Complaint Case No. 181/2014 | ( Date of Filing : 19 Nov 2014 ) |
| | 1. Bidyadhar Jena,S/O-Late.Jagabandhu Jena. | At.Talasahi,Malkangiri,Odisha. |
| ...........Complainant(s) | |
Versus | 1. Branch Manager,LIC of India | Main Road jeypore, | Koraput | Odisha | 2. Divisional Manager, LIC of India | Berhampur Division | Ganjam | Odisha |
| ............Opp.Party(s) |
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Final Order / Judgement | - Brief fact of the case of the complainant is that he is a policy holder under the O.Ps bearing policy no. 573282177 and deposited 3 instillments of premium of Rs.8407/- consecutively in the above policy and due to financial hardship he could not deposit the premiums after deposit the 3rd premium and requested the O.Ps to close the said policy, whereas the O.Ps have paid only Rs. 8501/- against the total deposit of Rs. 25,554/-. Thus alleging the deficiency in service, the complainant filed this case praying the Forum to direct the Ops to refund his deposited amount with interest, Rs. 20,000/- and Rs. 5,000/- towards compensation and costs to him.
- On the other hand, the O.Ps have appeared and filed their joint counter admitting the issuance of the alleged insurance policy in favour of the complainant, and denied the other allegations of complainant stating that the complainant has deposited only 3 numbers of premiums of Rs. 8407/- for consecutively for 3 premium years and applied for surrender value on 05.09.2014 along with relevant documents, as such after due calculation on the basis of the chart and table in connection with the alleged policy, they have paid an amount of Rs. 8501/- through NEFT credit system. Further they have contended that they have correctly calculated the Guaranteed Surrender Value (in short GSV) and special Surrender Value (in short SSV) and paid the higher of the two to the complainant, as such with other contentions, O.Ps have prayed to dismiss the case against them.
- Parties have filed certain documents in support of their submissions. We have gone through the documents filed by the parties and perused the materials available in record.
- In the instant case, there is no dispute about the issuance of alleged policy in favour of the complainant, deposit of 3 instilments by complainant and refund of Rs. 8501/- to the complainant by the O.Ps. The allegations of the complainant is that the O.Ps. have refunded an amount Rs.8501/- against the total deposit of Rs. 25,554/- as surrender value and he approached the O.Ps. for recalculation of the surrender value, which yielded no result. On the other hand, the O.Ps have strictly contended that they have properly calculated the surrender value against the said insurance policy and paid him accordingly.
Now the questions which arose at this stage to discuss are :- - Whether the O.Ps have properly calculated the surrender value as per terms and conditions of the alleged insurance policy ?
- Whether the complainant is entitled for refund of his deposited amount and other relief as prayed for ?
- If so, than what relief ?
- Coming to the first point, it is observed that the alleged insurance policy named “ Jeevan Saral with profit” issued in favour of the Complainant vide policy no.573282177 under plan and term 165-12 and the complainant has deposited 3 nos. of premiums of Rs.8407/- for 3 consecutive years, in toto he has paid Rs. 25,221/-. To corroborate their contentions, the O.Ps have filed the chart and table related to the alleged insurance policy. We have carefully gone through the chart and table filed by the A/R for the O.Ps. and found that the surrender value is being calculated on the basis of age factor and maturity factor and maturity sum assured as reflected in the terms of the policy, as such as per the said policy, the age of the policy holder is 58 years and as per the chart of the said policy the maturity sum assured (MSA) comes to Rs.1473/- per 3 year on premium of Rs. 100/- per month, as the policy holder-complainant has deposited only 3 instilments throughout the policy term.
Further the submission of complainant clearly proves that he has deposited only for 3 years, and due to financial hardship he could not deposit the further premium, hence it can be safely concluded that the maturity sum assured will be calculated only for 3 years terms basis. Further as per contentions of the O.Ps that the surrender value is calculated by way of two methods, one is guaranteed Surrender Value (GSV) and second is Special Surrender Value (SSV). To make it very clear, we have gone through the calculation Procedure of the Ops in respect of the above policy. It is observed that the terms o f GSV emphasizes “after paying 3 full years premium and after policy has completed 3 policy years, the GSV will be equal to 30% of the total amount of premiums paid excluding the premiums for the first year and all extra premiums and premium for accident benefit / term rider”. Whereas the SSV emphasizes that “clause (1). If 3 years of more premiums paid but less than 4 years then 80% of maturity sum assured”. Further as per clause 7 of the proposal form issued for such scheme policy clearly revealed that “Surrender Value : The policy can be surrendered after it has been in force for at least 3 full years. The surrender value will be greater of Guaranteed Surrender Value or Special Surrender Value as given below”. As per calculation sheet and counter submissions of the Ops submitted before us, we ascertained that the MSA under GSV is comes to Rs. 4939/- and under SSV it comes to Rs.8501/-, as such the Ops have paid the greater amount i.e. Rs.8501/- as per due calculation to the policy holder-complainant. Hence in our view the Ops have properly calculated the maturity sum assured on the basis the calculation sheet. As such the allegation of complainant did not succeed to this effect and accordingly, the answer gone in favour of the Opp. Parties. - As per the discussions made in the foregoing paras, we think since the Ops have properly calculated the maturity sum assured in the alleged insurance policy, the complainant is not entitled any further amount from the O.Ps towards his deposit and no reliefs con be extended to him to that effect. As such the second and third point also gone in favour of the Opp. Parties accordingly.
- Further we think, the complainant could not clearly understood the terms and conditions regarding the procedure of calculating the surrender value, which is clearly reflected in the proposal form, prior to acceptance of such policy and such calculation made by the Opp. Parties dose not attract the principle of unfair trade practice on their part. As such, keeping in view of the facts and circumstances, we are not inclined to accept the submissions of the complainant. Hence this order.
ORDER The complainant petition is dismissed on contest against the Opp. Parties having no merit. Parties to bear their own costs. Pronounced in the open Forum on this the 15th day of January, 2018. Issue free copy to the parties concerned. | |