DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II

Udyog Sadan, C-22 & 23, Qutub Institutional Area

(Behind Qutub Hotel), New Delhi- 110016

Case No.338/18

Razia Zehra

D/o Late Mr. babu Ram

R/o 885/5, R.K. puram

New Delhi-110022.                                                       ….Complainant

Versus

1. Star Union Dai-ichi Life Insurance Co. Ltd.

Off-2^nd Floor, Samyak Towers, Pusa Road

Karol Bagh, New Delhi-110005.

2. Union Bank of Inda

(Corporate Agent of Star Union Dia-ichi Co. Ltd.)

Safdarjung Development Area

C-4 Community Center, New Delhi-110016.

3. Dhiraj Kumar

Agent/Employee

Union Bank of India

Safdarjung Development Area

C-4 Community Center New Delhi-110016.           ….Opposite Parties

       Date of Institution : 15.11.2018

                                             Date of Order        : 14.06.2022      

Coram:

Ms. Monika A Srivastava, President

Ms. Kiran Kaushal, Member

Sh. U.K. Tyagi, Member

ORDER

Member: Sh. U.K. Tyagi

Complainant has put in a claim to refund her amount which was deposited by her with M/s Star Union Dai-ichi Life Insurance Ltd. (hereafter referred to as OP) as  premium for the purchase of policy.  The complainant has also requested to pass an award allowing the following claim as per her amended complaint:-

1. To refund the amount of Rs.2,50,000/- paid alongwith interest @13% p.a. from the date of deposition till its realization; (ii) to award Rs.2,50,000/- as compensation for mental agony and sufferings; (iii) to award the cost of Rs.2,50,000/- towards litigation expenses etc…

          Brief facts of the complaint are as under:-

          The complainant has A/c No.349902010005551 in Union Bank of India and Dheeraj Kumar, one of its employees posted at Safdarjung Development Area Branch, requested her to invest in the Dia-ichi Life Insurance Company Ltd. The complainant told Mr.Dheeraj Kumar that she was not in position to pay the high premium. She was assured by him that if she was unable to pay the premium in future date, the company would pay after 3 years the premium paid by her.  On this assurance, she purchased the insurance policy and paid Rs.59,038/- for the first instalment of premium through cheque No.045534 dated 4.9.2014.  Thereafter two persons, namely, Manoj Kumar and Anil Gupta came to her house and handed over some documents. After one month, she received policy documents.  As per terms & conditions, the policy documents should have been delivered within 15 days.  She further told all this to Sh. Dheeraj Kumar.

After 3 years, complainant called to Star Dia-ichi Company about the refund of money. The Company refused to consider her request of refund and stated that the policy provided to her, did not provide the facility of refund. She felt that she had been given other policy than that of refund of premium in case of failure to continue the same.  She wrote to Manager of the Company about the above.  Mr. Bhaskar Gupta – Consumer Protection Officer came and enquired about the policy and assured her to refund the money at the earliest.

It may be relevant to point out here that the complainant has amended Memo of Parties and M/s Star Union Dai-ichi Life Insurance Co. Ltd. has been made OP-1 but Shri Dheeraj Kumar had been found dropped from the array of parties in the amended Memo of parties.

Due to this mis-match and for the sake of convenience we shall be using the names of the Ops wherever it is required.

The policy so received may be seen as exhibited as CW1/1.  The complaint made to Manager of the above said Insurance Company is exhibited as CW1/2.  The complainant contended that the assurances given by the agent for securing business are part of contract. The said company cannot escape the liability for the commitment to the buyer of his product.

The Star Union Dai-ichi Insurance Co. Ltd., on the other hand in its reply stated that the policy in question was issued on 4.9.2014 and complaint was raised first time in June 2018. Thus the complaint is beyond the limitation period of two years.  The complainant has alleged forgery and cheating. Such grave issues cannot be decided without the examination and cross-examination of the witnesses.  Whereas the proceedings before this Commission are of summary in nature, thus, disputed question of fact cannot be decided in this Commission.  It is therefore requested to seek redressal of grievance in the appropriate forum.  It is also averred that the insurance company had received proposal/application form bearing No.12657319 dated 14.8.2014 duly filled in and signed by the complainant with the initial premium of Rs.58,890/-.  The same is exhibited as OP-1.  The details of the policy is provided as under:-

Policy holder/Razia Zehra

It is also averred by insurance company that in accordance with Insurance Regulatory And Development Authority Regulations, 2002, every policy is sent with forwarding letter stating that if policy holder is not satisfied with the features and terms & conditions, he/she can withdraw/return the policy under “Free Look period” provision. On 8.9.2014, No Objection was raised at this stage, meaning thereby, she was in agreement with policy features of T&C.  The same is exhibited OP/Ex.2.

          It is also noticed that Shri Dheeraj Kr. who was made OP earlier as well as in amended Memo but it has been dropped as found written in amended Memo itself.  Union Bank of India is made OP-2.  But no reply on its behalf was found filed. It was never pressed by any of the parties for the same.

          The Insurance Company and complainant filed written submissions as well as evidence in-affidavit.  Written statement is on record so is rejoinder.  Argument were heard and concluded.

          This Commission has gone into the material placed on record minutely and thoughtful consideration was also given to the oral arguments.  It is noticed that the averments so made by the complainant do not find consistency with the policy documents.  It is also noticed that she had demanded refund of the amount of Rs. 59830/- deposited as premium for the said policy in her earlier hand written complaint.  Later on, she demanded the refund of the amount of Rs. 2,50,000/- and Rs.2,50,000/- as compensation and so on. No consistency is found in the refund amount. The refund is what one has paid to someone. It is beyond comprehension, how the premium amount of Rs.58,890/- has become Rs.2,50,000/-.  In such contradictory averments, it is very hard to believe the statements of the complainant.

          On the other hand, the Star Union Dai-ichi Insurance Company Ltd. has proved its case by evidencing many documents such as duly filled in and signed application form.  It is also maintained by the Insurance Company that the complainant is literate person and graduate.  The application form is also found signed in English by the complainant which goes to show that she do understand the policy features and terms & conditions thereto.  The Insurance Company has also contended that the policy is legal contract between insurer and insured and parties to it, are bound by its terms & conditions.  It was further noticed that the annual premium was due on 4.9.2015 and initial deposit was made on 04.09.2014. And the policy in question got lapsed due to non-payment of renewal premium.  Subsequently, it was terminated on 5.9.2017.  As stated somewhere in the averments that the complaint is time barred but said policy was got terminated in 05.09.2017, hence, the cause of action had arisen from this date. Hence, the objection of the Insurance Company is not sustainable and same is found within limitation period.

          During the oral arguments, the attention of this Commission was drawn 5(c) of terms and conditions the under the head “Payment of Premium” which provides as under:-

“ (c) If the due but unpaid Premium is not paid to the company by the Policyholder on or before the expiry of the grace period, the, this Policy will lapse and no benefits shall be payable by the Company under this Policy except as mentioned under Section 4 ( c) for Reduced Paid up Benefit.”

As is evident from the above which goes to reiterate that no benefit shall be payable by the company under this policy except as mentioned under Section 4(C) for reduced paid up benefit. It seems that this provision does not seem to help the complainant to further her interest. Any how, the complainant could not produce any shred of evidence to prove her case.  And OP has negated all averments/contentions through its well documented evidences and statement.

          In nutshell, under these facts and circumstances, this Commission feels that the complaint fails in entirety and also reject the claim of the complainant in view of above narrations.

          No order as to costs.

File be consigned to the record room after giving copy of the order to the parties as per rules.