CC No.2304/2017                                         Date of filing:17.08.2017

                                                              Date of Disposal:03.09.2020

BEFORE THE III ADDITIONAL BANGALORE URBAN DISTRICT

CONSUMER DISPUTES REDRESSAL COMMISSION

BENGALURU– 560 027

DATED THIS THE 03^rd DAY OF SEPTEMBER 2020

CONSUMER COMPLAINT NO.2304/2017

PRESENT:

Sri.   Venkatasudarshan  D.R.  B.Com,LL.M.,   ….  PRESIDENT

Smt. L.Mamatha, B.A., (Law), LL.B.                ….       MEMBER

Sri.  M.B. Seena, B.A., (Law), LL.B.           ….       MEMBER

COMPLAINANT:

Krishna Gopal Jana

S/o Dinabandhu Jana,

34 years, Occ Self Employed

R/at No.136, Krishna Sadan ST Bed,

1^st main, Koramangala,

Bengaluru-560049.

(Complainant by Sri.A.P.Sasidharan Nair, Advocate)          

 V/s

OPPOSITE PARTIES:

1. SBI  Life Insurance Company Ltd.,

Plot No.96/04, 3^rd floor,

Chandra Sales, South End Road,

2. The Regional Director,

SBI Life Insurance Company Ltd.,

(Opposite Party by Sri.K.P.Thrimurthy, Advocate)

= = = = = = = = = = = = =

WRITTEN BY SRI VENKATASUDARSHAN D.R., PRESIDENT

          ******

//ORDER//

This is a complaint filed under section 12 of the Consumer Protection Act 1986 by the complainant Sri. Krishna Gopal Jana against SBI Life Insurance Company Ltd., and another praying for direction to the opponents to refund a sum of Rs.30,000/- paid by him on 19.08.2015 towards SBI life Shubh Nivesh Policy No.35095060002 issued in the name of the complainant and for another sum of Rs.30,000/- as compensation for mental agony undergone and also for payment of the same with interest at 12% p.a.

2. The brief facts of the case of the complainant as per the complaint are that the complainant is a self-employed individual engaged in his livelihood by running paying guest house at the address mentioned in the cause title.

3. The complainant was enticed by Mr.Santosh  Bellad, who is a business executive of the opposite party and as a result he subscribed to the Life Insurance Scheme name as “ SBI Life- Shubh Nivesh by making a first subscription premium of Rs.30,000/- vide cheque No.331372 dated 19.02.2015.  It is stated that at the time of initial briefing Mr.Santosh Bellad representing opposite party had explained about the product with highly motivating offers namely viz.,

1. Yearly premium of Rs.30,000/- for 7 years.
2. At the end of 7 years policy term, the maturity value would become Rs.3,38,000/- and additional benefits.
3. Insurance coverage at Rs.1,70,000/- and accident coverage at Rs.3,40,000/- for the complainant and his spouse.

According to the complainant these offers, made him to believe that it is appreciative and hence subscribed for the same.It is stated that he was also assured of the promotional gift of one gram gold coin at the enrolling, but that was not given.

4. It is the further case of the complainant that on 24.08.2015 when he received the policy certificate and perused it, he found to his surprise that the terms of the policy were different from what was verbally indicated as detailed above.  The duration of the policy was shown 10 years instead of 7 years.  Similarly the maturity value of other benefits were also not the same as briefed by Mr. Santhosh Bellad. Shocked by this he contacted one Miss. Divya of the opposite party office and thereafter Mr. Kishor Kumar. D and Ms. Sridevi who came with a response that they would look into the matter.  This unfair evasive tactics continued for the month or so.  As the complainant became suspicious of different responses, he sent e-mail message one after other the e-mail messages and replies are dated 17, 18, 21, 23, 24 of October-2015, 16 and 18 of November 2015.  Being not satisfied with the response of the opposite party the complainant sought for policy cancellation vide letter dated 26.11.2015 which was acknowledged by Mr. Kishor Kumar.  On 21.10.2015 the complainant was informed by message that as the request for cancellation was not received within 15 days it was not possible for them to cancel the policy.  The complainant responded immediately to the said message through his e-mail dated 23.10.2015 and raised objection claiming that he had served in the notices to prove his stand fully justified in demanding the money.  It is contended that the opposite party has adopted unfair trade practice.  The complainant has also got issued a legal notice on 01.02.2016.  The opposite party has sent reply on 15.02.2016 taking the same stand which they earlier took.  The second notice dated 22.02.2016 was also sent for which the same type of reply was sent.  Hence, the complaint.

5. In this case there are 2 opposite parties.  After admitting the complaint the notices were ordered to be issued to the opposite parties.  The opposite party who entered through an advocate had filed version.  In this case the 1^st Opposite Party is the SBI Life insurance corporation and 2d opposite is the Regional Director of SBI Life Insurance Corporation. As such both are one and the same organization. It is contended in the version filed by the Opposite Party that the policy was issued based on the proposal form duly signed and submitted by the Complainant.  The Proposal Form is the basis of contract of insurance and hence it is an important document.  The contract of insurance is a contract of good faith and no force was employed on the Complainant by the Opposite Party at any point of time to purchase policy.  It is contended that what has been received from the complainant is only the initial premium under the policy and no renewal premium was received by the Opposite Parties.  Therefore the policy had lapsed due to non-receipt of the renewal premium which was due on 22.08.2016 and onwards.  The consequences of lapsation of policy has been mentioned in the policy document itself to which the Complainant is bound. It is contended that if the Complainant was not satisfied with the terms and conditions of the policy he had an option to cancel the policy within the free look period of 15 days.  The policy was issued till the date of commencement as 22.08.2015 and the same was dispatched to the Complainant on 25.08.2015.  In that policy there is a specific recital at Clause No.9 regarding free look period.  So if for any reason the Complainant was not agreeable to any of the condition mentioned in the policy he could have returned the policy stating the reasons for refusal within the free look period.  In that event, the Opposite Parties would have refunded the premium amount after deducting legally admissible charges.   But in the instant case the Complainant never exercised this option of availing free look period and thereby he has agreed to abide himself by the terms and conditions of the policy.  It is stated that all the Complaints made by the Complainant had been duly replied and so also the legal notices dt.01.02.2016 and 22.02.2016.  Under these circumstances, it is contended that there is no deficiency in service on the part of the Opposite Parties.  Hence prays for dismissal of the complaint.
6. When the case was set down for recording evidence, the Complainant filed his affidavit evidence and referred to certain documents which would be referred and discussed in the course of this order.
7. On behalf of the Opposite Party Mis.Danya W/o H.N.Munikrishna, an Authorized Representative of SBI Life Insurance Company has appeared and filed her affidavit evidence and also produced certain documents, about which reference would be made in the course of the order. 

8.  When the case was  set-down for hearing arguments, the counsels on both sides have argued.

9.      The points that arise for our determination are:-

(1) Whether the complainant proves that there is deficiency in service on the part of the Opposite Parties ?

(2) Whether the complainant is entitled for the reliefs sought in the complaint?

10.    Our findings on the above points are:-

Point No.1:- In the Negative.

Point No.2:- does not survive for consideration.

Point No.3:- As per the final order for the following

•  
• Point No.1:-This is a complaint filed under section 12 of the Consumer Protection Act 1986 by the complainant Sri. Krishna Gopal Jana against SBI Life Insurance Company Ltd., and another seeking direction to the Opposite Parties to refund a sum of Rs.30,000/- being the premium amount paid by him on 19.08.2015 towards SBI life Shubh Nivesh Policy No.35095060002 issued in the name of the complainant and for another sum of Rs.30,000/- towards compensation for  mental agony, pain and suffering undergone by the Complainant and also to order for payment of interest at 12% p.a. from 19.08.2015 till the actual payment.

12.   It is the case of the Complainant that there is deficiency in service on the part of the Opposite Parties in not refunding the premium amount when requested as terms and conditions of the policy incorporated in the policy document were contrary to the assurances given by Mr.SanthoshBellad the Business Executive of the opposite parties. 

13. The undisputed facts of this case are that the Complainant had obtained SBI Life Shubh Nivesh Policy from the Opposite Parties under policy No.35095060002.  1^st premium amount of Rs.30,000/- was paid by the Complainant to the Opposite Parties by way of cheque which was encashed.  Apart from this, for obtaining the policy the Complainant has also forwarded the proposal duly signed by him.
14.  It is the case of the Complainant that the business executive of the Opposite Parties had assured that:

1. Yearly premium was Rs.30,000/- payable for 7 years.
2. At the end of the 7 years the maturity value would be Rs.3,38,000/- with additional benefits of insurance coverage of Rs.1,70,000/- and accident coverage at Rs.3,40,000/- for the Complainant and his wife. 

So it is contended that the Complainant was lured by this offer and therefore submitted the proposal.According to him, when he received the policy certificate dt.24.08.2015 he found to his surprise that the terms of the policy were quite different from what was verbally communicated. The duration of the policy was shown as 10 years instead of 7 years.Similarly the maturity value and other benefits were not in accordance with what was assured to the Complainant by the business executive.Therefore, he sought for policy cancellation by way writing letter dt.26.11.2015.Prior to that there was email correspondence also in that regard. It is contended that inspite of that his request was not considered by the Opposite Parties on the ground that the Complainant did not avail 15 days of “Free Look Period”.  According to the Complainant this amounts to deficiency in service.  The burden of proving that there is deficiency of service on the part of the opposite parties is on the complainant.

15.   In order to substantiate this aspect the Complainant has filed his affidavit as a part of his evidence and has sworn to the contents of it. He has also produced the documents along with the complaint which includes the policy document with terms and conditions also. The same documents in the form of copies have also been produced by the Opposite Parties.  Since the averments contained in the affidavit of the Complainant are the repetition of the averments made in the complaint, and as the averments made in the complaint have already been narrated above, there is no need for us to discuss here again about the averments in the affidavit of the Complainant.  Similarly the affidavit evidence of the Authorized Representative of the Opposite Parties also contain averments which are made in the version.  Hence even discussion on those averments in the affidavit is not necessary. 

16.   On the basis of the available documentary evidence coupled with the oral evidence available on record now we have to see whether there was any negligence which amounts to deficiency in service on the part of the Opposite Parties.

17.   The copy of the proposal submitted by the Complainant for the issue of the Life Shubh Nivesh endowment policy has been made available by the Opposite Parties.    The close perusal of the said proposal copy shows that the Complainant is a graduate by qualification and also he is a businessman.  Thus he is not a layman having no knowledge of worldly affairs.  He is a literate.  Therefore he cannot claim that he has no knowledge of what has been written in the proposal form.  It is also not the case of the Complainant that the proposal form was not filled by him and it was filled by business executive or some other person.  Even if it is filled by someone else he being graduate would have gone through the same before signing. Therefore he cannot claim the ignorance of contents of the proposal form submitted by him to the opposite parties for purchasing insurance policy.  The proposal form is an important document as it is the basis or foundation for the issuance of policy. If we have a look at the proposal form there is a clear mention in clause-9.1 which deals with Basic Plan Details that the premium frequency was yearly and it was payable regularly. Further, it is also mentioned in Clause-9.3 that the policy term is 7 years and the sum assured is Rs.1,84,000/- and the yearly premium is Rs.29,999/-.  If these details are read with the policy document furnished by the Opposite Parties, it is clear that what is mentioned in the proposal is also mentioned in the policy document.

18. The original policy document is produced by the Complainant himself.  The policy schedule found at Ink Page No.21 and 22 shows that the name of the policy holder is Mr.Krishna Gopal Jana and the policy number is No.35095060002 and important dates are mentioned in ink page No.22 as under;-

1. Date of commencement of policy 22.08.2015.
2. Date of commencement risk 22.08.2015.
3. Policy anniversary date. 22.08.
4. Premium due date on 22.08 every year.
5. Endowment maturity date August 22.2022.
6. Endowment with whole Life Maturity date N/A.

This apart, in column No.23 of in page No22 i.e., Basic Policy Information, it is mentioned that the plan option was endowment option and basic sum assured is Rs.1,84,000/- and premium frequency is annual.  Apart from this in Ink Page No.23 of the policy schedule it is clearly mentioned under the caption Basic policy and Rider Benefit that the sum assured is Rs.1,84,000/- term of the policy is 7 years premium paying terms 7 years and installment premium is Rs.28,983.68 paisa rounded off to Rs.28,984/-, the last premium was payable on August 22.2020 and date of maturity is August 22.2022.  As already stated above if these details found in the policy are read along with what is stated in para-3 of the complaint it clearly shows that the Complainant has either misconceived or misconstrued the term of the policy as 10 years.  This is because in Para-5 of the complaint the Complainant has stated that the duration of the policy was shown as 10 years instead of 7 years in the policy.  This is not correct.  The above narration made which is culled out from the policy schedule clearly shows that the term of the policy was only 7 years with the maturity date as August-2022.  Therefore it is not understandable on what ground the Complainant has contended that the term of the policy has been stated in the policy certificate as 10 years.

19.  Apart from the above, the other contention taken by the Complainant about the alleged assurances said to have been given by the business executive of the Opposite Parties is concerned  no doubt, they do not find place in the policy schedule.  To this the contention taken by the Opposite Parties is that if at all the terms of the policy are different from the one which was assured to the Complainant by the policy executive or otherwise is true, he could have exercised his option of availing free look period and could have returned the policy seeking cancellation and in that event, the Opposite Parties would have deducted such amount as is applicable and would have refunded the amount.  But in this case having not availed free look period option of 15 days, the Complaint now filed is not maintainable is the contention of the Opposite Parties. There appears to be some force in this contention of the opposite parties.

20. In order to understand what the Free Look Period is it is necessary for us to go through the provisions of Regulation No.6(2) of IRDA Regulations 2002.  Regulation-6 deals with the matters to be stated in Life Insurance Policy, which reads as under;-

      Regulation 6(2) of IRDA regulations 2002

“While acting under Regulation 6(1) in forwarding the policy to the insured, the insurer shall inform by the letter forwarding the policy that he has a period of 15 days from the date of the receipt of the policy document to review the terms and conditions of the policy document and where the insured disagrees to any of those conditions, he has the option to return the policy stating the reasons for his objection, while he shall be entitled to a refund of the premium paid, subject only to deduction of 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 reading of the above makes it clear that in every life insurance policy there would be a Free Look Option.So also in the case on hand there is a free look option in the covering letter dated 24.08.2015 (Document No3 of complainant document) addressed to the Complainant by the Opposite Parties which reads as under.

“FREE LOOK OPTION”

“you can review the terms and conditions of the policy within 15 days for the policies sourced through any channel mode other than distance marketing and 30 days for policies sourced through distance marketing, from the date of receipt of the policy document and where you disagree any of those terms and conditions; you have the option to return the policy stating the reasons for your objection.

Your free look option request must be reached to your local SBI Life Service Branch or nearest SBI Life Branch within 15 days”.

This free look option is as per Regulation 6(2) of the IRDA Regulation 2002.This free look option is also mentioned in the policy document under the heading General Terms at Serial No.9.The free look period is stated at 9.1.So if at all the Complainant was of the view that the terms and conditions containing the policy document is not in accordance with what was assured to him by the business executive nothing prevented him from exercising his option of free look period and return the policy so as to reach the Opposite Parties within 15 days from the date of receipt of the policy document.In the case on hand the Complainant did not chose to avail this option at all having received the policy document dt.24.08.2015 he kept quite till 26.11.2015 i.e., the date on which the Complainant has sought for policy cancellation.The copy of which is produced by the Complainant himself at document No.5.That means the Complainant has kept quiet for 3 months from the date of the receipt of the policy without availing the free look period option.Even the so called email messages averred in the complaint at para 5 were from 17.10.2015 and onwards, i.e., much beyond the stipulated period of 15 days. When such being the position the Complainant cannot put blame on the business executive or the opposite parties. If at all his plea that the concerned business executive has given him various offers as mentioned in para-3 of the complaint which made the complainant to believe and purchase the policy and later found that the same were not found in the policy document is true, nothing prevented him from availing option of Free Look Period and return the policy and seek for cancellation and refund.. It is more so when the complainant as already stated is not an illiterate, he is a graduate a well-qualified person and also a businessman.So having not exercised that option in time, it is the Complainant who is at fault and not the Opposite Parties.Hence the opposite parties cannot be held liable. In this context, we may also refer to the decision of the Hon’ble National Commission reported in 2015 part-3 page 56(NC) Reliance Life Insurance Company Limited & another V/s K.S.Eshwarappa and another. The facts of that reported case are almost similar to the facts of this case. Both the cases are relating to the same point of not availing Free Look Period option. In that reported decision also the claim of the complainant has been held in the negative.Under such circumstances it cannot be held that there was deficiency in service on the part of the opposite parties. Thus in view of the above discussion and the said decision we are of the considered view that the Complainant has failed to prove that there is deficiency in service on the part of the Opposite Parties. Accordingly, we answer Point No.1 in the negative and against complaint.

21. POINT NOs.2 & 3:- In view of the finding recorded on point No.1 holding in the negative that there is no deficiency in service on the part of the opposite parties, the question of considering about the entitlement of the Complainant for the reliefs sought does arise.  Accordingly, we answer point No.2 as the same does not survive for our consideration and proceed to pass the following final order.

:ORDER:

The complaint filed by the complainant Krishna Gopal Jana against SBI Life Insurance Company Ltd., and another u/s 12 of the Consumer Protection Act is dismissed.  No order as to cost.

Supply free copy of this order to both the parties.

(Dictated to the Stenographer, typed by her, the transcript corrected, revised and then pronounced by the open Forum on 3^rd day of September 2020.)

(M.B. SEENA)       (L.MAMATHA)    (D.R. VENKATASUDARSHAN)                              MEMBER                   MEMBER                      PRESIDENT  

Witness examined for the complainant side:

1. Sri. Krishna Gopal Jana, who being the Complainant has filed his affidavit.

Witness examined for the Opposite Party side: 

1. Ms. Dhanya K.P., authorized representative of SBI Life Insurance Company Ltd., being the Opposite Party by way of affidavit.

Documents marked for the complainant side:

1. Complainant’s ID card in proof of residence, age etc –Dcoument-1.
2. Proposal Deposit Receipt- Document-2.
3. Insurance Policy booklet- Document-3.
4. E-mail messages between complainant and opponent-Document-4.
5. Letter dated 26.11.2015- Document-5.
6. Legal notice dated 01.02.2016 – Dcoument-6.
7. Letter dated 15.02.2016 –Document-7.
8. Notice dated 22.02.2016- Document-8.
9. Letter dated 01.03.2016 – Document-9.

Documents marked for the Opposite Party side:

1. Copy of the Proposal Form.
2. Copy of the policy document.
3. Copies of Legal Notices and replies.                         

(M.B. SEENA)       (L.MAMATHA)    (D.R. VENKATASUDARSHAN)                              MEMBER                   MEMBER                      PRESIDENT