Delhi

New Delhi

CC/206/2015

Rajpal Singh Jaykiya - Complainant(s)

Versus

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

21 May 2019

ORDER

 

                                            CONSUMER DISPUTES REDRESSAL FORUM-VI(DISTT. NEW DELHI),

‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN,

I.P.ESTATE, NEW DELHI-110002.

 

Case No.CC.206/2015                                                                   Dated:

In the matter of:

Rajpal Singh Jaykiya,

S/o Ram Singh Jaykiya,

R/o 11/38, Trilokpuri,

Delhi-91.                                

   ..COMPLAINANT

VERSUS

 

DHFL Pramerica Life Insurance Co. LTD.,

DLF Centre, Sandad Marg,

New Delhi-110001.

 

Also at:

 

DHFL Pramerica Life Insurance Co. LTD.,

Tower-B, Cyber City, DLF City,

Ph.3, Gurgaon, Haryana

...OPPOSITE PARTY.

NIPUR CHANDNA, MEMBER

 

O R D E R

 

 

The complainant has filed the present complaint against the OP under section 12 of Consumer Protection Act, 1986. The facts as alleged in the complaint are that Sh. Sanjay Kaushik, representative of OP Co. came to the house of the complainant and collected four cheques of amounts of Rs.1,00,000/- each and made applications for the allotment of the flats and all the said cheques were credited in the account of Co. of OP.  The official of OP gave the assurance to the complainant that they would hand over the flats within six months.  After expiry of six months, when the complainant asked the status of flats then they pretended that they are having some disputes and they would allot the flat to him.  Thereafter,  OP issued two life insurance policies in the name of complainant and two life policies in the name of his son Sh. Dharmender Kumar and sent the same to the complainant through post.  The complainant is almost illiterate person and having no knowledge of English language  and all the policies’ papers were in English language therefore he could not understand the same.  The complainant when enquired from some friends he found that OP was befooling the complainant and fraud in the name of flat.  The policies were issued which shall mature 18 years. 

 

2.     On 10.09.2014, the complainant went to the office of OP at Gurgaon office and gave written complaint and thereafter the OP has sent reply  of the written complaint.  The complainant also made a written complaint to the ACP and SHO, P.S., Kalyanpur, Delhi  but they have not taken any action in this regard, hence this complaint.

 

3.     Complaint was contested by the OP.  It has filed its written statement, wherein it denied any deficiency in services on its part and stated that the policy terms and conditions specifically provides for a Free Look Period of 15 days.  During this 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.  All the four  policies documents were delivered to the complainant between  3.7.2012 to 24.7.2012 and the same was duly received by him.  The complainant failed to approach OP for conversion/cancellation for refund of the policy during free-looking period, it was presumed that the contract was legally concluded between the parties.  The OP had acted with utmost care and diligence and as such the complainant is not entitled for any relief prayed.

4.     Both the parties have filed their evidences by way of affidavit.

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

6.     Some facts are not disputed by the parties such as the policy documents, receipt of the policy documents.    Admittedly, the complainant received the policy in the year 2012, if he was not satisfied with the policy than he ought to have approached the OP for the cancellation of the same. 

7.     The complainant has failed to place on record any document which shows that he requested the OP to cancel 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.

8.     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.

9.     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.

10.    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.

11.    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.”

12.    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.”

 13.   Having regard to the facts and circumstances of the case, we are of the considered view that since the complainant had deposited a sum of Rs.4,00,000/- as 1^st premium against the four policies in question. Accordingly, he is entitled for refund of the surrender value of the policy in question as parties are bound by the terms and conditions of policy in question, although he failed to exercise his right of cancellation of policy in free look  period.

14.    In view of the above discussion, we direct OP to refund to the complainant surrender value of all the 4 policies in question within 30 days from the receipt of the order. The present complaint is disposed off in above terms.

        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 21/05/2019

 

 

(ARUN KUMAR ARYA)

          PRESIDENT

(NIPUR CHANDNA)                                                  (H M VYAS)

       MEMBER                                                                MEMBER