Kuldip Studley vs Icici Prudential Life Insurance Company Ltd.

BEING aggrieved by judgment dated 6.4.2011 passed by State Consumer Disputes Redresal Commission, Chandigarh (for short, ''State Commission '') (in Appeal No.10 of 2011), Petitioner/Complainant has filed the present revision against the Respondents/OPs.

BRIEF facts are that petitioner took Life Insurance Policy for insurance cover of Rs.36,000/ - in her name and in the name of her two minor children through respondent No.2. She also took, another policy for Rs.36,000/ - in the name of her husband Sh.Nigel Studley along with her minor daughter namely Abigail Studley, aged 5 years through respondent No.3. It was stated that the splitting of the insurance into two policies as per the petitioner was on the initiative of respondent No.3. The insurance of just one person for Rs.36,000/ - was not demanded or requested by the petitioner. The proposal form for insurance from petitioner was received on 10.8.2009, alongwith first premium deposit of Rs.36,000/ -. Accordingly, respondents issued the policy on 10.8.2009. The policy document was delivered to the petitioner on 20.8.2009. It was further stated that the proposal form and the other forms were signed by the petitioner and her husband on the assurance of respondent No.3 on 16.7.2009. The petitioner made one time payment of Rs.72,000/ - for insurance cover and insurance cover of her husband and three children. The petitioner gave two cheques drawn on HSBC Bank for Rs.36,000/ - each to respondent No.3. The policy holder as per the assurance of the respondents had the option to cancel the policy during the free look period of 15 days from the date of receipt of the policy documents, as mandated by the Insurance Regulatory and Development Authority. It was further stated that the petitioner was surprised to find that policy No.12339976 received on 2.8.2009 for Rs.36,000/ - was only in her name and did not include the names of her three children and husband. The total premium of Rs.72,000/ - was paid for whole family to have one time policy, whereas the annual policy in the name of only the petitioner was issued by the respondents. The petitioner tried to contact respondent No.1 to 3 for revoking policy No.12339976 within the free look period but they intentionally and deliberately did not acknowledge the receipt of telephone calls and emails sent by her. It was further stated that the husband of the petitioner fell seriously ill, in the intervening period and was in need of medical help, but as there was no policy cover provided by the respondents in his name, the petitioner had to spend huge amount on his treatment. The above said act of the respondents amounted to deficiency in service and unfair trade practice. Hence, the complaint was filed. Reply was filed by the respondents wherein they stated that they received the duly filled and signed application form/proposal form, from the petitioner on 10.8.2008, for the issuance of a policy. In the proposal form, the petitioner had opted for yearly mode of premium payment of Rs.36,000/ - and on receipt of the first premium deposit vide cheque No.055565 dated 16.7.2009 for Rs.36,000/ -, the policy bearing No.12339976 was issued, as per the details updated in the proposal form. As prescribed under Regulation 4(1) of the Insurance Regulatory and Development Authority Regulation 2002, the policy document was duly dispatched to the petitioner on 17.8.2009, and the same was received by her on 20.8.2009. It was further stated that as per regulations of the IRDA, the petitioner was entitled to revoke the policy during the free look period of 15 days but she retained the same and did not return the same to the respondents for cancellation during this period. It was further stated that the petitioner contacted the respondents only in December, 2009 and started raising frivolous allegations and demanded that the amount paid by her be refunded. Since, request of the petitioner was received by the respondents long after the free look period, so they were not liable to refund the amount of the policy to the complainant. The respondents have, however, returned the amount of Rs.36,000/ - vide another cheque for the second policy. All other material allegations levelled by the petitioner, in the complaint, were denied. It was further stated that there was no deficiency in service on their part nor did they indulge into unfair trade practice.

THE District Consumer Disputes Redressal Forum, Chandigarh (for short, ''District Forum '') dismissed the complaint, vide its order dated 13.1.2011.

AGGRIEVED by the order of District Forum, an appeal was filed by the petitioner. However, the same was also dismissed by the State Commission, vide the impugned order. Hence, the present revision petition.

WE have heard the petitioner, who argued her case in person, as well as counsel for respondents no.1 and 2 and gone through the record.

THE main grouse of the petitioner is that respondents did not cover the entire family of the petitioner under the Life Insurance Scheme despite having received the premium of Rs.72,000/ - for ensuring the entire family, petitioner herself, her husband and three minor children. In support of her contention, petitioner relied upon various the following judgments namely; i) United India Insurance Company Ltd. Vs. M/s. M.K.J. Corporation, [ 1997 AIR ( SC) 408 ]; ii) Andagro United Services Ltd. Vs. United India Insurance Company Ltd. and another, [ O.P. No.165 of 2000 decided on 19.2.2013 by this Commission. ]; iii) Bajaj Allianz Life Insurance Company Ltd. and others Vs. Sali Thomas, [ R.P. No.1953 -1954 of 2012 decided on 2.7.2012 by this Commission ]; iv) Usha Kumari Ranawat Vs. Senior Divisional Manager, LIC of India and another, [ 2011(ACJ 2505 ] and V) Sundaram BNP Paribas Home Finance Limited and another Vs. Consumer Guidance Society, [ R.P. No.4308 of 2012 decided on 27.11.2012 by this Commission ].

ON the other hand, it has been contended by learned counsel for the respondents that as per the proposal form, petitioner has clearly mentioned that policy is being sought in her name alone and not in the name of other family members. Under these circumstances, there is no infirmity or ambiguity in the orders passed by the fora below.

DISTRICT Forum in its order held; ''''The complainant has filed this complaint against the OPs because she is aggrieved and dis -satisfied that they have issued a policy in her favour and not in favour of her husband. Also the names of her children as promised by the OPs have not been entered in her policy. Again the complainant has alleged that the premium payable was one time and not annual. The OPs have contended that the policy had been issued to the complainant as per the proposal form and the terms contained therein. The policy was in the name of the complainant with premium payable annually. Further, they had not issued a policy in the name of the husband and the amount had accordingly been refunded to the applicant. The complainant has submitted that she was not willing to continue with the policy in her name alone after her husband ''s premium amount was returned. However, she has not been able to impress this fact upon them within the time of free look period. All the correspondence exchanged between the parties relates to a period beyond the free look period. Hence, we are of the opinion that the complaint is not maintainable and deserves dismissal. The allegations and desire for refund of the complainant seem an afterthought when her husband did not receive his policy.

The State Commission while affirming the decision of District Forum, in its impugned order observed; ''''10. After giving our thoughtful consideration, to the rival contentions advanced by the Counsel for the parties, we are of the considered opinion that the appeal is liable to be dismissed for the reasons to be recorded herein after it is evident from Annexure C -4, application/proposal form submitted by the appellant that she signed the same, for obtaining ICICI Prudential Health Care Policy, in her own name. The annual premium mentioned in the form aforesaid is Rs.36,000/ -. She paid this amount through cheque and receipt in that regard is Annexure C -6. She nominated her husband as a nominee, in the proposal from. In Annexure C -4, there is nothing to show that she intended to obtain two policies, in her name, and in the names of her minor children and husband. The OPs are required to act according to the terms and conditions of the proposal form, at the time of issuing the policy. In case, the appellant was not satisfied with the terms of the policy issued to her, she could revoke the same, within 15 days i.e. the free look period, from the date of receipt of the policy documents. She, however, failed to revoke the policy, within the free look period. No doubt, the appellant sent e -mails Annexure C -1 dated 7.12.2009, Annexure C -2 dated 9.1.2010, Annexure C -3 dated 30.12.2009 and letter Annexure C -8 dated 8.10.2009, for cancellation of the policy, but the said correspondence, was beyond the free look period of 15 days, from the date of receipt of the policy papers. In these circumstances, there was no deficiency in rendering service by the OPs, nor they indulged into unfair trade practice. The appeal is, thus, liable to be dismissed. ''''

AS per proposal form placed on record, in the column of Life Assured name of petitioner alone has been mentioned. It would be pertinent to point out that name of spouse and children have not been mentioned by the petitioner at all in this proposal form.

THERE are concurrent findings of facts to this effect that the proposal form was only for the petitioner alone and not for her family members. Under these circumstances, when petitioner herself has furnished the proposal form seeking policy for herself alone, the respondents were fully justified in not issuing the policy in the name of her other family members. It is well settled that under section 21(b) of the Act, this Commission can interfere with the order of the State Commission where such State Commission has exercised jurisdiction not vested in it by law, or has failed to exercise jurisdiction so vested, or has acted in the exercise of its jurisdiction illegally or with material irregularity.

HON ''ble Supreme Court in Mrs. Rubi (Chandra) Dutta vs. United India Insurance Company, 2011 (3) Scale 654 has observed; ''''Also, it is to be noted that the revisional powers of the National Commission are derived from Section 21 (b) of the Act, under which the said power can be exercised only if there is some prima facie jurisdictional error appearing in the impugned order, and only then, may the same be set aside. In our considered opinion there was no jurisdictional error or miscarriage of justice, which could have warranted the National Commission to have taken a different view that what was taken by the two Forums. The decision of the National Commission rests not on the basis of some legal principle that was ignored by the Courts below, but on a different (and in our opinion, an erroneous) interpretation of the same set of facts. This is not the manner in which revisional powers should be invoked. In this view of the matter, we are of the considered opinion that that the jurisdiction conferred on the National Commission under Section 21(b) of the Act has been transgressed. It was not a case where such a view could have been taken, by setting aside the concurrent finding of two fora. ''''

HENCE , we do not find any illegality or infirmity in impugned order passed by the State Commission. There is no merit in this revision petition. Accordingly, the same is hereby dismissed. No order as to cost.