Date of Filing 08.01.2021

                                                                                                             Date of Disposal: 19.03.2024

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION

THIRUVALLUR

BEFORE TMT. Dr.S.M. LATHA MAHESWARI, MA. ML, Ph.D (Law),                                          …….PRESIDENT

               THIRU.P.VINODH KUMAR, B.Sc., BL,                                                                                ……MEMBER-I

               THIUR.P.MURUGAN, M.Com, (ICWA), BL.,                                                                     ……MEMBER-II

RBT/CC.No.61/2024

THIS TUESDAY, THE 19^th DAY OF MARCH 2024

Mr.L.Sureshkumar, S/o. Late D.L.Pathy,

No.65, Sasthri Nagar, 4^th Street,

Tondiarpet,  Chennai – 600 081.                                                           ......Complainant.

                                                                                   //Vs//

1.M/s. Exide Life Insurance Company Limited,

    Formerly known as

   M/s.ING Vysya Life Insurance Company Limited,

   Rep. by its Managing Director& CEO,

   Gold Hill Square, 1^st Floor,

   690, Hosur Road, Begur Hobli,

   Bangalore - 560 068.

2.M/s.Exide Life Insurance Company Limited,

    Formerly known as

   M/s.ING Vysya Life Insurance Company Limited,

   Rep. by its Managing Director & CEO,

   Regd. & Corporate Office,

   ING Vysya House,

  5^th Floor, No.22, M.G.Road, Bangalore 560 001.

3.The Branch Manager,

   M/s. Exide Life Insurance Company Limited,

   Formerly known as

   M/s.ING Vysya Life Insurance Company Limited,

   Ground Floor, Prince kushal Tower,

   No.96, Anna Salai,

   Chennai , Tamil Nadu 600 002.                                                     ……Opposite parties.

Counsel for the complainant                              : M/s.A.Murali, Advocate.

Counsel for the opposite parties                       : M/s.V.Samuthira Vijayan, Advocate.

This complaint has been filed before DCDRC, Chennai (North) as CC.No.17/2021 and transferred to this commission by the administrative order in RC.No.J1/3145/2023 dated 09.11.2023 of the Hon’ble State Consumer Disputes Redressal Commission, Chennai and taken on file as RBT/CC.No.61/2024 and this complaint coming before us finally on 05.03.2024 in the presence of M/s.A.Murali, counsel for the complainant  and M/s.V.Samuthira Vijayan,  counsel for the opposite parties and upon perusing the documents and evidences of both sides this Commission delivered the following:

ORDER

PRONOUNCED BY Tmt. Dr.S.M. LATHA MAHESWARI, PRESIDENT

1. This complaint has been filed by the complainant u/s 35 of the Consumer Protection Act, 2019 alleging deficiency in service against the opposite parties with regard to the Maturity Sum Assured for the policy taken by the complainant’s father along with a prayer to direct the opposite parties to pay the Matured Sum Assured Rs.5,00,000/- along with a sum of Rs.10,00,000/- towards compensation for the mental agony and hardship caused to the complainant.

Summary of facts culminating into complaint:-

2. It was the case of the complainant that in the year 2008 the 3^rd opposite party marketing people approached the complainant’s father, Late D.L.Pathy to take a life insurance policy in its company.  The complainant’s father also agreed for the same and the 3^rd opposite party issued the policy commencing from 31.03.2008 and the policy Matures on 31.03.2024.  The policy assured for a sum of Rs.5,00,000/- and the term  of payment of premium was five and the premium amount was Rs.50,000/-.  As per the said policy’s rules and regulations the complainant’s father paid the 1^st premium amount of Rs.50,000/- on 31.03.2008 vide receipt No.00981645.   As per the 3^rd opposite party’s advice the complainant’s father consecutively paid 3 years of the premium amount without any default. When the complainant’s father enquired about the maturity amount details, thereafter only he knows that premium had to be paid for total 5 years. Complainant’s father paid the rest of the 2 years premium for year 2012 & 2013 from the partial withdrawal benefit under the opposite party terms and conditions in clause 3.5.2. As per the rules and regulations complainant’s father had paid 5 premiums for the said life insurance policy.  Therefore the complainant’s father and his family are entitled to get the benefits of the insurance.  Complainant’s father/policy holder died on 24.08.2020. Complainant approached the 3^rd opposite party Chennai Branch office for claiming the benefits of the policy.  But the 3^rd opposite party informed that the complainant’s father had obtained the maturity benefit a sum of Rs.50,000/-.  Hence opposite parties summarily rejected the claim of the complainant. It is crystal clear that some manipulation had been done in the complainant’s father policy benefits.  Hence on 09.11.2020 the complainant issued a legal notice to all the opposite parties but there was no response.  Thus aggrieved by the act of the opposite parties the present complaint was filed to direct the opposite parties to pay the Matured Sum Assured amount of Rs.5,00,000/- along with a sum of Rs.10,00,000/- towards compensation for the mental agony and hardship caused to the complainant.

The crux of the defence put forth by the opposite parties:-

3. The opposite parties filed version disputing the complaint allegations contending inter alia that the complainant by way of the present complaint was claiming the sum assured for which he was not at all entitled.  It was submitted that the complainant had claimed that his father/policy holder died on 24.08.2020.  However the policy had been foreclosed and the foreclosure amount was paid to the policy holder on 21.03.2017 i.e., much prior to the death of the policy holder.  Since the policy was foreclosed prior to the death of the policy holder, the sum assured was not payable under the policy. This commission has no jurisdiction to entertain and adjudicate upon the dispute involved in the complaint in as much as it was not a dispute which falls within the ambit of Consumer Protection Act and is exclusively triable by a Civil Court. Complaint does not disclose any cause of action against the opposite parties. The complainant failed to approach the opposite parties within free look period making any grievance with respect to the proposal forms or the terms of the policy implying that the terms and conditions of the policy were in order. The life assured remained silent and paid five premiums and never approached with regard to any discrepancies in the terms of the policy which itself creates the doubt to any prudent person on genuineness of the present complaint.  Therefore the complainant is now estopped from raising any grievances or issue relating to the policy.  The complainant/ Life Assured was bound by the policy contract and was deemed to have given-up-waived his rights by not exercising the free look provision. Thus they sought for the dismissal of the complaint.

4. On the side of the complainant proof affidavit was filed and documents marked as Ex.A1 to Ex A13 were submitted. The opposite parties filed proof affidavit and documents marked as Ex.B1 to Ex.B5 were submitted. 

Points for consideration:-

1)    Whether the act of opposite parties in denying the Maturity Sum Assured for the policy taken by the complainant’s father amounts to deficiency in service and whether the same has been successfully proved by the complainant by admissible evidence?

2)    If so, to what relief the complainant is entitled?

Point No.1:-

5. Heard the oral arguments of both sides and perused the pleadings and material evidences produced by them.

6.  The crux of the oral arguments adduced by the learned counsel appearing for the complainant is that the complainant’s father took an insurance policy with Maturity Sum Assured Rs.5,00,000/- and had paid upto 3 instalments, the first premium amount of Rs.50,000/- paid on 31.03.2008.  On 24.08.2020 complainant’s father died.  Out of 5 instalments 3 instalments has been paid and 2 instalments paid out of the amount paid earlier for 3 instalments.   It is his argument that the opposite parties are liable to pay the Maturity Sum Assured of Rs.5,00,000/- as the policy matured on 31.03.2024.

7. On the other hand, the learned counsel appearing for the opposite parties argued that the policy taken by the complainant’s father got foreclosed even before the death of his father and the foreclosure amount after settlement of all charges a sum of Rs.50,606.64/- has already been deposited in the complainant’s father Account.  Thus, they argued nothing survives in the present claim towards Maturity Sum Assured.

8. On perusal of the documentary evidences produced by both parties the factum of taking policy and payment of premium was not disputed by either of the parties.  However the complainant’s case is that out of 3 payments made by the father adjusting from the said amount Rs.1,00,000/- was received and paid as 4 & 5^th instalments.  However, it is the submission of the opposite parties that the policy is a unit linked policy and that the complainant was required to pay 5 premiums continuously and thereafter the policy term will continue automatically till the fund value falls below 1 year’s regular premium.  Vide Ex.B3 it is seen that the opposite parties on 23.01.2017 had sent a letter to the policy holder/complainant’s father informing him that due to non maintenance of minimum fund balance in the policy his policy was likely to be foreclosed on 14.03.2017 and advising him to top-up for continuing the policy. But, when no top-up was done, Vide Ex.B4 it is found that the opposite parties as per clause 4.2 of the policy had foreclosed the policy and transferred an amount of Rs.50,606.64/- to the account of the complainant’s father.  Clause 4.2 & 4.3 deals with discontinuance of regular premium after paying the Regular Premium due for at least three consecutive years. The insurance cover under the policy will continue if 3 consecutive payments made subject to levying the applicable Mortality charges, Policy Administration Charges, Fund Management Charge and Rider Premium Charges if any, from the policy holder’s fund value.  In the present case in Ex.B3 the terms and conditions were already intimated to the policy holder vide Ex.B4, Foreclosure intimation was also given.  However when no top up was done, the opposite party had terminated the policy as per clause 4.4 wherein it was provided that “in the event of Policy holder’s fund value is insufficient to pay the charges, the company may terminate the policy forthwith”. Though reinstatement facility was given, the complainant’s father did not avail the same.  As per foreclosure intimation Ex.B4 & Ex.B5 we could see that vide letter dated 21.03.2017 the opposite parties had informed that the foreclosure amount of Rs.50,606.64/- for the policy has been transferred to the Bank Account.  At this juncture it is to be noted that the complainant did not dispute the deposit of the said amount.  However his only grievance is that the termination/foreclosure of the policy was not proper.   When the dispute pertains to the terms and conditions of the policy which binds both parties under the insurance contract, the complainant has to approach the jurisdiction of a Civil Court.  Therefore on the available materials this commission holds that when already the policy was foreclosed during the life time of the complainant’s father no question of paying the Matured Sum Assured after his death arises. Thus the complainant’s case could not be accepted.  Thus we answer the point accordingly in favour of the opposite parties and as against the complainant.

Point No.2:-

 9. As we have held above that the opposite parties had not committed any deficiency in service the complainant is not entitled any relief from the opposite parties.

In the result the complaint is dismissed.  No order as to cost.

Dictated by the President to the steno-typist, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this 19^th day of March 2024.

      -Sd-                                                    -Sd-                                                           -Sd-

MEMBER-II                                        MEMBER-I                                              PRESIDENT

List of document filed by the complainant:-

            List of documents filed by the opposite parties:-

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MEMBER-II                                              MEMBER-I                                      PRESIDENT