Chandigarh

DF-II

CC/166/2015

Megha Singh - Complainant(s)

Versus

The Manager, DHLF Pramerica Life Insurance Company Ltd. and Others - Opp.Party(s)

Sh. Krishan Lal Advocate

22 Dec 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II U.T. CHANDIGARH Consumer Complaint No. : 166/2015 Date of Institution : 26.03.2015 Date of Decision : 22/12/2015 Megha Singh son of S.Niranjan Singh r/o H.No.606-A, JTPL City, Sector 115, Landran Kharar Road, Post Office Landran, District SAS Nagar, Mohali. ... Complainant. Versus 1. The Manager, DHLF Pramerica Life Insurance Co. Ltd., 4th Floor, Tower-B, Building No.9, DLF Cyber City, Phase-3, Gurgaon (Haryana)-122002. 2. The Senior Branch Manager, DHLF Pramerica Life Insurance Co. Ltd., SCO No.335-336, Sector 35-B, Chandigarh 160035. 3. Sh.Lakhvir Singh, Agent, DHLF Pramerica Life Insurance Co. Ltd., SCO No.335-336, Sector 35-B, Chandigarh 160035. 4. Sh.Harpreet Singh, Agent, DHLF Pramerica Life Insurance Co. Ltd., SCO No.335-336, Sector 35-B, Chandigarh 160035. …. Opposite Parties. BEFORE: SHRI RAJAN DEWAN, PRESIDENT SHRI JASWINDER SINGH SIDHU, MEMBER SMT.PRITI MALHOTRA, MEMBER Argued by: Complainant in person. Sh.Ashok Arora, Counsel for OPs Nos.1 and 2. OPs 3 & 4 exparte. PER RAJAN DEWAN, PRESIDENT 1. Brief facts of the case as alleged by the complainant is that he purchased an Insurance Policy for Rs.30,000/- annually for a period of 15 years in August, 2011 through the agent(OP No.3) and received the Insurance Policy No.000081627 dated 30.08.2011. A copy of the premium receipt is Annexure C-1. In December, 2001 another agent of OP-Insurance Company contacted the complainant and offered that he could convert the aforesaid policy into one time premium policy again by paying Rs.25,000/-. Accordingly, he handed over a cheque of Rs.25000/- but he received another new Insurance Policy No.000109319 of Rs.25000/-dated 11.01.2012 as yearly premium for another 15 years instead of conversion of his earlier policy. A copy of the premium receipt is Annexure C-2. He contacted the Insurance Agent on his mobile phone who informed him that the Company had closed the scheme by that time. It was further averred that on the assurance of the agent that he could convert the aforesaid two policies in single one time policy, he paid another Rs.30000/- for the purpose aforesaid. Instead of receiving one time single premium, he received another new Insurance Policy No.000119950 dated 24.02.2012. A copy of the premium receipt is Annexure C-3. Thereafter, he approached the Insurance Company and its agent in this regard but to no effect. According to the complainant, believing the assurance of the Insurance Agent-Sh.Harpreet Singh that all aforesaid three policies could be converted into single one time premium policy, he again paid a cheque for Rs.50,000/- . Sh.Harpreet Singh, Agent took all the previous three policies from the complainant for conversion into single one time premium policy. Thereafter he received no response from the Insurance Company and ultimately he made a complaint to the IRDA on 02.11.2012 and sent various reminders (Annexures C-4 to C-8) but to no effect. Finally, he filed a complaint before the Insurance Ombudsman, Chandigarh on 13.12.2013. It was further averred that after the passing of the award dated 10.09.2014 by the Insurance Ombudsman, he received refund of Rs.50,000/-. However, he made a request vide letter dated 07.11.2014 for refunding the entire money deposited against all three policies or adjusting the amount of second and third insurance policy into first policy as he was unable to continue all the three policies. But his request was not accepted by the Insurance Company. Ultimately, he got served a legal notice dated 29.11.2014 upon the OPs but to no effect. Alleging that the aforesaid acts amount to deficiency in service and unfair trade practice on the part of the Opposite Parties, the complainant has filed the instant complaint. 2. OPs No.1 and 2 in their written statement have stated that after understanding the terms and conditions, the complainant proposed for aforesaid Insurance Policies vide different proposal forms [Annexure R-3 (Colly.)] and believing the same to be true and upon receipt of the duly filled proposal forms alongwith the initial premium, information and signed documentations, the OPs issued the policy contracts alongwith the schedule and terms and conditions thereof and the welcome letter. The details of all three Policy Contacts are as below: Policy No. Commencement date/Risk commencement details 000081627 30.08.2011 000109319 11.01.2012 000119950 24.02.2012 Copies of the welcome letters, schedule of Insurance Policies and premium receipts in respect of the aforesaid insurance policies are Annexures R-4(Colly.) to R-6 (Colly). It has further been pleaded that the policy holder at liberty to review the terms and conditions of the Insurance Policies and has the option to cancel the same by stating the reason for his/her objection within 15 days of the receipt of the policy bonds(free look period) and in such cases, the OP-Company is entitled to deduct charges like stamp duty, etc. and refund the balance premium to the policy holder. However, the OP-Company neither received any query nor a complaint during the free look period with respect of the above mentioned policies and as such the complainant is estopped from challenging the terms and conditions of the concluded contract and denying the contents of the application forms. It has further been pleaded that OPs did not receive any communication from the policyholder with respect of cancellation or alteration of the Insurance Policies within the said free look period, thereby implying that they agreed to the policy terms and conditions and the same was in consonance with the application forms. It has further been pleaded that the first complaint was made on 18.06.2013 i.e. after almost two years from the commencement of the first policy with baseless allegations and the same was duly replied to vide letter dated 11.07.2013 (Annexure R-7). It has further been pleaded that the fourth policy bearing No.161998 was not received by the complainant and in pursuance of the award dated 10.09.2014 passed by the Insurance Ombudsman, the amount of Rs.50000/- vide cheque dated 01.10.2014 was refunded to the complainant. The remaining allegations were denied, being false. Pleading that there is no deficiency in service on its part, a prayer for dismissal of the complaint has been made. 3. Despite due service through registered post, Opposite Parties No.3 and 4 failed to put in appearance and as a result thereof they were ordered to be proceeded against exparte vide order dated 10.06.2015. 4. The complainant filed rejoinder to the written reply of the Opposite Parties No.1 and 2 controverting their stand and reiterating his own. 5. We have heard the complainant in person, and the Counsel for the OPs No.1 and 2 and have gone through the documents on record including the written arguments. 6. After going through the evidence on record and the rival contentions of the parties, we are of the considered view that the complaint is liable to be dismissed for the reasons recorded hereinafter. It is evident from the record on file that all the Insurance Policies Nos. 000081627, 000109319, 000119950 for Rs.30,000/-, Rs.25,000/- and Rs.30,000/- with date of commencement as 30.08.2011, 11.01.2012 and 24.02.2012 respectively have been issued to the policy holder on the basis of the proposal forms given/signed by the complainant after understanding of features/terms and conditions of the plans (Annexures R-4 (Colly.) to Annexure R-6 (Colly.). It is not the case of the complainant that he did not sign the application/proposal forms. It is also not the case of the complainant/policyholder that he did not receive the policy documents. In the welcome letters dated 30.08.2011, 11.01.2012 and 24.02.2012 of the policy documents issued to the complainant/policy holder it was clearly stated as under: “…….if you are not satisfied with any aspect of the policy, you can return it to us within 15 days of receipt. For unit link products, we will refund you the fund value on the date of cancellation and any charges paid by you (Post deduction of charges already incurred by us such as medical fees, stamp duty and risk premium for the period covered). For other products, we will refund premium paid less expenses incurred and risk premium for the period covered. In view of the afore-extracted clause, in case, the complainant/policy holder was not satisfied with the terms and conditions of the Policy or the same had not been issued, as proposed by him, then it was required of him, to make a request for cancellation thereof, within the free-look-period of 15 days, from the date of receipt of the same, but he did not do so. The complainant is a well-educated and prudent person, and it could not be expected of him, that he did not know the contents of the Policy(s). It also could not be imagined that he did not know that he was required to make a request for cancellation of the same, in case, the terms and conditions were not acceptable to him, within free look period of 15 days. In the instant case, the complainant for the first time made the representation to the OP-Company for cancellation of the policies in question on 18.06.2013 through IGMS (IRDA Website) i.e. after almost two years from the date of the issuance of the first policy. Since the complainant did not apply for cancellation of the Policy, within the free look period of 15 days, from the date of receipt of the same, and as such his request was rightly declined by the OP-Company vide its letter dated 11.07.2014(Annexure R-7). Moreover, it is not understood that if the complainant was not satisfied with the terms and conditions of the first Insurance Policy then as to why he proposed for the second and the third Insurance Policies. In this view of the matter, we are of the considered view that since the complainant/policy holder did not raise the issue within the free look period of 15 days, from the date of receipt of the policies document and, therefore, he could not raise a grouse that the Policies were not issued as proposed by him. 7. Resultantly, the complainant has failed to prove any deficiency in service on the part of the Opposite Parties. 8. In view of the above discussion, we are of the opinion that there is no merit in this complaint and the same is accordingly dismissed with no order as to costs. 9. Certified copy of this order be communicated to the parties, free of charge. After compliance file be consigned to record room. Announced 22/12/2015 Sd/- (RAJAN DEWAN) PRESIDENT Sd/- (JASWINDER SINGH SIDHU) MEMBER Sd/- (PRITI MALHOTRA) MEMBER