Consumer Complaint No. 102 of 2016
Date of filing: 06.6.2016 Date of disposal: 03.03.2017
Complainant: Sk. Korban Ali, S/o. Sk. Rahaman, resident of Village & Post Office: Amila Bazar, Police Station: Khandaghosh, District: Burdwan, PIN – 713 423.
-V E R S U S-
Opposite Party: 1. PNB Met Life India Insurance Company Limited (Formerly known as Met Life India Insurance Co. Ltd.), having its office at PNB, B. C. Road, PO., PS. & Dist: Burdwan, PIN – 713 101, represented by its Sales Manager.
2. PNB Met Life India Insurance Company Limited (Formerly known as Met Life India Insurance Co. Ltd.), having its Registered Office at Brigade Seshamahal 5, Vani Vilas Road, Basavanagudi, Bangalore, PIN – 560 004, Karnataka, represented by its Chairman/Managing Director.
3. PNB Met Life India Insurance Company Limited (Formerly known as Met Life India Insurance Co. Ltd.), having its Branch Office at 4th Floor, P. C. Chatterjee Market, Rambandhutala, 74 (192) G. T. Road, PS: Asansol (South), District: Burdwan, PIN – 713 303, represented by its Branch Manager.
4. Punjab National Bank (PNB), situated at B. C. Road, PO., PS. & District: Burdwan, PIN – 713 101, represented by its Branch Manager.
Present: Hon’ble President: Sri Asoke Kumar Mandal.
Hon’ble Member: Smt. Silpi Majumder.
Appeared for the Complainant: Ld. Advocate, Debdas Rudra.
Appeared for the Opposite Party No. 1&2: Ld. Advocate, Kanchan Kumar Banerjee (ex parte).
Appeared for the Opposite Party No. 3: Ld. Advocate, Kanchan Kumar Banerjee.
Appeared for the Opposite Party No. 4: None.
J U D G E M E N T
This complaint is filed by the Complainant u/S. 12 of the Consumer Protection Act, 1986 alleging deficiency in service, as well as, unfair trade practice against the OPs as the OPs did not refund him the amount as paid by him towards premium in respect of the questioned policy till filing of this complaint.
The brief fact of the case of the Complainant is that he being a businessman used to maintain a good relation with the OP-4 regarding transaction of money. The OP-1 has signed a corporate agency relationship with the OP-4 and used to provide life insurance solutions to the customers via Bank. On 10.07.2015 the Complainant went to the office of the OP-4 regarding monetary transaction in his account. At that point of time he was offered by the OP-1 for opening a life insurance policy. The Sales Manager Mr. Sanjay Kumar Tewari requested the Complainant to open a life insurance policy for the period of 5 years and the premium amount is of Rs.2, 58,750=00 which is to be paid twice in a year by the intending insured. The OP-1 also told the Complainant that after 5 years the maturity amount will be double against total deposited amount. The OP-1 assured the Complainant that the original policy bond will be delivered to him within one month from the date of receipt of the first premium amount. When the Complainant could not decide what to do, then the OP-1 told the Complainant that upon receipt of the original policy bond if the Complainant has any objection in connection with the terms and the conditions of the policy, then the Complainant may request for cancellation of the policy by submitting a written cancellation request to them within 15 days from the date of receipt of the original policy bond i.e. within the free-look period and upon successful processing of the cancellation request from the side of the Complainant the OP-1 will refund the premium amount to the intending insured. As per request of the OP-1 the Complainant obtained one policy bearing no-21626985 and paid the first premium amount of Rs.2, 58,750=00 from his account. The OP-1 told him that the original policy bond will be delivered to him within one month i.e. on or within 12.08.2015. Thereafter a period for one month has already been lapsed, but the Complainant could not get the original policy bond and for this reason he went to the office of the OP-1 requesting to supply the original policy bond to him as early as possible. The OP-1 assured him that he would get delivery of the original policy bond and also told him that the OP-2 has already issued the original policy bond in his favour and it is now on transit. Thereafter a long period has already been elapsed and inspite of several requests by the Complainant to the OP-1 the Complainant could not get the original policy bond till January, 2016. Each and every time the OP-1 has been avoiding their liability taking plea one after another. In the month of February, 2016 the OP-1 told the Complainant to pay second premium amount of Rs.2, 58,750=00 in respect of the said policy. The Complainant told the OP-1 that until and unless the Complainant would get the original policy bond, he would not pay the second premium amount in respect of the policy. The Complainant was requested by the OP-1 to pay the next premium and assurance was given that after making payment of the second premium he would get the original policy bond within a week. Finally the Complainant received the original policy bond on 22.03.2016 from the OP-4. The Branch Manager of the OP-4 delivered the original policy bond bearing policy no- 21626985 to the Complainant on 22.03.2016. The Branch Manager of the OP-4 told the Complainant for issuing a receipt copy of the said original policy bond on the photocopy of his voter identity card and as per the said instruction the Complainant issued the same by putting his signature on 22.03.2016 and the OP-4 also put its seal and signature on the said receipt copy of the original policy bond. Therefore, it is crystal clear from the policy document that the OP-4 delivered the original policy bond to the Complainant on 22.03.2016. Upon receipt of the original policy bond the Complainant carefully perused the entire terms and conditions of the said policy and it was revealed to him that the terms and the conditions of the policy are totally different as was reflected in the original policy bond and also from the statement and assurance made by the OP-1 before taking out the policy. Then the Complainant without making any delay rushed to the OP-1 and intimated the fact, but the OP-1 did not pay any heed to the request of the Complainant. Being aggrieved and dissatisfied with the service as well as conduct of the OP-1 the Complainant decided to cancel the said policy within free-look period as per the terms and the conditions of the policy and as per the guidelines of IRDA. The Complainant went to the office of the OP-3 on 01.04.2016 and submitted a written cancellation request, to cancel the said policy and to refund the entire premium amount of Rs.2, 58,750=00 to him as early as possible. Upon receipt of the written cancellation request the OP-3 told the Complainant to submit the original policy bond along with the requesting letter and as per direction of the OP-3 the Complainant complied with the same on 01.04.2016 before the OP-3. Upon receipt of the cancellation letter along with the original policy bond the OP-3 thoroughly checked the same through its official system and after being assured regarding the free look period received the requesting letter along with the original policy bond and issued an acknowledgement slip on 01.04.2016 in favour of the Complainant. The OP-3 assured the Complainant that upon successful processing of his cancellation request the OPs will refund the premium amount of Rs.2, 58,750=00 to him as early as possible. After submitting the cancellation letter along with original policy bond before the OP-3 the OP-1 had sent the message in the mobile no-9932411770 of the Complainant stating that ‘your free look request for policy no-21626985 has been received. Request will get processed subject to validation of documents within 10 days.’ But very surprisingly the Complainant received another message from the OP-1 on 09.04.2016 wherein it was stated that ‘you free look refund request for policy no- 21626985 has been rejected. Preference ID 32587744.’ Upon receipt of the said message in his mobile the Complainant came to know that his free look refund request for the above-mentioned policy has been rejected by the OPs without explaining any reason, which is nothing but deficiency in service as well as unfair trade practice on the part of the OPs. The OPs have illegally, arbitrarily and with ill motive rejected the free-look refund request of him on 09.04.2016. Thereafter the OP-1 had sent the letter dated 08.04.2016 along with the original policy bond to the Complainant stating that the OPs were unable to process the request of the Complainant due to the following reasons:-“the request has been received outside free look period of 15 days.” The Complainant received the said letter along with the original policy bond in the last week of May, 2016. Therefore the actual fact is that the Complainant received the original policy bond on 22.03.2016 and as per the terms and condition of the policy the Complainant went to the office of the OP-3 on 01.04.2016 and submitted the written cancellation request of the policy. Therefore, it is very much clear that the Complainant applied for cancellation of the policy before the OP-3 within the free look period, but the OPs knowing fully well illegally and arbitrarily rejected the free-look cancellation request of the Complainant which is a glaring example of deficiency in service and unfair trade practice on behalf of the OPs and such kind of activities of the OPs cannot be tolerated at all as there is a question mark upon the credibility and reliability of the OPs as per their commitment to the public. As the grievance of the Complainant had not been redressed by the OPs hence, having no alternative the Complainant has approached before this Ld. Forum by filing this complaint praying for direction upon the OPs to make refund of Rs.2, 58,750=00 to him as paid by him in respect of the policy towards premium, to pay a sum of Rs.7,00,000=00 as compensation due to mental pain agony and harassment and litigation cost of Rs.30,000=00 to him.
The petition of complaint has been contested by the OP-3 by filing written version contending that the averments as made out in the complaint are vague, baseless and with malafide intent. The Complainant does not fall within the definition of a consumer dispute under the Consumer Protection Act as there is neither any unfair trade practice adopted by this OP nor any deficiency in service hence, the averments made in the petition of complaint are false, frivolous and misconceived one and for this reason the complaint is liable to be dismissed. It is stated by the OP-3 that the Complainant had voluntarily applied for the policy for the purpose of investment and insurance after fully knowing well about the terms and conditions of the policy as per the clause no 6(2) of the IRDA Regulation, 2002 ‘while acting under Regulation 6(1) in forwarding the policy of the insured, the insurer shall inform by letter forwarding the policy that he has a period of 15 days from the date of receipt of the policy document to review the terms and conditions of the policy and where the insured disagrees to any of those terms and conditions, he has the option to return the policy stating reasons for his objections when he shall be entitled to refund of the premium paid subject to deduction of a proportionate risk premium for the period on cover and the expenses incurred by the insurer on medical examination of the proposer and stamp duty charges.’ The similar free-look provision has been incorporated by this OP in the Clause (1) of the terms and conditions of the MetLife Endowment Savings Plan as taken by the Complainant which clearly states that, ‘if you have any objection to the terms and conditions of this policy, you may cancel the policy by giving a signed written notice to us within 15 days from the date of receiving this policy stating the reasons for your objection and you will be entitled to a refund of the regular premium paid subject to deduction of proportionate risk premium for the period of cover in addition to the expenses incurred on medical examination (if any) and the stamp duty charges.’ The policy was issued on 30.07.2015 and thereafter the policy documents were dispatched to the Complainant on 02.08.2015 through speed consignment note no- EA776738118IN and was duly delivered on 10.08.2015. However, the Complainant despite receipt of the policy documents did not raise any objection/complaints during the free-look period and hence it was presumed that the contract of insurance which we had with the Complainant was legally concluded. It is submitted by the OP-3 that the Complainant knowing fully well the terms and the conditions of the product i.e. MetLife Endowment Savings Plan had voluntarily applied for a policy submitting a filled up proposal form on 13.07.2015. The Complainant offered a sum of Rs.2, 58,750=00 towards premium (half-yearly) under the said plan for a proposed sum assured amounting to Rs.51, 85,000=00. The Complainant has also signed the benefit illustration form for the above-mentioned policy and therefore he was well aware of all the terms and conditions pertaining to the given policy. Upon receipt of the duly filled up proposal form along with the initial premium against the application, the OP-1 evaluated and processed the proposal form on the basis of the information provided by the Complainant and issued the policy on 30.07.2015 to the Complainant and as per the terms and the conditions of the policy the Complainant was under obligation to pay premium twice in a year for the period of 10 years. Entire terms and condition were sent to the Complainant along with the original policy document on 02.08.2015 through speed post which the Complainant received on 10.08.2015. As the Complainant inspite of receipt did not raise any objection during the free-look period hence, according to this OP the contract for insurance with the insured was concluded. Thereafter the Complainant requested to issue duplicate policy document and accordingly the same was also dispatched on 09.03.2016, which he received on 13.03.2016. By issuing a letter dated 01.04.2016 the Complainant requested for cancellation of the policy under the free-look provision of 15 days but this OP by issuing a letter dated 08.04.2016 informed the Complainant that the request for free-look cancellation could not be processed as the request was made beyond the free-look period of 15 days as envisaged under Clause of 6 (1) of policy document. Therefore, the application or request was not entertained by this OP and such cancelation of the request cannot be termed as deficiency in service because in view of the terms and the conditions of the policy the OP-3 had acted the same. According to the OP-3 as the contract of insurance based on utmost good faith and the OP has performed its part complying with the same and provided due service to the Complainant hence, the allegation as made out by the Complainant cannot be entertained at all and the prayer as sought for is liable to be dismissed. The OP-3 has relied on some judgments passed by the Hon’ble Supreme Court and Hon’ble NCDRC. Prayer is made by the OP-3 for rejection of the complaint.
After admission of this complaint notices were sent to the OPs by this Ld. Forum through speed post with A/D. On 08.07.2016 the track report revealed that the notices upon the OP-1, 2 & 4 were duly served but none was present on behalf of the said OPs. An un-served envelope in respect of the OP-3 was returned as ‘left without address’. Therefore, the Complainant by filing one Misc. Application had prayed for amendment in the address of the OP-3 and the same was allowed by this Ld. Forum. After amendment notice was issued upon the OP-3 and on 10.08.2016 it was observed by this Ld. Forum that the complaint will run ex parte against the OP-1, 2 & 4 because those OPs inspite of receipt of notices choose not to turn up to contest the complaint either personally or though their Ld. Advocates. From the Order no-9 dated 21.10.2016 it is evident to us that the OP-3 received the notice on 17.09.2016 and on that date one petition was filed on behalf of the OP-1, 2 & 3 for setting aside the ex parte hearing order passed against these OPs, but on repeated calls the petition was not moved. On that date on behalf of OP-1,2 & 3 written version supported by affidavit was filed but as this complaint was fixed earlier for ex parte against the OP-1, 2 & 4, hence having no review power we were not inclined to set aside the earlier order passed by us in this complaint, therefore the written version was accepted filed on behalf on behalf of the OP-1,2&3 as the written version of the OP-3 only, but not on behalf of the OP-1 & 2. On that date evidence on affidavit were also filed on behalf of the OP-1, 2 & 3 along with a photocopy of the same but as the OP-1 & 2 missed the chance for filing their written version within the statutory period as per the C.P. Act, hence the evidence filed by the OP-1 & 2 could not be entertained and be kept in the record. We were also inclined to treat the said evidence as the evidence of the OP-3 only, not the evidence of the OP-1 & 2. As the copy of the evidence was not served upon the other side, the OP-3 was directed to serve the same on the next date positively. On the next date i.e. 21.11.2016 we have noticed that as the copy of the evidence was duly been received by the complainant, the evidence filed by the Op-3 was accepted. Scope was given to the Complainant to challenge the evidence of the OP-3 by putting questionnaire, but the Complainant as well as the OP-3 by filing separate petitions has stated that they are not willing to cross-examine each other and hence, this record was fixed for argument.
The Complainant has adduced evidence on affidavit along with several documents in support of his contention. The OP- 1, 2 & 3 have filed written notes of argument with a copy to the Complainant.
We have carefully perused the record; documents filed by the contesting parties, WNA filed by the OP-1, 2 & 3 and heard argument at length advanced by the parties. It is seen by us that admittedly the Complainant purchased one MetLife Endowment Saving Plan (insurance policy) from the OP-1, the premium was scheduled for Rs.2, 58,750=00 (twice in a year), assurance was given by the Insurance Company that the insured will get double amount of the deposited premium amount after maturity of the policy, assurance was given that the original policy bond will be delivered to the insured within one month from the date of purchase of the policy i.e. on or within 12.08.2015, the Complainant paid the first premium on 10.07.2015, in the terms and conditions of the policy there is mentioned that the Complainant will be at liberty to cancel the policy within free-look period i.e. within 15 days from the date of receipt of the original policy bond stating reasons, the Complainant received the policy bond on 22.03.2016, being dissatisfied with the terms and conditions with the said policy the Complainant made an application requesting for cancellation of the policy on 01.04.2016, the said prayer for cancellation of the policy was processed by the OP-3, the OPs by issuing a letter dated 08.04.2016 intimated the Complainant that they are unable to cancel the same as the Complainant had failed to make application praying for cancellation of the policy within free-look period i.e. within 15 days from the date of receipt of the original policy bond, at the time of making prayer for cancellation of the policy the Complainant prayed for refund of the premium amount paid by him to the tune of Rs.2,58,750=00. The allegation of the Complainant is that though the prayer for cancellation was made by him within the free-look period in view of the specified terms and conditions of the policy, but till filing of this complaint no step has been taken by the OPs for refund of the premium amount, rather the OPs have illegally and arbitrarily rejected the prayer for cancellation of the policy made by the Complainant. The rebuttal case of the OP-3 is that the Complainant has violated the clause (1) of the terms and conditions of the policy because he had miserably failed to make a written notice to the OPs for cancellation of the policy within 15 days from the date of receipt of the policy stating the reason, hence the Complainant is not at all entitled to refund the premium amount paid by him. It is stated t by the OP-3 that policy was issued on 30.07.2015, policy document dispatched on 02.08.2015 to the Complainant through speed post, the same was duly received by the Complainant on 10.08.2015 and the Complainant submitted the written prayer for cancellation of the policy on 01.04.2016 i.e. not within the free-look period from the date of receipt of original policy bond by him. According to the OP-3 due to such violation of the terms of the policy the Complainant he is not entitled to get any relief through this complaint as sought for.
At the very outset it is pertinent to mention that we have noticed that though the OP-3 has placed its reliance on several judgments passed by the Hon’ble Supreme Court as well as the Hon’ble NCDRC, but as the copy of those judgments has not been filed by the OP-3, hence, we do not get any opportunity to go through the same for coming to a conclusion based on those judgments. The Complainant has filed several documents in support of his contention. We have noticed from the averment of the complainant as mentioned in the paragraph no- 6 of the petition of complaint that he was told by the OP-4 to issue a receipt copy of the said original policy bond of his photocopy of voter identity card and as per instruction of the OP-4 the Complainant issued a receipt copy of the original policy bond bearing the policy no-21626985 on the photo copy of his voter identity card and put his signature on 22.03.2016 and the Branch Manager of the OP-4 also put his seal and signature on the receipt copy of the original policy bond. The OP-4 handed over a photo copy of the said receipt dated 22.03.2016 to the Complainant. We have noticed that the Annexure-C of the petition of complaint corroborates the abovementioned averment of the Complainant. Therefore the document shows that the Complainant received the original policy bond on 22.03.2016. Though the OP-3 has claimed that the Complainant received the original policy bond on 10.08.2015, but no cogent and convincing document is adduced by the OP-3 in support of such claim, so the averment of the OP-3 does not stand at all. It is stated by the Complainant that upon receipt of the original policy bond the Complainant being aggrieved and dissatisfied with the terms and conditions of the policy decided to cancel the said policy within the free look period as per the terms and submitted written cancellation request praying to cancel the said policy and refund the premium amount of Rs.2,58,750=00 as paid by him. The OP-3 has mentioned in this regard that as the prayer for cancellation was made by the Complainant beyond the free look period; hence his application was rejected stating the reason. In this respect we are to say that the page-9 of the annexure-B (copy of the subject policy) as filed by the Complainant shows that there exits the clause for Free Look Period, wherein it is mentioned that ‘if you have any objections to the terms and conditions of this policy, you may cancel the policy by giving a signed written notice to us within 15 days from the date of receiving this policy stating the reasons for your objection and you will be entitled to a refund of the regular premiums paid subject to a deduction of proportionate risk premium for the period of cover in addition to the expenses incurred on medical examination (if any) and the stamp duty charges.’ It is necessary to mention herein that no expenses was incurred towards the medical examination of the intending insured, as this is not a life insurance policy, hence question for deduction on the said account does not arise at all. The annexure-D filed by the Complainant shows that the Complainant made written cancellation request to cancel the policy before the OP-3 on 01.04.2016 and upon receipt of the said prayer along with required document the OP-3 had acknowledged a receipt in favour of the Complainant. So it is crystal clear that the Complainant received the original policy bond on 22.03.2016 and prayed for cancellation of the policy on 01.04.2016, i.e. within 10 days from the date of receipt of the original policy bond the Complainant submitted the written request for cancellation of the policy before the OP-3 in view of the specific clause as mentioned in the terms of the policy under the heading ‘Free look period’. The Complainant was under obligation to make written request to cancel the policy within 15 days from the date of receipt of policy document, but in the instant complaint the Complainant did the same within 10 days, so there is no violation of the terms and conditions of the policy by the Complainant. Therefore the cause for rejection of the prayer of the Complainant alleging that he has violated the said term of the policy as assigned by the OPs is vague, illegal and without any basis, rather the OPs have violated their own terms and conditions by rejecting the written request of the Complainant, which according to us not a glaring example of deficiency in service, but also denotes an unfair trade practice of the OPs and for this reason the Complainant is entitled to get compensation from the OPs. In our view the Complainant is entitled to get refund of the premium amount of Rs.2,58,750=00 as paid by him during taking out the policy. Admittedly as the grievance of the Complainant had not been redressed by the OPs before coming to this Ld. Forum and by filing this complaint the Complainant had to incur some expenses, in our considered view he is also entitled to get some amount as litigation cost.
Going by the foregoing discussion hence, it is
O r d e r e d
that the complaint is allowed on contest with cost against the OP-3 and allowed ex parte against the OP nos-1 and 2 and dismissed ex parte without any cost against the OP-4. The OP-1, 2 & 3 are directed either jointly or severally to refund the premium amount to the tune of Rs.2,58,750=00 to the Complainant along with interest @ 6% p.a. for the period from 01.04.2016 till realization of the entire amount within 45 days from the date of passing of this judgment, in default, the decreetal amount (principal + interest) shall carry penal interest @9% p.a. for the default period. The OP 1, 2 and 3 are further directed either jointly or severally to pay compensation for Rs.3,000=00 due to unnecessary harassment, mental agony and pain and litigation cost of Rs.1,000=00 to the Complainant within 45 days from the date of passing of this judgment, in default, the Complainant will be at liberty to put the entire order in to execution as per provision of law.
Let plain copies of this order be supplied to the parties free of cost as per provisions of Consumer Protection Regulations, 2005.
(Asoke Kumar Mandal)
Dictated and corrected by me. President
DCDRF, Burdwan
(Silpi Majumder)
Member
DCDRF, Burdwan
(Silpi Majumder)
Member
DCDRF, Burdwan
