Adv.for the complainant- Self.
Adv.for the O.Ps - Sri A.K.Sarangi.
Date of filing of the case- 19.08.2013
Date of order - 21.09.2015
JUDGMENT.
Sri P.Samantara, President.
The complainant has obtained/enrolled in SBI launched Group Insurance Scheme fitted as Swarna Ganga meant for SBI staff members the Group policy No.84001000110. By contributing Rs 396/- each month from the salary from dt.01.01.2004 to May 2007.
2. The modification policy further allowed in renewal in continuation upto 60 years ,fixing the premium Rs 4609/- in each year from July 2007 to 2012. It is averred. The complainant in total deposited premium Rs 39 996/- .The matured amount also not even paid to the complainant in spite of repeated reminder and writing letters.
3. The O.P credited a sum of Rs 26 629/- only out of total and the remaining balance of Rs 19 392/- has been deducted towards risk premium and levying service tax. The grouse is that the O.P has not supplied the terms and conditions attach to the policy and policy holder remains in dark. So in the interest of justice, the O.P may be directed to make refund the curtailed amount along with other benefits as assured.
4. Relied on policy premium paid receipts and letters in photo copies and affidavit.
5. Pursuant to notice, the O.Ps filed the version admitting issuance of Master Policy No.8400100110 to SBI covering eligible staff members with effect from 01.01.2004 against provident fund No.915157.
6. Averred that as per the Master Policy, clause No.10 1 Table of rates premium rates it is clearly stated that for a sum assured of Rs 3 lakhs,a total of Rs 300/- is payable for the staff member out of which risk component is Rs 96/- and savings component is Rs 204/-. As per clause No.10 c it is clearly stated that in case of spouses, a premium of Rs 96/- is payable for a cover of Rs 3 Lakhs. Thus a total of Rs 396/- was payable monthly towards premium to cover both the complainant, who is the staff member and his spouse.
7. Further stating, the complainant retired from the services of the SBI in May 2007 and as per the records of the company an amount of Rs 9,006/- was paid to the complainant towards maturity value. In addition to his option for continuation an amount of Rs 4,752/- Rs 396/- x 12 was payable towards annual premium a rebate of Rs 143/- in the premium was given to the complainant and it is specifically submitted that the O.Ps have paid interest till date of payment of maturity value.
8. As per the certificate of Insurance clause No.5 Benefits under Swarna Ganga Plan In case of survival till the maturity date the accumulated savings component along with interest would be payable.
9. As admitted by the complainant a total premium of Rs 39 996/- was paid by him under the scheme. Out of the said amount of Rs 39 996/- an amount of Rs 19392/- was deducted towards risk premium and Rs 1988/- was paid towards service tax. The remaining amount along with interest amounting to Rs 26 629/- has been transferred to the account of the complainant held in State Bank of India on 13.05.2013 which is admitted to have received by the complainant. The calculation of the amount is as under.
| Mr Yudhistir Mishra | Mrs Padmini Mishra | Total |
Total Premium Paid | 30300 | 9696 | 39996 |
Less-Risk Premium | 9696 | 9696 | 19392 |
Less -Service Tax | 1988 | 0 | 1988 |
Total Saving Amount | 18616 | 0 | 18616 |
Add -Total Interest Paid till May 2013 | 8013 | 0 | 8013 |
Total Amount Paid Saving + interest | 26629 | 0 | 26629 |
10. On payments of the benefits above, the liability of the company to the grantees beneficiary Member as the case may be herewith stand extinguished.
11. The O.Ps have acted as per the terms and conditions of the Master policy Rs 19 392/- which was deducted towards risk premium by the O.Ps .Having availed the services and enjoyed the risk cover the demand for refund of premium is preposterous and does not have sanction of the law. This forum has no jurisdiction no cause of action further submitting relief prayed for is unjust illegal and unfair on the part of the complainant and abuse of the process of law. So the case be dismissed with cost.
12. Relied on Swarna Ganga schemes policy photo copy, certificate of Insurance Payment statement of Account letters & notices.
13. Heard and perused the record.
14. Perusal record reveals complainant used to receive the accrued interest on savings component of the policy. The other contention is that the policy scheme does not allow any bonus on maturity so the entitlement to bonus does not arise to note.
15. The expressions under Super Suraksha and Swarna Ganga as follows
Clause 4—This policy will be force for a period of 60 months .Further extended validity is subject to the company and the Grantees mutually agree otherwise.
Clause-7- Benefits- Running Account of this policy become payable to the grantees for the benefit of the member.
Clause- 8- Running Account- The account to be maintained by the company, in respect of each admitted member under this policy which will be credited with the premiums relating to the savings portions after utilizing such part of premium as is required to provide life assurance benefit. The account will show the details of the periodical interest credited from to time at the agreed rates.
Schedule IV- General conditions:-
Clause-7- The company agrees to pay an interest 5 P.A compounded on annual basis for savings component premium credited to the Running Account during the first 5 years of admission.
Clause-17- Where the company is liable to deduct any tax, levy or any other duties on the benefits sums so deducted.
16. The verification enclosed statement account and certificate of insurance we found the deductions payments and calculations under the scheme are consistent to assured sum and schedule of repayment that contained in the mater policy.
17. On other hand the complainant submits the certificate of insurance has not given to the insured which rebutted in para-4 of the pleadings that the insured should raise the issue immediately not after 9 years. On such question it is clear and transpires from the record the scheme matured on the year 2012 and assured maturity amount was paid on 13.05.2013 after writing reminder and advocate notice which is lapse in rendering service to the Insured complainant. We hold the benefits accrued and paid not in time so the O.P is in deficiency of service within the provision of the term u s.2 g of C.P.Act.
ORDER.
The O.Ps are directed to pay a sum of Rs 2 000/- Rupees Two thousand only towards compensation to the complainant for the loss harassment and mental agony sustained within 30 days of this order failing which interest 9 P.A. will accrue on same from the date of this order till realization.
ORDER PRONOUNCED IN OPEN FORUM THIS THE 21ST DAY OFSEPTEMBER 2015.
I agree.
( G.K.Rath) (P.Samantara)
MEMBER. PRESIDENT.
