For Complainant : Sri Sunil Kumar Mohanty, Advocate
For OP No.1 : Sri B. N. K. Choudhury, Advocate & associates.
For OP No.2 : Self.
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1. The brief history of the case of the complainant is that he subscribed a policy vide No.891585788 namely Max Life Gain Plus 20 issued by OP.1 through its agent OP No.2 for a period of 20 years with annual premium of Rs.30, 000/- to be paid for 6 years. It is submitted that the complainant has paid 2 premiums @ Rs.30, 000/- each on 13.10.2013 and 26.11.2014 totalling Rs.60, 000/- towards the premiums but due to financial crisis he could not deposit the premiums for the year, 2015 to 2018 and requested the OP.2 to refund the deposit amount of Rs.60, 000/- with accrued benefits. As the Ops did not respond, the complainant has issued a notice on 31.10.2019 to the Ops through its advocate and on receipt of said notice, the OP.2 replied that they will examine the matter and will reply within 15 days. As the Ops did not take any step to refund the deposits, he filed this case praying the Forum to direct the Ops to refund Rs.60, 000/- with accrued benefits and to pay Rs.60, 000/- towards compensation and cost to the complainant.
2. The OP.1 filed counter admitting the policy in question issued in favour of the complainant and payment of initial premium of Rs.30, 000/- with renewal premium of Rs.29, 669/- by the complainant. It is contended that the complainant availed the policy for a sum assured of Rs.1, 77,615/- under base policy and under term rider clause he got additional sum assured of Rs.1, 30,000/- payable in the event of death of the complainant. It is further contended that the complainant has paid only two premiums instead of 6 premiums and on 01.11.2019 the complainant has sent a legal notice demanding the refund of premiums paid on the behest of his financial crisis which is beyond the free look period as per terms and conditions of the policy. It is also further contended that vide letter dt.20.12.2019 the OP Company communicated its willing to cancel the policy and refund the premium amount paid by the complainant as an exception and service gesture but the Company did not receive any confirmation from the complainant. Thus denying any fault on its part, the OP.1 prayed to dismiss the case of the complainant.
3. The OP No.2 in spite of valid notice did not prefer to participate in this proceeding in any manner. Both the parties have filed certain documents along with affidavit in support of their respective cases. Heard from the parties through their respective A/Rs and perused the materials available on record.
4. In this case Max Life Gain Plus 20 participating Plan Policy No.891585788 issued in favour of the complainant by OP.1 on 26.09.2013 with sum assured of Rs.1, 77,615/- and rider clause sum assured of Rs.1, 30,000/- in case of death are all admitted facts. It is also a fact that the Policy is for 20 years and the annual premiums were to be paid for 6 years @ Rs.30, 000/- p.a. The complainant submitted that he paid two premiums under the policy on 13.10.2013 and 26.11.2014 and due to financial problem he could not pay the rest of the premiums and requested the Ops to refund the premiums with benefits. The case of the complainant is that as the Ops did not refund the premiums, he sent notice to the Ops through his advocate but the Ops did not take any action.
5. The OP.1 stated that they have received Rs.30, 000/- as initial premium and Rs.29, 669/- towards renewal premiums from the complainant but on the behest of his financial crisis the complainant has sent a letter dt.01.11.2019 demanding refund of premiums paid. The OP.1 stated that the complainant violated the agreed terms and conditions but considering the case of the complainant they have sent their willingness to the complainant vide their letter dt.20.12.2019 to cancel the policy and refund the premiums but they did not receive any confirmation from the complainant in this regard.
6. On perusal of record it is found that the OP No.1 has sent willingness of the Company vide its letter dt.20.12.2019, the copy of which available on record. The OP No.2 has also replied on 06.11.2019 to the notice of the complainant stating that they will examine the matter and shall reply to the complainant within 15 days or so. In its letter to the complainant dt.20.12.2019, the OP.1 has stated that as an exception and service gesture, they are ready to cancel the policy and refund the total received premium amount of Rs.59, 669/- and requested the complainant to confirm through return mail/letter if the above offer is full and final satisfaction of his grievance. It is seen that the complainant is yet to reply to the said letter of OP.1.
7. It is a fact that the insurance is a contract between the parties and they are bound by its terms. Free look period of 15 days under the policy is provided to read and understand the policy terms and if insured is not satisfied with the terms of the policy, he is at liberty to return the policy within said period. This case is different one. An agreed and consented contract cannot be denied after the free look period. However, the Ops in this case are willing to cancel and refund the premium amount of Rs.59, 669/- and communicated their willingness to the complainant seeking his consent but the complainant did not turn up. Hence we do not find any deficiency in service on the part of the Ops in the above circumstances of the case. As the Ops are will to refund Rs.59, 669/- as total premiums received, we direct the OP.1 to refund the said amount to the complainant after cancelling the policy. As we hold that the Ops have not committed any deficiency in service, the complainant is not entitled for any compensation except a sum of Rs.2000/- towards cost of this litigation.
8. Hence ordered that the complaint petition is allowed in part and the OP No.1 is directed to refund Rs.59, 669/- only along with Rs.2000/- towards cost of litigation to the complainant by cancelling the policy in question within 30 days from the date of communication of this order failing which the awarded sum shall carry interest @ 12% p.a. from the date of this order till actual payment.
(to dict.)
