Complaint no. 111/2011

                                                Filed on. 13/09/2011.

                                          Decided on. 22/01/2014

Mr. Y.V.N. Rao, S/o. Y.V.S. Murthy

8/47, Artist Village, Sector 8,

C.B.D. Belapur, Navi Mumbai 400614.          .. Complainant

               Versus 

1.The Branch Manager LIC of India

Persopilis Bldg. Sector 17, Vashi,

Navi Mumbai .

2.Mr. Anil Bhoj

Add. 603, Hiltop, Nr. Mary Immaculate School,

L.J.Road, Borivali (w) – 400 103.                 .. Opponents

BEFORE – HON’BLE PRESIDENT MRS. S. S. MHATRE

            HON’BLE MEMBER MR. S. S. PATIL

Present –  Complainant in person.

                 Ld. Adv. Dipti Desai for the Opponent no. 1

                Opponent no. 2 absent         

  JUDGEMENT         

   (24/01/2014)

Per HON’ABLE MR. S.S.Patil  MEMBER.

1.           In this case Opponent no. 1 is an Insurance Company and Opponent no. 2 is its authorized agent. Complainant is an individual who has availed the insurance policy known as Jeevanshree Policy bearing no. 891218137 from Opponent no. 1 through Opponent no. 2 by paying premium towards the said policy since 2002.  The Jeevanshree plan presentation statement of the Opponent no. 1 (LIC) provided that by investing Rs. 5,78,640/- in ten years by regular payment of the premium of Rs. 57,864/- the Complainant was to get Rs. 12,99,352/- plus additional bonus of Rs. 2 lacs as explained by Opponent no. 2.  The Opponent no. 1 had also agreed to give loan as per statement  Exh. 2. As per this agreed terms, the Opponent no. 1 gave loan for five years. Thereafter the Complainants policy was transferred to Vashi Branch Vide letter dtd. 12/09/2006. On 05-01-2007, the Complainant by his letter gave instructions for further dealing of policy as regards further loan, interest payment of loan etc, However, the Opponent no. 1 abruptly stopped giving loan to the Complainant without giving any valid reason.

2.          Opponent no. 1 issued letter dtd. 18-06-2009 stating that the loan outstanding on the policy was Rs. 2,34,250/- which does not confirmed with the statement given as per Ex. 2.  Opponent no. 1 did not give any explanation for the discrepancy.

3.          The Complainant then wrote a letter to the Insurance Ombudsman to solve the above problem but in vain.

4.          The Complainant has stated in para 12 that his policy was foreclosed resulting in paid up policy suffering financial loss. The Complainant issued notice to the Opponents but the Opponents did not respond to these notices.

5.          Finally it is prayed by the Complainant that the Opponent no. 1 be directed to revive his LIC policy without charging any penal interest and rectifying the calculation mistake to tally with the Jeevanshree plan presentation          dt. 29-07-2002.

6.          The Complainant has attached the xerox copies of the following documents in support of his complaint.

a) Policy no. 891218137

b) Jeevanshree Plan Presentation.

c) Loan reinvestment chart.

d) Summary of Insurance proposal under Jeevanshree plan of LIC.

e) Letter dtd. 05/01/2007 from Complainant to Opponent no. 1. (Standing instructions)

f) Letter dt. 18-06-2009 from Opponent no. 1 to Complainant.

g) Letter dtd. 30-09-2009.

h) Letter dtd. 05/11/2009.

i) Letter dtd. 05/01/2010.

j) Letter dtd. 30-12-2009.

k) Letter dtd 08-12-2009.

l) Letter from Complainant dtd. Nil.

m) Letter dtd. 16-12-09 of LIC Ombudsman.

n) Letter dtd. 14-03-2011.

o) Letter dtd. 08-04-2011, 19-04-2011, 18-05-2011.

7.          The Complaint was admitted and notices were served on Opponents. Opponent no. 1 filed its written version Opponent no. 2 did not appear before this Forum inspite of the service of notice on him.  Therefore an exparte order was passed against him vide Roznama dtd. 13/12/2012.  Opponent no. 1 in his written version has denied that there is a deficiency in service on its part and specifically stated that the Complainant is a defaulter as he has not paid the premium of the insurance policy consequently the policy is in lapsed condition.

8.          The Opponent no. 1 has further admitted that the Complainant had purchased the Jeevanshree Policy bearing No. 891218137 dtd. 28-02-2002 through Opponent no. 2. As per the policy, the annual premium amount was Rs.57,864/- to be paid by the Complainant for 10 years and the Complainant would get an amount of Rs. 12,09,352/- + bonus of Rs.2 lacs. The Complainant was fully aware of the terms and conditions of the policy.

9.          The Opponent no. 1 has further stated that the Complainant paid the premium from 2002 to February 2007 regularly.  He had yearly applied for loan against the above said policy.  Opponent no. 1 granted the loan facility to the Complainant for February 2008. The loan amount disbursed was Rs. 2,34,250/- on 09-02-2008 and this disbursement of loan was as per condition no. 8.

10.         As stated earlier by the Opponent no. 1, the Complainant has regularly paid the premium till February 2007, he was supposed to pay the next premium in February 2008.  However the Complainant failed to pay the said premium.  Therefore, Opposite party no. 1 sent letter dtd. 18-06-09 to the Complainant regarding payment of the premium.  The Opposite party no. 1 has vehemently stated that the Complainant not only failed to pay the premium for 2008 but he also failed to repay the loan interest from February 2008.  Therefore, Opposite party no. 1 sent a foreclosure notice to the Complainant.  Even after getting the foreclosure notice, the Complainant did not pay the premium and loan interest.  Thereafter, Opposite party no. 1 also gave several chances for revival of the said policy, by sending letters in writing.

11.          Opposite party no. 1 has further explained that the Complainant had to pay the interest on loan in instalment on half yearly basis i.e. in August 2008.  However, the Complainant failed to pay the same as well as the regular premium in February 2008 onwards.

12.         The Opposite party no. 1 has admitted that Opposite party no. 1 agreed to give loan to the Complainant as per statement Ex. 2 filed by the Complainant and infact it gave loan to the Complainant as per terms and conditions of the policy. But it was vehemently denied that it stopped giving further loan to the Complainant. It had disbursed the loan of Rs. 2,34,250/- to the Complainant on 11-02-2008, but the Complainant failed to pay the above said loan interest amount.  It is the opposite party no. 1’s policy and procedure to deduct previous loan and interest due there on at the time of granting further loan.  Finally the opposite party no. 1 has stated that there is no deficiency in service on its part & the complaint be dismissed with cost.

13.         The opposite party no.1 has attached the Xerox copies of the following documents in support of its written version.

a)Copy of policy no. 891218137.

b)Letters dt. 26-03-2003, regarding loan 24-03-2004, 17-06-2005, 31-07-2006,   18-07-2007, 11-02-2008.

14.         Again the Complainant has filed one document dtd. Nil which appears to be a reply to the written version of the Opposite Party no. 1.  He then filed his affidavit on 06-09-13 and written argument & additional written argument.  The Opposite Party no. 1 also filed its affidavit and written argument.  We heard the Ld. Complainant in person and the Ld. Adv. for Opposite Party no. 1 as well as the legal officer Mr. Shisode for Opposite Party no. 1.  We also perused the papers submitted by both the parties and our findings are as follows-

15.         The Complainant has obtained an insurance policy no. 891218137 known as Jeevanshree since 2002, the premium amount being Rs. 57,864/- p.a.  The main cause of dispute is the loan facility availed of by the Complainant from Opposite party no. 1.  The Opposite party has agreed to give loan for payment of the premium.  In this connection the Complainant has attached one xerox copy of a document purported to be issued by one Anil Kumar Bhoj (Opposite party no. 2) dtd. 29-07-02. The title shows Jeevanshree plan presentation.  This document does not bear any signature of the Opposite parties.  Even though this unsigned document is considered, it discloses that the new loan available to the Complainant in the year 2008 was Rs. 51,636/-.  It is admitted by both the parties that the premium was regularly paid up to February 2007. 

16.         The Complainant was supposed to pay the premium in February 2008, the amount being Rs. 57,864/-.  The loan available was Rs. 51,636/-.  From the papers it is seen that the Complainant himself has neither paid the remaining amount of premium i.e. 57,864 – 51,636 = 6,228/- nor he has made any efforts to get loan of Rs. 51,636/- from Opposite party no. 1.  The Complainant cannot obtain loan only by showing an unsigned document which appears to be issued by one Mr. Anil Kumar Bhoj & he cannot claim on the basis of this paper only that the Opposite party no. 1 did not pay the loan amount to him and therefore, he could not pay the premium to insurer.  As per the insurance law, it is the primary obligation of the insured to pay the Premium amount to the insurer within a stipulated time including the grace period. In this case, the Complainant has failed in his obligation to pay the premium for the financial years February 08 and February 09. Only vide letter dtd. 18-06-09 i.e. after one & half year, lapse of time the Opposite party no. 1 has reminded the Complainant that the premium has not been paid by the Complainant since February 2008. The Opposite party no. 1 had requested in this letter to pay the outstanding loan interest.  But the Complainant has not complied with this letter.

17.         In the letter dtd. 30-09-09 the Complainant has raised the point that the Opposite party no. 1 did not grant loan facility to the Complainant from the year 2008.  But there is nothing on record to show that the Opposite party no. 1 has refused the loan facility in February 2008.  The Complainant has failed to show that the Opposite party no. 1 did not grant him loan facility in February 2008.  Only a bare sentence in letter dtd. 30-09-09 do not establish that the Opposite party no. 1 didn’t give him loan.

18.         The basic point was to pay the insurance premium of Rs. 57,864/- in February 2008. The Complainant has availed the loan facility from the Opposite party no. 1 for this purpose. Therefore, it is the Complainant to see that the Opposite party no. 1 gives him loan and by adding the remaining amount, he should pay the entire premium amount.  In our candid view, the Complainant himself has failed in his obligation to obtain a loan facility from the Opposite party no. 1 and pay the entire premium amount to the Opposite party no. 1.

19.         It is further alleged by the Complainant that the loan amount shown outstanding on the policy as per letter dtd.18-06-09 was Rs. 2,34,250/-.  This amount does not confirm with statement given in Exh. 2 (dtd. 29-07-02). In this respect we again perused this unsigned statement which does not show any outstanding.

20.         The main prayer of the Complainant is to review the above said Jeevanshree policy. However, taking into consideration the main principle of the insurance, the Complainant has failed to pay the premium amount.  Hence, this prayer cannot be granted.  Regarding the dispute of loan amount and interest thereon, the Complainant has miserably failed to establish that the loan amount outstanding was in excess of what the complainant was supposed to repay. Hence, in view of these observations we are of the candid opinion that there is no merit in this complaint and the Complainant has failed to establish the deficiency in service on the part of the Opposite party no. 1 as alleged in the complaint. Hence the complaint needs to be dismissed with no cost.  Hence we pass the order as follows:-

-: FINAL ORDER :-

1.Complaint bearing no. CC/111/2011 is hereby dismissed with no cost.

2.Copies of the above said order be supplied to both the parties free of cost.

Date :- 22/01/2014.

Place :- Kokan Bhavan, Navi Mumbai.

                                     (S.S.Patil)      (S.S.Mhatre)

                                      Member         President