Order No. 17 dt. 08/11/2017
The case of the complainant in brief is that the complainant was approached by the representative of o.p. insurance company for opening a policy and the complainant had the idea that the premium of the policy was onetime payment only. The complainant after knowing the said fact paid only one premium of Rs.2 lakhs for the said life insurance policy. At the time of purchasing the policy the complainant had the idea that the payment was made by the complainant as onetime payment towards the said policy, but after receiving the policy the complainant came to learn that the premium of Rs.2 lakhs annually and the complainant will have to pay the said amount for 5 years. The complainant demanded the said amount paid by him, but no reply was given by o.ps. On the basis of the said fact the complainant filed this case praying for direction upon the o.ps. for refund of the amount of Rs.2 lakhs with interest and compensation of Rs.1 lakh.
The o.ps. contested this case by filing w/v and denied all the material allegations of the complaint. It was stated that the documents of the complainant was despatched by o.ps. on 12.12.13 by speed post and the complainant did not raise any objection against the said policy within the free look period of 15 days which was mentioned in the policy papers. It was further stated that the complainant having received the policy and had the 15 days time from the receipt of the policy to go through the terms and conditions of the policy and longafter the expiry of the said period the complainant filed this case praying for refund of the amount by stating inter alia that he never had the intention to pay the amount of Rs.2 lakhs per annum towards the premium and it was not possible for him to continue the policy for 5 years. In view of such background of the case o.ps. prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant had the policy with o.ps.?
- Whether the complainant was misled by o.ps. for payment of the premium for 5 years @ Rs.2 lakhs per annum?
- Whether there was any deficiency in service on the part of o.ps.?
- Whether the complainant will be entitled to get the relief as prayed for?
Decision with reasons:
All the points are taken up together for the sake of brevity and avoidance of repetition of facts.
Ld. lawyer for the complainant argued that the complainant was approached by the representative of o.p. insurance company for opening a policy and the complainant had the idea that the premium of the policy was onetime payment only. The complainant after knowing the said fact paid only one premium of Rs.2 lakhs for the said life insurance policy. At the time of purchasing the policy the complainant had the idea that the payment was made by the complainant as onetime payment towards the said policy, but after receiving the policy the complainant came to learn that the premium of Rs.2 lakhs annually and the complainant will have to pay the said amount for 5 years. The complainant demanded the said amount paid by him, but no reply was given by o.ps. On the basis of the said fact the complainant filed this case praying for direction upon the o.ps. for refund of the amount of Rs.2 lakhs and other reliefs.
Ld. lawyer for the o.ps. argued that the documents of the complainant was despatched by o.ps. on 12.12.13 by speed post and the complainant did not raise any objection against the said policy within the free look period of 15 days which was mentioned in the policy papers. It was further stated that the complainant having received the policy and had the 15 days time from the receipt of the policy to go through the terms and conditions of the policy and after the expiry of the said period the complainant filed this case praying for refund of the amount by stating inter alia that he never had the intention to pay the amount of Rs.2 lakhs per annum towards the premium and it was not possible for him to continue the policy for 5 years. In view of such background of the case o.ps. prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the complainant purchased the policy from o.ps. and the same was issued on 12.12.13 and the complainant received the policy. Thereafter within 15 days from the date of receipt of the policy the complainant did not raise any objection as per IRDA Regulation that the policy will have a free look period of 15 days from the date of receipt of the insurance policy by him and an insured had the option to return the policy and get refund of the premium subject to deduction of stamp duty and cost of medical (if any), receipt of policy document has not been denied by the complainant and the complainant did not raise any objection or complain during the free look period. It was presumed that the contract of insurance which started between the complainant and o.ps. was legally concluded. After the lapse of more than 2 years the complainant sent a letter to o.ps. stating that he was convinced by the agent that it is a single pay policy, however he has been provided the policy for 5 years pay term. Accordingly the complainant wanted to cancel the policy with refund of premium. It appears from the materials on record that o.ps. replied the letter dt.29.1.15 regarding its inability to cancel the policy and refund the premium amount as the complainant has not approached within free look period. The complainant being an educated person and before signing the policy papers he read the terms and conditions of the policy which clearly stipulated the pay term. Since the complainant did not express his willingness regarding the cancellation of the policy within the free look period and after the lapse of several years he prayed for cancellation of the policy and in the mean time since the contract between the policy holder and insurance company started with the expiry of the several years and non availing of the benefit of 15 days free look period by the policy holder, therefore we hold that the subsequent claim made by the complainant for withdrawal of the premium was not entertained by o.ps. Accordingly, we hold that since the complainant himself was at fault for not availing the opportunity for cancellation of the policy within free look period and subsequently by manufacturing a story that he was misled by the agent cannot be accepted. As such, we hold that the case filed by the complainant has got no merit and the complainant will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.122/2015 is dismissed on contest without cost against the o.ps.
Supply certified copy of this order to the parties free of cost.
