Chandigarh

StateCommission

A/347/2018

Aegon Life Insurance Company Limited - Complainant(s)

Versus

Narain Singh Chauhan S/o Late Kali Dass Chauhan - Opp.Party(s)

Jaswinder Singh Mann Adv.

23 Jul 2019

ORDER

 STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

 

 

Appeal No.	:	347 of 2018
Date of Institution	:	30.11.2018
Date of Decision	:	23.07.2019

 

Aegon Life Insurance Company Limited, Registered Office: Building No.3, Third Floor, Unit No.1, NESCO IT Park, Western Express Highway Goregaon (E), Mumbai 400063, Branch Office: 2^nd Floor, SCO 407, Sector 35C, Chandigarh 160035.

…..Appellant/Opposite Party.

Versus

 

Narain Singh Chauhan S/o Late Kali Dass Chauhan, Resident of House No.94, Ward 3, Solan Bye Pass, Opposite D.A.V. School, Katherh, Solan.

...Respondent/Complainant.

 

Appeal under Section 15 of the Consumer Protection Act, 1986  against  order  dated  19.07.2018 passed by District   Consumer Disputes Redressal Forum-I, U.T. Chandigarh  in Consumer Complaint No.39 of 2016.

 

BEFORE: JUSTICE JASBIR SINGH (RETD.), PRESIDENT.

                MRS. PADMA PANDEY, PRESIDING MEMBER.

                MR. RAJESH K. ARYA, MEMBER.

 

Argued by:

 

Sh. J. S. Mann, Advocate for the appellant.

Sh. Rajesh Sabharwal & Sh. Mandeep Kumar, Advocates for the respondent.

 

PER  RAJESH  K.  ARYA, MEMBER

                By filing this appeal, the appellant/opposite parties have laid challenge to order dated 19.07.2018 passed by District Consumer Disputes Redressal Forum-I, U.T., Chandigarh (in short ‘the Forum’) vide which, consumer complaint bearing No.39 of 2016 filed by the respondent/complainant was partly allowed by the Forum in the following manner:-

“12.   In the light of above observations, we are of the concerted view that the Opposite Parties are found deficient in giving proper service to the complainant. Hence, the present complaint of the Complainant deserves to succeed against the Opposite Parties, and the same is partly allowed, qua them. The Opposite Parties are directed to:-

[a]    To refund the premium amount of Rs.1,06,545/-      (Policy No.100912320969), Rs.45,540/- (Policy No.   101212908683) and Rs.6,03,058/- (Policy No.      110413104680) to the Complainant (minus) the          mandatory deductions applicable to the free look           period, alone;

[b]    To pay Rs.25,000/-on account of deficiency in service and causing mental and physical     harassment to the Complainant; 

[c]    To pay Rs.11,000/- as cost of litigation;  

13.        The above said order shall be complied within 30 days of its receipt by the Opposite Parties; thereafter, Opposite Parties shall be liable for an interest @12% per annum on the amounts mentioned in sub-para [a] & [b] above, apart from cost of litigation as mentioned in sub-para [c] above, from the date of institution of this complaint, till it is paid.” 

2.             The factual matrix of the case as given by the Forum in its judgment has not been disputed by the parties.

3.             The contention raised by the appellant/opposite parties in this appeal is that the respondent/complainant in his complaint nowhere averred that he did not receive the policies in question whereas the Forum has wrongly assumed that the same were not delivered to him, therefore, the respondent/complainant could not exercise the free look option. It was next argued that the insurance contract is governed by terms and conditions of the policy documents and thus, the respondent/complainant was well aware and it was within his knowledge that the terms of the policies is 16 years and premium payment term was 10 years. It was next argued that in case, the respondent/complainant was not satisfied with the terms and conditions of the policies, he could have used the free look option within 15 days of receipt of policy documents and could have got the policies cancelled. Based on above arguments, it was prayed that the appeal be accepted and the impugned order passed by Forum be set aside.

4.             On the other hand, the case of the respondent/ complainant is that the policies, in question, were sold to him by the agent of the appellant/ opposite parties by misrepresenting that the same would get matured after three years. However, later on, it was learnt that the polices issued were for the term of 16 years and premium payment term was 10 years, as a result whereof, the complainant could not opt for free look period. As the respondent/complainant was not in a position to pay premium for a long time, he requested for cancellation of policies, in question, which, the appellant/ opposite parties declined.

5.             After hearing the Counsel for the parties and having gone through the record of the case and the impugned order, we are of the considered opinion, the Forum has rightly come to the conclusion that in the absence of any cogent proof to prove that the policies, in question, were delivered to the respondent/complainant, he could not opt for the free look period of 15 days. Otherwise also, it also rightly held that had the agent of the appellant/ opposite parties not misrepresented as regards the terms and conditions of the policies qua three yeas lock-in-period, then there was no need for the respondent/complainant to approach the appellant/ opposite parties before expiry of three years lock-in-period. The letters dated 15.02.2012 and 11.06.2013 written by the respondent/complainant did not ring up in the ears of the appellant/ opposite parties. We endorse the view held by the Forum that as the respondent/complainant was not aware about the terms and conditions of the policy, the same could not be made applicable to his detriment.

6.             The Forum cited the judgment of Hon’ble National Consumer Disputes Redressal Commission, New Delhi in the case of “Oriental Insurance Company Vs. Charan Dass” (Revision Petition No. 1324 of 2012), decided on 01.08.2012, where it was held that the onus to prove the delivery of the policy document lay at the door of the insurance company.

7.             Not only above, the Forum in Para 10 of its order also rightly observed that the mandatory IRDA Guidelines with regard to the policies in which the premium amount exceeds Rs.50,000/- actually attracts the KYC (Know Your Customer) and AML (Anti Money Laundering) provisions, which make it mandatory for the appellant/Opposite Parties to ensure that the premium paying capacity of the insured or proposer is looked into and confirmed from the proof given to them as is applicable to a different individual.

8.               In our considered opinion, and as rightly held by the Forum, the appellant/opposite parties did not lead any such proof on record qua the age of the respondent/complainant, his actual address, his income proof and his identity proof. The fault itself laid with the appellant/opposite parties, for which, the respondent/ complainant could not be made to suffer. The appellant/opposite parties were required to look into previous three years income tax returns of the respondent/complainant in order to ascertain his paying capacity, which it did not do. The appellant/opposite parties did not adhere to IRDA guidelines, which amounted to deficiency in service.

9.               For the reasons recorded above, we concur with the findings given by the Forum in its judgment and are in agreement that the respondent/complainant was not made aware about the terms & conditions of the policies as a result whereof he could not exercise his option of free look period. Thus, the Forum rightly directed the appellant/opposite parties to refund the premium amount besides payment of compensation on account of deficiency in service & causing mental and physical harassment to the respondent/complainant and cost of litigation.

10.           Hence, we are of the opinion that the order passed by the Forum, being based on the correct appreciation of evidence and law, on the point, does not suffer from any illegality or perversity.      

11.           For the reasons recorded above, the appeal filed by the appellant/opposite parties is dismissed being devoid of merit with no order as to costs. The impugned order dated 19.07.2018 passed by District Forum-I, U.T., Chandigarh in Consumer Complaint bearing no.39 of 2016 is upheld.

12.           Certified copies of this order, be sent to the parties, free of charge.

13.           The file be consigned to Record Room, after completion.

Pronounced.

23.07.2019.

[JUSTICE JASBIR SINGH (RETD.)]

PRESIDENT

 

 

(PADMA PANDEY)

        MEMBER

 

 

(RAJESH  K. ARYA)

MEMBER

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