O R D E R
AS PER SRI G.APPALA NAIDU,MEMBER
This complaint is filed U/s-12 of C.P.Act, 1986 seeking reliefs to direct the O.P’s jointly and severally to cancel the insurance policy and refund the amount of Rs.30,000/- that was paid by the complainant towards premium instalments together with interest at the rate of 24% per annum from the respective dates of payment of each instalment, to pay an amount of Rs.75,000/- towards compensation and damages, to pay costs of the complaint and to grant such other relief or reliefs as the Honourable Forum deems fit and proper in the circumstances of the case on the following averments:-
The complainant is a resident of Nellimarla Village in Vizianagaram District and the O.P.No.1 is carrying on insurance business under the name and style of Reliance Life Insurance Company Limited having its registered office in Navi Mumbai and O.P.No.2 is branch office near R.T.C.Complex in vizianagaram. The complainant took an insurance policy bearing No.17948527 from O.P.No.1 through O.P.No.2 under Reliance Traditional super Invest Assure plan by depositing Rs.10,000/- towards First premium under the 1st premium receipt bearing No.1105111 B dated 21.09.2010. The premium paying term and policy term is 15 years. Basic sum assured is Rs.75,000/- and installment premium is Rs.10,000/- per year. The complainant paid an amount of Rs.10,000/- in the year 2011 towards 2nd year installment premium and also paid an amount of Rs.10,000/- in the year 2012 as the 3rd year installment premium. When the complainant visited the office of O.P.2 to pay the 4th installment premium for the year 2013, he did not accept the premium amount but informed the complainant that the payment of installment premium for the year 2012 was not credited to the policy Account of the complainant till date.
The complainant further submits that he made a written complaint to the O.P.2 asking him to supply statement copy to know the details of the policy account of the complainant but the O.P.2 refused to supply the same and thus the O.P.2 committed deficiency in service and unfair trade practice. It is further submitted that the O.P.No.2 having received the amount did not credit the same to the policy account of the complainant and also not supplied/provided the statement of policy account which amounts to unfair trade practice and unscrupulous exploitation of the consumer.
With the behavior of the O.P.2 the complainant was shocked and also lost faith in the insurance business of the O.P. company and hence he demanded the O.P.2 to cancel the policy and to refund amount that was deposited with the O.P. company towards installment premium amounts but the O.P.2 having agreed to refund the amount, postponing the same on one pretest or the other. As a result of the negligence and deficiency in service on the part of O.P.2, the complainant suffered loss and injury due to deprivation, harassment, financial hardship and mental agony for which the O.P’s are jointly and severally liable to pay compensation to the complainant.
The complainant got issued a registered lawyers notice dated 28.01.2014 to the O.P’s demanding them to cancel the policy and to refund the amount of Rs.30,000/- which was paid by the complainant towards premium installments together with interest at the rate of 24% per annum from the respective dates of payment of each installment and also to pay compensation and damages for which the O.P. insurance company sent an interim reply dated 30.01.2014 where in they have stated that they are looking into the allegation mentioned in the notice of the complainant and will revert shortly. Thereafter even though months have elapsed, the O.P. insurance company made no efforts to settle the matter. Hence this complaint.
Reply of O.P’s in response to the consumer complaint was filed by denying the allegations leveled against them in the complaint except those which are specifically admitted therein and puts the complainant to strict proof of the same. The O.P’s submits that in accordance with clause-6 (2) of the insurance regulatory and development authority (protection of policy holders interests) regulations, 2002 every policy document sent by it is accompanied by welcome letter which clearly mentions that in case policy holder is not satisfied with the features or the terms and conditions of the policy, he/she can withdraw/return the policy under the “Free look period” provision. However the complainant retained the policy document but did not raise any objection towards the policy during the said “Free look period” which means that the complainant agreed to the policy and its terms and conditions as the same was in order.
The O.P. without prejudice to the contentions mentioned supra, issued the Reliance Traditional Super Invest Assure plan to the complainant with the following features:-
a)Policy Number 17948527
b)Name of the life assured Mr.Meesala Appala Naidu.
c)Nominee Ms.M.Dhanalakshmi
d)Policy issue date 21.09.2010.
e)Policy Term 15 years.
f)Premium paying Term 15 years.
g)Premium amount Rs.10,000/-
h)Frequency Yearly
i)Total premium received Rs.30,000/-
It is further submitted by the O.P. that the policy was issued as per the terms and conditions mutually agreed by the parties and as per the said terms if the complainant disagrees with any of the terms and conditions of the policy, he has the right to return the policy of the company within the “Free Look Period” of 15 days from the receipt of the policy document for cancellation by stating the objections. In such case the company refunds the premium paid subject to nominal applicable deductions. But after the receipt of the proposal form and policy document, the complainant never approached the O.P’s to express any concerns within the mandatory period of 15 days of Free look period” and hence the policy has continued and the terms and conditions mentioned in the policy documents are binding upon both the parties, since the “Free look period” ends on 20.10.2010. Thereafter the complainant approached the O.P’s to cancel the aforesaid policy.
In the present case, the O.P’s have not violated any terms and conditions of the insurance policy and also have not made any change in the terms and conditions of the policy and therefore pleads that there is no deficiency in service on the part of O.P’s.
It is further submitted and admitted by the O.P’s that the complainant paid total amount of Rs.30,000/- for the three consecutive annual premium installments and the same has been reflected in the policy account of the complainant. As per the terms and conditions of the policy, the complainant waived his right to request the O.P’s to cancel the aforesaid policy after the “Free look period” which ends on 20.10.2010. It is also submitted by the O.P’s that they have duly replied to the legal notice dated 18.01.2014 on 30.01.2014 got issued by the complainant stating that “We are looking into the allegation mentioned in the notice and will revert shortly” but in the meanwhile the complainant filed the present complaint before this Honourable Forum. In view of all the above, the O.P’s pleads that the complainant is not entitled to any relief as prayed for in the complaint since there is no deficiency in service on the part of O.P’s and hence the complaint is liable to be dismissed with compensatory costs to the O.P’s.
Exhibits A1 to A8 are marked on behalf of the complainant and exhibits B1 to B2 are marked on behalf of the O.P’s.
Heard arguments from the side of the complainant whereas the O.P’s and their counsel called absent inspite of several opportunities given. Hence It is deemed that there are no arguments to be advanced from the side of O.P’s. Posted for orders. The orders are as follows:-
The counsel for the complainant advanced arguments by reiterating what was stated in the complaint, evidence affidavit and brief written arguments respectively. Since there are no oral arguments advanced by the O.P’s, the contents in their counter, evidence affidavit and brief written arguments were perused.
The main contention of the complainant is that even though he paid the respective premium installments for all the three years i.e. 2010, 2011 and 2012, the third installment of premium paid in the year 2012 was not credited to his policy account until he filed the present complaint in this Forum. When he approached the 2nd O.P. for the payment of the 4th annual installment, he was shocked to learn that the amount paid by way of premium in respect of the 3rd installment was not credited to his policy account and hence the 2nd O.P. did not accept the 4th installment due for the year 2013 since the premium paid in respect of the year 2012 installment was not credited to his account and therefore he requested the 2nd O.P. to provide copy of the statement of account but invain. Hence there is a clear deficiency in service, dereliction in duty and unfair trade practice on the part of the O.P’s for not crediting the 3rd installment premium paid in the year 2012, for failure to supply the statement of account and also for refusal to receive the 4th installment premium when he approached the 2nd O.P.
The main contention of the O.P’s is that in accordance with clause-6 (2) of the Insurance regulatory and development authority (Protection of policy holders interests) regulations, 2002, every policy document sent by the Insurance Company is accompanied by a welcome letter which clearly states that in case, policy holder is not satisfied with the features or the terms and conditions of the policy he/she can withdraw/return the policy under the “Free Look Period” provision and the complainant could not avail the option of returning the policy within 15 days of receipt i.e. within “Free Look Period” and when once the said period is over, policy documents become binding on both the parties and the contents therein are also binding on both of them. In view of the above failure on the part of the complainant, his request to refund the premium amount already paid could not be serviced by the O.P’s as there is no deficiency on their part.
Also the O.P’s cited the following judgements delivered by Honourable National Commission in support of their contentions:-
a)Mohan lal Benal Vs ICICI prudential life insurance Company limited.
b)Harish kumar chadha Vs Bajaj Allianz Life Insurance Company Limited that if the insured/complainant is not satisfied with the policy taken, then he/she should avail the option of returning the policy within 15 days of receipt i.e. within “The Free look period.”
c)Srikant Murlidhar Apte Vs Life Insurance Corporation of India for the revision petition No.634 of 2012 decided on 02.05.2013 in which the aforesaid proposition was also clearly laid down. Further the Honourable National Commission concurred with the findings of Maharashtra State Commission, Mumbai that “Once 15 days” cooling off period is over, policy document become binding on both the parties and the contents therein are also binding on both of them. Hence the complaint deserves to be dismissed on the above ground.
Further the present complaint is arising out of an investment policy taken by the complainant for speculative gain and hence the complainant is not a consumer, as the policy in question is a unit linked policy.
d)The Honourable National Commission in Ramlal Aggarwalla Vs Bajaj Allianz Life Insurance Company Limited (R.P.No.658/2012) referred the Honourable State Commission Odisha in Smt. Avanthi Kumari Sahoo Vs Bajaj Allianz Insurance Company Limited (F.A.No.162/2010) wherein it was held that if the money of the complainant had been invested in the share market, it is no doubt that It is speculative gain and the speculative investment matter does not come under the Consumer Protection Act, 1986. Therefore the present complaint is not maintainable and the Honourable Forum has no jurisdiction to admit this complaint.
e)Another citation is submitted by the O.P. in respect of Ravneet Singh Bagga Vs K.L.M.Royal Dutch Airlines (2000)1SCC 66) where the Honourable Supreme Court laid down that the test of deficiency in service: “The deficiency in service cannot be alleged without attributing fault, imperfection, short coming or inadequacy in the quality, nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the person who alleges it. The deficiency in service has to be distinguished from the Tortuous acts of the respondent. In the absence of deficiency in service the aggrieved person may have a remedy under the common law to file a suit for damages but cannot insist for grant of relief under the Act. If on facts it is found that the person or authority rendering service had taken all precautions and considered all relevant facts and circumstances in the course of the transaction and that their action or the final decision was in good faith, it cannot be said that there had been any deficiency in service”.
f)In another citation in the case of Kishore Chandrakant Rathod Vs Managing Director, ICICI Prudential Life Insurance Company Limited and others (Revision petition No.3390 of 2013, NCDRC) held that “it must be borne in mind that the petitioner is an educated person. He was supposed to read each and every terms and conditions of the policies. There are no oral rules and conditions of the policy. One has to act in accordance with the frame work of the policy. The complainant is not a Gullible person who could have been taken up garden path. It appears that he did not act prudently. He used the ink but not his brain. It is well settled that man may tell lies but the documents cannot. Everywhere he has mentioned that he was informed by the bank official. The name of that bank official did not see the light of the day. His story does not just stack up. No deficiency can be attributed to the respondent. They have acted in accordance with the law and on the other hand the complainant swallowed the bait.”
The O.P. submitted another citation in the case of United India Insurance Company Limited Vs Harchand, Rai chand Rai Chandanlal I (2003) CPJ 393 & Vikram Greentech (I) Limited and another Vs New India Assurance Company Limited II (2009) CPJ 34 where the Honourable Supreme Court held the on insurance policy is to be construed strictly as per the terms and conditions of the policy document which is a binding contract between the parties and nothing can be added or substracted by giving a different meaning to the words mentioned therein. Therefore, in the light of the above principle, the complainant is bound by the terms and conditions of the policy. Further, The Honourable Supreme Court in the case of Expert credit guarantee corporation of India Limited Vs Garg Sons international (2013 (1 scale 410) held that while construing the terms of the contract of insurance, the court must give paramount importance to the terms used in the said contract.
Now the point for consideration is whether there is deficiency in service or dereliction in duty or unfair trade practice on the part of the O.P’s?
The following vital points are to be reckoned with for arriving at appropriate finding decision:-
1)The complainant paid an amount of Rs.30,000/- in total towards policy premium in respect of three years continuously from 2010 to 2012 at the rate of Rs.10,000/- per year as annual premium.
2)The same fact was admitted by the O.P’s in their Reply/ Counter/Evidence Affidavit and Brief written arguments submitted into this Forum. Hence admitted facts need not be proved.
3)When the complainant approached the 2nd O.P. for payment of the premium in respect of 4th installment for the year 2013, the 2nd O.P. refused to accept/receive the same for the reason that the 3rd installment of premium paid in respect of the year 2012 was not credited to the policy account of the complainant even though the same was paid by way of cash on 05.11.2012 through the O.P’s channel development associate (CDA office) Code-F 43221.
4)The complainant addressed a letter dated 04.12.2013 to the Territory Manager of the insurance company informing the payment of premium in respect of the 3rd annual installment but the mistake committed from their side was not rectified. Hence the complainant was shocked to learn that the said installment amount was not credited to the policy account till that date.
5)Even though requested by the complainant, the O.P.2 refused to supply the statement of his account.
6)The 2nd O.P. having agreed orally to refund the amounts of premium paid by the complainant was postponing the same on one pretest or the other since longtime, which is nothing but intentional.
7)For the legal notice dated 28.01.2014 got issued by the complainant, the O.P. sent interim reply dated 30.01.2014 stating that they are looking into the allegation mentioned in the said notice and will revert shortly further mentioning that through this reply no allegation mentioned in the notice is deemed to be accepted/admitted unless agreed specifically. And thus It clearly shows that in each and every oral or written reply they are very careful only to avoid their obligation on one pretest or the other.
8)Even for all the above sequence of events and though the complainant has been approaching the O.P’s with vigorous follow up the O.P’s could not reply so far by only mentioning vagnely that in the meanwhile the complainant filed the present complaint before this Honourable Forum but without any commitment on their part regarding settlement of the issue.
9)The O.P’s or their counsel were called absent for hearing of the case even though several opportunities are allowed, which is deemed to be intentional and therefore adverse inference can be drawn that they have no further points/material to be offered in support of their case. Even they could not produce/adduce any material evidence to the satisfaction of this Forum in respect of the allegations made in the complaint or in support of the contentions made by the O.P’s.
In view of all the above discussions and perusal of the entire material placed on record, we are of the considered opinion that the complaint can be partly allowed, as there is deficiency in service and unfair trade practice on the part of O.P’s.
In the result, the complaint is partly allowed directing the O.P’s 1 and 2 jointly and severally to refund the amount of Rs.30,000/-(Rupees Thirty Thousand Only) to the complainant with interest at 9% per annum from the respective dates of payment of premium for each installment by cancelling the insurance policy to be received from the complainant. The O.P’s are further directed to pay Rs.10,000/-(Rupees Ten Thousand Only) to the complainant towards compensation and damages for the inconvenience, hardship and mental agony suffered by the complainant. The O.P’s are also directed to pay Rs.2,000/- (Rupees Two Thousand Only) towards costs of the complaint which includes advocate fee of Rs.1,000/- (Rupees One Thousand Only). This order shall be complied within one month from today.
Dictated to the Steno, transcribed by him, corrected by me and pronounced by us in the open Forum, this the 25th day of June, 2015.
MEMBER PRESIDENT
C.C.No.51 / 2014
APPENDIX OF EVIDENCE
WITNESSES EXAMINED
For complainant:- For opposite parties:-
PW 1 RW1 & RW2
DOCUMENTS MARKED
For Complainant:-
Ex.A-1 First Premium Receipt bearing No.1105111 B for
Rs.10,000/- Dt.21.09.2010.
Ex.A-2 Premium Receipt bearing No.WC0014593663 for
Rs.10,000/- Dt.23.11.2011.
Ex.A-3 Cash Receipt for Rs.10,000/- Dt.05.11.2012.
Ex.A-4 Written complaint with acknowdgement, Dt.10.01.2014.
Ex.A-5 Office copy of Legal Notice, Dt.28.01.2014.
Ex.A-6 Acknowledgement from O.P.2, Dt.30.01.2014.
Ex.A-7 Interim Reply, Dt.30.01.2014.
Ex.A-8 Acknowledgement from O.P.1, Dt.03.02.2014.
For OP’s:-
Ex.B-1 Reliance Life Insurance Copy.
Ex.B-2 Reliance Life Insurance Copy.
President
