Delhi

New Delhi

CC/99/2014

Sh. R.N. Sharma - Complainant(s)

Versus

M/S. Kotak Mahindra Old Mutual Life Insurance Ltd. - Opp.Party(s)

06 Mar 2020

ORDER

 

 

                                         CONSUMER DISPUTES REDRESSAL FORUM-VI

                 (DISTT. NEW DELHI),

                       ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

      NEW DELHI-110001

 

Case No.C.C. 99/2014                                                                Dated:

In the matter of:

R.N.  Sharma

303, Shikha Apartment,

Plot no. 48, IP Extention,

Delhi-110092.

                                                                                             ……..COMPLAINANT

VERSUS

Kotak Mahindra Old Mutual

Life Insurance Ltd.

23, E-2A, Himalaya House, K.G. Marg,

New Delhi.                                                                           ……..OPPOSITE PARTY     

 

ARUN KUMAR ARYA-PRESIDENT

ORDER

The complainant has filed the present complaint against the OP under section 12 of Consumer Protection Act, 1986.  The gist of the complaint is that the agent of the OP visited the resident of the complainant and lured his to purchase the life Insurance Policy by stating that he will get guaranteed sum of Rs. 02,50,000/- plus other benefits after a period of 10 years subject to the condition that he has to pay a sum of Rs. 25,000/- p.a. for continuous five years. Believing on the verbal advice of the agent of OP Company the complainant paid a sum of Rs. 25,000/- by way of cheque in the name of OP against which a policy deposit receipt bearing No. 01643363 was issued by the OP. Neither the policy nor any document or any contract was ever provided to the complainant by OP.

Since, one other policy of complainant was matured in 2011, he sent a letter dated 29/04/2011 to the OP to refund the amount alongwith the benefits accrued, but no response was received from OP. Keeping in view the conduct of the OP regarding the previous policy, the complainant wrote a letter to the OP to refund the premium paid under the policy in question. The OP vide its letter dated 23/11/2012 informed the complainant that his policy was terminated due to non-payment and sent a sum of Rs. 3,276.74/- to the complainant as a surrender value.

Complainant requested to the concerned executive and officials of OP, to provide the reason for short payment, but no satisfactory reply was given by OP.  Complainant, therefore approach this Forum for redressal of his grievance.

Complaint has been contested by the OP.  In its written statement OP stated that as per policy terms and conditions, due to non-payment of further premium, policy in question was in lapse status.  The complainant has failed to place on record any document which shows that he requested the OP to cancel the policy during free look period.  Insurance is a contract between the insured and insurer and both the parties are bound by the terms contained therein. It is submitted that the complainant is not entitled to any relief as the claim of complainant is barred by Law of Estoppel, since the complainant had already availed the benefits under the policy as per terms of the policy.  Admittedly, the complainant opted to exercise his right/option to surrender the policy.  After receipt of Surrender Request from the complainant and completion of necessary formalities, OP processed his claim and surrender amount was disbursed to the complainant vide cheque dated 23/11/2012 and the same has been received and encashed by the complainant.  It is also submitted by the OP that it has complied with all its obligations under terms of the Insurance Contract.  Therefore, complainant is not entitled for any other relief and further prayed for the dismissal of present complaint.

Both the parties have filed their evidences by way of affidavits.  

We have heard argument advance at the Bar and have perused the record.

Some facts are not disputed by the parties such as the policy documents, payment of first premium and the request of surrender of policy on behalf of complainant. Perusal of the file shows that the complainant deposited the first premium on 17/11/2009. The complainant has pleaded in his complaint that he neither received any policy document nor any premium renewal receipt from the OP, However, at the same time he never approached OP for getting the policy documents till 2011. For the first time on 29/04/2011, he wrote the letter to the company wherein, he specifically states that the agent of the company never approached his for collection of the next premium, but on this occasion he did not asked the OP to supply the policy documents. This shows that the complainant was negligent and failed to take reasonable steps against the premium paid. We failed to understand as to why the complainant remained silent till 2011 for getting the refund of the premium paid in the year 2009 against the policy in question.

Per contra, the OP also failed to placed on record the proof of delivery of policy documents to the complainant. The OP is a company who spread its business through its agents. Lured with the benefits of the policies put forth by the agent of the OP, the complainant purchased the policy, hence, the company succeeded in getting the business for itself. As per the terms and condition the OP company is duty bound to sent the reminder or the renewal premium receipt to the complainant for making the payment of further premiums, which OP failed to do. Hence, we also found OP to be deficient in rendering its services.

In view of the above discussion, we are of the considered view that both the parties are negligent in performing the part of their contract/agreement regarding the questioned policy in equal proportion. We therefore, direct OP to refund a sum of Rs. 10,862/- i.e. half of the balance  amount of the premium to the complainant.

With the above direction, the present complaint is disposed off.

File be consigned to record room.

A copy of this order each be sent to both parties free of cost by post.  This final order be sent to server (www.confonet.nic.in ).

Announced in open Forum on 06/03/2020.

 

 

 

(ARUN KUMAR ARYA)

PRESIDENT

(NIPUR CHANDNA)                                                                           (H M VYAS)

       MEMBER                                                                                         MEMBER