ORDER

BY SRI.H.R.SRINIVAS, PRESIDENT.

This is the Complaint filed by the Complainant U/S Section 35 of Consumer Protection Act 2019, against the Opposite Party (herein referred in short as O.P) alleging the deficiency in service in not paying the entire policy amount after maturity and direct OP to pay Rs.13,08,622.91 ps., being the matured/surrender value of the policy, for Rs.50,000/- as compensation for causing mental agony and hardship and for other reliefs as the Commission deems fit.

2.      The brief facts of the complaint are that;

The complainant is a Current account holder with the canara Bank, Bagalur Branch, Bangalore, the Manager of the Bank advised the complainant to get an insurance policy stating that OP is well known and provides timely and useful services. Believing the words she obtained an insurance policy from OP on 24.07.2010 for a period of 10 years, and the premium payment at Rs.1,00,000/- per year for ten years.  The start date of the insurance was on 24.07.2010 and the maturity date was 24.07.2020.  OP informed after the maturity of the policy, on 21.07,2020 intimating the complainant that Rs.13,08,622/- is the maturity value. She approached OP personally with the documents and wrote letter requesting for refund of the entire amount.  They did not ready to receive the letter and release the amount. She wrote another letter on 05.10.2020 requesting to pay the said amount as it is required for her, as she is facing financial problem.  She also wrote a letter through RPAD on 07.10.2020 demanding the refund of the said amount which OP neither replied nor complied.  There is deficiency in service on the part of OP in not refunding the amount even though upon the maturity of the policy, and hence, she was made to suffer physically, mentally and financially and hence the complaint.

3.      Upon the service of notice, OP appeared before the Commission and filed its version contending that the complaint filed is on false, malicious, incorrect and malafide grounds, which is nothing but abusing the process of law and the same is liable to be dismissed u/s 36(2) of the C.P. Act. 2019.   This Commission has no jurisdiction to decide the complaint as the investment made by the complainant is under unit linked insurance policy which is a speculative gain and speculative investment which do not come under the C.P. Act as held by various decision by the NCDRC.   Complainant do not fall within the definition of the Consumer and there is no consumer dispute at all.  

4.      The complainant after completely understanding the terms and conditions of the insurance policy, Canara HSBC, Oriental Bank of Commerce, Life Retire Smart plan, applied for insurance by filing the proposal on 16.07.2010.  The risk commenced on 24.07.2010 and the annual premium was Rs.1,00,000/- for a period of 10 years. The policy was dispatched to the complainant on 31.07.2010 and the same was delivered through the courier.  She was having ample opportunity to go through the terms and conditions and understand the same and in case not satisfied with it, she could have returned the policy or cancel the policy during the free-look period, which the complainant did not do.

5.      It is contended that the complainant paid all the premiums and it matured on 24.07.2020.  Under the said terms and conditions of the policy, the vesting benefit as per clause 2.2.1 is payable to the complainant.  The life assured has to choose any one of the alternative payments.

1. Use the entire vesting benefit for purchase of annuity products offered either by the company or any other annuity provider as be permitted under the regulations.
2. The life assured may opt to receive the maximum amount from the vesting benefit permitted to be commuted as per the then prevailing regulations as a lumpsum payment and use the remaining amount if any for purchase of annuities as mentioned in clause 2.2.1(a).

        6.     Hence they intimated regarding the maturity of the policy and the amount available in the fund as Rs.13,08,622.91 on 24.07.2020 requesting the complainant to exercise any of the option as above and in case exercising the second option, she would be entitled for 1/3 of the amount.  She did not exercise the option and requested for release of the entire amount.  The same was rejected as per the terms and conditions of the policy and inform that only 33.33% of the total amount could be paid in lumpsum and for the remaining amount, the complainant has to purchase the annuity.  Hence the complainant is not entitling for the entire maturity amount in terms of the policy amount.  It is decided by various decisions of the Hon’ble Supreme Court of India that the terms and conditions of the policy has to be given paramount importance and the court or the forums cannot add, delete or exclude any terms.  Knowing fully well the terms and conditions of the policy, without exercising the free look period and also the options available after maturity, complainant has filed this complaint which is not maintainable and that the said terms and conditions or in accordance with the approved guidelines of IRDAI and hence prayed the commission to dismiss the complaint.

 7.     In order to prove the case, both the parties have filed their affidavit evidence and produced documents. Arguments Heard. The following points arise for our consideration:-

1) Whether the complainants have proved deficiency in service on the part of the Opposite Party?

2) Whether the complainants are entitled to the relief prayed for in the complaint?

8.     Our answers to the above points are:-

POINT NO.1 & 2:             In the Negative

                                                For the following.

REASONS

9.     POINT No.1 AND 2:-

   Perused the complaint, version, affidavit evidence and the documents produced by respective parties.   It is not in dispute that the complainant obtained insurance policy from the OP as mentioned by paying Rs.1,00,000/- as annual premium for a period of ten years.  It is also not in dispute that it is a unit linked insurance, wherein upon the maturity the OP is liable to pay to the complainant a sum of Rs.13,08,622.91, as per the letter written by the OP to the complainant.  It is also not in dispute that there is a mention of the mode of payment and the amount of payment as per plan option 2.1, 2.1.1 and the vesting benefits at 2.2 and 2.2.1 a and b. 

        10.   It is the specific contention of OP that as per clause 2.2.1 a and b the complainant has to exercise her option regarding payment of the amount.  Since the said vesting benefit has been incorporated in the terms and conditions of the insurance policy issued to the complainant, and since complainant did not return the insurance policy during the free look period, and having accepted the terms and conditions of the policy regarding vesting benefits, now she cannot claim the entire amount and they are liable to pay 1/3 of the total amount to the complainant as per clause 2.2.1b and would invest remaining amount for the purchase of the annuities as mentioned in clause 2.2.1a.  She will be getting or receiving or entitle to receive the maximum amount from vesting benefit permitted to be commuted as per the then prevailing regulations as a lumpsum payment.  In the version it is mentioned that she will be entitled for 33.33% out of the amount payable to her.  The remaining according to the clause to be invested in annuity.  

        11.   When such being the case, this commission cannot direct the OP to pay the entire amount.  It was the duty of the complainant to look into the terms and conditions at the time of issuing the policy and if not satisfied and not agreeable to the terms and conditions, she was having an option to return the policy which she did not exercise.  Hence in view of the same, not paying the entire amount as requested by the complainant by the OP cannot be held as deficiency in service or unfair trade practice.

        12.   The counsel for the complainant has argued that as per the surrender of the policy terms, OP has to pay the entire amount.  The said argument is not acceptable as in this case, complainant has not exercised her option of surrendering the policy within 3^rd annual premium period.  Hence we answer point No.1 in the negative and in the result complainant is not entitled for any of the reliefs prayed.  However it is made clear that OP is liable to pay the maximum out of the amount payable to the complainant and to invest in purchasing the annuity for the remaining amount. In the result we answer point No.2 also in the negative and pass the following;

ORDER

1. Complaint is Dismissed. No cost.
2. Send a copy of this order to both parties free of cost.

Note:You are hereby directed to take back the extra copies of the Complaints/version, documents and records filed by you within one month from the date of receipt of this order failing which the same will be weeded out/destroyed.

(Dictated to the Stenographer over the computer, typed by him, corrected and then pronounced by us in the Open Forum on this 13^TH DAY OF OCTOBER 2021)

MEMBER                                PRESIDENT

ANNEXURES

1. Witness examined on behalf of the Complainant/s by way of affidavit:

Copies of Documents produced on behalf of Complainant/s:

Ex P1: The original policy issued by OP

Ex P2: Receipts for having paid the premium

Ex. P3: Letter issued by OP

Ex P4: Letter written by me to OP

Ex P5: Postal track record

2. Witness examined on behalf of the Opposite party/s by way of affidavit:

-

Copies of Documents produced on behalf of Opposite Party/s

-

MEMBER                                        PRESIDENT

HAV*