DATE OF FILING : 10.04.2015.
DATE OF S/R : 07.07.2015.
DATE OF FINAL ORDER : 24.06.2016.
Smt. Saswati Dey nee Das,
wife of Sri Sourav Dey,
residing at 28, Kailash Bose Lane,
P.O. & P.S. & District Howrah,
PIN 711 101. ……………………………………………………… COMPLAINANT.
1. The Branch Manager,
AVIVA Life Insurance Company Ltd.,
having its branch office at 5 P, 1st floor, Stadium Complex,
P.O. & P.S. & District Howrah,
PIN 711101.
2. The General Manager,
AVIVA Life Insurance Company Ltd.,
having its head office at AVIVA Tower, Sector Road,
opposite Golf Course, DLF Phase V, Sector 43,
Gurgaon 122 003 ( Haryana). ……………………………OPPOSITE PARTIES.
P R E S E N T
Hon’ble President : Shri B. D. Nanda, M.A. ( double ), L.L.M., WBHJS.
Hon’ble Member : Smt. Jhumki Saha.
Hon’ble Member : Shri A.K. Pathak .
F I N A L O R D E R
- This is an application U/S 12 of the C.P. Act, 1986 filed by the petitioner, Smt. Saswati Dey nee Das, against the Branch Manager, AVIVA Life Insurance Company Ltd., and its G.M. praying for a direction upon the o.p. to refund the sum of Rs. 1,22,893/- to the complainant and to pay compensation of Rs. 2 lakhs and costs.
- The case of the petitioner is that he is a consumer under the o.p. insurance company and initiated a fixed deposit policy and to pay the single premium to the o.p. for two such policies amounting to Rs. 1,22,893/- in total . The first policy commenced on 19.03.2014 and the second policy commenced on 11.04.2014.
- When the petitioner received the documents from the o.p. then he was surprised to note that that o.p. actually practiced fraud upon him because the o.p. made no fixed deposit policy and invested the money as regular traditional premium of insurance policy in two such insurance policies bearing nos. 10114247 dated 19.03.2014 with premium amount of Rs. 51,545/- in the first and the second policy bearing no. 10126198 dated 11.04.2014 with premium amount of Rs. 71,348/-. After receiving the papers the petitioner went to the o.ps. and expressed his intention that he never wanted to have the insurance policies and he never paid the premium for such insurance. Rather he paid the money for the fixed deposit scheme amounting to Rs. 1,22,893/- in two such fixed deposit schemes in place of insurance. The petitioner was not in a position to pay the successive premiums due to his financial condition. The act of the o.ps. amounts to gross negligence and unfair trade practice on their part and so the petitioner filed the case for getting refund of his deposited sum as the o.p. refused to pay the amount.
- The o.ps. AVIVA Insurance Company contested the case by filing a written version denying the allegations made against them and submitted that the complaint of petitioner is false, incorrect and malafide and filed before this Forum to take undue advantage. The complaint before the Forum does not fall under the definition of consumer dispute. The petitioner alleged fraud against the o.p. company and this Forum trying the case in a summary manner cannot adjudicate such fraud, forgery which involved disputed questions. Further the petitioner voluntarily applied for insurance policy fully knowing the terms and conditions of the policy and as per clause 6(2) of Insurance Regulatory and Development Authority Regulations 2002 the insurer shall inform by letter to the insured forwarding the policy so that he gets a period of 15 days from the date of receipt of the policy documents to review the terms and conditions of the policy and if he disagrees then he had right to cancel the policy. In the instant case there was a free look period of clear 15 days for the petitioner to discard the policy but instead of doing so he came before the Forum after long lapse of over 11 months and also he raised no objection after receiving the policy documents and thus the contract was legally concluded.
- The o.p. further stated that the petitioner for the first time made a complaint on 24.3.2015 and the o.p. replied seeking certain documents which are not produced by the petitioner till the date and no cancellation request was made and the policy cannot be cancelled also as no objection was raised during the free look period. The petitioner made complaint after a lapse of 11 months from the date of policy. Further the policy was issued as per consent of the petitioner and the information provided by the petitioner in the proposal form. The petitioner approached the o.p. after long lapse of 11 months without raising any objection during the free lock period praying for cancellation of the policy and so once the contract is concluded and the petitioner has enjoyed the life risk cover for a certain period so the prayer of the petitioner to get the full premium amount back cannot be accepted as the same would cause loss to the o.p. The petitioner being an educated person would not sign the proposal form blindly and would not have given money blindly. The o.ps. followed all the terms and conditions and to harass the o.p. the petitioner filed false and frivolous case which is liable to be dismissed as our National Commission as well as Supreme Court in many decisions opined that the contract between insurer and insured is to be interpreted on the terms and conditions of the policy documents. The petitioner having no primafacie case the o.ps. prayed for dismissal of the present case.
- Upon pleadings of parties the following points arose for determination :
- Is the case maintainable in its present form ?
- Whether the petitioner has any cause of action to file the case ?
- Whether there is any deficiency in service on the part of the O.Ps. ?
- Whether the complainant is entitled to get any relief as prayed for ?
DECISION WITH REASONS :
- All the issues aretaken up together for the sake of convenience and brevity for discussion and to skip off reiteration. In support of his case the petitioner filed affidavit as well as documents. The o.ps. also filed documents in support of their case. On scrutiny of the documents filed by the petitioner it is noticed that the o.p. AVIVA Life Insurance Company sent him letter expressing thanks for choosing AVIVA Life Insurance for his insurance need and also in the said letters dated 28.03.2014 and 17.04.2014 the Director, Vijayalakshmi Natarajan of the AVIVA Insurance Company informed him to review the enclosed policy document in detail to help him to understand the AVIVA Policy better. They also told him that if he was at all dissatisfied with the terms and conditions of the policy then he can cancel the policy within 15 days free look period from the date of receipt of the said letter. In the said letters the next date for payment of premium was clearly mentioned being 19.03.2015 and 11.04.2015 dates of next premium for the two policies. In those two letters there is mention of the policy no. being 10114247 & 10126198 and in the policy documents there is clear mention that the policy was for 12 years and the first policy starting from 19.03.2013 and the next premium be paid on 19.03.2014 and the premium amount isRs. 51,545/-. The total sum assured is also mentioned in the policy document Rs. 12,00,000/- each. Thus on scrutiny of the policy document this Forum finds that even if the petitioner received the policy document on 01.04.2013 and 18.4.2014 yet he did not cancel the policywithin 15 days free look period from the date of receiving the documents when in the said letter there was clear mention of the next date of premium and also those letters were annexed with the policy document wherein clear mention of the terms and condition of the policy and the dates of last premium, policy period and sum assured and other necessary informations.
- Our Supreme Court as well as our National Commission opined that the policy document is binding on both the parties and the policy is a contract between the insurer and the insured and both the parties are bound by the terms and conditions of the contract. In that instant case it is the case of the petitioner that he deposited the amount in the fixed deposit scheme but save and except his statement in the complaint petition there is no document in support of his case that he deposited the amount for the purpose of fixed deposit scheme and not for getting the life insurance policy as is the case of the o.p. Further, after the commencement of the policy on the date on which the first premium was paid, the o.p. sent the letter of thanks along with policy documents, but in spite of getting the policy documents the petitioner made no objection to the same or praying for cancellation of the same whether the free look period of 15 days and now in the complaint petition also the petitioner made vague statement as to on which date he paid the money and what was the basis of his payment and he has not filed any document or made no statement as to how he paid the money either by cash or by cheque and he has not filed the statement of account of his bank wherefrom it could have been known as to for what purpose he paid the money whether for FD or for insurance policy and what was the exact amount paid on which date. Simply in para 4 of his case he stated that he invested a total sum of Rs. 1,22,893/- in two fixed deposit policy on two separate occasions through bank transfer from his account of Indusind Bank as could be noticed from the bank statement of the petitioner even if the transactions took place on different dates with long gap and also he did not file any such bank statement in support of her case wherefrom it could be seen as to for what purpose he paid the money. Further in case of a fraud as alleged by petitioner this Forum has no jurisdiction to entertain the same as opined also by our National Commission.
In view of above discussion and findings this Forum finds that the petitioner miserably failed to prove his case that he made payment for two fixed deposit scheme and o.ps. illegally issued insurance scheme..;
In the result, the application fails.
Court fee paid is correct.
Hence,
O R D E R E D
That the C. C. Case No. 147 of 2015 ( HDF 147 of 2015 ) be and the same is dismissed on contest without costs against the O.Ps.
Supply the copies of the order to the parties, free of costs.
DICTATED & CORRECTED
BY ME.
( B. D. Nanda )
President, C.D.R.F., Howrah.
