Sri B.NARAYANAPPA,

     President

1. The complainant  Smt. Jyothi Ramachandra has filed this complaint against the opposite party The Manager, Bharti AXA Life Insurance Company Limited praying to direct the opposite party  to refund money atleast the amount of last 3 insurance policies

2. The brief facts are that:-

The petitioner and her husband are living on the pension, they are living in a rented house.The husband of the petitioner get Rs.48,000/- per month as pension it is not possible to maintain the family and to pay the insurance premium since they were not having any other source of income except pension.

3.      The petitioner is the customer of opposite party, she has taken 5 insurance policies from the opposite party on the advice of the opposite party company agent.  The petitioner is aged about 55 years and her husband 75 years old and suffering from joint pain, spinal problem and heart problem etc., and her husband is  bed ridden.  It is further contended that the agent of the opposite party company issued policy in the name of the husband of the petitioner  bearing policy No. 501-6228263 on monthly installment of Rs.5,199.87 dated 26.09.2017 and the amount is withdrawing from the joint account of the petitioner and her husband.

4.      The agent of opposite party also issued yearly premium policy bearing No.501-7221242 dated 06.04.2018  an annual premium of Rs.51,999.14/- and also issued one more policy in the name of the husband of the petitioner bearing No.501-7428797  on 28.05.2018 on annual premium of Rs.51,999.18/- and also issued another policy bearing No.501-8111129 on 29.10.2018 on annual premium of Rs.52,499.76 and also issued one more policy No.501-8069301 on 30.10.2018 on annual premium of Rs.1,04,999.52/-.  It is further contended that before issuing the insurance policy it is the bounded duty of opposite party to verify the financial position of their client and capability of the customer, the petitioner is the customer who is not eligible to take insurance policy as she is not in a position to continue three yearly policies as such it is just and necessary to advise the opposite party to refund the policy money without fails.  Hence, this complaint.

5. After registration of this complaint, notice was ordered to be issued to opposite party.  In spite of service of notice upon the opposite party he does not turned up.  Hence, he was placed exparte.

6. The complainant has filed her affidavit by way of examination in chief and the same was taken as PW.1 and got marked documents at Exhibits P.1 to P.7.

7. Heard the arguments of complainant’s counsel and also he filed written arguments.

8. The points that would arise for our consideration are as under:-  

1. Whether the complainant proves that the act of the opposite party in issuing insurance policy to the petitioner without verifying her financial position as she was not eligible to take insurance policy is amounts to deficiency in service?
2.  What order?

9.      Our findings on the aforesaid points are as follows:

       Point No.1 :- In the negative;

      Point No.2 :- As per final order for the following

:: R E A S O N S ::

10.       Point No.1:- The learned counsel for the complainant has vehemently argued as per the contention taken in the complaint, affidavit of complainant and documents produced on behalf of complainant and as per the notes of arguments.

11.      It is the case of the complainant that the agent of opposite party has issued 5 following polices to the petitioners they are;

1. Policy No.501-6228263 dated 26.09.2017
2. Policy No.501-7221242 dated 06.04.2018.
3. Policy No.501-7428797 dated 28.05.2018.
4. Policy No.501-8111129 dated 29.10.2018.
5. Policy No.501-8069301 dated 30.10.2018.

  It is the specific contention of the complainant that the petitioner is aged about 55 years and her husband aged about 75 years and she is suffering from joint pain, spinal problem and heart problem and her husband is  bed ridden and her husband getting pension of Rs.48,000/- per month which is the only source of income for their maintenance,  except the pension amount they are not having  any other source of income to pay the premium amounts to the above said 5 policies and it is further contended that the agent of the opposite party without ascertaining the financial position of the petitioner and her capability to pay the premium of the insurance policies instigated her and issued the above said 5 insurance policies in her name but the complainant is unable to pay the premium as she has no source of income except the pension amount of Rs.48,000/- which is insufficient to pay the premium amounts to the above said 5 policies.  Therefore the complainant has come up with this present complaint praying to direct the opposite party to refund atleast the amount of last 3 insurance policies to the complainant and produced 5 insurance policies.  We have carefully gone through the terms and conditions of the said 5 policies.  1^st policy bearing No. 501-6228263 was issued in the name of the policy holder Sri. Y.M. Ramachandra who  is none other than husband of the petitioner and life insured is the petitioner herein the term of the policy is 12 years.  The 2^nd policy bearing No. 501-7221242 was also issued in the name of petitioner Sri. Y.M. Ramachandra, who is the  husband of the petitioner and the life insured is the petitioner herein Smt. Jyothi Ramachandra the term of the policy is 10 years.  The 3^rd policy bearing No. 501-7428797, 4^th policy bearing No. 501-8111129 and 5^th policy bearing No. 501-8069301.   All these 3^rd to 5^th  policies are also issued in the name of the policy holder Sri. Y.M. Ramachandra and the life insured is the petitioner herein and the 3^rd to 5^th policies are for the term of 12 years.  As per the part-D(1) free look period, if policy holder disagrees with any of the terms and conditions of the policy, there is an option to return the original policy along with a letter stating reasons within 15 days of receipt of the policy, in case of offline  policy and within 30 days of receipt of the policy in case of policy sourced through distance marketing.  The policy will accordingly be cancelled and the company will refund an amount equal to the premium paid and may deduct a proportionate risk premium for the period on cover.  So as per part-D(1) free look out period, if the policy holder does not like to continue the policy they can surrender the policy within 15 days or 30 days from the date of receipt of policy in such an event the insurer/opposite party will refund the amount equal to the premium paid whereas all these 5 policies have been obtained in the year 2018 and the complaint was filed in the year 2019 after lapse of one year and the complainant not surrendered the policies within 15 days or 30 days from the date of receipt of the same to get the refund of the premium paid amount and as per the terms and conditions of the policy terms No.3 surrender which  reads thus subject to the policy being in force No.1 for premium payment term of 5 years and 7 years, the policy acquires a surrender value provided atleast 2 annualized premium have been paid. No.2 for premium payment terms of 12 years, the policy acquires a surrender value provided 3 annualized premium have been paid.  On surrender of the policy lumsum amount equal of guarantor surrender value to be paid to the policy holder whereas the 1^st policy is for a period of 10 years and policy No.2 to 5 are for a term of 12 years each and the complainant had paid single instalment of premium but she has not at all paid 3 annualized premium to the above said 5 policies.  Therefore as per terms 3 surrender sub clause 2 the petitioner/complainant is also not entitle for surrender value of the policies since  has fail to pay 3 annualized premium amount to the policies. under such circumstances the prayer of the complainant to direct the opposite party to refund atleast the premium amount paid for the last 3 policies i.e., 4^th to 5^th policies cannot be considered since the terms and conditions of the policy does not permit to claim refund of premium amount paid to the policies.  Therefore we are of the opinion that the complainant has failed to prove the deficiency in service on the part of opposite party.  Therefore we are of the opinion that the complaint of the complainant has no merits.  Hence, we answer point No.1 in the negative.

12.    Point No.2:- For the aforesaid reasons, we proceed to pass the following

:: ORDER ::

The complaint of the complainant is dismissed.

No order as to cost.

Furnish the copy of order to the complainant at free of cost.

(Dictated to the Stenographer transcribed, typed by her, corrected by us and then pronounced in open Forum on this the 5^th August, 2020)