ORDER
Per Sh. Rakesh Kapoor , President
The complainant had purchased a life insurance policy from the OP and had paid the first premium of Rs. 99895/-. He was issued with a receipt bearing no. ID1457904 dated 12.4.2011. The policy documents were received by the complainant on 18.2.2012. On perusal of the policy documents , the complainant learnt that its terms and conditions were at variance with what was agreed to between the parties. at the time of entering into the agreement. The complai nant, therefore, wrote a letter dated 22.2.2012 seeking the cancellation of the policy with immediate effect. He received a letter dated 12.4.2012 from OP1 stating that the request for cancellation had been processed and the amount invested will be refunded within 3 weeks. Since, the amount was not refunded to the complainant, he wrote a letter dated 28.5.2012 to OP1 praying for the refund of the amount. To his shock, he received a letter dated 1.8.2012 wherein OP1 expressed its inability to cancel the policy and refund the premium. The complainant has alleged that this act of the Ops amounts to deficiency in service. He has , therefore, approached this forum for redressal of his grievances.
The complaint has been contested by OP1 who has filed a written statement. Para s 1& 2 of the preliminary objections of the written statement are relevant for the purposes of the disposal of this complaint and are reproduced as under:-
1.That the present complaint of the complainant is not maintainable and is liable to be dismissed as there is no deficiency in service on part of the respondent. Complainant applied for policy of respondent by paying annual premium to the agent of answering respondent but the acceptance of the policy was subject to certain terms and conditions as provided to the complainant at the time of policy acceptance. At the time of filing the said application form, the Life assured was explained that the contract of insurance is based on doctrine of ubberma fide, i.e. utomost good faith, and he should correctly, honestly and fairly disclose all the material facts within its knowledge to the Opposite Party to allow them to assess the risk to be undertaken with respect to the policy to be issued to him in the application form and that he should correctly , honestly and fairly disclose all the material facts within his knowledge to the OP that may arise from the date of signing of the application form to the date of issuance of the policy to him. That the life assured also signed all the declarations to that effect after reading and understanding the same as admitted that all the benefits of the said policy have been disclosed by the respondent no. 2. Hence, it is admitted that complainant signed the documents after getting all the details and information about the policy. Hence, there is no deficiency in services and misrepresentation on the part of answering respondent.
2.That in para 5 of the complaint, it is mentioned that complainant has purchased the policy TATA AIG Life Assure 21 years of Money Saver (110NV001V01) No C181887689 by paying premium of Rs. 99895/-. It is relevant to mention here that same policy is mentaioned on the application form filled up by the complainant and the same policy wordings have been forwarded to him by the company. Hence, the allegation of complainant in Para 10 that different policy is provided to him is not tenable and hence not maintainable. Hence, the complainant is deviod of any cause of action and deserves dismissal.
OP1 has contested the complaint on merits and has reiterated that the terms and conditions of the policy were explained to the complainant and were the same which were contained in the policy documents. OP1 has denied that the policy documents were received by the complainant on 18.2.2012. It has claimed that the complaint has no merits and it is liable to be dismissed. It has prayed accordingly.
We have heard arguments advanced at the bar and have perused the record.
The Insurance Regulatory and Development Authority has issued guidelines to all the insurance companies to provide for a fifteen days free –look-in-period during which an insured can seek the cancellation of the policy , if its terms and conditions are not acceptable to him. In the present case, the complainant has alleged that even though he had paid the premium for the policy in April 2011, he had received the policy documents after a long delay on 18.2.2012. The complainant has placed on record the original envelope Ex. CW 1/A1 which proves that the policy documents were delivered to him on 18.2.2012 at 3.15 PM. The complainant has also placed on record a letter dated 22.2.2012 addressed by the him to OP1 stating that he had received the policy documents on 18.2.2012 after a period of 10 months of making payment for the same. The complainant had further stated that he was exercising the option of cancellation of the policy within the free-look-in period and had also sought the refund of the amount paid by him. In response to this letter OP1 had sent in a letter dated 5.3.2012. which inter-alia reads as under:-
“ This is with refrence to your letter for cancellation of the above application. Please note that we have processed the request for cancellation. The premium paid , if any, will be refunded to you within three weeks from the issue of this letter.”
However OP1 had written another letter on 1.8.2012 whichinter-alia reads as under:-
We refer to your request for cancelliation of the policy. We wish to inform you that the policy owner can request for cancellation of the policy and obtain refund of the premium paid by giving a written request within the free look period. We regret to inform you that we are unable to comply with your requeest, since this period has passed in the above policy.
OP1 has not explained as to how and in what circumstances letter dated 1.8.2012 had been written which is in direct contrast to the letter dated 5.3.2012 written by it whereby it had cancelled the policy and had promised to refund the premium amount within a period of three weeks. In its letter dated 1.8.2012 OP1 has not stated as to when it had sent the policy documents to the complainant and as to when these were delivered to him. The complainant on the other hand has given ample evidence that the policy documents were delivered to him on 18.2.2012 and further that he had exercised the option of cancelation of the policy within the free-look-in period of 15 days by sending a letter on 22-2-2012. It is, therefore, clear that the stand taken by OP1 in its letter dated 1-8-2012 is false and not tenable. It , therefore , proves that OP1 had knowingly and purposefully refused to refund the amount received by it and had brushed aside the guidelines of IRDA issued in this behalf. We, therefore, hold OP1 guilty of deficiency of service and direct it as under:-
- Pay to the complainant a sum of Rs. 99895/- along with interest @ 12 % p.a. with effect from 12.4.2011 till payment.
- We further direct OP1 to pay a sum of Rs. 40,000/- to the complainant as compensation for pain and agony suffered by him.
- Pay to the complainant a sum of Rs. 5,000/- as cost of litigation.
The OP shall pay this amount within a period of 30 days from the date of this order failing which they shall be liable to pay interest on the entire awarded amount @ 10% per annum. IF the OP fails to comply with this order, the complainant may approach this Forum for execution of the order under Section 25/27 of the Consumer Protection Act.
Copy of the order be made available to the parties as per rule.
File be consigned to record room.
Announced in open sitting of the Forum on.....................
