Order date: 27.06.2024.
Today is fixed for admission hearing.
The record is taken up for admission hearing.
Heard the Ld. Advocate for the complainant in full.
The Ld. Advocate submitted that the OP No.1 , the Insurance Company, Op No.2 is the Branch Head of the OP No.1. OP NO.3 is the Branch Head at Burdwan from where the complainant purchased the Insurance Policy. On 30.01.2014 the complainant purchased a Life Insurance Policy namely Super Money Back Plan being contract No. 51459384 and Client I.D. 87291538 and he paid the premium amount of Rs.50,000/- through Cheque and the OP issued the Policy certificate . At the time of payment, of next premium in the year 2015 the insurance agent and a few staff of the insurance company convenience the complainant to pay a three year premium amount of Rs.1,50,000/- at a time to avail of Rs.30,000/- discount . Accordingly, the complainant paid Rs.1, 20,000/- at a time with an intension to get Rs.30,000/- discount in three premiums of impugned policy through demand draft dt. 06.03.2015. The complainant further states that he received a mail of three pages from the OP stating the details of new policy regarding the inability to change the policy and others. Subsequently, the complainant received the new policy certificate , he became perplexed as it is a new policy which is also a Super Money Back Plan created due to payment of Rs.1,20,000/- being No. 52095389 depicts the name of the policy holder is Tapas Kumar Roy and the life of Chhaya Roy assured and yearly premium is Rs.1,20,000/- which is not possible to pay yearly for him. So, it is clear from the face of the policy that the OP created a new policy bearing No. 52095389 having yearly premium of Rs.1, 20,000/- in the name of this complainant. But fact remains that the complainant being convenience by the agent and personal of OP Insurance Company, paid a sum of Rs.1,20,000/- for the payment of premiums for three years. But the Insurance Company issued a new policy instead of payment of three years premiums of earlier policy without the knowledge of the complainant. After getting the new policy, the complainant shocked and surprised and immediately lodged a complainant through e-mail , praying to cancel the policy being No. 52095389 and to refund the premium amount of Rs.1,20,000/- but the OP turned down the request of the complainant vide letter dt. 5.01.2016 as the Free-Look period was elapsed. Again, the complainant wrote a letter dt. 12.02.2016 to the OP No.3 seeking the refund of premium amount at a time in respect of policy No. 51459384 paid by the complainant. Then the OP took away the original Policy Bond from the complainant. But of no result. The complainant getting no alternative lodged a complaint dt. 4.03.2016 before the Ombudsman at Kolkata stating the grievances . After a contested hearing, the Ld. Insurance Ombudsman settled the dispute in the complainant unconditionally accepted the award the Ld. Insurance Ombudsman and sent the consent letter to the Ld. Insurance Ombudsman the Insurance Company in the prescribed format. The complainant states that after expiring 5 years the Insurance Company did not pay the maturity amount till date. So, the complainant knocked the door of the OP for getting the maturity amount. Later on, the complainant as per advice of the OP compelled to pay Rs.25,000/- on 22.12.2020 , Rs.26,272/- on 30.01.2021 and Rs.20,000/-on 7.5.2021 because the concerned staff of the Company assured that all the three payments are taken as GST . The complainant has been anxiously waiting for prolonged period to get the maturity value of the insurance policy being No. 5209589.
After waiting for a prolonged period the complainant again wrote letter to the concerned authority on 23.04.2024 praying to pay the maturity amount of the policy No. 52095389 but the OP remained silent.
Perused the complaint and the Xerox copies of documents so filed by the complainant.
On perusal of the documents of Policy Certificate, it is noticed under the Clause of “Free Look Period” if the Insured wants to disagree with the terms and conditions o f the policy, he has to return the policy within 15 days of its receipt. We find to this complaint , the complainant as insured wants to terminate the policy, when as per terms and condition the time limit is over accordingly as per contract paper 15 days already been over from the commencement of the policy when this Commission finds no reason to issue any notice to the OPs, on admitting of the complaint in Para No.6 of the complaint , the complainant lodged an e-mail praying to cancel the Policy No. 52095389 and to refund the premium amount of Rs.1,20,000/- . After that the complainant wrote a letter dt. 12.02.2016 to the Insurance Company at Burdwan i.e. OP No.3 seeking the refund of premium amount which the complainant paid as three premiums at a time in respect of policy No. 51459384. Then the OP-Insurance Company took away the original policy bond from the complainant. We obviously observed that the matter is pre-matured one when the original certificate is returned to the company. This Commission is bound to observe that there is no documentary evidence about this. The Commission fails to make any presumption about this transfer from Old Certificate to New Certificate bereft of any cogent evidence or any proof. The complainant was quite silent or not clear on this transacted money dt. 22.12.2020 Rs.25,000/-, 30.01.2021 Rs.26,272/- and on 07.05.2021 Rs.20,000/- . Account Statement from 22 Dec.2020 to 23 Dec. 2020 shows that the accounts stand in the name of Mr. Raziya Mohammad Gous Hotgi and not in the name of Tapas Kr. Roy. Similarly, Account Statement from 30 Jan.2021 to 31 Jan. 2021 shows that the account stand in the name of MS R.M. Enterprise and not in the name of Tapas Kr. Roy. Hence, the date of cancellation policy by the complainant probably near about 10 years ago. Naturally, we find this complaint is highly time-barred .
Thus the complaint is rejected for admission on the strength of its merit.
Accordingly, considering all those materials, this Commission has failed to give effect to this complaint petition as admitted one. Let the petition rejected for admission.
Let a copy of this order be given to the complainant on free of cost.
Member Presiding-Member
D.C.D.R.C., Purba Bardhaman D.C.D.R.C., Purba Bardhaman
