Final Order / Judgement | - The fact the case of Complainant is that he a life insurance policy holder under the O.Ps having availed the New Bima Gold policy bearing insurance policy no.571809416 on dated 28.07.2008 for sum assured of Rs.55,000/- on premium payment of Rs. 3496/- on being promised for periodical money back @ Rs. 8285/- on completion of 5 years. It is alleged that on completion of 8 years in the year 2013, the O.Ps did not pay the promised amount of Rs. 8,285/-, the complainant contacted with the O.Ps time to time for the said money back amount, but the O.Ps have not paid the promised amount of Rs. 8,285/- for which he sustained financial loss, mental agony and physical harassment. Thus alleging deficiency in service on the part of the O.Ps, he filed the present case with a pray to pay Rs. 10,000/- towards compensation and Rs. 5,000/- towards costs of litigation to him.
- On the other hand, the O.Ps have appeared the in the case on 30.01.2015, but did not choose to file their counter / written version nor participated in the hearing ever though several opportunities / adjournments were given to them keeping in view of natural justice, as such we lost every opportunities to hear from them. It is also seen from the records, that on 18.12.2017 the A/R for complainant has filed a petition for amendment which was allowed after due hearing and on 05.01.2018 he filed the amended claim petition, which was accepted and the copy of the said amended claim petition was also received by the A/R for O.Ps on the same day i.e. 05.01.2018, but till sate no counter / written version was filed by the O.Ps inspite of several adjournments were provided to them.
- Complainant filed certain documents to prove his submissions, whereas non filing of counter / written version and non participation by the O.Ps during the hearing, the hearing, the allegations of complainant remained unchallenged and unrebuttal from the said of O.Ps.
- It is admitted fact that the complainant is a life insurance policy holder of the O.Ps under the scheme “New Bima Gold” bearing insurance policy no.57809416 commenced on dated 28.07.2008 for sum assured of Rs.55,000/- on premium payment of Rs.3,496/- Complainant has filed the Xerox copy of the insurance policy bond issued by the O.Ps to that effect. The allegations of complainant is that on being promised for periodical money back @ Rs.8,285/- on completion of 5 years, while on contact to the O.Ps after a period of 5 years in the year 2013, the O.Ps did not pay the promised amount of Rs.8,285/-. Since the O.Ps have not filed any counter to make contradict to the allegations of complainant nor they have participated in the hearing, as such the allegations of complainant remained unchallenged. In the case between Urban Improvement Trust, Bikaner vrs Babu Lal and Another, Hon’ ble National Commission has held that – “Unrebutter averments shall be deemed to be admitted”. Considering the above view of Hon’ble National Commission, we think the O.Ps have nothing to say in the present case though they have received the notice from the Fora as well as the amended petition filed by the complainant.
- Further it is seen from the record that the yearly premium towards alleged policy id for Rs. 3,496/- and the complainant has deposited premiums for five years from 2008 to 2012 i.e. (1) dated 31.07.2008 for Rs. 3,496/- vide receipt no. 0046303, (2) dated 30.08.2010 for Rs. 7,326/-vide receipt no.0509733, (3) dated 09.08.20011 for Rs. 3,496/- vide receipt no.1303929 and (4) dated 24.08.2012 for Rs. 3,496/- vide receipt no. 1140458 and in to the complainant has deposited Rs. 17,814/- with the O.Ps. Further as per the terms of the policy conditions, it is revealed that the insurance policy in disputes is a money back policy as such the complainant is entitled for money back amount at the time of stipulated period. Therefore, non release of money back amount to the complainant by the O.Ps is a matter of surprise. We feel, there is no justification for non release of the money back amount in favour of the complainant by the O.Ps although the complainant has deposited five years premium amount with the O.Ps. Though the O.Ps have received the notice from the For a, but did not choose to file their counter nor participated in the hearing also, as such we feel the O.Ps have nothing to say in this regards and therefore, the allegations of complainant holds strong stand value and we have no hesitation to disbelieve the version of complainant. Hence complainant is entitled for the money back amount as per terms of the policy.
- Further at the time of hearing, the complainant submitted that the he has not deposited further premium amounts after paying premiums for five years, accordingly the policy comes under the paid up value system. In this connection, we have gone through the clause 4 of the “Conditions and privileges within referred to” mentioned in the terms and conditions of said insurance policy, wherein it is clearly mentioned that “xxxxx Notwithstanding what is stated above, if after at least three full years premiums have been paid in respect of this policy any subsequent premium be not paid, this policy shall not be wholly void after the expiry of two years Auto Cover period from the due date of first unpaid premium paid (excluding any extra/optional premium) less than survival benefits paid earlier, if any. This amount is called as paid up value. The paid up value shall be payable on the date of expire of the policy term or at life assureds’ prior death. No survival benefit shall be payable under paid up policies. The policy, thereafter, be free from all liabilities for payment of the within mentioned premiums”, hence as per the above provisions under clause 4 of the terms and conditions of the alleged insurance policy, the complainant is not entitled the full amount paid by him.
- Further keeping silence over the case by the O.Ps, it is prima facie evident that the O.Ps have totally overlooked the future aspects of their genuine customer i.e. complainant by not providing their best services throughout the policy premium praying term, hence the O.Ps are liable to compensate the policy holder i.e. complainant in accordance with the law, as the complainant was suffered mental agony and physical harassment for non release of money back amount in time, which compelled him to file the present case incurring some expenses. Hence this order.
ORDER The complaint petition is allowed in part. The O.Ps are jointly and severally are herewith directed to pay the money back amount of Rs. 8,285/- along with Rs.3,000/- towards compensation and Rs.2,000/- towards costs of litigation within one month from the date of the receipt of this order, failing which the money back amount of Rs.8,258/- will carry interest @ 10% p.a. from the date on which the money back amount was to be paid, till payment. Further the O.Ps are herewith directed to release the rest deposited premium amount at the time of maturity of the aforesaid insurance policy. Pronounced in the open Forum on this the 31th day of July, 2018. Issue free copy to the parties concerned | |