ORDER

SH. RAKESH KAPOOR, PRESIDENT

       On 28.3.2010 , the complainant had purchased a life Insurance Policy from the OP.  the premium payable was Rs.15014/- . The maturity value of the policy was Rs. 327000/- and the maturity date was 8.4.2040.  The second premium was paid on 16.9.2011. It is the case of the complainant that he had paid  a sum of Rs. 30030/- through cheque on 26.8.2013 . It was duly encashed by the OP  as a result of which payment of four premiums had been completed.   It is also the case of the complainant that he had received a cheque dated 6.5.2014 for a sum of Rs. 1273.74  along with a letter dated 17.2.2014 about the termination of the policy. It is alleged by the complainant that the termination of the policy was illegal and unwarranted.  He had taken up the matter with the Ops but to no result . Hence, the complaint.

            The Ops have contested the complaint and have filed a written statement.

            They have taken preliminary objections that the complaint is not maintainable . They have claimed that the complainant has not stated the correct facts. They have claimed that the complaint is liable to be dismissed. Under the heading “Facts of the case”  the ops have stated as under in Paras 3 to 6 of its written submissions.

3.     That the said policy was issued under BSLI Dream Endowment Plan and the premium was Rs. 15,014/- per annum. In the Policy No. 004014935 the complainant was required to make the payment of the premium annually on due dates or during the grace period. The Complainant made the payment of Rs.15,014/- of the premium in the first year vide Receipt No 20640722 dated 29.03.2010 and Second premium of Rs. 15,015/- vide Receipt No. 29231456 dated 16.09.2011 was paid during grace period only and later on due to his own wrong and negligence failed to pay the subsequent premiums therefore, allowing the Policy to go on lapsed status.

4.     That again the premium came to be due on 28.02.2012 but the Complainant on his own negligence and carelessness failed to pay the premium and again the said policy went into lapsed mode.

5.     That the Opposite Party-Company  sent a letter dated 26.08.2013 and 29.08.2013 to the Complainant informing about the Policy not being in force. However the opposite party asked the Complainant (Life Assured) to pay Rs. 30,030/- to the reinstate the instant policy along with Certificate of Insurance (hereinafter referred to as COI) within 35 days. It is pertinent to submit that since the policy was in lapse mode for more that 180 days, the Complainant was also required to undergone Full Medical Test and submit the medical report along with COI to the Opposite Party. The Complainant paid the said revival amount of Rs. 30,030/- to the opposite party but failed to provide COI duly signed and undergo Full medical test and submit its report and along with blood report which was ,required to be submitted within. 35 days. It was explicitly averred and urged to the Complainant to initiate the reinstatement. Process at the earliest, failing which, after 35 days opposite party would be forced to process the refund of the amount received post lapsation. Since the complainant failed to do the needful for the restoration of the policy, the complainant to refund the premium amount paid after lapsation, sent a cheque no. 958790 dated 21.10.2013 of Rs. 30,030/- to the registered address of the Complainant but the same was returned back undelivered to the answering insurance company’s  office. The letter dated 26.08.2013 & 29.08.2013 is annexed and marked ANNEXURE R/3  & ANNEXURE R/4 Respectively.

6. That Opposite Party-Company again sent a letter dated 03.09.2013 but ant failed to fulfill the aforesaid requirement to reinstate the. Despite sending reminders and communications, Complainant deliberately failed to satisfy the aforesaid condition for restoring' his policy which was mandatory required since Complainant on his own fault and negligence had failed to pay the premium on time and fulfill the condition for the reinstatement of the policy thus eventually, the Policy went into lapse mode. Since the complainant failed to do the needful for the restoration of the policy, the complainant refunded the premium amount paid after lapsation, a sent a cheque no. 958790 dated 21.10.2013 of Rs. 30,030/- to the registered address of the Complainant but the same was returned back undelivered to the answering insurance company's office. The Complainant was again asked to reinstate the policy vide letter dated 28.02.2014 by submitting the fresh COI duly signed by the Complainant and a witness but no response was received by the Complainant. As a result policy went into termination and sunder value i.e. Rs. 1,273/- so attained by the policy was paid after the expiry of the lapse period to the Complainant on 06.05.2014 vide cheque no. 310493. The letter dated 03.09.2013 is annexed herewith and marked as ANNEXURE R/5and Email dated 25.02.2014 sent to the Complainant is annexed herewith and marked as ANNEXURE R/6.

             The Ops have contested the complaint on merits and have prayed for its dismissal.

         We have heard arguments advanced at the bar and have perused the record.

            Admittedly, the first premium was paid on 29.3.2010.  The second premium had become due on 29.3.2011 but was paid on 16.9.2011, during the grace period.  The third premium had become due on 28.03.2012 but the complainant had failed to pay the same.  In fact by his own admission, the complainant had paid the third and fourth premium on 26.8.2013. In the meanwhile, the policy had lapsed due to nonpayment of the third premium.  The policy was to be revived in accordance with the terms and conditions of the policy. The complainant was not only required to pay the premium due but was also required to submit  the certificate of insurance along with a medical report after undergoing full  medical tests. This was to be done within 35 days of the request  for revival of the policy.  The complainant had failed to submit the certificate of insurance and had also  not submitted the  medical report regarding  his state of health at the time of revival of the policy. In the circumstances, the OP was justified in refusing to revive the policy and to pay the surrender value.  In our considered opinion, the OP had acted in accordance with  the terms and conditions of the policy purchased by the complainant.  We, therefore see no deficiency in service on the part of the OP. Consequently, we hold that this complaint has no merits. The same is hereby dismissed. 

Copy of the order be made available to the parties as per rule. 

File be consigned to record room.

          Announced in open sitting of the Forum on.....................