DATE OF FILING : 10.04.2015.
DATE OF S/R : 07.07.2015.
DATE OF FINAL ORDER : 24.06.2016.
Smt. Soma Das,
wife of Sri Babulal Das,
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. Soma 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. 92,781/- to the complainant and to pay compensation of Rs. 2 lakhs and costs.
- The case of the petitioner is that she 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 such policy amounting to Rs. 92,781/-. The policy commenced on 30.05.2014.
- When the petitioner received the documents from the o.p. then she was surprised to note that that o.p. actually practiced fraud upon her because the o.p. made no fixed deposit policy and invested the money as regular traditional premium of insurance policy bearing no. 10140638 dated 30.05.2014 with premium amount of Rs. 92,781/-. After receiving the paper the petitioner went to the o.ps. and expressed her intention that she never wanted to have the insurance policy and she never paid the premium for such insurance. Rather she paid the money for the fixed deposit scheme amounting to Rs. 92,781/- in fixed deposit scheme in place of insurance. The petitioner was not in a position to pay the successive premiums due to her 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 her 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 she 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 she disagrees then she 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 she came before the Forum after long lapse of over 11 months and also she 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 are taken up together for the sake of convenience and brevity for discussion and to skip off reiteration. In support of her 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 her letter expressing thanks for choosing AVIVA Life Insurance for her insurance need and also in the said letters dated 4th June, 2014 the Director, Vijayalakshmi Natarajan of the AVIVA Insurance Company informed her to review the enclosed policy document in detail to help her to understand the AVIVA Policy better. They also told her that if he was at all dissatisfied with the terms and conditions of the policy then she 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 30th May, 2015 being date of next premium for the policy. In that letter there is mention of the policy no. being 10140638 and in the policy documents there is clear mention that the policy was for 15 years and the first policy starting from 30th May, 2014 and the next premium be paid on 30th May, 2015 and the premium amount is Rs. 92,781/-. The sum assured is also mentioned in the policy document Rs. 21,60,000/- each. Thus on scrutiny of the policy document this Forum finds that even if the petitioner received the policy document on 06.06.2014 yet he did not cancel the policy within 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 she 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 her case that she 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 within the free look period of 15 days and now in the complaint petition also the petitioner made vague statement as to on which date she paid the money and what was the basis of her payment and she has not filed any document or made no statement as to how she paid the money either by cash or by cheque and she has not filed the statement of account of her bank wherefrom it could have been known as to for what purpose he paid the money whether for FD or for insurance policyand what was the exact amount paid on which date. Simply in para 4 of his case she stated that she invested a total sum of Rs. 92,781/- in fixed deposit policy through bank transfer from her 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 she did not file any such bank statement in support of her case wherefrom it could be seen as to for what purpose she 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 her case that she made payment forfixed 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. 149 of 2015 ( HDF 149 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.
