, for a sum assured of Rs.1,50,000/- with a half yearly premium of Rs.15,000/- for a premium payment term of 5 years.

That through ‘Right  to Reconsider’ notice the complainant had an option to reconsider his decision to  purchase the policy within 15 days ( freelook period) of receipt of the policy documents in case complainant disagreed with the terms and conditions of said policy. Thus the complainant the an option to cancel the aforesaid policy within 15 days of his receipt of the policy documents in case he was not satisfied with any of its terms. In such circumstances, the policyholder is entitled to entire refund of the premium paid subject to nominal deductions. The said term of freelook  period is also specifically mentioned in the key Feature Document.

It is stated that as per the records of the opposite party, the policy documents were dispatched to the complainant on 21.09.2007 through overnite courier service bearing airway bill no.#547719475 and duly delivered to him on 22.09.2007. Copy of the POD is annexed herewith as Annexure-R6. It is stated that no objection was received from the complainant during the free look period: therefore the terms of the policy are strictly binding upon the Complainant.

Both the parties filed their evidence by way of affidavits. We have heard the arguments advancd at the bar and have perused the records.

It is contended by the Ld counsel for the Op that  policy documents were dispatched to the complainant on 21.09.2007 and were delivered to him on 22.09.2007 , No objection was received from the complainant during the Free Look Period , therefore the terms of the policy are strictly binding upon the complainant .

The Ld counsel for the complainant on the other hand, had argued that the policy term and condition on which op is relying upon was never been supplied to the complainant nor it bears the signature of the complainant hence the same are not binding on the complainant. It is stated by the complainant in his affidavit that that he had signed the proposal form regarding his health condition and other information and the same cannot be undertaken as terms and condition of Insurance Policy by any means. Moreover, the complainant had also sent the legal notice to the op asking it to provide the copy of signed term and condition on which op is relying upon, but the op failed to reply the same.

Now, the question arises as to whether the insurance co. can rely on terms and conditions which were never supplied to the insured. The answer is in the negative. In case titled IV (2014) CPJ 14A ( CL) HAR. Oriental Insurance co. Ltd. Vs. Vivek Rekhan, the claim was filed on the basis of mediclaim policy which was repudiated by the Insurance Company vaguely denied by it without pointing out as to in which manner and on which date terms and condition were supplied to the complainant . Therefore, unless terms and condition have been supplied to the complainant before taking a policy, its clauses cannot be enforced. 

 In view of the above, we are of the considered opinion that the terms and condition on which op is  justifying the deduction does not help it. The complainant had not mentioned in his complaint as to  how much premium he had paid, and in what manner, he had simply mention in his complaint that he paid a total sum of Rs. 150,000/- to the op and the same was also admitted by the op in its written statement, It is prayed by the complainant that the amount deposited with op should be refunded to him along with due interest, compensation and litigation expenses .

Keeping in view the discussion made  above, we are of the opinion that the deductions made  by the op was arbitrary , we therefore, hold op liable for unfair trade practice and direct it as under :-

Refund to the complainant a sum of Rs. 25,258 ( Rs.1,50,000 – Rs.1,24,742 ) and pay to the complainant a sum of Rs. 25,000/- on account of mental agony suffered by him , it will also include cost of litigation.

The order shall be complied with within 30 days of the receipt of the copy of the order. If the said amount is not paid by the OPs within a period of one month from the date of receipt of this order, the same shall be recovered by the complainant along with simple interest at the rate of 10% per annum from the date of this order till recovery of the said amount of Rs. 50,258/–. This final order be sent to server (www.confonet.nic.in ). A copy each of this order each be sent to both parties free of cost by post.

Pronounced in open Forum on ........................

 

                                                                                (S K SARVARIA)

                                                                                    PRESIDENT

 

 

 

                                                          (H M VYAS)                               (NIPUR CHANDANA)

                                                                MEMBER                                            MEMBER