For Complainant         :           Sri Sunil Kumar Mohanty, Advocate.

For Ops 1 & 2              :           Sri Santosh Kumar Mishra, Advocate & associates.

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1.                     The brief history of the case of the complainant is that she subscribed for the following policies and made payments towards premiums to the Ops which are detailed below:

            Sl. No.  Policy No.                                Amount

1. 51486848/ 51486891        Rs.50, 000/-

Rs.50, 000/-

Rs.1, 08,462.72

Rs.52, 525/-

Rs.53, 858/-

Rs.04, 678/-

Rs.03, 322/-

2. 51760061                          Rs.49, 999/-

Rs.49, 999/-

Rs. 06, 800/-

3. 51805416                          Rs.50, 000/-
4. 51801714                          Rs.50, 000/-

Rs.49, 380/-

5. 51809212                          Rs.50, 000/-
6. 51810925                          Rs.50, 000/-

Total    :                   Rs.6, 79, 023.72

It is submitted that the complainant being a widow having no individual source of income, surrendered all the above policies before the Ops but to her utter surprise the Ops have made following payments noted against each policy.

                        Policy No.                    Amount received.

1. 51486848              Rs.  19, 403/-
2.  51486891             Rs.1,27,866/-
3. 51760061              Rs.  14, 579/-

Rs.1, 61,848/-

It is further submitted that she has received Rs.1, 61, 848/- against the total premium deposit of Rs.6, 79,023/- leaving a deficit of Rs.5, 17,175/-.  It is also submitted that the complainant got issued notice to the Ops through her advocate to pay the deposited amount but the Ops did not think it appropriate to settle the claim amount.  With these and other contentions alleging unfair trade practice on the part of the Ops, she filed this case praying the Forum to direct the Ops to refund Rs.5, 17,175/- with attached benefits and interest and to pay Rs.2, 20,000/- towards compensation and costs to the complainant.

2.                     The Ops filed counter in joint denying the allegations of the complainant and contended that as per proposal of the complainant 7 Nos. of policy as detailed below have been issued in her favour and the premiums noted against each have been received by them.

The Ops contended that the complainant on surrender of her policies and as per terms of the policies they have effected payment towards fore closure value of the following policies as detailed below:                                                                                                

  Foreclosure Amount Received

According to the Ops the above policies require a surrender value provided the first annualised premium is paid in full and since the complainant had paid first annualised premium for the above policies the Ops have paid the surrender value.  Regarding Policy No.51805461, 51801714, 51809212 and 51810925 the Ops contended that the surrender value will be acquired on receipt of full annualised premium for 1^st three consecutive years.  Under the above policies as the complainant has not completed premium paying term of first 3 years, she is not entitled to get any surrender value against the said policies.  The Ops contended that the insured after being completely aware about the policy premiums, terms, risks and consequences of the policy, has submitted proposal forms for insurance duly signed with her free will and consent and believing information given in the proposal forms to be true and correct, the proposals were accepted and policies were issued giving 15 days free look period in favour of the complainant.  After surrender of the policy, as per  policy terms, the Ops have effected payments towards fore closure settlements and the complainant is not entitled for any more payments from the OPs.  Thus denying any deficiency in service or unfair trade practice on their part, the Ops prayed to dismiss the case of the complainant.

3.                     Both the parties have filed certain documents along with affidavits in support of their cases.  Heard from the parties through their respective A/Rs and perused the materials available on record.

4.                     In this case the policies issued in favour of the complainant and the premiums received are all admitted facts.  It is also an admitted fact that upon surrender of policies, the Ops have effected surrender amount in total of Rs.1, 61,848/- against three policies bearing No.51486891, 51486848 and 51760061.  It is seen that under the above 3 policies, the complainant has deposited Rs.4, 29,396/- but the Ops in the name of surrender value have paid Rs.1, 61,848/- only.  No doubt the policies cover the insurance on the life of the complainant but the deposits of the complainant is a type of investment for future savings also and the Ops cannot deny that.  In this case, the complainant has paid 4 premiums in case of Policy No.51486891 for Rs.2, 17,000/- and in case of Policy No.51486848 also paid 2 premiums.  The above policies accrue surrender value and other attached benefits after 1^st year premiums paid but what did the complainant get from the Ops?  Out of deposit of Rs.4, 29,396/- the Ops only paid Rs.1, 61,848/- leaving a deficit of Rs.2, 67,548/-.  Then where did the money of the complainant go?

5.                     It is seen from the record that the policies obtained by the complainant are traditional policies but not invested in share market.  If this is so, the money so deposited by the complainant must accrue interest.  So why such less payments should made by the Ops?  The Ops have not clarified as to how much amount was paid towards insurance and expenditure towards establishment charges.  Therefore, in our opinion, the Ops have not made a fair payment in case of the complainant under the above 3 policies.

6.                     The Ops have paid the surrender value under 3 policies and stated that nothing is to be paid to the complainant under the policies but after filing of this case, the Ops have transferred Rs.56, 540/- to the accounts of the complainant on 01.06.2019.  It is not understood as to where did not the Ops bring that money from and paid to the complainant without any intimation and description.  This activity of the Ops shows that the Ops are adopting unfairness in their business while settling the claims.  Thus the complainant has received Rs.1, 61,848/- plus Rs.56, 540/- which comes to Rs.2, 18,388/- under the above 3 policies leaving deposit of Rs.2, 11,008/-.

7.                     Regarding other 4 policies the Ops stated that the surrender acquires only deposit of 1^st 3 years consecutive premiums.  It is seen that the complainant has paid 1 or 2 premiums under the policies and hence the Ops denied for any payment.  The complainant has deposited Rs.2, 49,380/- under the above 4 policies with hope that her money will grow and fetch a good return but the Ops in the guise of their terms and conditions of the policy have grabbed the hard earned money of the complainant.  It purely violates natural justice.  The Ops have not categorically mentioned that how much money has been invested towards insurance for a year or two.  Without mentioning the details of their expenditure, they cannot retain the entire money of the complainant.  Moreover, it is a traditional policy but not invested in the share market.

8.                     We remember a recent decision dt.30.05.2020 of this Commission vide C.C.No.70 of 2019 between Laba Bissoi and Maxlife Insurance, New Delhi.  In the above case, the complainant had deposited only two premiums and upon surrender of policy, the Ops denied any surrender value with a plea that the policy does not acquire any surrender value.  During course of trial, the said insurance company intimated this Commission that they are ready to return the deposits of the complainant.  Accordingly order was made and the complainant gets return of his deposited amount.

9.                     In this case also the Ops effected payment of surrender value at a lesser amount in case of 3 policies and denied any payment in other 4 policies.  In our opinion, this is unfair and the Ops cannot grab the hard earned money of the complainant and they are to return at least the premiums received by them.  They have also kept the deposits for long 6 years and the deposits certainly accrue interest.  Let the interest amount be enjoyed by the Insurance Co.  Considering the facts and circumstances of the case and the grievances of the complainant before the Ops through her Advocate, we feel that, return of deposited premium amount by the Ops in favour of the complainant will meet the ends of justice.  In this case, the complainant has deposited Rs.6, 78,776/- and has received Rs.2, 18,388/- and hence entitled for rest of the amount of Rs.4, 60,388/-.  The amount bears interest @ 6% p.a. from the date of filing of this case.  In the peculiar circumstances of the case, we are not inclined to award any compensation in favour of the complainant as prayed for except a sum of Rs.10, 000/- towards cost of this litigation.

10.                   Hence ordered that the complaint petition is allowed in part and the Ops being jointly and severally liable are directed to return Rs.4, 60,388/- with interest @ 6% p.a. from 21.07.2018 and to pay Rs.10, 000/- towards cost of litigation to the complainant within 30 days from the date of communication of this order.

(to dict.)