SRI BIJOY KUMAR DAS,PRESIDENT:-
Non-payment of surrendered value on Insurance Policy is the allegations arrayed against OP.
2. Complaint in nutshell reveals that, Complainant being a retired teacher availed a Life Insurance Policy on dt. 29/11/2010 under Pension Plus Scheme Plan-803 from OpNo.1, Branch by paying a single premium of Rs. 2 lakhs. The Policy bears its No. 597982187 and the date of maturity of Policy is dt. 29/11/2020. It is revealed from the complaint petition that in the year 2015, Complainant was under medical treatment of Dr. J.P.Das(M.D.) and required a good amount for his treatment, accordingly complainant surrendered the Policy before Op No.1 Branch on dt. 02/02/2016 after complying the Official formalities and on the presence of the Agent of the Op-Corporation, Sri Nihar Ranjan Mishra. But the Op-Insurance Corp. on dt. 22/03/2016 intimated the Complainant that as per the terms and conditions of the Policy, the said Policy can’t be surrendered as it is an ‘annuity’ Policy and Rs. 1570/- was due from dt. 01/04/2016 as annuity amount of the Complainant. Complainant being aggrieved made written representation to Ops on dt. 29/04/2016, dt. 23/05/2016 and lastly on dt. 30/06/2016. But all the attempts of the Complaint went invain and did not receive the surrender value which is required for the purpose of his Medical treatment. It is also alleged that Op-Corp. by violating the terms and conditions of the Policy have committed deficiency in service and the cause of action of the instant case lastly arose on dt. 30/06/2016, when the Complainant made the last written representation. The complaint is filed before this Forum with prayer that, a direction may be given to the Ops to release the premium amount of Rs. 2 lakhs along with legitimate financial benefits under pension plan(Plan-803) and also a direction be issued to Op-Corp. to pay Rs. 55,000/- which includes compensation for mental agony and cost of litigation.
3. On receipt of the Notice, Branch Manager L.I.C. of India, Pattamundai Branch(Op-1) and Divisional Manager, L.I.C. of India(Op-2) appeared into the dispute through their Ld. Counsel Mr. R.K.Samal and Associates and filed joint written statement denying the allegations of the Complainant and submitting the facts, it is averred that, Complainant had taken a L.I.C. Pension Plus Policy, vide Policy No. 597982187. The L.I.C. of India issued the letter as alleged, is based on terms and conditions, which is a ‘contract’ between the parties clearly reflects that, on the said policy, if the Policy holder applies for surrender after Five years from the date of commencement of policy, then the Policy holders found value as the date of surrender shall be utilized for payment of an ‘annuity’. It is also averred that as per the terms and conditions of the policy, if the same is discontinued or surrendered after 5 years of commencement of the Policy, or vesting shall compulsorily be utilized to provide an annuity subject to Policy holder’s option to commute up to a maximum of 1/3rd of the Policyholders found value and the commutation will be allowed provided the balance amount is sufficient to purchase a minimum of amount annuity. It is further averred on the written statement that Op-Corp. have neither committed any deficiency in service nor caused any harassment and trouble to the Complainant and the Complaint is base on false and fabricated grounds which is liable to be dismissed with cost.
Though Notice was served to Regional Manager, L.I.C. of India, Bhubaneswar, through Regd. Post with A.D., but had did not prefer to appear into the dispute, have set ex-parte by order of this Forum bearing No.12 dtd. 22.04.2017 Op No.4. Nihar Ranjan Mishra, Agent of the L.I.C. of India was deleted during the pending of the proceeding basing on the memo filed by Complainant.
4. Heard the arguments advanced by Complainant and Ld. Counsel for contesting Ops, perused the documents i.e, attested photocopies of Policy, letter dt. 22/02/2016 addressed to complainant by Op-Corp., surrender Form and attested copies of written complaints of Complainant to Op-Corp. After going through the Complaint, written statement, documents and submission of the parties, the facts of the disputes are that complainant obtained a Life Insurance Policy, under Pension Plus (Plan-803) on dt. 29/11/2010 by paying a single premium of Rs. 2 lakhs, and Policy was issued to the Complainant bearing No. 597982187. The date of maturity of the Policy is dt. 29/11/2020. It is also a fact that the said Policy was surrendered by the Complainant-Policy holder after lapse of 5 years from the date of commencement for the Policy avail the financial benefits of the Policy. It is further a fact Complainant did not receive amount after the surrender of policy as the terms and condition of the policy does not allow the Op-Corp. to release the financial entitlements in favour of the Complainant.
The only question to be decided here that, whether the Complainant-Policy holder is entitled to receive the financial befits under the said Policy. It is the settled principle of law that Insurance Policy is a ‘contract’ between the insured and insurer, and parties entered into the contract are binding to its terms and conditions described on the Policy. In the present dispute clause-11& 14 of the terms & conditions of the Policy are related in case of surrender of Policy. Clause11(ii) of the policy discloses that “ if the Policy is surrendered after 5 years from the date of commencement of the Policy”:
If a life assured applies for surrender of policy after 5 years from the date of commencement of policy, then the Policy holders found value, as at the date of surrender, shall be utilized for payment of an annuity as specified in condition 14. There will be no discontinuance charge, condition 14 of the policy deals with ‘conversion of annuity’.
The clause 14 of the condition is not applicable to the present dispute as Complainant has no grievance regarding conversion/commutation of the Policy’ rather the Complaint is limited to release of financial benefits on premium amount, when the policy is surrendered before the Op-Corp. We, carefully examined the clause11(ii) of the condition of Policy, which clearly defines that after 5 year from the date of commencement of the Policy, if the policy is surrendered, than the Policy –holders found value at the date of surrender shall be utilized for payment of an ‘annuity’, according to letter addressed to Complainant dtd. 22/03/2016, where it is mentioned that the monthly ‘Annuity’ amount is for Rs. 1570/- due from dt. 01/04/2016 and the letter addressed to the Complainant substantiate the condition of the Policy by stating that policy can’t be accept as ‘surrender’ as it violates the terms and conditions of the policy. Hence, we do not see any deficiency is service on part of Op-Corp. by not accepting the ‘surrender of policy’ as alleged by the Complainant-Policy holder, and Op-Corp. has acted in accordance with the terms and conditions of the Policy. Accordingly we, freed Ops from any such liabilities of deficiency in service.
Having observations reflected above, the Complaint is dismissed on contest, without any cost.
Pronounced in the open Court, this 31st day of October,2017.
I, agree. I, agree.
Sd/- Sd/- Sd/-
MEMBER MEMBER PRESIDENT
