Orissa

Cuttak

CC/94/2018

Ketu Das - Complainant(s)

Versus

The Managing Director,Exide Life Insurance Company Ltd - Opp.Party(s)

S Satapathy & associates

19 Nov 2022

ORDER

IN THE COURT OF THE DIST. CONSUMER DISPUTES REDRESSAL COMMISSION,CUTTACK.

C.C.No.94/2018

 

Mr. Ketu Das,

S/O:Late Raghunath Das,

House No.77,At:Jhola Sahi,PO:Buxibazar,

Near HDFC Bank,Dist:Cuttack,

State:Odisha-753001.                                                            ... Complainant.

 

                                                Vrs.

1.        The Managing Director,

Exide Life Insurance Company Ltd.,

3^rd Floor,JP Technopark,No.3/1,

Millers Road,Bengaluru-560001,

State:Karnataka.

 

2.        The General Manager-Customer Service,

Exide Life Insurance Company Ltd.

3^rd Floor,JP Technopark,No.3/1,

Millers Road,Bengaluru-560001,

State:Karnataka.

 

3.        The Branch Manager,

Exide Life Insurance Company Ltd.,

1^st and 2^nd Floor,Unit No.39,Silpapuiri,Madhupatna,

Above Sagar Motors,Link Road,

P.O/PS:Madhupatna,City/Dist:Cuttack,

Odisha-753010.                                                         ... Opp. Parties.

 

 

Present:               Sri Debasish Nayak,President.

                                Sri Sibananda Mohanty,Member.

 

Date of filing:      23.08.2019

Date of Order:   19.11.2022

 

For the complainant:          Mr. S.Satapathy,Adv. & Associates.

For the O.Ps               :          Mr. R.Pradhan,Advocate.

 

Sri Debasish Nayak,President.                                     

            Case of the complainant bereft unnecessary details as made out from the complaint petition in short is that the complainant had paid a sum of Rs.10,00,000/- through cheque bearing no,405402 dt.26.2.2013 to the O.Ps towards one time/single premium for obtaining insurance policy of Rs.1 crore from them.  But later the complainant could know that the O.Ps had deliberately opened a policy namely, ING Market Shield Plan bearing no.02632465 on 26.3.13 which requires five number of instalments with a premium value of Rs.10,00,000/- each.  The complainant after returning from his foreign tour when knew about the same, he had contacted the officials of the O.Ps, the said official of the O.Ps  had sent a letter to the complainant that his policy bearing no. 02632465 has been changed to  single premium and the matured value moreover by 17.03% in the year 2013-14.  In the month of March,2017 one Mr. Asish Rout who was Manager of the O.Ps had disclosed before the complainant after verifying that his policy had been discontinued as the premium mode was not changed.  The complainant thus on 7.3.18 had lodged his complaint before the O.Ps and the same was received by the O.Ps on 9.3.18 but the O.P no.2, General Manager, Customer Service had replied to the complainant that as per the terms and conditions of the policy he should have opted to review the terms and conditions therein within a period of 15 days of receipt of the policy papers.  The policy papers were delivered to the complainant on 2.4.13 but the complainant had not exercised any such option within 15 days thereafter.  The complainant thus urges that being assured by the officials of the O.Ps for changing his policy to a single premium and to file an application in that context, the complainant received a letter to that effect also.  After five years of maturity period, the complainant was surprised to know from O.P no.3 that the policy conditions were not changed and rather it was discontinued since 26.4.2014.  Thus, it is alleged by the complainant that he had to suffer loss due to the oblique motive of the officials/agent of the O.Ps for which he had to approach this Commission seeking direction to the O.Ps in order to pay him a sum of Rs.12,80,000/- towards his legitimate entitlement after deducting a sum of Rs.12,20,000/- out of the matured sum assured of Rs.25,00,000/-.  He has further sought for a sum of Rs.3,20,000/- from the O.Ps towards loss of his work and another sum of Rs.2,00,000/- towards his mental agony together with a sum of Rs.1,00,000/- towards his legal expenses.

            He has filed copies of some documents in order to prove his case.

2.         The O.Ps having contested this case have filed their written version jointly wherein they have averred that the complaint petition is liable to be dismissed.  They have mentioned about the proposal form and the forwarding letter which clearly envisages that in case the policy holder is not satisfied with the terms and conditions, he can withdraw/ return the policies within 15 days under the “Free Look Cancellation Period”.  The policy documents were sent to the complainant as per the registered address which was duly delivered and thereafter the complainant had not approached the O.Ps for any discrepancies therein.  The complainant had not raised any objection to the terms and conditions nor had he preferred for cancellation of those within the said Free Look Cancellation Period.  When the complainant remained silent after receiving the policy papers, without protesting for those, it was presumed that the complainant has consented to the details in the proposal form.  In this context, the O.Ps have relied upon a decision of the Hon’ble National Consumer Redressal Commission,New Delhi in the case of Mohanlal Benal Vrs. ICICI Prudential Life Insurance Company Ltd.(R.P.No.2870 of 2012 decided on 16.10.2012 and in the case of Harish Kumar Chadha Vrs. Bajaj Allianz Life Insurance Co. Ltd. (decided on 7.10.2013 in R.P No.3271 of 2013) where it has been held 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 Cancellation Period”.  The said propositions has also been clearly laid down in the case of Shrikant Murlidhar Apte Vrs. LIC of India,R.P. No.634 of 2012 decided on 2.5.2013.  Thus, it is the contention of the O.Ps through their written version that the Hon’ble National Commission had concurred the findings of the Hon’ble State Commission of Maharashtra that once 15 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 this context, the O.Ps have also relied upon in the case Tarsem  Singh Vrs. PNB Metlife India Insurance decided on 5.9.2016 by Hon’ble NCDRC in R.P no.303 of 2016.  They have also relied upon the decision in the case of Export Credit Guarantee Corporation of India Ltd. Vrs. Garg Sons International (2013(I) SCALE 410) wherein the Hon’ble Supreme Court has held that while construing the terms of the contract of the insurance, the court must give paramount importance to the terms used in the said contract.  In this context the O.Ps have also relied upon the case of Suraj Mal Ram Niwas Oil Mills Pvt. Ltd. Vrs. United India Insurance Company Ltd.[(2010) 10 SCC 567], in the case of General Insurance Society Ltd. Vrs. Chandumul Jain and another (1966) 3 SCR 500, in the case of United Insurance Company Ltd. Vrs. Harchand Rai chand Rai Chandanlal I (2003) CPG 393 and in the case of Vikram Greentech (I) Ltd and another Vrs. New India Assurance Company Ltd. II (2009) CPJ 34.  The Hon’ble Supreme court has held that an insurance policy is to be construed as per the terms and conditions of the policy document which is a binding contract between the parties and nothing can be added by giving a different meaning to the words mentioned therein.  The O.Ps have also relied in the case of Narsing Ispat Ltd. Vrs. Oriental Insurance Co. Ltd. and another 2017(2) CPR 856 (NC) wherein the Hon’ble National Commission has observed that insurance contract is a species of commercial transaction and it must be construed strictly like any other contracts to its own terms and by itself.  Insurance contract like any other contract is binding on the parties and endeavour of Court must always be to construe contract in context of terms and conditions in insurance policy.  The O.Ps have also relied upon the case of Ravneet Singh Bagga Vrs. KLM Royal Duch Airlines (2000) 1 SCC 66 wherein the Hon’ble Supreme Court has laid down that deficiency in service cannot be alleged without attributing fault, imperfection, shortcoming 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.

            Thus, according to the O.Ps there was no deficiency on their part.  The complainant had not preferred to come up with any discrepancy in the policy terms and conditions within the Free Look Cancellation Period and thus the complaint petition being not maintainable is liable to be dismissed with cost.

3.         Keeping in mind the averments of the complaint petition and the contents of written version, this Commission thinks it proper to settle the following issues in order to arrive at a proper conclusion.

i.          Whether the case of the complainant is maintainable ?

ii.         Whether there was any deficiency in service on the part of the O.Ps & if there was practice of any unfair trade by the O.Ps ?

            iii.        Whether the complainant is entitled to the reliefs as claimed ?

Issue no.ii.

Out of the three issues, issue no.ii being the pertinent one is taken up first to be considered here in this case.

Admittedly, the complainant had paid premium intending to have a policy from the O.Ps.  The complainant alleges that the policy which he had intended was not the policies as done by the O.Ps.  He has mentioned that being assured by the officials of the O.Ps namely Tapan Kumar Mohanty and another Umakanta Jha, the complainant was of a view that the policy would be rectified according to his wish.  He has not made any written application to the O.Ps for the same within “Free Look Cancellation Period” of 15 days after getting the policy papers.  He had not also examined any of the said two officials of the O.Ps like Tapan Kumar Mohanty and Umakanta Jha.  On the other hand, while going through the catena of decisions as cited by the O.Ps here in this case and since when the Hon’ble Supreme Court has fairly laid down that the policy in-between the insured and the insurer is a contract and after execution of the same, both the parties are bound by the terms and conditions of it.  Ofcourse there was a provision of putforthing the dissatisfaction by the insured/complainant within the “Free Look Cancellation Period” of 15 days which the complainant has not availed.  Thus, after probing the facts and circumstances of this case, it is noticed that the O.Ps had not committed any deficiency in their service nor had they practised any unfair trade.  Accordingly this issue goes in favour of the O.Ps.

Issues no.i & iii.

From the aforesaid discussions, it can never be said here that the case of the complainant is maintainable and he is entitled to any of the reliefs as claimed by him.   Hence it is so ordered;

ORDER

            Case is dismissed on contest against O.Ps and as regards to the facts and circumstances of the case without any cost.

Order pronounced in the open court on the 19^th day of   November,2022 under the seal and signature of this Commission.           

                                                                                                                                Sri Debasish Nayak

                                                                                                                                            President

                       

                                                                                                                                                            Sri Sibananda Mohanty

                                                                                                                                      Member