PER HON’BLE MS.DR.RICHA BANSOD, PRESIDENT
This complaint is filed under section 12 of Consumer Protection Act 1986. The complainant is 25 year old resident of Thane West. The opponents are HDFC Life Insurance Company Limited through branch manager at Thane and HDFC Life Insurance Company through branch manager at the head office. The facts of the complaint are as follows:
1. The complainant states that he bought a life insurance policy named HDFC life Sampoorna Samriddhi insurance plan from HDFC standard life insurance company limited that is opponent No.1.
Policy No.16541740 issued on 03/01/2014 policy term 5 years.
The complainant states that the representative of the opponent approached the complainant with a proposal showing benefits of the policy showing three elements of maturity payment a) sum assured b) premiums invested and c) attaching bonus.
The complainant states that on page-2 of policy documents under the point of benefits the opponent has confirmed that all benefits and the schedule of benefits mentioned on page-3 and attaching bonuses if any will be paid at the time of maturity. The complainant states that while paying the maturity benefits of the policies, the opponent has not paid the element of annual premium in spite of it being clearly mentioned under the schedule of benefits. The complainant alleges that he wrote to the opponent on 14/01/2019, but they have refused to pay the amount. The complainant further states that the HDFC Life that is opponent number one paid the complainant a total bonus of 39% of the sum assured as against 57% of sum assured paid for similar policies.
The complainant states that the total amount payable for each of the policies to the complainant by the opponent is Rs.1080411/-
The actual payment by the opponent is rupees 527134/-
The complainant prays that
-The opposite party no 1 be directed to pay the amount of Rs.553277/- as pending due.
-The opposite party be directed to pay interest at the rate of 18% per annum on the set amount of Rs.553277/- from the date of part payment to the date of its realisation.
-Opposite party be directed to pay Rs.1,00,000/- as compensation towards financial loss and mental agony.
The opposite party directed to pay Rs.5000/- towards legal expenses.
The complainant submitted a list of documents along with the complaint that include proposal by opponent prior to policy, copy of policy No.16541740 , copy of mails and letters sent to opponent, final response of the opponent copy, bonus given to similar policies and copy of calculation of the bonus discrimination.
2. The complaint was admitted, and notice was sent to the opposite parties to appear.
3. The opposite parties appeared and filed their written version. In the written version, the opposite parties state that they have not committed any deficiency in services. Therefore, this complaint was not maintainable. They also stated that the complainant had filed and signed the proposal form, giving her consent for the said policies. The complainant has also paid all the premiums in the said policy. They also state that the opponents received duly filled proposal form along with the signed benefit illustration for the policies bearing No.16541740. The opposite party further state that they have abided by the IRDA regulations. The opposite party submit that upon maturity of the policies calculated the sum assured adding bonus to the same and along with interest and revised bonus explained as benefit illustration transferred the amount of Rs.5,21,862.56/- through NEFT to the complainant towards both the policies. They further state that upon receiving a query from the complainant about the shortfall in the maturity amount, the opponent sent bifurcation of the maturity amount to the complainant. The opposite party also state that the complainant has taken the policies through insurance broker and failed to add them as a necessary party to the matter. The opponent attached a copy of the proposal form along with benefit illustration and copy of letters dated 31/01/2019, and the copy of maturity bifurcation.
4. The complainant and the opponent filed affidavit of evidence and written notes of argument.
We perused the complaint and the submitted documents as well as the affidavits of evidence and written notes of arguments. We heard oral arguments and perused the citations provided.
The commission perused the complaint, and the following points arise out of the dispute, and we answer the said points with reasons given below;
Sr.No. | Points | Findings |
1. | Whether the Commission has jurisdiction to entertain the complaint? | In affirmative |
2. | Whether the opponent has committed deficiency in service towards the complainant? | No. |
3. | Is the complainant entitled to the relief sought ? | No. |
4. | What order? | As per final order |
REASONS
5. As for point No.1:- It is an admitted fact that the complainant purchased a Policy No.16541740 issued on 04/01/2014.
The complainant is, therefore, a consumer within the meaning and definition of the consumer in the Consumer Protection Act, 1986. As the complainant is a resident of Thane therefore this complaint is within the jurisdiction of this Commission.
6. As for point No.2 :- It is also an admitted fact that the opponent transferred the amount of Rs.5,27134 through NEFT to the complainant after the maturity of the policy. The same was communicated with the complainant on 07/02/2019. The service that was provided cause of life insurance and the entire maturity amount was paid to the complainant, as promised. Therefore appears to be no deficiency in service by the opponent.
The expectation of the complainant that the premium amount will be refunded is not part of the policy purchased by the complainant.
The complainant took the reference of the judgment of the Hon’ble Supreme Court in case of United India Insurance Company Limited versus M/S Orient Treasures Private Limited Civil Appeal No.2140/2007 where there was ambiguity on the policy documents. However, this commission does not see any ambiguity in the policy document.
As for point 3: - Therefore, on the basis of the perusal of the complaint and the documents provided by both the parties, this Commission does not find any deficiency in service and therefore no cost to the opponent.
FINAL ORDER
1. The consumer complaint No. CC/378/ 2019 is rejected on the basis of the merits of the complaint.
2. No cost to the opponent
3. The copy of this order shall be furnished to both parties free of cost
4. The member sets, if any, shall be returned to the complainant. In case the complaint fails to collect the same within a period of 30 days from the receipt of the copy of the order, the same may be destroyed.
