Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 9.
Instituted on : 07.01.2015.
Decided on : 05.09.2016.
Smt.Sarla Devi w/o Sh. Anil Kumar, resident of H.No.789/1, Ward No.31, Azad NAgar-Rohtak-124001(Haryana).
………..Complainant.
Vs.
- Manager, TATA AIG Life Insurance Company Ltd. Delhi-B Wing, 2nd Floor, Orchard Avenue, Hiranandani Business Park, Powai, Mumbai-400076(Maharashtra).
- Manager, Branch Office, TATA AIG Life Insurance Company Limited, 1st Floor, Shivalik Apartments, SCF-14, HUDA Commercial Complex, Civil Road, Rohtak-124001.
……….Opposite parties.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.JOGINDER KUMAR JAKHAR, PRESIDENT.
MS. KOMAL KHANNA, MEMBER.
SH. VED PAL, MEMBER.
Present: Sh. Rinku Jangra, Advocate for the complainant.
Sh.Gulshan Chawla, Advocate for the opposite parties.
ORDER
SH. JOGINDER KUMAR JAKHAR, PRESIDENT :
1. The present complaint has been filed by the complainant with the averments that the complainant took a life insurance policy bearing no.C189345495 on 18.08.2011 from TATA AIG Life Insurance company Ltd. and while taking policy she was told that she has to pay premium of Rs.21422/- per year for continuous three years and after 3 years the company will double up all the paid premium amount and no surrender charges will be deducted by the company and it included the sum assured of Rs.290000/- in case of any mishappening. It is averred that complainant paid the regular premium of Rs.21422/- per year for next 3 years. The complainant has paid total premium of Rs.64266/- and asked about the policy growth but they misguided the complainant and framed wrong growth of the policy and grab regular installments for 3 years and also did not hand over the complete policy bond to the complainant. It is averred that complainant was in urgent need of money then she again went to the opposite party no.2 on dated 05.09.2014 to surrender her policy. But she was shocked to know that her policy value was Rs.16553/- only whereas she has already paid Rs.64266/- and as per the advisor/officials of the opposite party it should have been Rs.128532/-. It is averred that opposite party no.2 assured the complainant to settle the matter alongwith bonus of Rs.10875/- for the policy but despite her repeated requests opposite parties did not give any positive response of the same. Complainant also served a legal notice dated 07.10.2014 upon the opposite parties but to no effect. It is averred that the act of opposite parties is illegal and amounts to deficiency in service. As such it is prayed that opposite parties may kindly be directed to pay the amount of Rs.111979/- alongwith bonus of Rs.10875/- alongwith interest, compensation and litigation expenses to the complainant.
2. On notice opposite parties appeared and filed their written reply submitting therein that the complainant being an educated lady submitted a proposal form with the request of issuance of the Tata AIG life assured 20 years security and growth plan, with annual premium of Rs.21422/- for the basic sum assured of Rs.290000/- and as per the policy, it was crystal clear that she has to make the premium for the period of 20 years. The story regarding doubling of amount is false and fabricated and there does not exist any policy nor there is any possibility of the said policy. It is averred that every policy documents sent by the company to the policyholder is accompanied by a forwarding letter which clearly mentions that in case policy holder is not satisfied with the terms and conditions of the policy, he/she can withdraw the same within 15 days i.e. under the “Freelook period”. But the life assured never approached the opposite party during the freelook period. It is admitted that complainant applied for surrender of policy on 05.09.2014 alongwith payout request accepting the surrender value of Rs.16553/-. It is denied that the complainant is entitled for Rs.128532/-. It is averred that the amount of Rs.16553/- has been credited in the account of the complainant. It is averred that there is no deficiency in service on the part of opposite parties and dismissal of complaint has been sought.
3. Both the parties led evidence in support of their case.
4. Ld. Counsel for the complainant in his evidence has tendered affidavits Ex.CW1/A, Ex.CW2/A & documents Ex.C1 to Ex.C5 and has closed his evidence. On the other hand ld. Counsel for the opposite parties has tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R6 and has closed his evidence.
5. We have heard ld. counsel for the parties and have gone through the material aspects of the case carefully.
6. In the present case it is not disputed that complainant had availed the policy no.C189345495 from the opposite parties and had paid the three instalments of Rs.21422/- each with the opposite parties. It is also not disputed that as per document Ex.C4, the opposite party had declared the bonus of Rs.10875/- on the alleged policy. The contention of ld. Counsel for the complainant is that the complainant was misguided by the opposite parties about the policy premium that she has to pay premium of policy only for 3 years whereas the premium for 20 years. It is further contended that opposite parties have not supplied the terms and conditions of the policy to the complainant. It is contended that complainant applied for surrender of policy as she was unable to pay the huge premium and had requested the opposite parties to refund the alleged amount alongwith accrued bonus but the opposite parties have only awarded an amount of Rs.16553/- as surrender amount which was credited to her account on 12.09.2014. On the other hand, contention of ld. Counsel for the opposite parties is that the policy data was delivered to the complainant whereby it was clear that the policy was for the period of 20 years but as the complainant did not contact the opposite party within free look period as such she is only entitled for surrender value of Rs.16553/- which has already been credited to her account and as such she is not entitled for any other relief.
7. After going through the file and hearing the parties it is observed that as per copy of I.Card Ex.CW2/B Sh. Suresh Chander is the agent of opposite parties and as per the affidavit Ex.CW2/A of Suresh Chander, he has admitted this fact that complainant was entitled for refund of instalments paid by her alongwith bonus. It is also observed that complainant had applied for surrender of policy after three years but the opposite parties had only paid the policy value of Rs.16553/- and has withheld the remaining amount of premium and bonus on the ground that the complainant had not applied for the same within 15 days of free look period. But to prove their contention, opposite parties have not placed on record any document to prove that when the policy was issued to the complainant as no dispatch number or receipt number of the same have been placed on record. Hence by merely placing on record terms & conditions of the policy Ex.R4, the delivery of the policy document to the complainant is not proved on file. As such the opposite parties cannot take the benefit of the terms and conditions of the insurance policy. In this regard reliance has been placed upon the law cited in IV(2015)CPJ84(Punj.) titled as National Insurance Co. Ltd. & Anrs. Vs. Harpal Singh & Ors. whereby Hon’ble Punjab State Commission, Chandigarh has held that: “Most illiterate and rustic villagers are not aware about niceties of law and unless and until, terms and conditions of contract of insurance are conveyed to them, they cannot be said to be binding on them”, as per III(2014)CPJ 96(Punj.) titled SBI Life Insurance Company Ltd. Vs. Amrit Kaur & Ors. Hon’ble Punjab State Commission, Chandigarh has held that: “Complainant had not received insurance policy with full terms and conditions-No evidence on record as to when insurance policy was dispatched to the complainant by OP No.1-No question of taking the benefit of free look period clause thereof by complainant-Unfair trade practice established-OP No.1 is actually beneficiary of insurance policy and its liability has to be fixed jointly and severally with OP Nos. 2 and 3” and Hon’ble National Commission in 2014(2)CLT 305 titled The Oriental Insurance Co. Vs. Satpal Singh & Ors. has held that: “Insured not bound by the terms and conditions of insurance policy unless it is proved that policy was supplied to the insured by the insurance company-Onus of proof that terms and conditions of the policy were supplied to the insured lies upon the insurance company”. In view of the aforesaid law which are fully applicable on the facts and circumstances of the case it is observed that the opposite parties have failed to prove that the policy was delivered to the complainant. Hence the plea taken by the opposite parties regarding applying for refund of amount within free look period is not applicable to the complainant. As such the opposite parties are liable to refund the amount of all the three instalments paid by the complainant i.e. Rs.21422/- each total Rs.64266/- and amount of bonus Rs.10875/- by deducting the amount already paid by the opposite parties i.e. Rs.16553/-.
8. In view of the facts and circumstances of the case it is observed that opposite parties shall pay the amount of (Rs.64266/- + Rs.10875/- less Rs.16553/-) i.e. Rs.58588/-(Rupees fifty eight thousand five hundred eighty eight only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 07.01.2015 till its realisation and shall also pay a sum of Rs.5000/-(Rupees five thousand only) as litigation expenses to the complainant maximum within one month from the date of decision failing which the awarded amount shall carry further interest @ 12% p.a. from the date of decision. Complaint is allowed accordingly.
9. Copy of this order be supplied to both the parties free of costs.
10. File be consigned to the record room after due compliance.
Announced in open court:
05.09.2016.
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Joginder Kumar Jakhar, President
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Komal Khanna, Member.
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Ved Pal, Member
