SMT. RAVI SUSHA : PRESIDENT
Complainant filed this complaint U/S 12 of Consumer Protection Act 1986 for getting an order directing opposite parties to pay Rs.1,00,000/- towards maturity sum assured together with Rs.50,000/- towards compensation alleging deficiency in service on the part of OPs.
Complainant’s case is that on the instigation of 3rd OP, complainant has taken a policy with 2nd OP and paid premium of Rs.1440/-. Complainant submitted that 3rd OP assured that the complainant will get maturity sum assured of the policy was Rs.1,00,000/- and Accident benefit sum assured was also Rs.1,00,000/-. It is submitted that he had remitted the premium without any fault and thus remitted Rs.57600/- in total, but after maturity of the policy, complainant got only Rs.15,885/- from OP as Maturity sum Assured . Complainant submitted that though he had remitted Rs.57600/- towards premium for 10 years, OP had given only Rs.15,855/- as maturity sum assured. Complainant alleged that the said action of OPs amounts to deficiency in service and unfair trade practice and hence complainant is entitled to get Rs.1,00,000/- as maturity sum assured along with compensation.
Opposite parties entered appearance and filed written version. It was contended by the OPs that the complaint is not maintainable either in law or on merits. OPs admits that the complainant has taken a policy with No.796682395 from 2nd OP under Jeevan Saral plan for 10 years The date of commencement of the policy is 19/8/2009 with maturity sum assured Rs.12236/-The death assured under the plan is Rs.1,00,000/- and the double accident benefit sum assured is 1,00,000/-. The premium under the plan is Rs.1440/- to be paid quarterly for 10 years. The policy was issued on the receipt of the proposal dt.4/5/2009 signed by the life assured complainant and delivered to him in 2009. In the petition the complainant has stated that he has received the policy bond after certain weeks from the date of proposal and he had seen the maturity benefits printed on the bond as on date of maturity, if the policy holder is alive, a sum equal to maturity sum assured will be payable. In the bond it is clearly mentioned that the maturity sum assured is Rs.12236/-. So his statement that he was unaware of the maturity benefit is wrong. OPs submitted that Jeevan Saral policy plan 165 is a high risk coverage plan providing a death sum assured which is 250times of monthly premiums which can be chosen by the life assured. Death benefit payable under… the policy is death sum assured + total premiums paid under the policy less the first year premiums and health extra premiums remitted. Maturity sum assured is arrived as per the chart depends on the premium selected, policy holder’s age at entry and term of policy. Maturity sum assured varies with premium selected by the life assured. Maturity benefit payable on maturity is maturity sum assured plus loyality addition . Maturity sum assured , Death sum assured and accident benefit sum assured is separately mentioned in the policy bond .The complainant has paid all the premiums under the policy The policy matured on 19/8/2019 and on receipt of the requirements , maturity amount of Rs.15885/- was settled his SB account on that day. The complainant has raised the complaint only after receiving the complete risk coverage throughout the policy period and after receiving the maturity benefit. According to OPs this plan is mainly intended to cover the risk, the savings/return on the policy on maturity will be less. OPs further stated that LIC can act only as per the policy terms and conditions and the benefits are paid as per the policy conditions. Maturity sum assured payable as per the policy was settled to him on 19/8/2019 with loyality additions . This policy had given the life assured coverage of Rs.1,00,000/- for 10 years from the age of 60 and maturity benefit of Rs.15,885/- just for an amount of Rs.480/- monthly. Complainant had enjoyed this benefits at this age of life. The insured cannot claim anything more than what is covered in the insurance policy. There is no deficiency of service or cheating from the part of OPs. Hence prayed for the dismissal of the complaint.
The evidence adduced by the OPs consists of chief affidavit of complainant and Exts.A1 to A5 and Exts.B1 to B5 marked.
It was not disputed that the complainant has taken a Jeevan Saral Plan for 10 years from 2nd OP Insurance Company. The OPs have relied on Ext.B1 policy that the date of commencement of policy was on 19/8/2009 and the date of maturity was on 19/5/2019. Further the maturity sum assured amount as Rs.12236/- Death benefit sum assured as Rs.1,00,000/- and Accident benefit sum assured as Rs.1,00,000/-. OPs submitted that Maturity sum assured is arrived as per the chart depends on the premium selected, policy holder’s age at the entry and term of policy. Maturity benefit plus loyality addition will pay on maturity of the policy. Further maturity sum assured, Death sum assured and accident benefit sum assured is separately mentioned and the amount was printed in the policy bond itself. Hence the complainant’s averment that he was not aware about the maturity sum assured amount cannot be believed. During cross-examination complainant admitted the contentions of the OPs. OP can act as per the policy conditions and terms. Hence as per the terms of the policy, the complainant is entitled to get only the sum assured mentioned in the policy bond ie Rs.12,236/- along with the corresponding loyalty addition. Here OP had calculated the amount as Rs.15,885/- and deposited in the account of complainant. On considering the terms in the policy bond, there is no deficiency in service on the part of opposite parties. Hence complainant is not entitled to get any further benefit from opposite parties.
In the result, complaint is dismissed. No order as to cost.
Exts:
A1-Insurance policy
A2- premium receipt
A3-statement issued by 1st OP
A4-letter sent by complainant to 2nd OP
A5-Reply
B1- copy of proposal form
B2-copy of proposal review slip
B3-copy of policy bond
B4-Agents manual
B5- Status report
PW1-K.K.Rajan-complainant
Sd/ Sd/ Sd/
PRESIDENT MEMBER MEMBER
Ravi Susha Molykutty Mathew Sajeesh K.P
eva
/Forwarded by Order/
ASSISTANT REGISTRAR
