Sri Debasis Bhattacharya, Member

This appeal is filed by M/s TATA AIA Life Insurance Co. Ltd. against the Order dated 25-11-2014, passed by the Ld. District Consumer Disputes Redressal Forum, North 24 Parganas (hereinafter referred to as the District Forum) in C. C. No. 61/2014, whereby the instant complaint case been allowed.  Being aggrieved by and dissatisfied with the same, OPs thereof have preferred this appeal.

To narrate in brief, case of the Complainant is that, she took a single premium insurance policy from the OP Insurance Company being no. C002709707 dated 22-06-2012.  On receipt of the policy bond from the Insurance Company, she noticed several discrepancies with the policy vis-à-vis representation made by the employee of the Insurance Company over phone.  Therefore, she sent several letters to the OP Insurer to issue a fresh policy bond, but to no avail.  Hence, she filed the case before the Ld. District Forum.

Per contra, case of the OP Insurance Company, is that, in the month of June 2012, it received a duly filled up and signed proposal form of the Complainant through its broker, i.e., OP No. 4.  In order to avail such policy, the Complainant also signed the illustration document which clearly stated the working benefits, term and type of policy.  As per the terms of the policy, the Complainant was required to pay annual premium of Rs. 48,460/- for 14 years and the policy term was 15 years.  As per the duly filled up application form, the OP Insurance Company issued the subject policy and dispatched the policy document through Speed Post.  However, the Complainant lodged a complaint with the OP Insurance Company for the first time vide her letter dated 17-10-2012 alleging mis-sell of policy and sought for refund of the premium amount.   The OP Insurance Company vide its reply letter dated 17-10-2012 informed the Complainant that the policy was issued on the basis of application form and policy illustration signed by the Complainant.  It was further stated that in case of any discrepancy in the document and plan offered to her, the same should have been brought to the notice of the OP Insurer within 15 days of receipt of the policy document as per the IRDA Regulations.  As the request for cancellation was not made within the free look period, the OPs were unable to process the request for cancellation and refund of premium.  The OP Insurance Company repeated and reiterated the said reply through letter dated 30-11-2012.  The Complainant only paid the initial premium and failed and/or neglected to pay further premiums which fell due in June, 2013 and June, 2014, respectively.  As a result, the policy got lapsed.  It is further pointed out that as the Complainant failed to pay minimum three premiums under the aforesaid policy, the policy did not acquire minimum surrender value as per terms and conditions of the policy.  Accordingly, the OP Insurer prayed for dismissal of the case.

Vide its impugned Order, the Ld. District Forum directed the OP Insurance Company to cancel the policy in question and refund the policy amount to the Complainant.

The core issue to be decided in this appeal is whether such order for refund of the policy amount stands to judicious reasoning.

Decision with reason

The present dispute arises over non-cancellation of an insurance policy by the Appellants.  Undisputedly, the instant policy was issued by the Appellants on 22-06-2012.  It is stated by the Appellants that they sent policy documents through Speed Post on 28-06-2012.  However, apart from mentioning the Speed Post registration no., neither they have submitted any postal receipt to show that the policy document was indeed sent on 28-06-2012, nor furnished any PoD (proof of Delivery) to show when the same was actually received by the Respondent. This was important because the free look period starts from the date of receipt of policy document by the Insuree.

Be that as it may, it appears from the photocopy of a letter on record dated 20-07-2012, that the Complainant drew the attention of the Barasat Office of the Appellants towards some alleged discrepancies with the policy concerned.  Incidentally, from the endorsement on the said letter it appears that the said letter, together with original policy document, was received by one Avijit Khan (Mob. No. 98049-37937), an employee of Respondent No. 2 company, who acted as a broker of the OP Insurer on 21-07-2012. It further appears that the Appellants returned the policy documents to the Respondent No. 1 through DTDC courier vide C/N No. 58786256, which the Respondent No. 1 stated to have received on 12-10-2012. Thus, we find no reason to disbelieve the fact that the policy document was indeed taken by an employee of Respondent No. 2 company.  It is another matter that the same was returned without any rectification/correction as sought for by the Respondent No. 1.

Against this backdrop, it cannot be said with certainty that the Respondent No. 1 did not apply for correction of the policy document within the free look period.

It is claimed by the Appellants that the Respondent No. 1 lodged her first official complaint with the Insurer on 17-10-2012.  On going through the documents on record, it appears that a complaint was indeed lodged by the Respondent No. 1 on 17-10-2012.  However, it transpires from the contents of said complaint letter that the Respondent No. 1 stated in clear terms that she handed over the policy bond to an employee of Respondent No. 2 company on 21-07-2012 and given that the policy bond was indeed returned by the Appellants after few months leaves nothing to imagination that the Respondent No. 1 handed over the policy bond to the representative of the Respondent No. 2 for making necessary corrections.  Thereafter, another complaint was lodged with the OP Insurance Company on 04-10-2012. Such documentary proof belies the contention of the Appellants that the first official complaint was lodged by the Respondent No. 1 only on 17-10-2012. 

It appears that the Respondent No. 1 took strong exception to the fact that although she was given to understand that it would be a single premium Insurance Policy, on receipt of the policy bond, she discovered that it was not so and as per the policy terms she was required to pay premium in respect of the said policy over a period of 14 years, which was not acceptable to her.  True, it was incumbent upon the Respondent No. 1 to carefully go through the finer details of policy terms and conditions.  However, it is an open secret that agents of Insurance Company rarely advise one to do so.  They simply get the policy documents signed by the proposer on the dotted lines without even filling up all the columns of the proposal form in presence of proposer.  As a result, discontentment among policyholders are rising leaps and bounds, still there is no abatement to such malpractice. 

In the present case also it is found that the proposal form was not filled up by the Respondent No. 1 herself.  Therefore, there is enough doubt as to the fact that the Respondent No. 1 was duly apprised of the pros and cons of the policy or that the each and every column of the proposal form was filled up in presence of the Respondent No. 1. Further, it is also unnatural for a person to cry foul within few weeks of receipt of policy document.  Also, on going through the first complaint letter dated 21-07-2012 it appears that by such complaint letter the Respondent No. 1 merely asked for rectification of the policy bond and did not seek refund of premium amount. 

Considering all these facts in mind, we find no reason to doubt the bona fide of the allegations made by the Respondent No. 1.  In such circumstances, the impugned order, to our mind, fully stands to reason and therefore, we see no reason whatsoever to interfere with the same.

The instant appeal, accordingly, fails.

Hence,

O R D E R E D

         that A/160/2015 be and the same is dismissed on contest against the Respondent No. 1.  The impugned order is hereby affirmed.