Date of Filing : 20/05/2016
Order No. 15 dt. 27/12/2017
The case of the complainant in brief is that the complainant on being approached by the agent of the insurance co., o.p. applied for two policies one after another. The complainant put his signature on two forms and issued two cheques amounting to Rs. 25,000/- and Rs. 30,000/- respectively towards the premium of those policies. The complainant paid three premiums amounting tp Rs. 75,000/- in respect of the first policy and due to his financial stringency he paid Rs. 30,000/- only for the second policy. Since the complainant was in need of money he surrendered the policies and asked for the surrender value of the policies. The complainant became astonished to find that against the premium paid by him to the tune of Rs. 75,000/- the surrendered value of the amount determined by the insurance co. of Rs. 24544.06 and no amount was paid towards the surrendered value of the second policy. On the basis of the said fact the complainant filed this case alleging deficiency of service on the part of the insurance co. and prayed for direction upon the o.p. insurance co. to refund the premium amount after deducting the amount already paid by the insurance co. and also prayed for compensation Rs. 1,00,000/- along with litigation cost of Rs. 50,000/-.
The O.P. insurance co. contested the case by filing a written version and denied all the material allegations of the complaint. It was stated that the complainant filed this case on the basis of false and manufactured allegations. As per Clause 6 (2) of IRDA Regulations every policy document send by the insurance co. is accompanied by a welcome letter which mentions that in case policy holder is not satisfied with the features of the terms and conditions of the policies he can withdraw / return the policy during the free look period but the complainant did not avail of the said opportunity and continued the policy by paying further premium. In such manner the complainant paid three premiums in respect of the first policy and with the surrender of the policy the surrendered value was provided to the complainant. So far as thje second policy of the concerned since the policy become lapsed as per the terms and condition of the policy the complainant could not be provided with the surrendered value. In support of the such contention the o.p. insurance co. cited various rulings in the w/v. On the basis of the said fact the o.p. insurance co. prayed for dismissal of the case.
On the basis of the pleadings of parties the following points are to be decided:
- Whether the complainant was insured with the insurance co.?
- Whether the complainant wanted to surrender the policies?
- Whether the insurance co. provided the surrendered value as per the terms of the policy?
- Whether there was any deficiency in service on the part of o.p.?
- 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 on being approached by the agent of the insurance co., o.p. applied for two policies one after another. The complainant put his signature on two forms and issued two cheques amounting to Rs. 25,000/- and Rs. 30,000/- respectively towards the premium of those policies. The complainant paid three premiums amounting tp Rs. 75,000/- in respect of the first policy and due to his financial stringency he paid Rs. 30,000/- only for the second policy. Since the complainant was in need of money he surrendered the policies and asked for the surrender value of the policies. The complainant became astonished to find that against the premium paid by him to the tune of Rs. 75,000/- the surrendered value of the amount determined by the insurance co. of Rs. 24544.06 and no amount was paid towards the surrendered value of the second policy. On the basis of the said fact the complainant filed this case alleging deficiency of service on the part of the insurance co. and prayed for direction upon the o.p. insurance co. to refund the premium amount after deducting the amount already paid by the insurance co. and also prayed for compensation Rs. 1,00,000/- along with litigation cost of Rs. 50,000/-.
Ld. lawyer for the o.ps. argued that the complainant filed this case on the basis of false and manufactured allegations. As per Clause 6 (2) of IRDA Regulations every policy document send by the insurance co. is accompanied by a welcome letter which mentions that in case policy holder is not satisfied with the features of the terms and conditions of the policies he can withdraw / return the policy during the free look period but the complainant did not avail of the said opportunity and continued the policy by paying further premium. In such manner the complainant paid three premiums in respect of the first policy and with the surrender of the policy the surrendered value was provided to the complainant. So far as thje second policy of the concerned since the policy become lapsed as per the terms and condition of the policy the complainant could not be provided with the surrendered value. In support of the such contention the o.p. insurance co. cited various rulings in the w/v. On the basis of the said fact the o.p. insurance co. prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the complainant applied for two policies from the o.p. insurance co. and according paid premiums. The insurance co. issued the policies to the complainant. It is undisputed fact that the complainant did not ask for cancellation of the policies with the free look period as per Clause 6 (2) of IRDA Regulations. It appears from the materials on record that the complainant paid three premiums in respect of first policy thereafter, he surrendered the policy and insurance co. paid him the surrendered value i.e. the 30% of the premium paid by the insured. It appears from the record which has also been mentioned by the complainant in the complaint itself that for his financial stringency he could not pay the premium for which the policy lapsed. As per the terms and conditions of the policy the insured will not be entitled to get any amount in case of surrender of policy if the policy is lapsed. Accordingly the insurance co. did not pay any amount in respect of surrendered value of the premium paid by the complainant in respect of the second policy. In view of such fact and relying on the decision as decided by Hon’ble National Commission in case of LIC of India Vs. Shibaprasad Dash reported in IV (2008) CPJ 156 NC wherein it was held that the premium is given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period for which the premium has been paid. It is not the case of the complainant that the risk was not covered for the period for which the premium was given. If after the policies lapsed, under no provision of terms of policies or law, could any forum direct for refund any premium for the simple reason, as already stated, that the risk stood covered for the period for which premium had been paid. Even if the policies were mis-sold in such a peculiar situation the complainant must have approached the company for cancellation of the policy within the free look period. But the complainant chose the said policies which prove that he had no discrepancies with regard to the policies.
Having regard to the facts and circumstances of the case we hold that the amount paid by the insurance co. as per the terms and conditions of the policy in respect of the surrender of the first policy. Since second policy lapsed therefore on the basis of the judgement cited hereinabove the question of returning of the surrender value do not arise. Therefore we hold that we do not find any deficiency in service or unfair trade practice adopted by insurance co. for which the complainant will be entitled to get any relief as prayed for.
Thus all the points are disposed of accordingly.
Hence
ordered,
that the case no. CC/204/2016 is dismissed on contest without cost against the o.ps.
Supply certified copy of this order to the parties free of cost.
