PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SAMBALPUR
CONSUMER COMPLAINT NO.57/2023
Present-Dr. Ramakanta Satapathy, President,
Sri. Sadananda Tripathy, Member,
Rabi Narayan Mishra,
S/O-Late Braja Kishore Mishra,
R/O- Mohanty para PO-Jharuapara,
Dist-Sambalpur, Odisha-768001. .……….......Complainant.
Vrs.
- The Zonal Manager, Life Insurance Corporation of India,
East Central Zone Office, “Jeevan Deep”,
Office at-6th Floor, Patna-800001.
- The General Manager, Consumer Affairs Department, Insurance Regulatory and Development Authority of India(IRDAI),
Office At-S.Y. No. 115/1, Financial District, Nanakramguda,
Gachibowli, Hyderabad-500032.
- The Divisional Manager Life Insurance Corporation of India,
“Jeevan Prakash” Building, Ainthapali, Sambalpur-768004.
- Sapan Mishra, Development Officer, Branch-1, LIC of India,
Ainthapali, Sambalpur-768004.
- Avijit Roy, Agent, Branch-1, LIC of India,
Ainthapali, Sambalpur-768004…...……….Opp. Parties
Counsels:-
- For the Complainant :- Self
- For the O.P.1 to 3 :- Sri. D.K. Thakur, Adv.
- For the O.P. No.4 & 5 :- Self.
Date of Filing:12.04.2023,Date of Hearing :22.08.2023,Date of Judgement : 09.10.2023
Presented by Dr. Ramakanta Satapathy, PRESIDENT
- The case of the Complainant is that the Complainant did a policy “JEEVAN SARAL” Table No. 165 from the agent Abhijit Roy, O.P. No.5 with the Development officer Sapan Mishra, O.P. No.4 on 28.04.2019. Yearly premium was paid Rs. 18,015/- for 14 years and matured on 28.04.2023. Death sum assured was Rs. 3,75,000/- but the Complainant only received Rs. 1,62,675/- from the O.Ps. The Complainant deposited Rs. 18,015/-x14= Rs. 2,52,210/- but received less amount of Rs. 89, 535/- then the deposits. Although bonus was to be paid, with maturity value. The O.P. No.4 & 5 assured the Complainant return of 8% of maturity value including loyalty addition and other profits. The Policy was awarded with golden peacock, best policy ever. After maturity on 28.04.2023 assured amount was not returned, for this complaint was filed.
- The O.P. no.4 Development officer submitted that the case is not maintainable. The allegations are denied. The Complainant was a professor in an university and acquainted with the terms and conditions of the policy No. 5936119880. The Complainant was interested to purchase the plan as he was approaching his retirement and attaining the maximum age of entry for the plan. In the policy plan benefit of Rs. 1,08,450/- and death benefit Rs. 3,75,000/- has been clearly mentioned. For high death coverage most people prefer this policy. After issuance of policy bond and certificate the Complainant within 15 days not made any complaint on the policy, during free look period. The O.Ps are not deficient in their service.
- The insurance agent, O.P. No.5 submitted that as per terms and conditions of policy No. 593619880 maturity value and other benefits paid have been admitted by the Complainant. The Complainant during free look period as not raised any complaint it is binding on him. There is no any deficiency on the part of the O.Ps.
- The O.P. No.1 & 3 in their version submitted that the Complainant availed the policy at the age of 56, policy No. 593619880 on 28.04.2009 with yearly premium Rs. 18,015/- S.A. Rs. 3,75,000/- MSA: Rs. 1,08,450/- and accident benefit sum assured. Rs. 3,75,000/- under plan/terms 165-14 and date of maturity 28.04.2023. The Complainant is duly entitled to receive Rs. 1,62,675/-(Maturity sum assured Rs. 1,08,450+ Loyalty addition Rs. 54,225/-) which was due on 28.04.2023. After receipt of original policy bond, discharge voucher NEFT and ID proof from policy holder the amount has been disbursed. The Complainant not raised any objection within 15 days after receipt of policy bond. The policy was introduced on 16.02.2004 covering high risk and extended free death cover for 1 year.
The answering O.Ps have submitted calculation sheet of Rs. 1,62,675/- payable to the Complainant and submitted that there is no any deficiency on the part of the O.Ps.
- The Insurance Regulatory Authority, O.P. no.2 submitted that its function is supervisory in nature and not a necessary party. No any Complaint has been filed before Integrated Grievance Management System(I.G.M.S), “Bima Bharosa”. Accordingly, prayed for dismissal of the Complaint.
- Perused the documents filed by the parties. It is the admission of the Complainant that he has received the maturity value of Rs. 1,62,675/- from the Insurance Company. Categorically the O.Ps submitted that the policy is a high risk factor policy and in case of death of an insured or accidental death the policy is more beneficial.
Insurance is a contract and the parties are bound by its terms and conditions. The insured himself present and filed the complaint. Accordingly, claiming death benefits or any other amount is no acceptable.
Secondly, after receipt of the policy bond, the Complainant within 15 days not filed any objection nor for cancellation of the policy. Only after maturity knocked the door of the commission when the contract is complete. Further regarding allegations against insurance agent, O.P. No.5 and Development officer, O.P. no.4 is not acceptable as it is merely a bald statement against about return of profit of more than 8% of the maturity value. When the Complainant is availing the death benefit plan, for the life risk coverage receipt of less amount than paid amount of Rs. 2,52,210/- is obvious and as the Complainant is alive can not get the death benefit nor any bonus as assumed by him hypothetically. Accordingly, we are of the view that the O.P. insurer has rightly paid Rs. 1,62,675/- to the Complainant.
Basing on the circumstances of the case the following order is passed:
ORDER
The complaint is dismissed against the O.Ps. There is no any deficiency or unfair trade practice on the part of the O.Ps. Further the O.P. no.2 is not a necessary part to the complaint. No cost.
Order pronounced in the open Court on this 9th October, 2023
Supply free copies to the parties.
