Order by:
Sh.Amrinder Singh Sidhu, President
1. This Consumer Complaint has been received by transfer vide order dated 26.11.2021 of Hon’ble President, State Consumer Disputes Redressal Commission, Punjab at Chandigarh under section 48 of CPA Act, vide letter No.04/22/2021/4 C.P.A/38 dated 17.1.2022 from District Consumer Commission, Ludhiana to District Consumer Commission, Moga to decide the same in Camp Court at Ludhiana and said order was ordered to be affected from 14th March, 2022.
2. The complainant has filed the instant complaint under section 12 of the Consumer Protection Act, 1986 (now section 35 of Consumer Protection Act, 2019) on the allegations that one agent of Opposite Parties visited the complainant for the purpose of gaining their business & allured the complainant with the scheme ‘Met Smart Plantium’ and succeeded in obtaining their business while getting signatures of the complainant on each and every papers of proposal form on 08.09.2015 for the assured sum of Rs.7,00,000/- to Rs7,70,000/- and at that time annual premium disclosed to be Rs.25,000/- for paying 5 years installments only and being seeing benefits, the complainant paid the premium amount of Rs.25,000/- and Opposite Parties duly issued receipt on 08.09.2015 to the complainant. Thereafter, the Opposite Parties sent the policy bearing No.21675297 to the complainant on 11.09.2015 under the nature non participating unit linked insurance plan and disclosed quarterly installment of Rs.25,000/-. Being unsatisfied with the plan and terms as assured by the agents, the complainant lodged protest with the Opposite Parties through various letters and in this regard, the Opposite Parties deputed Mr.Bhupinder Singh official of the Opposite Parties for listening their grievance of the complainant. Said official visited the premises of the complainant on 29.12.2015 and taken the complaint in writing. Thereafter, the complainant requested the Opposite Parties to send the sum of Rs.50,000/- and interest thereon but the Opposite Parties stated that they have not received the copy of PAN Card/ DL/ Passport or duel signature form. The complainant many times requested the Opposite Parties for cancellation of policy on the ground that the customer has a period of 15 days from the date of receipt of policy document to review the terms and conditions of the policy, but to no affect and as such, there is deficiency in service on the part of the Opposite Parties. Vide instant complaint, the complainant has sought the following reliefs.
a) The Opposite Parties may be directed to refund the sum of Rs.50,000/- alongwith interest @ 15% per annum and also to pay Rs.25,000/- on account of compensation for causing him mental tension and harassment besides Rs.7500/- as litigation expenses or any other relief to which this District Consumer Commission complainant may deem fit be also granted.
3. Opposite Parties appeared through counsel and contested the complaint by filing the written version taking preliminary objections therein inter alia that the complaint filed by the complainant is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead this District Consumer Commission. It is submitted that after completely understanding the terms and conditions of the product had voluntarily applied for a policy by filling up the proposal form dated 08.09.2015 and the complainant has also signed the Unit Linked and Benefit Illustration form for the above mentioned policy and therefore she was well aware of all the terms and conditions pertaining to the given policy. Upon receipt of the duly filled proposal form alongwith the initial premium against the application, the Opposite Parties evaluated and processed the proposal form on the basis of the information provided by the complainant and issued policy bearing No. 21675297 on 16.09.2015 stipulating for quarterly premium of Rs.25,000/- against a sum assured of Rs.7 lakh and for the premium term of 5 years and coverage term of 33 years. Thereafter all the policy terms and conditions were sent to the complainant on 2.10.2015 through Speed Post Consignment No. EA7789755251N which has been admittedly received by the complainant. In the welcome letter it is clearly stated that in case the complainant was disagreed with the terms and conditions of the policy, she should return the policy within 15 days of the receipt of the same and was entitled for cancellation as per the terms and conditions of the policy. But the complainant never requested for the cancellations of the policy within free look period of 15 days. The complainant under the said policy has paid a total premium of Rs.50,000/- and failed to pay the subsequent premiums and resultantly, the policy moved to premium discontinued fund. On merits, Opposite Parties took up the same and similar pleas as taken up by them in the preliminary objections. Hence, the instant complaint is not maintainable and the same may be dismissed with costs.
4. In order to prove his case, the complainant has tendered into evidence the affidavit Ex.CA1 alongwith copies of documents Ex.C1 to Ex.C9.
5. On the other hand, to rebut the evidence of the complainant, Opposite Parties also tendered into evidence the affidavit Ex.RA alongwith copies of documents Ex.R1 and R2 and closed their evidence.
6. We have heard the ld.counsel for the parties, perused the written submissions of the complainant and also gone through the documents placed on record.
7. Ld.counsel for the Complainant as well as ld.counsel for the Opposite Parties has mainly reiterated the facts as narrated in the complaint as well as in their written statements respectively. We have perused the rival contention of the ld.counsel for the parties. The only contention of the complainant is that when the complainant has come to know that the agent of the Opposite Parties has sold him the wrong policy by showing him green pasters, then he applied with the Opposite Parties for the cancellation of the policy in question and also requested to refund the paid up amount alongwith interest, but the Opposite Parties refused to admit the rightful claim of the complainant. On the other hand, ld.counsel for the Opposite Parties has repelled the aforesaid contention of the ld.counsel for the complainant on the ground that after completely understanding the terms and conditions of the product had voluntarily applied for a policy by filling up the proposal form dated 08.09.2015 and the complainant has also signed the Unit Linked and Benefit Illustration form for the above mentioned policy and therefore she was well aware of all the terms and conditions pertaining to the given policy. Upon receipt of the duly filled proposal form alongwith the initial premium against the application, the Opposite Parties evaluated and processed the proposal form on the basis of the information provided by the complainant and issued policy bearing No. 21675297 on 16.09.2015 stipulating for quarterly premium of Rs.25,000/- against a sum assured of Rs.7 lakh and for the premium term of 5 years and coverage term of 33 years. Thereafter all the policy terms and conditions were sent to the complainant on 2.10.2015 through Speed Post Consignment No. EA7789755251N which has been admittedly received by the complainant. In the welcome letter it is clearly stated that in case the complainant was disagreed with the terms and conditions of the policy, she should return the policy within 15 days of the receipt of the same and was entitled for cancellation as per the terms and conditions of the policy. But the complainant never requested for the cancellations of the policy within free look period of 15 days. The complainant under the said policy has paid a total premium of Rs.50,000/- and failed to pay the subsequent premiums and resultantly, the policy moved to premium discontinued fund. In this regard, we find force in the judgment of Hon’ble Supreme Court in the case of Grasim Industries Ltd. Vs. Agarwal Steel, 2009(4) CCC598 (SC), wherein it was observed that the person who signed the documents, there is presumption that he understood the document and only then he signed it specifically he is an educated person unless contrary is proved that it was obtained under some threat, pressure or coercion. It is well settled principle of law that the parties are bound by the terms and conditions of the Insurance Policy, and none of the parties can seek any relief beyond those terms and conditions. In this regard reference may be made to the observation made by the Hon’ble Apex Court in case cited as Suraj Mal Ram Niwas Oil Mills (P) Ltd. Versus United India Insurance Co. Ltd and another, 2011 CTJ 11 (Supreme Court) (CP) wherein the Division Bench of the Hon’ble Apex Court consisting of Hon’ble Mr. Justice D.K. Jain and Hon’ble Mr. Justice T.S. Thakur, held that:-
“22. Before embarking on an examination of the correctness of the grounds of repudiation of the policy, it would be apposite to examine the nature of a contract of insurance. It is trite that in a contract of insurance, the rights and obligations are governed by the terms of the said contract. Therefore, the terms of a contract of insurance have to be strictly construed, and no exception can be made on the ground of equity………..”
“24. Thus, it needs little emphasis that in construing the terms of a contract of insurance, the words used therein must be given paramount important, and it is not open for the Court to add, delete or substitute any words. It is also well settled that since upon issuance of an insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risk covered by the policy, its terms have to be strictly construed to determine the extent of liability of the insurer. Therefore, the endeavour of the court should always be to interpret the words in which the contract is expressed by the parties.”
Further moreover, in the instant case, the complainant has not sought to cancel the policy in question within free look period of 15 days rather chose to pay the second premium of Rs.25,000/-, as such, as per the terms and conditions of the policy, he can not get cancel the policy after free look period of 15 days as per the terms of the policy. In this regard, Hon’ble State Consumer Disputes Redressal Commission, Punjab at Chandigarh in case Vipin Kumar Vs. ICICI Prudential in Appeal No.95/2013 decided on 01.05.2013 has held that where insured had not sought the cancellation of the policy within the free look period, he is bound by the terms and conditions of the policy. The facts and circumstances of the instant case are fully attracted to Suraj Mal Ram Niwas Oil Mills (P) Ltd case (Supra). Same view has also been expressed by Hon'ble State Consumer Disputes Redressal Commission, Punjab at Chandigarh in First Appeal No.485 of 2019 in case Reliance Nippon Life Insurance Company Limited, Versus Atma Singh, decided recently on 11.11.2021.
8. In view of the aforesaid facts and circumstances of the case, we find no deficiency in service on the part of the Opposite Parties and hence, the instant complaint stands dismissed. Keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the order be furnished to the parties free of cost by District Consumer Commission, Ludhiana and thereafter, the file be consigned to record room after compliance.
9. Reason for delay in deciding the complaint.
This Consumer Complaint was originally filed at District Consumer Disputes Redressal Forum (Now Commission) at Ludhiana and it keep pending over there until Hon’ble State Consumer Disputes Redressal Commission, Punjab vide letter No.04/22/2021/4 C.P.A/38 dated 17.1.2022 has transferred the instant Consumer Complaint alongwith Other Complaints to District Consumer Commission, Moga with directions to work on this file onward from 14th March, 2022 and accordingly District Consumer Commission, Moga has decided the present complaint at Camp Court, Ludhiana, as early as possible as it could decide the same.
Announced in Open Commission at Camp Court, Ludhiana.
