DISTRICT CONSUMER DISPUTES REDRESSAL FORUM PALAKKAD
Dated this the 17th day of May 2019
Present : Smt.Shiny.P.R. President
: Sri.V.P.Anantha Narayanan, Member Date of filing:18/09/2017
CC/133/2017
K.V.Gopakumar,
S/o.Late.Vasupillai,
Nadham, Vandhana Layout,
Puthur(PO), Palakkad – 678 001. - Complainant
(By Adv.Surenderan.P.A)
Vs
1. The Managing Director,
Mr.Sandeep Bakshi,
M/s.ICICI Prudential Life Insurance Co. Ltd.,
Raheja Tipco Plaza, Safi Marg,
Malad, East Mumbai.
2. The Branch Manager, - Opposite Parties
M/s.ICICI Prudential Life Insurance Co. Ltd.,
Palakkad Branch, Kanakath Tower,
2nd Floor, Opp.Rappadi, West Fort Maidan,
Palakkad – 678 001.
(Both By Adv.C.Srekumar)
O R D E R
By Sri.V.P.Anantha Narayanan, Member
Brief facts of the case are narrated below:
The complainant is a layman with basic education and residing in Palakkad. During the 2nd week of January 2016, the 2nd opposite party along with his agent contacted the complainant over mobile phone many times and also visited him at his residence at the behest of the 1st opposite party and introduced certain schemes having both financial benefits and life insurance cover. The 2nd opposite party told the complainant about their one of the fast growing financial products, banking, insurance and mutual funds and multi bigger benefits by investing in their most attractive life insurance policy ie. ICICI Pru-Elite life II Insurance. This is a ten year term policy, envisaged fixed annual premium of Rs.2,50,000/- p.a with a total period of 10 years and total sum assured of Rs.25,00,000/-. According to the complainant the 2nd opposite party and his agent also informed him about the amazing returns from the investment which could be checked every six months in the system at the ICICI office or elsewhere online. Complainant pleads that initially he did not commit to join the policy, but the 2nd opposite party and his agent continuously persuaded the complainant to join the policy and reiterated the assurance of amazing returns from the premia paid in the first 4 years; the 2nd opposite party also promised the additional benefit on this policy that the policy holders need not pay after 4 years and the premia for the rest 5 to 10 years need not be paid because the annual premium collected for the first 4 years will be invested by the opposite parties in a most scientific way in reliable progressive highly rewarding mutual funds and because of quick capital appreciation the invested funds will grow more than double in a couple of years and the future premia for the years 5 to 10 need not be paid by the complainant. Believing in their offers and promises of the quick superior returns of the company, the complainant agreed to take the insurance policy offered. Complainant paid Rs.2,50,000/- as the 1st year premium by way of ICICI Bank, Palakkad cheques bearing Nos.4391, 4392, 4393 and 4394 dated 18/01/2016. In addition, the 2nd opposite party collected three post dated cheques of Rs.2,50,000/- as fixed deposit each for the remaining 3 years premia as security and assurance as the premia for the years 5 to 10 were dispensed with which will be added from the growth of 4 years premium and according to the complainant, hence no post dated cheques were collected from him by the 2nd opposite party for 5 to 10 years. Within 30 days of the payment of the 1st premium complainant was issued the policy certificate No.19730192. After the payment of the 1st premium of Rs.2,50,000/- no communication between the 2nd opposite party or his agent and the complainant occurred. After six months of the payment of 1st premium complainant checked the growth of his investment and found that there was erosion in the value of his investment to the extent of Rs.9,000/- as the value of his investment came down from Rs.2,50,000/- to Rs.2,41,000/-. The complainant contacted the 2nd opposite party to enquire about this erosion and he was told to wait for another six months to get a clear picture and the 2nd opposite party also promised that the value of investment will increase in the coming nine months. After nine months the complainant again checked the value of his investments in the system at the 2nd opposite party’s office and found that his investment suffered further erosion to Rs.2,34,000/- ie. a loss of Rs.16,000/- over twelve months. Sensing the danger the complainant contacted the agent and the 2nd opposite party but no satisfactory and convincing reply was received from the 2nd opposite party or his agent. According to the complainant, they shirked from their responsibility and the complainant lost his confidence in the opposite parties and got afraid of loss of his hard earned money investment and realized that the opposite parties have missold an unsuitable policy to him by concealing the inherent risks involved in this policy investment for earning huge commission. According to the complainant the risk factors in the policy were concealed and superior unimaginable returns were highlighted by the 2nd opposite party. Again complainant approached the 2nd opposite party and sought explanation for fall in the value of his investment, he got a reply from the 2nd opposite party that the invested funds are deployed as per the decision of the corporate office and the 1st and 2nd opposite parties have nothing to say about it. The complainant strongly believes that the corporate office of the opposite parties invested the collected amount in unreliable, unscientific and hopeless mutual funds instead of progressive, highly rewarding mutual funds and that was the reason for the decrease in the value of his investment which indicates the failure of the corporate administration of the opposite parties. A registered letter was sent by the complainant to which the reply of the 2nd opposite party was shocking and disappointing which affected the complainant mentally, physically and financially and complainant asked the opposite parties to refund the money collected from him and in their reply letter it is mentioned that complaint is rejected because the ‘free look period is over’ and ‘signature on the form confirms the complainant’s assent’. In the opposite party’s letter dated 09/05/2017 it is stated that there is no promise or provision to return or refund the money already paid. Then registered lawyer notice was caused to be sent by the complainant on 06/06/2017 to which a reply was received from the 1st opposite party stating that there is no provision to refund the paid amount. Hence this complaint is filed to this Forum praying for orders to the opposite parties for refund of the invested amount of Rs.2,50,000/- with 12% interest, award Rs.50,000/- compensation towards physical, financial and mental agony suffered, award Rs.20,000/- towards the cost of litigation, award Rs.1,00,000/- as the cost for persuading cajoling and pestering unimaginable returns to attack the common man etc.
The complaint was admitted and notices were sent to the opposite parties to enter their appearance and file their versions. In the version jointly filed by the 1st and 2nd opposite parties, the preliminary objections are raised by the opposite parties regarding the very maintainability of this complaint that this Forum has no jurisdiction to entertain the present complaint because in the present case the complainant opted for ‘ICICI Pru Elite life II plan’ which is a unit linked policy where in premium amount after deduction of applicable charges will be invested in ‘equity and equity related securities, debt instruments, money market and cash’. According to these opposite parties it is a settled law that investment made under the unit linked policy is a speculative gain and speculative investment matter does not come under the Consumer Protection Act 1986; the investment made by the complainant was to gain profit and it was invested for commercial purpose and hence the complainant is not a consumer under the Act. Hence the present complaint is liable to be dismissed for the absolute lack of jurisdiction. The opposite parties also contend that as per clause 6(2) of the IRDA(Protection of Policyholders Interest Regulation, 2002) every policy document sent by the insurance company is to be accompanied by a forwarding letter which clearly mentions that if the policy holder is not satisfied with the features, all the terms and conditions of the policy he can return the policy within 15 days under the ‘free look period provision’. In this case free look period expired on 15/02/2016 on the expiry of 15 days, but complainant approached the opposite parties for the first time on 03/05/2017 after the expiry of one year and 3 months from issuance of the policy through a letter to which the opposite party has replied on 09/05/2017. According to the opposite parties the complainant (life assured) retained the policy documents for more than one year and 3 months after the expiry of ‘free look in period’ and did not return the policy document to the opposite parties for cancellation of the policy during the ‘free look in period’ which implies that the complainant agreed to all the policy terms and conditions. Hence these opposite parties contend that the present complaint should be dismissed. Again through various judgments passed by the Hon’ble National Commission, New Delhi, it is determined that if the insured complainant is not satisfied with the policy taken, he/she should avail the option of returning the policy within15 days of receipt ie. within the ‘free look in period’. The opposite parties also contend that the complainant received the policy document and was well aware of the terms and conditions of the policy and has failed to produce any evidence to prove any misselling and deficiency of service on the part of the opposite parties which shows after thought on the part of the complainant to take undue advantage from the opposite parties. According to these opposite parties complainant’s prayer for refund of premium in this case is against the established laws of life insurance; it is trite law that the premium was given by an insured to cover the risk for a given period and the insurance company covers the risk for the period for which the premium has been paid. It is a settled law in insurance that there is no question of refund of any premium amount. Also since the present complaint involves allegations of misselling it cannot be adjudicated under summary proceedings but it can only be adjudicated in a civil court. The proceedings before this Forum are essentially summary in nature and adjudication of issues which involve disputed factual questions should not be adjudicated and hence the present complaint should be dismissed. These opposite parties also contend that the onus is only on the policy holder to thoroughly read the contents of the proposal form before signing the same and the policy holder cannot place reliance on oral promises and assurances provided by anyone on behalf of an insurance company. The opposite parties acted as per the mandate given to the complainant in proposal form and issued the insurance policy and took decision in conformity with insurance terms and conditions which is concluded contract between the insurance company and the complainant life assured. It is a settled law that the insurance terms have to be construed strictly and no relief which travels beyond the terms of the insurance policy can be granted and hence no case for deficiency in service is made out in this case. The allegation of the complainant that he was misguided as to the policy is absolutely false, imaginary and untrue. The company has acted strictly as per the proposal form and terms and conditions of the policy document which are approved by IRDA. It is also a settled principle of law that if any person signs any document it is presumed that he/she has signed the same after reading and understanding it properly. The opposite parties also contend that the opposite party company received filled in online proposal form from the proposer for issuance of insurance policy on his life on the basis of information provided in the proposal form the company issued the insurance policy No.19730192. The policy terms and conditions were despatched along with policy documents and the clause No.5 of the terms and conditions (investment and fund details) elaborates that accumulated premium less charges will be invested in equity and equity related securities, debt instruments, money market and cash and at the top of terms and conditions it is mentioned that in this policy investment risk in investment portfolio will be borne by the policy holder. In accordance with regulation for sub section (1) of the IRDA (Protection of Policyholder’s Interest Regulations) 2002 the opposite parties had sent a copy of the proposal form duly signed by the complainant along with the policy document to the complainant to review the contents of the same. In accordance with clause 6(2) and 4(1) of the Insurance Regulatory and Development Authority (Protection of Policyholders Interest Regulations) 2002 the opposite parties sent the policy documents to the communication address mentioned in the proposal form stating the policy terms and conditions and a forwarding letter stating the free look provision along with a copy of the proposal form. The complainant retained the policy document and did not raise any objection towards the policy during the said free look period with any grievance regarding the policy or its terms and conditions meaning thereby that the complainant agreed to the policy and its terms and conditions. The said policy was despatched on 29/01/2016 and duly received on 01/02/2016 by the complainant, the free look period of the complainant expired on 15/02/2016 and he never raised any allegations regarding non receipt of policy documents neither before nor in the present complaint. The complainant did not approach the opposite parties with any grievance or discrepancy during the free look period. As per the terms and conditions of the policy the contract continued on implied acceptance of the terms of the contract by the complainant by not availing free look cancellation. The complainant paid premium only till 27/01/2017 and thereafter no premium was received, hence the policy got lapsed and the same was intimated to the complainant, also intimating him about the 30 days grace period within which he could pay the premium and continue the policy but the complainant failed to pay the same, thus the policy remained in lapse mode and the same was again intimated to the complainant. As per the terms and conditions of the policy the complainant was intimated about the option available to him through a letter. Since the complainant failed to pay the premium the policy was in discontinued stage and the same was conveyed to the complainant. It is submitted that as per clause 4.3 of the policy terms and conditions even if the policy is not received before the completion of the 5th policy year the DP fund value will be payable to the complainant at the end of the 5th policy year and thereafter the policy will stand terminated. After one year 3 months from the date of issuance of policy, the complainant for the first time approached the opposite parties on 03/05/2017 through a letter and the company was bound to decline his request since the same was beyond the free look period and the same was communicated through a letter dated 09/05/2017. To the legal notice dated 16/06/2017 issued by the complainant to the opposite party company a reply letter dated 20/07/2017 was sent to the complainant that in the subject policy of the complainant the premium was to be paid for 10 years but no premium was received by the company on the policy, therefore, initially the policy got lapsed and later it was discontinued because the complainant failed to pay the premium during the grace period. The policy is a legal contract between the policyholder and the insurance company and the parties to the said contract are bound by its terms and conditions. Being educated, the complainant is a diligent person to understand the policy terms and conditions; he must have definitely gone through the proposal form cautiously before signing the same and proposing the said policy and the complainant had applied for the subject policy after clear knowledge and understanding of the terms and conditions. The opposite parties also contend that the complainant is a well educated person with prudent decision making ability before releasing Rs.2,50,000/-; he has taken subject policy after going through the terms and conditions, he was well aware that being a unit linked policy investment it is subject to market risks, accordingly he was checking the status and he had noticed that fund value is decreasing, then he came up with a false complaint to malign the reputation of the opposite party company. According to the opposite parties, complainant agrees that the policy was well explained by the opposite party company and he was aware that the subject policy was for 10 years; the policy terms and conditions in clause No.5 (investment and fund details) elaborates that accumulated premium less charges will be invested in equity and equity related securities, debt instruments, money market and cash. At the top of terms and conditions it is mentioned that in this policy investment risks in investment portfolio will be borne by the policyholder. The complainant failed to pay the 2nd premium which is evident from records, the subject policy was governed by terms and contract, thus the onus is on the policyholder to go through the terms of contract rather than believing in the oral promises of the agent, the obligations and benefits are categorically mentioned in the terms and conditions of the policy. Apart from 1st premium no other amount was collected from the complainant. Had the future premium of the subject policy been collected the subject policy would have continued but the policy is discontinued due to nonpayment of premium by the complainant. The subject policy was issued on 27/01/2016 where in the proposal form was filled on 21/01/2016 ie. the policy was issued within one week and as per the mandate of the company a policy kit was sent to the complainant which included proposal form, 1st premium receipt, policy terms and conditions and other policy documents which were despatched on 29/01/2016 and duly received by the complainant on 01/02/2016, thus the opposite parties contend that they have duly rendered all services to the complainant. The complainant received policy kit from the opposite party company on 01/02/2016 after paying the 1st premium wherein the provision of free look period was again reiterated and communicated to the complainant, but the complainant kept silent and did not approach the opposite party company with any grievance. The subject policy is a unit linked plan subject to market risks which means the investment made by the complainant is invested in the market which is subject to market fluctuations which will affect complainant’s investment which included increase or decrease. Thus these opposite parties contend that decrease in the complainant’s investment in this case is due to the market risks. The complainant chose to invest in a unit linked plan instead of in an endowment plan which is not related to market fluctuations. These opposite parties also contend that even if the complainant stops paying any further premia under the policy he will be entitled to full fund value after completion of 5 policy years as per policy terms and conditions. Complainant’s investment is subject to market risks and it is not possible to give the assurance that complainant’s investment will increase within next 9 months. All the queries of the complainant were duly answered by the opposite parties. As far as the negative fluctuations are concerned the same is due to market and the company has no control over the same. The investment risk in the policy is to be solely borne by the policy holder, insurance is a long term contract and the complainant needs to be patient to fetch good returns on his investment. According to the opposite parties, the opposite party company has duly appraised the complainant about the market risks involved in the subject policy; complainant was supplied with a copy of the terms and conditions of the policy which categorically mentioned the risks involved in the subject policy. The complainant had ample opportunities to go through the terms and conditions of the subject policy and failure to do that is a fault on the part of the complainant who is an educated and diligent person and he was also repeatedly asked to go through them. The opposite party company being bound by the terms of the contract could not refund the 1st premium after the expiry of free look period and the act of the company was incompliance with the terms of contract. Thus according to the opposite parties complainant is not entitled for any refund of premium of Rs.2,50,000/- or interest thereon; further complainant failed to prove any deficiency in service on the part of the opposite parties; the complaint filed by the complainant is baseless, frivolous and not substantiated by any evidence; hence the opposite parties pray to the Hon’ble Forum to dismiss the complaint with cost.
Complainant filed chief affidavit, opposite parties also filed affidavit. From the side of the complainant Exts.A1 to A7 were marked and from the side of the opposite parties Exts.B1 to B7 were marked. Complainant and the opposite parties were heard.
The following issues arise in this case for consideration by this Forum.
- Whether the complainant is a consumer in this case as per Consumer Protection Act 1986.
- Whether there is any deficiency in service and unfair trade practice on the part of the opposite parties?
3. If so, the relief and cost which are available for the complainant?
Issue No.1
In this case, the complainant has taken an insurance policy offered by ICICI Prudential Life Insurance Company (Opposite parties), namely, ICICI Pru Elite II Plan. The opposite parties contend that the investment made by the complainant was to gain profit and it was invested for commercial purpose and hence the complainant is not a consumer under the Consumer Protection Act 1986. But, since the complainant has taken the subject policy as an investment but not for trading and profit making. Moreover the opposite parties also have not produced any evidence to prove that the purpose of complainant’s investment in the subject policy is commercial and profit making. Also, from the available records it is observed that complainant has made investment in this type of policy only once and the opposite parties have not proved that complainant is a habitual investor in this type of policies. Hence the complainant is considered as consumer under the Consumer Protection Act 1986 and the 1st issue is answered accordingly.
Issue 2 & 3 in detail
Complainant has filed Exts.A1 to A7 to support his arguments in this case. Ext.A1 is a summary of account as on 31/03/2016 issued by ICICI Bank to the complainant which shows complainant’s saving account number the balance therein, MICR code, IFSC code etc. Ext.A2 is life insurance policy certificate issued by ICICI Prudential Life Insurance Company which shows policy details such as name of the complainant, plan, policy number, complainant’s mobile number, e-mail ID, sum assured, premium amount, payment frequency, next premium due date, name of the advisor, refund/free look period details etc. Ext.A3 is summary funds statement from 01/04/2016 to 30/04/2016 showing total closing balance as Rs.2,41,338/-, it is also a unit statement for the period from 01/06/2015 to 22/06/2016 which shows as on 22/06/2016 closing balance total units as 5687.57101, allocated premium, service tax, mortality charges etc. Ext.A4 is a copy of the letter sent by the complainant dated 03/05/2017 requesting the opposite parties to return Rs.2,50,000/- within 30 days of the date of this notice. Ext.A5 is the reply received from the 1st opposite party dated 09/05/2017, thereby informing the complainant that the opposite parties are unable to comply with complainant’s request for cancellation of the policy because as per the terms and conditions of the policy, in case of any disagreement with the policy a policyholder is required to approach the company within 15 days from the date of receipt of the policy document, but the company did not receive any complaint from the complainant regarding the said matter within the stipulated period thereby confirming that the terms and conditions were agreed upon by him. Ext.A6 is a legal notice dated 16/06/2017 sent by complainant’s counsel to the 1st opposite party calling upon the latter to pay the collected amount of Rs.2,50,000/- with bank interest along with the legal notice charge of Rs.1,500/- within 15 days from the date of receipt of this notice. Ext.A7 is a reply to legal notice dated 16th June 2017 sent by complainant’s counsel which denies all the allegations made in the said notice and also informs the complainant that he retained the policy documents and did not approach the company with any discrepancies regarding premium payment, premium frequency and the policy terms and conditions, but complainant did not approach the company for cancellation of the subject policy during the free look period thereby implying that complainant had agreed to all the terms and conditions of the said policy and insurance being a contract between the policyholder and the company both parties are governed by the terms and conditions mentioned in the policy document and all the benefits are payable strictly as per the policy terms and conditions and hence the company is unable to consider complainant’s request for refund of premium amount under the subject policy.
Exts.B1 to B7 are marked from the side of the opposite parties to prove their contentions. Ext.B1 is an online application form for life insurance submitted by the complainant which shows customer name, income details of the proposer, personal assets of the proposer, date of application. It also contains the fact that being a system generated document contents of which were submitted on 21/01/2016 and does not need physical signature. Ext.B2 is a policy certificate of ICICI Pru Elite Life II Plan which shows that investment risks in investment port folio is borne by the policyholder. It also shows product charges, free look period (15/30 days refund policy) benefits available under the policy etc. Ext.B3 is a copy of policy document along with benefit illustration which shows sales details, proposer benefits, proposer electronic insurance account, proposer personal details, contact details, previous policy details, nominee details, proposer KYC details, health details, product details, particulars of 1st premium deposit, declaration and authorization etc. Ext.B4 is a copy of a letter dated 26/04/2017 sent by the complainant to the 1st opposite party requesting the latter to return the amount of Rs.2,50,000/- with the nationalized bank interest within 30 days of the receipt of this notice. Ext.B5 is a copy of reply letter dated May 9, 2017 sent by the 1st opposite party to the complainant which informs him that as per terms and conditions of the policy in case of any disagreement with the policy a policyholder is required to approach the company within 15 days from the date of receipt of the policy document and if the company did not receive any complaint from the complainant regarding this matter within the stipulated period thereby it is confirmed that the terms and conditions were agreed upon. Hence the 1st opposite party informs the complainant about their inability to comply with his request for cancellation of the policy. Ext.B6 is a registered lawyer notice sent by the complainant’s counsel to the 1st opposite party dated 16th June 2017 which calls upon the 1st opposite party to pay the collected amount of Rs.2,50,000/- with bank interest and notice charge of Rs.1,500/- within 15 days from the date of receipt of this notice. Ext.B7 is a reply letter sent by the opposite party to the complainant thereby informing the latter that complainant first approached the opposite parties as per letter dated 03/05/2017 after one year and three months from the policy issuance date and the company was constrained to decline complainant’s request vide letter dated May 09, 2017 as the same was beyond stipulated free look period; by this letter the opposite party also states that insurance being a contract between the policyholder and the company, both parties are governed by the terms and conditions mentioned in the policy document and all the benefits are payable strictly as per the policy terms and conditions hence the opposite parties ie. the company is unable to consider complainant’s request for refund of premium amount under the subject policy.
We have closely examined the affidavits and documents filed by both parties in this case to prove their arguments and we understand that the complainant agreed to take the insurance policy offered by ICICI Prudential Life Insurance Company, namely ICICI Pru Elite II Plan for a 10 year term and paid 1st year premium of Rs.2,50,000/- which is clear from his online application for life insurance(Ext.B1). We also observe that complainant is a graduate and a business man and within 30 days of the payment of the 1st premium complainant was issued by the opposite parties the policy certificate bearing policy no.19730192. We also observe that there is a free look period provision (15/30 days refund policy) which clearly mentions that complainant policyholder can cancel the policy within 15 days of the date of its issuance, if he does not agree to the terms and conditions the existence of this provision is clearly indicated in Ext.B2 document. We also understand from the Exts. that the investment risks in investment portfolio in respect of this policy are to be borne by the policyholder complainant. It is also mentioned that the premium was invested in equity, equity related securities, debt instruments, money market and cash and the fund is 100% income fund which is subject to market fluctuations which means increase or decrease in fund. It is also observed that although the complainant has paid 1st year premium of Rs.2,50,000/- he is seen to have not carefully and fully read the terms and conditions of the disputed policy certificate and the policy document; he also is seen to have not availed free look period provision of 15 days which expired on 15/02/2016 but seen availed the provision only after one year and three months on 03/05/2017. Hence he was not able to cancel the policy. As per Ext.B3 it is seen that the marketing officer has explained all the terms and conditions of the product to the policyholder and the policyholder has signed this document for having received the information with respect to the given illustration in Ext.B3 before entering into the contract and thereby indicating complainant’s assent to the terms and conditions of this policy. It is also viewed that he could have made use of switch over facility to switch his investment from highly risky equity fund to comparatively less risky debt fund; also he could have waited for at least 4 years paying regularly annual premium of Rs.2,50,000/- without default so that from 5th year to 10th year he need not pay premium and also his policy will not lapse and he could have enjoyed the policy benefits. Therefore we view that although opposite parties have clearly given written intimation to the complainant about the benefits associated with this policy and also the risks connected with this policy through their evidences, it is seen that the complainant has not acted prudently and wisely and gone through the evidences produced by the opposite parties carefully in this case.
In this connection the following judgements are also to be noted. “It has been determined through various judgements passed by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi specifically in Mohanlalbenal Vs ICICI Prudential Life Insurance Company Ltd (RP No. 2870/2012 decided on 16/10/2012) and Harish Kumar Chadha Vs Bajaj Allianz Life Insurance Company Ltd (decided on 07/10/2013 in revision petition number – 3271 of 2013) that if the insured/complainant is not satisfied with the policy taken then he/she should avail the option of returning the policy within fifteen days of receipt i.e within the “free look period”. The said proposition has been clearly laid down in the case of Sreekant Muralidhar Apte Vs Life Insurance Corporation of India, Revision Petition number 634 of 2012 decided on 02/05/2013. Further the National Commission concurred with the findings of Maharashtra State Consumer Disputes Redressal Commission, Mumbai that “once fifteen days cooling off period is over policy documents become binding on both the parties and the contents therein are also binding on both of them”.
In Kishor Chandrakant Rathod Vs the Managing Director ICICI Prudential Life Insurance Company Ltd and another decided by the National Consumer Commission on 21/05/2014 in revision petition number 3390 of 2013 “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 that the documents cannot. Everywhere he was mentioned that he was informed by a 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 on the other hand the complainant swallowed of the bait.”
In M/s Grasim Industries Ltd. Vs M/s Agarwal Steel 2010 (1) SC 33 The Hon’ble Supreme Court has held that “When a person signs a document, there is a presumption, unless there is proof of force or fraud, that he has read the document properly and understood it and only then he has affixed his signature thereon, otherwise, no signature on a document can over he accepted”.
Prema and Ors. Vs Life Insurance Corporation India Ltd, IV (2006) CPJ 239 (NC) “8 insafar as the filing of the proposal forma is concerned, Manjunath was a lineman in K.E.B at Davangere. As such the State Commission was justified in taking the view that it was reasonable to believe that he would have the minimum knowledge of these matters. Consequently it could not be believed that he had simply put his signatures on different proposal form without understanding the contends of the relevant items. Besides, it may be mentioned that in terms of LIC V.M.Gowri’s Ors, the Judgement referred to by the State Commission the agent who got the proposal form could be an agent of the person seeking insurance policy. The plea that the insured was not aware of the requirement to give correct answer and about contents of the answers given cannot be accepted”.
Under the above circumstances and considering the above judgements of the Hon’ble Supreme Court and Hon’ble National Commission we decide to dismiss this complaint.
Pronounced in the open court on this the 17th day of May 2019.
Sd/-
Shiny.P.R
President
Sd/-
V.P.Anantha Narayanan
Member
Appendix
Exhibits marked on the side of complainant
Ext.A1 – Copy of summary of account as on 31/03/2016 issued by ICICI Bank to the complainant
Ext.A2 – Life insurance policy certificate issued by ICICI prudential life insurance
Ext.A3 – Copy of summary funds statement from 01/04/2016 to 30/04/2016
Ext.A4 – Copy of the letter sent by the complainant dated 03/05/2017
Ext.A5 – Copy of reply received from the 1st opposite party dated 09/05/2017 addressed to the
complainant
Ext.A6 – legal notice dated 16/06/2017 sent by complainant’s counsel to the 1st opposite party
Ext.A7 – Reply to legal notice dated 16th June 2017 sent by complainant’s counsel
Exhibits marked on the side of Opposite parties
Ext.B1 – Online application form for life insurance submitted by the complainant
Ext.B2 – Policy Document – Terms and Conditions of your policy- Policy certificate of ICICI Pru
Elite Life II
Ext.B3 – Copy of policy document along with benefit illustration
Ext.B4 – Copy of a letter dated 26/04/2017 sent by the complainant to the 1st opposite party
Ext.B5 – Copy of reply letter dated May 9, 2017 sent by the 1st opposite party to the complainant
Ext.B6 – Copy of registered lawyer notice sent by the complainant’s counsel to the 1st opposite
party
Ext.B7 – Copy of reply letter sent by the opposite party to the complainant
Witness examined on the side of complainant
NIL
Witness examined on the side of opposite parties
Nil
Cost - NIL
