By Sri. MOHANDASAN.K, PRESIDENT
The complaint U/s 12 of the Consumer Protection Act 1986.
The complaint in short is as follows:-
1. The husband of the complainant had one LIC policy and on its maturity the first and second opposite parties contacted and came to the residence of the complainant on 28/06/2018. They collected all the documents related to LIC policy and obtained signatures also of the policy holder. They advised to subscribe another policy and on their pressure the complainant agreed to subscribe a small policy. The complainant being aged 48 years, the appropriate policy available for the complainant was a policy of Rs.11, 338/- as annual subscription. Though complainant told them it is very difficult to remit the huge amount but they insisted and so the complainant agreed. The opposite parties obtained all the signed documents from the complainant. Thereafter certain days the policy amount belongs to the husband of the complainant credited to his account after deducting the premium amount of new policy infavour of the complainant. Since there was no issuance of document of new policy enquired with opposite parties, but there was no proper reply. Thereafter on 28/08/2018 the complainant received an envelope issued by the insurance company. When it was opened complaint could see two policy documents instead of single policy. As per the document the policy amount was for Rs.5, 425/- per policy, which was not agreed by the complainant. Thereafter though contacted opposite parties there was no responsible answer from the opposite parties. The complainant was struggling to remit single policy but both the first and second opposite parties subscribed the complainant in to two policies which caused mental agony and inconvenience to the complainant. As per the terms of the policy the complainant has to pay the policy amount for the long 16 years. The complainant approached insurance office several times to cancel one of the policies but there was no result. Thereafter the complainant sent letters and also enquired through telephone but the reply was that they had not received copy of the complaint. It was also informed that if the complainant had any grievance, it should have submitted within 15 days cooling off time. There was no written reply to the complaint also. Even though there was policy of small amounts, misleading the complainant forced to subscribe two policies. Hence the prayer of the complainant is to pay Rs.30, 000/- on account of financial loss, Rs. 25,000/- on account of mental agony and cost of Rs.5, 000/-
2. On admission of the complaint issued notice to the opposite parties and the opposite parties No.1,2 and 4 appeared and filed version. The first and second opposite parties filed version denying the entire averments and allegations contained in the complaint. They submitted that the husband of the complainant directly contacted the opposite parties and as per the instructions of the husband of the complainant the policy was issued in favor of the complainant while servicing the matured policy of the husband of the complainant. He had instructed to credit the policy amount from the maturity amount. The opposite parties acted as per the instruction of the husband of the complainant and all the documents were signed and given by the husband of the complainant. He had instructed the opposite parties that on crediting the matured amount in to the bank account, to subscribe two policies worth Rs.5,669/- each. The opposite parties accounted first installment as per the instruction of the husband of the complainant. There was no pressure or plan from the opposite parties. It was the instruction of the husband of the complainant to subscribe two polices instead of remitting single premium Rs.11,338/-. The subscription of two policies were intentionally done since in future if there is any default occurs to save the lapse of total policy, two policies subscribed. The allegation that for the purpose of getting two numbers of policies to the opposite parties as insurance agents is not at all correct. The first and second opposite parties working as insurance agents for the last so many years. The complainant was aware when the amount of premium was transferred to two installments, there were two number policies. The contention of the complainant that she came to know only on receipt of policy by post is not correct. The complainant and her husband are being educationally qualified, they are able to understand the fact and it is not possible to hide the fact and there by cheat the complainant. The opposite parties acted in accordance with the acts and rules of LIC and higher employers. The opposite parties deny the allegation of deficiency in service and unfair trade practice. The complainant or her husband never sustained any financial loss on account of the policy. The opposite party contented that some of the relatives of the complainant misadvised and as a result the complainant filed this complaint. Hence the prayer is to dismiss the complaint.
3. The forth opposite party filed detailed version denying the averments and allegations in the complaint. The fourth opposite party submitted that the LIC of India Kozhikode branch had issued Aadhaar Shila policies Nos 308901368 and 308901372 dated 28/06/2018 on the basis of proposal form filled and signed and submitted by the complainant with full consent. The amount of premium under the policy was Rs.5, 425/- each as opted by the complainant and the sum assured was Rs.1, 00,000/- each. The policies were taken for a period of 16 years and the date of maturity of the policy was on 28/06/2034. The complainant had received the policy bonds on 28/08/2018. The duly signed proposal form submitted by the complainant is the consent given by the complainant or entering in to the insurance contract as per the terms and conditions and as such this 4th opposite party issued the policy in the name of complainant. Life insurance is an alienated contract on the principles of utmost good faith and performance of the contract is as per the conditions and privileges embedded in the policy document. If the policy holder is not satisfied with the terms and conditions of the policy the policy holder is available, the option of cancelation of policy within 15 days from the date of policy document as per the IRDA regulations. In this complaint the policy document received by complainant on 28/08/2018. It can be seen that no steps has been taken by the complainant to cancel the policy and she has sent the request for cancelation only on 18/09/2018, after the expiry of stipulated time for cooling off cancellation. As per the policy there is no provision to refund the premium paid. The premium paid by the insured complainant was to cover risk on her life for the given period. The only option available to the complainant is to surrender the policy after payment of three years premium regularly. The opposite party acted as per the terms and conditions of the policy and the opposite party issued policy certificates as early as possible without any delay or latches. There is no deficiency of service or cause of action as alleged against the opposite party. The question of mental agony, hardship or financial loss to the complaint also denied by the opposite party and the prayer is to dismiss the complaint with compensatory cost.
4. There is no claim raised against third opposite party and the third opposite party stands deleted as per the request of the complainant.
5. The complainant and opposite parties filed affidavit and documents. The documents on the side of complainant marked as Ext. A1 to A3. Ext. A1 is copy of complaint dated 10/09/2018 submitted by the complainant before Divisional Manager LIC of India Calicut. Ext. A2 is copy of insurance policy Aadhaar Shila policy No.308901368. Ext. A3 copy of insurance policy Aadhaar Shila policy No.308901372. The documents on the side of opposite parties marked as Ext. B1 to B8. Ext. B1 is proposal deposit receipt dated 29/06/2018. Ext. B2 is copy of request submitted by one Alikoya to the branch manager LIC of India Kozhikode dated 28/06/2018. Ext. B3, B4, B5 & B7 are copy of proposal form dated 29/06/2018. . Ext. B6 is Aadhaar Shila Policy copy number 308901372. Ext. B8 is Aadhar Shila policy copy.
6. Perused affidavit and documents and heard both side.
The following points arise for consideration: -
- Whether there is deficiency in service on the part of opposite parties?
- Relief and cost?
7. Point No.1 &2
The admitted case of complainant and opposite parties is that the complainant subscribed policy of the opposite party. But the complainant submit that she had subscribed single policy with annual premium 11,338/- rupees. But she received two policies with premium 5,425/- rupees each. According to the complainant it was not done with the consent of complainant. Complainant alleges the opposite party manipulated the documents and subscribed as two policies in favor of the complainant. Thereafter complainant approached opposite parties but there was no proper reply and the response was that they are not able to do anything without a complaint within the cooling off time limit of 15 days. The opposite parties mislead the complainant and thereby subscribed two policies and that is the reason for filing this complaint.
8. The contention of the complainant is that first and second opposite parties approached on 28/06/2018 at the residence of complainant and obtained signed documents to subscribe the policies. Hence there is no dispute the complainant issued signed documents to subscribe insurance policy. The fourth opposite party contended that they issued two policies bearing numbers 308901368 & 308901372 on 28/06/2018 which shows the opposite parties issued the policy on the day itself when the complainant submitted signed documents. The allegation is that the complainant submitted signed documents to subscribe single policy but the opposite party issued two policies. But there is no evidence to show that she had agreed only to single policy. But at the same time two policies are covered by the annual premium amount agreed between the complainant and first and second opposite party.
9. According to fourth opposite party it is submitted that the period of insurance is 16 years and the maturity period of the policies is on 28/06/2034. The complainant has received policy bonds on 28/08/2018. If the policy holder is not satisfied with the terms and conditions of their policy the policy holder is available with the option of cancelation of policy within 15 days from the date of receipt of policy document. The complainant herein approached the opposite party after the expiry of stipulated time for cooling off cancelation. There is no provision to refund premium once paid except during cooling off period. According to fourth opposite party the premium paid by the insured complainant was to cover risk on her life for the given period and only option available to the complainant is to surrender the policy after payment of 3 years premiums regularly. In this complaint the complainant remitted only single premium and so as per terms of agreement between complainant and Insurance Company there is no provision to refund the premium.
10. It can be seen that the complainant herein remitted single premium and as per the terms between the complainant and opposite parties the premium cannot be refunded. There is no substantive evidence that the complainant subscribed the policy at the compulsion of first and second opposite parties and they miss-leaded the complainant. The Commission finds that the complainant failed to establish the averment in the complaint. Hence the complaint dismissed.
Dated this 22nd day of March, 2022.
MOHANDASAN.K, PRESIDENT
PREETHI SIVARAMAN.C, MEMBER
APPENDIX
Witness examined on the side of the complainant: Nil
Documents marked on the side of the complainant: Ext.A1 to A3
Ext.A1: Copy of complaint dated 10/09/2018 submitted by the complainant before
Divisional Manager LIC of India Calicut.
Ext.A2: Copy of insurance policy Aadhaar Shila policy No.308901368.
Ext A3: Copy of insurance policy Aadhaar Shila policy No.308901372.
Witness examined on the side of the opposite party: Nil
Documents marked on the side of the opposite party: Ext. B1 to B8
Ext.B1: Proposal deposit receipt dated 29/06/2018.
Ext.B2: Copy of request submitted by one Alikoya to the branch manager LIC of India
Kozhikode dated 28/06/2018.
Ext.B3: Copy of proposal form dated 29/06/2018.
Ext.B4: Copy of proposal form dated 29/06/2018.
Ext.B5: Copy of proposal form dated 29/06/2018.
Ext.B6: Aadhaar Shila Policy copy number 308901372.
Ext.B7: Copy of proposal form dated 29/06/2018.
Ext.B8: Aadhar Shila policy copy.
MOHANDASAN.K, PRESIDENT
PREETHI SIVARAMAN.C, MEMBER
