Case No. CC/ 55/2019
FINAL ORDER/JUDGMENT
Sudeb Mitra, President:-
The factual matrix of the complaint case, as culled out reflects as follows:-
The complainant purchased a LIC policy bearing no 498614421 of Table no 165 under the LIC scheme in the name and style ‘LIC’s JEEVAN SARAL’ on 03.12.2008 from the O.Ps in his name keeping his wife Renuka Mal as the nominee of the said policy proposed by him, for the assured sum of Rs- 2,50,000/- with yearly premium of Rs- 12,010/-.
The complt. contended by filing this compliant that the date of commencement of the said policy was 03.12.2008 and that date was also the date of commencement of risk and it’s date of last premium payment of that policy was 03.12.2017 and it’s date of maturity was 03.12.2018.
The complt. contended further that by filing this complaint that he had regularly paid the premium in respect of his purchased policy without any interruption. Later, after the date of maturity of that LIC policy, the complt. had submitted the relevant original policy & other relevant papers before the O.P. side and claimed the sum assured in that policy, to the extent of Rs- 2,50,000/-.
It is the specific compliant of the complainant that in response to his claim, the O.P. side has only paid Rs- 64,281/- through cheque on his P.N.B. A/C of Narayangarh Branch in his A/C no 2610000100039927 on 30.01.2019. The complt. asserted by filing this complaint that inspite of his making request to pay him Rs- 1,85,719 (i.e. Rs- 2,50,000 – 64,281) to the O.P. no 1, the O.P. side had refused to make payment of Rs- 1,85,719/- towards him though he had paid premium of that policy for 10 years to the tune of Rs- 12,010/- per year. The complt’s claim that the complt’s Ld. Lawyer’s letter dtd. 16.04.2019 sent upon the O.P. side by Regd. post with A/D on that score was not also entertained by the O.P. side. So, the complt. has filed this complaint case seeking reliefs as stated in the prayer portion of the complaint, filed from his end.
The O.P’s filed W.V., denied all the material allegations as averred in the compliant and contended inter alia that this complaint is not maintainable and is barred by the rule of Estoppel, waiver and acquiescence and the O.Ps have specifically asserted by filing W.V. in
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this case from their end that after knowing all the rules, regulations, terms & conditions of the ‘JEEVAN SARAL’ scheme of LIC policy vide Table no 165, and after going through the entire contents of that particular LIC policy, the complt. purchased the same. It is submitted by the O.Ps that in that scheme of LIC policy so chosen & purchased by the complt. of his own accord, the proposed Death benefit sum assured was Rs- 2,50,000/- & Accidental benefit of the sum assured was Rs- 2,50,000/- and maturity sum assured in that policy was Rs- 47,440/- and all these numerical figures were categorically mentioned in the Policy Bond. Besides the mode & amount of payment of premium for that policy, it’s date of commencement & date of maturity were all clearly reflected in the Policy Bond.
This is also contended by the O.Ps that at the age of 58 years since the complt’s DOB was 19.05.1951 the annual premium of that policy, purchased by the complt. was fixed as Rs- 12,010/- and on his making payment of such premium firstly on 03.12.2008, on the proposal date the instant LIC policy was issued to its purchaser i.e. to the complt. and on making payment of premium for such policy for the last time i.e. on 03.12.2017, the specific duly of the complt. for making the payment of yearly premium for 10 years for such policy was completed and thereafter claim payment voucher was issued on 28.01.2019 in favour of the complt. for maintaining such LIC policy and as per terms & conditions of such policy the complt. was duly paid Rs- 47,440/- as maturity sum assured & Rs- 16,841/- as loyalty addition and letter issued to the complainant on that score was also received by the complainant.
The O.Ps have contended that the said amount of Rs- 47,440 + 16,841= Rs- 64,281/- was duly deposited by the O.Ps to the complt’s S.B. A/C of P.N.B. at Narayangarh Branch, Paschim Medinipur and the same was duly acknowledged by the complainant.
The O.Ps asserted further that the complt. had adopted ‘High risk’ term insurance plan at his advanced age and knowing fully well as to its terms & conditions, since the complt. has filed this complaint with malafied intention, so the complt’s instant complaint is not entertainable and thus be dismissed specially when the O.Ps had never assured the complainant that after the completion of the tenure of policy period, he would be paid Rs- 2,50,000/- on maturity.
On the basis of the following claims & counter claims of the contesting parties of this compliant, the following issues were framed for consideration.
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ISSUES / POINTS FOR DETERMINATION
- Is the complainant a consumer as per scopes of Sec 2 (i) (d) ii of the C.P. Act of 1986?
- Has this Commission/Forum jurisdiction to entertain the instant complaint, as per C.P. Act of 1986?
- Have the O.P’s of this complaint any deficiency in service, as alleged by the complt. and are the O.Ps liable?
- Whether the complainant is entitled to get the relief(s) as prayed for in this complaint?
DECISION WITH REASONS
We have gone through the available materials on record, documents furnished by the contesting parties of this complaint case and heard the arguments advanced by the contesting parties of this compliant case.
Issues No. 1 & 2:-
We take up both these two issues for discussion at first since the same is pertinent and as the decisions of these two issues lend ground to ascertain whether the remaining other issues need to be dealt with or discussed.
Having regard to the scopes of Sec 2(i)(d) clause ii of the C.P. Act of 1986(since this complaint was filed on 25.06.2019) and the ambit extent and interpretations of consumer in Sec 2 of the C.P. Act of 1986, we feel inclined to hold that the complt. was consumer, beneficiary and receiver of service from the O.P. side of this complaint. In this backdrop we also find that having regard to the scopes of Sec 11 of the C.P. Act of 1986, this Forum/Commission has the territorial jurisdiction to deal with this case. Besides in consonance with scopes of Sec 11 of the C.P. Act of 1986, having regard to the reliefs sought for in this compliant, this Forum/Commission has also the pecuniary jurisdiction to deal with this case too.
So, in the premises, weighing the available materials on record and the submissions of the contesting parties over these issues, we find that the issues no 1 & 2 both are to be decided in favour of the complainant and accordingly these issues no 1&2 are decided and disposed of in favour of the complt.
Issues No. 3 & 4:-
Now we take up both these two remaining issues for discussion to reach the conclusive decision of the merits of this compliant.
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It is the specific contention of the complainant in this complaint that he purchased the LIC policy from the O.P. side bearing no 498614421 vide table no 165 in the scheme of LIC’s JEEVAN SARAL on 03.12.2008 on giving premium of Rs- 12,010/- and LIC policy of that scheme was issued in his favour by the O.Ps assuring that on maturity of such policy tenure, he will got Rs- 2,50,000/- on 03.12.2008 provided he goes on paying annual premium of Rs- 12,010/- from December 2008 to December 2017 uninterruptedly.
It is the specific contention of the complainant that he had paid yearly premium for that policy from December 2008 to December 2017 i.e. for continuous period of 10 years but even then without just cause, the O.Ps have paid him in his specific Bank A/C Rs- 64,281/- only instead of paying him the sum assured for that LIC policy on maturity i.e. Rs- 2,50,000/- so he has prayed for direction upon the O.Ps to pay him Rs- 1,85,719/- i.e. the residual amount of Rs- 2,50,000 – 64,281/- as maturity amount of his purchased LIC policy from the O.P. side.
The O.Ps have contended categorically that the concerned policy papers, in respect of the LIC policy, purchased by the complt., reflected categorically, without any ambiguity, that in that particular ‘JEEVAN SARAL’ scheme vide Table plan T-165 for term of 10 years, the proposed ‘Death benefit sum’ is assured to the tune of Rs- 2,50,000/- and proposed ‘Accidental benefit sum’ assured was Rs- 2,50,000/- and maturity sum is Rs- 47,440/- and those have been categorically reflected in the policy bond issued by the O.P’s & received by the complt. and accordingly since the complt. remained alive he was given maturity sum assured to the extent of Rs- 47,440/- & loyalty addition of Rs- 16,841/- i.e. Rs- 47,440 + 16,841 = Rs- 64,281/- only and the O.Ps had never misguided him at all on any score.
We have given through consideration to the submissions of both sides while weighing the available documents on record. The documents furnished by the contesting parties reflected without any ambiguity that the complt. had purchased JEEVAN SARAL policy of LIC vide Table no 165, from the O.P. side on 03.12.2008 admittedly undertook & discharged the duty to pay premium of Rs- 12,010/- per year for the total tenure of that policy to the extent of 10 years since the initiation of that policy.
However, it is forthcoming from those documents of the contesting parties both that the maturity sum assured was Rs- 47,440/- in respect of the complt’s purchased insurance policy and the ‘Death benefit sum’ assured was Rs- 2,50,000/- besides the same amount for
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the ‘Accidental benefit sum’ assured and these contents were reflected categorically in specific manner in the complt’s purchased insurance policy and also in the policy bond of the said LIC policy, in the status report of the complt’s policy.
The complt. was given claim payment voucher dtd. 28.01.2019 and there too he was given specific account of what amount he is getting from the O.P. against the maturity of his purchased insurance policy and he had received that voucher by making his unchallenged signature there in.
Having regard to all these, we feel inclined to hold that since the complt. didn’t sustain accident or/and since he didn’t passed away during the course of his running the insurance policy purchased by him from the O.Ps, he was not entitled to be categorized to get the death benefit sum assured, accident benefit sum assured & was paid the maturity sum assured & loyalty addition, as determined unambiguously when the policy was purchased by him.
Ld. Counsel for the complt. cited 11(2011) CPJ 249(NC) passed by the Hon’ble N.C.D.R.C. in Anand Kr. Kejariwal-Petitioner Vs LIC & another-Respondent that touched the matter of suppression of material facts and the Ld. Counsel for the complt. also referred 1994(1) S.C.D.R.C. in Srimati S. Vijaya –Appellant Vs Marketing Manager, Divisional Office LIC of India-Respondent decided vide Appeal no 169/1992 decided on 06.12.1993 and that cited reference dealt with the issue regarding lapse of payment of premium on time.
We are afraid, in this complaint, those two issues have not been found to have any bearing in any way or manner and the same are appearing to be out of context of the given issues, facts and circumstances of this complaint case and so both the references, we apprehend are inapplicable in this complaint and are thus found otiose.
This appears that the terms & conditions of the LIC policy purchased by the complt. from the O.Ps were clear from its inception & the stand point of the O.Ps contentions are unambiguous & nothing could be found from their end to hold/apprehend that they had misguided/prevailed/induced upon the complt. in any way or manner to adopt the JEEVAN SARAL policy at his advanced age.
Nothing specific could be found from the four corners of the available documents furnished by both the contesting sides to suspect that there was adoption of any material
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deviation of any kind from the O.P’s end to pay the complt. only Rs- 64,281/- and not the amount asked for by the complt. to be paid to him by the O.P’s on maturity of complt’s purchased JEEVAN SARAL LIC policy vide Table no 165.
There appears cogent ground to hold that the terms & conditions, for giving the sum assured to the complt., on his remaining alive and for his not sustaining any accident or death, were actually followed for paying the insurance benefit to the complt. as determined since purchase of that policy by the complt. & he was not misguided by the O.Ps to indulge the belief of receiving Rs- 2,50,000/- on maturity of such policy, while his remaining alive.
In this backdrop, we find nothing to appreciate that the O.Ps have caused any kind of disservice or deficiency in service to the complt. & therefore the complt. is not entitled to get the relief/reliefs as prayed from his end, in this complaint. Accordingly both the issues no 3 & 4 are decided against the complt. & are thus disposed of.
Hence it is …
ORDERED
That the complaint case be & the same is dismissed on contest but without cost. Accordingly complt. is not entitled to get the reliefs as prayed for.
Let a plain copy of this order be supplied to the contesting parties of this complaint case, by hand/ by Regd. Post with A/D forthwith, free of cost, for information and necessary action, as per law & relevant rules.
