Date of filing : 18/07/2016
Order No. 20 dt. 03/04/2018
The case of the complainant in brief is that the complainant is a businessman, he lives in Kolkata, but his ailing parents live in Rajasthan and as a result thereof he has to travel from Kolkata to Rajasthan frequently. The complainant in order to have secured life in future decided to have life insurance policy with following insurance company being PNB Metlife Insurance and Kotak Insurance. Accordingly the complainant paid only annual premium of Rs.24,094/- to PNB Metlife Insurance and Rs.25,000/- to Kotak Insurance. Thereafter the complainant on 22.9.15 received a call from one Ms. Pallavi Sisodia who disclosed her identity as an executive officer calling from Integrated Grievance Management System of IRDA and enquired from the complainant whether he had any complaint with regard to existing insurance company of PNB Metlife Insurance and Kotak Insurance. The o.p. no.4 assured the complainant that it was possible to cancel the said two policies, but prior to that latter had to complete certain procedure and formalities which entailed payment of certain charges as well. He was further explained that while the cancellation is being processed the complainant will have to pay for a fresh, but temporary life insurance policy issued by Exide Life Insurance Co. Ltd. and the complainant was assured that the amount earlier paid by the complainant will be refunded. On the basis of the said fact the complainant issued a cheque of Rs.16,800/- and he was told that the cancellation could be done through Kolkata office. Thereafter on 11.10.15 o.p. called the complainant and assured that the cancellation of those two policies is under process. Subsequently on 12.10.15 the complainant was called up by one executive of IRDA and requested to pay the final amount of Rs.52,700/- and while he informed that he cannot provide he said amount until and unless he reached Kolkata, but the amount was collected from his native place at Rajasthan.
The complainant further stated that o.ps. in connivance with each other misled the complainant and the assurance given by o.ps. for refunding the amount of Rs.4 lakhs plus Rs.1,34,300/- totaling Rs.5,34,300/- was not refunded in spite of giving assurance by o.ps. The complainant after returning to Kolkata contacted the o.ps. but no fruitful result was achieved for cancellation of the policies and to get the refund of the amount. On the basis of the said fact the complainant filed this case praying for direction upon the o.ps. for cancellation of the policies issued by Exide Life Insurance Co. as well as Metlife insurance and Kotak Insurance and also prayed for compensation of Rs.5 lakhs and litigation cost.
The o.p. nos.1 and 2 contested the case by filing w/v and denied all the material allegations of the complaint. It was stated that the complainant prior to filing of this case registered a case before ombudsman with respect to the same cause of action and is still pending. It was stated that the complainant being an educated person (graduate) and businessman by profession availed 3 life insurance policies from o.p. company and duly executed proposal form proposing for Exide Life Guaranteed Income Insurance Plan. The complainant filled in the proposal form believing to be true and a statement made therein and on the basis of the proposal form duly submitted by the complainant policies were issued to the complainant. The policies were duly dispatched to the complainant’s address on 9.10.15, 11.12.15 and 25.10.15. As per 6(2) of IRDA Regulation if the policy holder is not agreeable with the condition of the policy he can pray for cancellation of the policy within 15 days of receipt of the policy bond (free look period). In such a case the company shall refund the premium receipt for those policies after deducting some necessary charges. The complainant did not raise his objection regarding the cancellation of the policy within the free look period and subsequently on 2.2.16 the complainant sent an e-mail making allegation that the o.p. insurance company made unfair trade practice and for which he prayed for cancellation of the policy. The o.p. nos.1 and 2 in their w/v stated that the complainant being an educated person and after knowing the terms and conditions of the policy he applied for the same, there are no oral rules and conditions of the policy, one has to act in accordance with the frame work of the policy. On the basis of the said fact it was stated that justice aids the vigilant not the sleeping one. The o.ps. have not acted contrary to any terms and conditions which was entered into between the parties and there was no deficiency in service or unfair trade practice on the part of o.p. nos.1 and 2 and as such, o.p. nos.1 and 2 prayed for dismissal of the case.
In spite of receipt of notices other o.ps. did not contest this case by filing w/v and as such, the case has proceeded ex parte against them.
On the basis of the pleadings of the respective parties following points are to be decided:
- Whether the complainant obtained the policies from o.ps.?
- Whether the complainant during the free look period exercised his option for cancellation of the policies?
- Whether there is any deficiency in service on the part of o.ps.?
- 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 is a businessman, he lives in Kolkata, but his ailing parents live in Rajasthan and as a result thereof he has to travel from Kolkata to Rajasthan frequently. The complainant in order to have secured life in future decided to have life insurance policy with following insurance company being PNB Metlife Insurance and Kotak Insurance. Accordingly the complainant paid only annual premium of Rs.24,094/- to PNB Metlife Insurance and Rs.25,000/- to Kotak Insurance. Thereafter the complainant on 22.9.15 received a call from one Ms. Pallavi Sisodia who disclosed her identity as an executive officer calling from Integrated Grievance Management System of IRDA and enquired from the complainant whether he had any complaint with regard to existing insurance company of PNB Metlife Insurance and Kotak Insurance. The o.p. no.4 assured the complainant that it was possible to cancel the said two policies, but prior to that latter had to complete certain procedure and formalities which entailed payment of certain charges as well. He was further explained that while the cancellation is being processed the complainant will have to pay for a fresh, but temporary life insurance policy issued by Exide Life Insurance Co. Ltd. and the complainant was assured that the amount earlier paid by the complainant will be refunded. On the basis of the said fact the complainant issued a cheque of Rs.16,800/- and he was told that the cancellation could be done through Kolkata office. Thereafter on 11.10.15 o.p. called the complainant and assured that the cancellation of those two policies is under process. Subsequently on 12.10.15 the complainant was called up by one executive of IRDA and requested to pay the final amount of Rs.52,700/- and while he informed that he cannot provide he said amount until and unless he reached Kolkata, but the amount was collected from his native place at Rajasthan.
The complainant further stated that o.ps. in connivance with each other misled the complainant and the assurance given by o.ps. for refunding the amount of Rs.4 lakhs plus Rs.1,34,300/- totaling Rs.5,34,300/- was not refunded in spite of giving assurance by o.ps. The complainant after returning to Kolkata contacted the o.ps. but no fruitful result was achieved for cancellation of the policies and to get the refund of the amount. On the basis of the said fact the complainant filed this case praying for direction upon the o.ps. for cancellation of the policies issued by Exide Life Insurance Co. as well as Metlife insurance and Kotak Insurance and also prayed for compensation and litigation cost.
Ld. Lawyer for the o.p. nos.1 and 2 argued that the complainant prior to filing of this case registered a case before ombudsman with respect to the same cause of action and is still pending. It was stated that the complainant being an educated person (graduate) and businessman by profession availed 3 life insurance policies from o.p. company and duly executed proposal form proposing for Exide Life Guaranteed Income Insurance Plan. The complainant filled in the proposal form believing to be true and a statement made therein and on the basis of the proposal form duly submitted by the complainant policies were issued to the complainant. The policies were duly dispatched to the complainant’s address on 9.10.15, 11.12.15 and 25.10.15. As per 6(2) of IRDA Regulation if the policy holder is not agreeable with the condition of the policy he can pray for cancellation of the policy within 15 days of receipt of the policy bond (free look period). In such a case the company shall refund the premium receipt for those policies after deducting some necessary charges. The complainant did not raise his objection regarding the cancellation of the policy within the free look period and subsequently on 2.2.16 the complainant sent an e-mail making allegation that the o.p. insurance company made unfair trade practice and for which he prayed for cancellation of the policy. The o.p. nos.1 and 2 in their w/v stated that the complainant being an educated person and after knowing the terms and conditions of the policy he applied for the same, there are no oral rules and conditions of the policy, one has to act in accordance with the frame work of the policy. On the basis of the said fact it was stated that justice aids the vigilant not the sleeping one. The o.ps. have not acted contrary to any terms and conditions which was entered into between the parties and there was no deficiency in service or unfair trade practice on the part of o.p. nos.1 and 2 and as such, o.p. nos.1 and 2 prayed for dismissal of the case.
Considering the submissions of the respective parties it is an admitted fact that the complainant obtained three policies from o.p. insurance company. The complainant has tried to build up a story that he was given assurance by the representative of IRDA to help him for refund of the amount which he invested in respect of earlier three policies obtained from Metlife Insurance and Kotak Insurance etc. It is hardly believable that the IRDA representative would make any contact with the policy holder and will give any suggestion to the policy holder for providing assistance of refund of the money from any insurance company. It appears from the materials on record that the complainant after payment of the premium in respect of the policies purchased from o.p. nos.1 and 2 failed to exercise his option for cancellation of the policies within the free look period. In the evidence the complainant was asked by o.p. nos.1 and 2 as to when he returned from Rajasthan or whether he can produce any document that his father was suffering from illness for which he was compelled to confined of Rajasthan for treatment of his parents to which the complainant could not give any satisfactory reply and evaded the answers to the questions. It appears from the materials on record that the complainant as per the guideline of IRDA 6(2) the complainant had the option to pray for cancellation of the policy within the free look period, but he did not avail of that option and after the lapse of several months the complainant made allegation against the o.ps. that there was unfair trade practice on the part of insurance company which is not at all believable. It appears from the materials on record that the complainant is a graduate and he is a businessman and at the time of obtaining the policies he answered the questions properly as mentioned in the proposal form and after going through the same he put his signature on the said proposal form. Immediately after the payment of the premium the condition of the policies started to work and binding upon both the parties and the complainant in order to make wild allegation against the o.ps. built up a story which is not at all a believable one and on the basis of the facts and circumstances of the case we hold that the case filed by the complainant has got no merit and the complainant will not be entitled to get any relief as prayed for. Thus all the points are disposed of accordingly.
Hence, ordered,
That the CC No.279/2016 is dismissed on contest against the o.p. nos.1 and 2 and dismissed ex parte against other o.ps. without cost.
