Sri Shyamal Gupta, Member

Challenging the Order dated 08-09-2014 passed by the Ld. District Forum, North 24 Parganas in CC/17/2014, whereof the complaint has been allowed, M/s Max Life Insurance Co. Ltd., OP No. 1 has moved this Appeal.

Case of the Complainant, in a nutshell, is that, being impressed by the officials of the OPs, he opted for an insurance policy of the OP No. 1 in the year 2012.  Before opening the said policy, the OPs drew a rosy picture about future prospect of the said policy.  However, after receiving policy paper, he found that all those promises were vague.  It is further stated that after careful perusal and scrutiny of the policy certificate, the Complainant discovered several anomalies for which he lodged a written complaint with the OPs on 19-09-2013.  It is also claimed that as soon as he detected the anomalies in the policy document, he immediately informed the same to the OP No. 2 several times and also visited its branch office, but in vain.  Against such backdrop, the complaint was filed.

Per contra case of the OP No. 1 is that the Complainant, after duly deliberating and understanding all the terms and conditions, subscribed to ‘Max Life Life Gain Plus 20 years 6 Pay Plan’ on 19-11-2012 by signing the proposal form.  The policy document was sent to the Complainant on 28-11-2012.  Complainant requested for changing the premium method on 23-10-2013.  Subsequently, the Complainant called up this OP on 08-11-2013 alleging misspelling of the subject policy and sought for cancellation of the same and get refund of the premium amount.  Since such request was made beyond the free-look period, this OP declined to honour such request.

Decision with reasons

At the time of hearing, Ld. Advocates of the parties were heard at length.  We have also gone through the documents on record.

It appears from the record that the concerned policy being issued on 19-11-2012, was delivered to the residence of the Respondent No. 1 on 30-11-2012.  Admittedly, the Respondent No. 1, on receipt of the policy bond, carefully gone through the same.

In view of such candid admission, it is naïve to believe that the Respondent No. 1 was fully aware of the option of free-look period which one can opts for in the event of any dissatisfaction with the concerned policy.  It is not understood, why the Respondent No. 1 did not opt for such privilege.

Though it is claimed by the Respondent No. 1 that, after detecting the so-called discrepancies in the policy bond, he immediately rushed to the Respondent No. 2 and urged them to rectify the anomalies, we afraid, in absence of any tangible proof to establish such claim, it would not be proper for us to jump to any conclusion by resorting to surmises and conjecture.  Furthermore, while it was clearly mentioned in the policy document as well in the policy forwarding letter dated 28-11-2012 that policy cancellation request would have to be made in writing, it was incumbent upon him to follow suit. 

It is claimed by the Respondent No. 1 that on 19-09-2013, he submitted a written complaint with the Appellant stating his dissatisfaction with the said policy.  However, we have not come across the copy of any such complaint letter on record.

Be that as it may, even if it is assumed for the sake of argument that a written complaint was indeed lodged by the Respondent No. 1 on 19-09-2013, we find it quite inexplicable that such written complaint was submitted after 293 days or 9 months 20 days since receipt of the policy bond.  In case officials of the Respondent No. 2 did not walk the talk in eradicating the so called anomalies in the policy bond, as claimed by the Respondent No. 1 in his petition of complainant, surely, as a person of normal prudence, he would surely lodge a written complaint much earlier and also took up the matter with higher authorities of the Appellant.

On the other hand, it transpires from the documents on record that the Respondent No. 1, by writing a letter on 23-10-2013 asked for changing the premium method and acting upon such request of the Respondent No. 1, the Appellant did the needful and confirmed doing so vide its letter dated 24-10-2013. 

For all these reasons, the allegations as made by the Respondent No. 1 in his petition of complaint does not seem at all believable to us.

It appears from the impugned order that the Ld. District Forum allowed the complaint out of its notion that since the policy documents were written in small prints, the Respondent No. 1 could not evaluate the implications of the concerned policy properly.  It is indeed strange, while the Respondent No. 1 made no such whisper anywhere in the petition of complaint, what prompted the Ld. District Forum to derive at such conclusion. Significantly, the Respondent No. 1 clearly stated in his petition of complaint that he had carefully gone through the details of the policy terms and conditions. In view of this, such proposition on the part of the Ld. District Forum appears to be a complete misnomer which is not tenable in law.

In the light of our above findings, we cannot endorse the decision of the Ld. District Forum.

The Appeal, accordingly, succeeds.

Hence,

O R D E R E D

The Appeal stands allowed on contest against the Respondent No. 1.  The impugned order is hereby set aside. Consequent thereof, the complaint case fails.