Sh. Sanjay Kumar, President

1. In brief facts of the present case are that complainant has a bank account vide account no.6582000100038687 with the OP2. The complainant went to her bank i.e OP2 13.04.2017 where she was told and allured to deposit the amount in PNB Metlife i.e OP1 for better benefits. She can earn more interest than the simple deposit in the bank and she can get monthly, quarterly or annually interest income and if in any need she can withdraw her total money after 3 complete years, if needed. She made the signature on the forms which was not duly filled. She also signed to slip for transfer/deposit the amount in PNB Metlife.
2. It is stated that complainant was issued the amount of Rs.26917/- as quarterly basis which was received by the complainant. Complainant as well as taking treatment regularly from various hospitals and doctors and due to the hard luck her son got seriously ill and complainant was in need of money she was refused to withdraw the same. She contacted with Rohit but his reply was very shocking. The meaning of his reply was that if I want to withdraw the total amount I shall have to die.
3. After hearing complainant was shocked and surprised and felt that she was cheated and looted by way of depositing the money in such type of plan/policy which is definitely not caring her and not fulfilling her requirement. Complainant is suffering from her old age diseases, she is facing a lot of pain as her lonely son is sick and patient of mental problems. He cannot survive his wife and is daughter. Further he cannot take treatment due to non fund. Being the mother she cannot see her son to be the patient whole life and she wants to give better treatment so that not only he may fit for his life and for his family but also he can look after the complainant in his old age.
4. It is stated that complainant tried her best to convince the OP1 about her financial as well as her family problems but no one is ready to listen the complainant. She wrote several mail to the OP but no fruitful result. The OP2 with the collusion of OP3 made unfair trade practice and under false, fabricated and allurgent type claims has cheated and looted the complainant and all her hard earned money which was received after her retirement from MCD school, where she was employed as school teacher, with the collusion of OP`1.
5. It is stated that all OPs are indulge in making unfair trade. Further the act and omission on the part of OPs come under deficiency in service as defined in Consumer Protection Act 1986.
6. The complainant is seeking direction to OP to pay/release the amount of Rs.18,00,000/-, to pay interest amount as it is being paid, till the final disposal of the case, to direct OPs to pay compensation amount of Rs.1,50,000/- causing physical pain, mental agony and harassment, to direct the OP to pay litigation cost of Rs.50,000/- being dragged in court for contest the case and any other order in favor of complainant.
7. The WS filed by OP1 PNB Metlife India Insurance Company Ltd. All the allegations made in the complaint are denied by OP1. OP1 had taken preliminary objections and stated that the relief claimed by complainant were refund of premium is against the terms and conditions of the subject policy and applicable regulatory norms. It is stated that it is trite law that the premium is given by a policy holder to cover the risk for a given period and the insurer covers the risk for the period for which premium has been paid. Therefore, there is no question of refund of any premium amount. Therefore, present complaint is liable to be dismissed. The OP referred the case of Life Insurance Corporation of India Vs. Siba Prasad Dash IV (2008) CPJ 156 (NC). It is further stated that in accordance to Clause 6 (2) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations, 2002 every policy document sent by the Insurance company is to be accompanied by a forwarding letter which clearly mentions that in case the policy holder is not satisfied with the features or the terms and conditions of the policy she/he can withdraw/return policy within 15 days from the date of receipt of the policy documents i.e under the “Free Look Period” provision.
8. The OP referred the judgments of Mohan Lal Benal Vs ICICI Prudential Life Insurance Co. Ltd. (R.P No.2870/2012 decidec on 16.10.2012), Harish Kumar Chadha Vs Bajaj Allianz Life Insurance Co. Ltd. (Decided on 07.10.2013, R.P No. 3271/2013) and Shrikant Murlidhar Apte Vs. Life Insurance Corporation of India (R.P No.634/2012, decided on 02.05.2013).
9. It is stated that subject policy, policy document was dispatched on 11.05.2017 through Bluedart courier vide POD no.40978293753 which was duly delivered and never returned undelivered. However complainant had approached OP for the first time on 14.08.2018 with a request to process annuity amount and no objection as to terms and conditions of subject policy. It is further stated that the notice that the life assured retained the policy document for substantial duration after expiry of free look period and did not return the same to insurance company herein for cancellation of policy during the free look period thereby implying that complainant had agreed to all the policy terms and conditions mentioned therein. Therefore, present complaint is liable to be dismissed.
10. It is stated that insurance company acted as per mandate given by complainant in the proposal form and issued the insurance policy and took all decision in conformity of insurance terms and conditions which is concluded contract between the insurance company and the complainant. It is further stated that the insurance terms have to construe strictly and no relief which travels beyond the terms of the insurance policy can be granted, therefore, there is no case for deficiency in services as there is no breach on the part of insurance company. The OP referred to the judgments Export Credit Guarantee Corporation of India Ltd. Vs. Garg Sons International 2013 (1) SCALE 410, Suraj Mal Ram Niwas Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. [(2010) 10 SCC 567], Reliance Life Insurance Co. Ltd. Vs. Madhavacharya (R.P No.211/2009) and United India Insurance Co. Limited Vs. HarchandRai Chand RaiChandanlal I (2003) CPJ 393 & VikramGreentech (I) Ltd. & Anr. Vs. New India Assurance Co. Ltd. II (2009) CPJ 34.
11. It is stated that the onus is on the policy holder to thoroughly read the contents of the proposal form before signing on the same and the policy holder cannot simply place reliance on oral promises and assurances provided by anyone purportedly on behalf of insurance company and insurance company is under no obligation to issue a policy in accordance with such oral promises and assurances. The OP referred to the judgments of KishorChandrakantRathod Vs. The Managing Director, ICICI Prudential Life Insurance Co. Ltd. & Another (Decided by the National Consumer Commission on 21.05.2014 in R.P No.3390/2013, ShrikantMurlidhar Apte Vs. Life Insurance Corporation of India (Decided by the National Consumer Commission on 02.05.2013 in R.P No.634/2012), Prema and Ors. Vs. Life Insurance Corporation of India Ltd. IV (2006) CPJ 239 (NC) and M/S Grasim Industries Ltd. & Anr. Vs. M/S Aggarwal Steel 2010 (1) SC 33.
12. It is stated that on the basis of proposal form the subject policy was issued to complainant and now false frivolous and untenable story concocted by complainant. It is further stated at the time of filling up the proposal form the agent acts as agent of insured and not of insurance company and no agent can be assumed to have authority from the insurer to write the answer in the proposal form. It is stated that if an agent nevertheless does that he becomes merely the amanuensis of the insured and he has knowledge of untruth or inaccuracy of any statement contained in the proposal form does not become the knowledge of the insured.
13. It is stated that if any person signs any documents, it is presumed that he/she has signed the same after reading and understanding it properly. The OP referred to the judgment of Sitaram V Santanu Prasad, AIR 1633 SC 1697 and V.K. SrinivasaSetty V Premier LGI Co. (Mysore HC 1958).
14. It is stated that present complaint has been filed with malafide, dishonest intention and complainant concealed the material facts from the court. It is further stated that complainant has failed to set up a nexus between the damages claimed in the present complaint and damage suffered. The damages claimed are arbitrary without basis and is an abuse of process of law.
15. It is stated that complainant failed to make out a case of “Deficiency of Service” and referred case of Ravneet Singh Bagg V. KLM Royal Dutch Airlines (2000) 1 SCC 66. It is stated that present complaint is liable to be dismissed.
16. It is stated that insurance company was in receipt of duly filed and signed proposal form from the complainant for issuance of insurance policy under MetLife Immediate Annuity plan and complainant had signed declaration in the proposal form wherein she declared that she had provided true and complete information as sought in the proposal form after understanding the terms and conditions of subject policy. Thereby making it evident on the face of it that complainant had duly understood the policy terms and conditions. It is stated that the policy no.22203527, application no.213825048, issuance date 28.04.2017, life assured Raj Bala, risk commencement date 28.04.2017, policy status single pay, premium  payment frequently single pay, product name Metlife Immediate Annuity New and base premium 1800000.
17. It is stated that as per clause 6 (2) & 4 (1) of the Insurance Regulatory and Development Authority (Protection of Policy Holder’s Interests) Regulations 2002, the insurance company had sent policy documents to the communication address mentioned in the proposal form, stating policy terms and conditions and a welcome letter stating the Free look provision alongwith a copy of proposal form. It is further stated that the subject policy document was dispatched on 11.05.2017 through Bluedart courier vide POD no. 40978293753 which was duly delivered and never returned undelivered. Thereby complainant had agreed to the policy and its terms and conditions.
18. It is stated that complainant for the very first time approached the insurance company on 14.08.2018 and submitted existence certificate with a request to process annuity amount under the said policy and the said request was duly accepted by OP1 and an email dated 24.08.2018 was sent to complainant acknowledging the same and apprising her that annuity amount shall be credited shortly.
19. It is stated that complainant again approached the insurance company on 31.08.2018 with request for updating contact details and Permanent Account Number details alongwith change in the name of beneficiary and appointee. The request was duly accepted by the insurance company vide letter dated 03.09.2018 sent to complainant.
20. It is stated that complainant subsequently again approached insurance company on 20.10.2018 through email raising allegations as to misselling of subject policy by agent. It is further stated that on reviewing history of subject policy, request of complainant was rejected by email dated 24.10.2018 wherein it was categorically explained that the subject policy was issued strictly as per the proposal form duly signed and submitted by complainant and she had not raised any objection either during the welcome call made at the time of issuance of subject policy or during the free look period post receipt of the policy.
21. It is stated that complainant again approached insurance company after a lapse of six  month on 20.04.2019 with same complaint of misselling which has been again rejected by the insurance company on 24.04.2019 in view of the policy history which prove beyond any doubt that the complainant had ample opportunity to review subject policy at the time of issuance and get the same cancelled in case of dissatisfaction. However, complainant failed to apply diligence even though she is sufficiently educated.
22. It is stated that insurance company being party to subject contract of insurance is bound by its terms and conditions therefore, decision of the insurance company to reject the request of the complainant is strictly based upon the terms and conditions of the subject policy. It is further stated that complainant has failed to prove under which clause of the subject policy terms and conditions, she is entitled to get refund of premium after duly enjoying the cover for considerable duration of more than one year. Therefore, present complaint is mere abuse of process of law in order to gain undue advantage from the insurance company, therefore, present complaint is liable to be dismissed.
23. On merit all the allegations made are denied and the contents of the preliminary submissions and preliminary objections are reiterated. It is stated that the present complaint is liable to be dismissed.
24. Complainant has not filed rejoinder to the WS of OP.
25. Complainant filed evidence by way of her affidavit. In the affidavit all the contents of the complaint are reiterated. The complainant relied on photocopy of bank account passbook Ex.CW1, photocopy of transfer voucher Ex.CW2, photocopy of bank statement Ex.CW3, photocopy of application form Ex.CW4 (colly), photocopy of policy paper Ex.CW5 (colly), photocopy of email Ex.CW6 (colly), photocopy of treatment paper of complainant Ex.CW7 (colly), photocopy of treatment paper of complainant’s son Ex.CW8 (colly), photocopy of aadhar card and treatment paper of complainant Ex.CW8 and Ex.CW9 (colly).
26. OP1 filed evidence by way of affidavit of Sh. Rajeev Sharma Senior Manager Legal. In the affidavit contents of WS are reiterated. The OP1 relied on copy of policy document Ex.R1, copy of existence certificate and email dated 24.08.2018 Ex.R2, copy of request of complainant and letter dated 03.09.2018 Ex.R3 (colly), copy of email dated 20.10.2018 and 24.10.2018 Ex.R4 (colly), copy of email dated 20.04.2019 and 24.04.2019 Ex.R5 (colly).
27. Written arguments filed on behalf of complainant as well as OP.
28. We have heard Sh. M.K Gill counsel for complainant and Sh. Bhavya Manchanda counsel for OP and perused the record.
29. The pleadings of the parties and documents filed on record establish that complainant signed and filled up proposal form for issuance of insurance policy under Metlife Immediate Annuity Plan. The complainant also signed declaration in the proposal form wherein she declared that she had provided true and complete information and understood the terms and conditions of subject policy. The OP1 Insurance company accepted the proposal and issued the policy. The policy was dispatched on 11.05.2017 through Bluedart courier vide POD no.40978293753 which was duly received by the complainant. The complainant for the first time approached the insurance company on 14.08.2018 and submitted existence certificate Ex.R2, thereafter, complainant again approached insurance company on 31.08.2018 for updating contact details and Permanent Account Number alongwith change of name of beneficiary and appointee vide letter dated 03.09.2018 Ex.R3. The complainant prior to 20.10.2018 never alleged that she was allured and apprised of getting mere benefits such as quarterly or annually interest and she can withdraw her total money after three years. She accepted the amount of Rs.26,917/- issued quarterly basis. The law is well settled by the Supreme Court in the case of Grasim Industries Ltd. Vs Aggarwal Steel (2010) 1 SCC 83. The Supreme court held that “when a person signed a document, there is a presumption unless there is proof of force or fraud that he had read the documents properly and understood it and only than he had affixed his signatures issued on otherwise no signature on a document can ever be accepted.
30. In the present case complainant has a retired teacher. It is expected that she must have gone through the proposal form and understood all the terms and conditions of the proposed policy and only thereafter she must have signed the documents. It is pertinent to mention here that since from the date of issuance of policy i.e 02.05.2017 till October 2018 she did not alleged any allegation against the insurance company or bank or the agent.
31. In the complaint also she has not pleaded a misrepresentation or fraud played upon her. However, it might by possible that she now requires the money for medical treatment but that would not constitute any misrepresentation or fraud by the insurance company or agent at the time of submitting the proposal form, issuance of policy. Therefore, complainant failed to establish a case of misselling of insurance policy.
32. It is pertinent to mention here that the complainant received the policy on 11.05.2017 thereafter she made correspondence as discussed in above till September 2018. As per terms and conditions of the policy and clause 6 (2) and 4 (1) of IRDA Regulations 2002 if policy holder is not satisfied with the features or the terms and conditions of the policy then within 15 days from the receipt of policy document that is called “free look period” can withdraw or return the policy.
33. In the present case complainant did not raise any objection after receiving the policy documents within the free look period rather she made request for change of address and appointee and nominee. These circumstances establish that complainant had agreed to all the policy terms and conditions therefore, in the present case there is no deficiency of service or breach of any term of condition as on the part of insurance company. Reliance can be placed on judgments referred by OP, Export Credit Guarantee Corporation of India Ltd. Vs. Garg Sons International 2013 (1) SCALE 410, Suraj Mal Ram Niwas Oil Mills (P) Ltd. Vs. United India Insurance Co. Ltd. [(2010) 10 SCC 567], Reliance Life Insurance Co. Ltd. Vs. Madhavacharya (R.P No.211/2009) and United India Insurance Co. Limited Vs. HarchandRai Chand RaiChandanlal I (2003) CPJ 393 & VikramGreentech (I) Ltd. & Anr. Vs. New India Assurance Co. Ltd. II (2009) CPJ 34.
34. On the basis of above observation and discussion present complaint is devoid of merit, therefore, dismissed. No order as to cost. File be consigned to record room.
35. Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving an application from the parties in the registry. The orders be uploaded on www.confonet.nic.in.

Announced in open Commission on  20.12.2023.

SANJAY KUMAR                    NIPUR CHANDNA                     RAJESH            

PRESIDENT                                      MEMBER                        MEMBER