Tamil Nadu
South Chennai
CC/236/2022
PG. Shanmugam - Complainant(s)
Versus
HDFC Ltd, Rep by its Chief Executive - Opp.Party(s)
P.G. Shanmugam
05 Jun 2023
ORDER
Date of Complaint Filed : 30.08.2019
Date of Reservation : 10.05.2023
Date of Order : 23.05.2023
DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,
CHENNAI (SOUTH), CHENNAI-3.
PRESENT: TMT. B. JIJAA, M.L., : PRESIDENT
THIRU. T.R. SIVAKUMHAR, B.A., B.L., : MEMBER I
THIRU. S. NANDAGOPALAN., B.Sc., MBA., : MEMBER II
CONSUMER COMPLAINT No.236/2019
TUESDAY, THE 23rd DAY OF MAY 2023
V V Subramanian,
E-31, Amudam Colony,
South Boag Road,
T Nagar, Chennai – 600 017. … Complainant.
..Vs..
1.Admin Officer,
Divisional Office II,
B Vijayalakshmi,
LIC of India, LIC Buillding,
97, Anna Salai,
Chennai – 600 002.
2.The Branch Manager,
LIC of India, 7th Floor,
88 M Mukkand West Branch,
360 Degree Business Park,
LBS Marg, Next to R” Mall,
Mumbai – 400 080.
3.The Divisional Manager,
Divisional Office-II,
Plot No.112, Sion Koliwada Road,
Sion East, Mumbai – 400 022.
The Divisional Manager
4.The Chairman,
LIC of India,
Yogakshema, Jeevan Bhima Marg,
5th Floor, West Wing, P B No.19953,
Near Air India Building,
Nariman Point, Mumbai 400 021. .. Opposite parties.
* * * * *
Counsel for the complainant : Party in person
Counsel for Opposite parties : M/s. A. Panneerchelvam, N. Ratna
Kumar Raju, R. Venkatesan, B. Ravikumar
On perusal of records and having heard the oral arguments of the Complainant in person and the Counsel for the Opposite Parties, this Commission delivered the following:
ORDER
Pronounced by Member-I, Thiru. T.R. Sivakumhar., B.A., B.L.,
(i) The Complainant has filed this complaint as against the Opposite Parties under section 12 of the Consumer Protection Act, 1986 and prays to pay a sum of Rs.7,30,068/- as interest charges for holding his money illegally without returning nor with his concurrence and to pay a sum of Rs.62,365/- for travel expenses incurred to visit office and to pay a sum of Rs.2,00,000/- as mental agony created over a period of 15 years as Lump sum as Rs.25,000/- per year along with legal cost total claims amounting to Rs.9,92,443/-.
I. The averments of Complaint in brief are as follows:-
1. The Complainant had taken a Double cover Policy with LIC, the Opposite Parties bearing policy No.880731491 on 02.10.1998 with maturity date on 02.10.2018. The premium towards the said policy was regularly paid until 2003, thereafter the service of the Opposite Parties and their agents was very poor he was forced to stop but when he met the 2nd Opposite Party in Mumbai it was assured to provide better service and advised to continue by conducting medical tests. As suggested he had done medical tests with their authorized Medical panel in Mumbai through their agent and paid a sum of Rs.28,104/-. As the said sum was not updated in their system he was asked to report for medical and the same could be possible only in 2005. Thereafter their agent took medical tests and collected the payment of Rs.35,000/-.
2. Further, when he was moving to Gulf in November 2005 for employment he visited the 2nd Opposite Party’s office along with their agent and due to outstanding payment, his policy was not renewed and again he had paid a sum of 28,105/-. He assumed that their agent might have deposited the said sum. When he had contacted their agent he was told that his policy was not renewed/revived and the amount was kept as suspense and no information nor reasons for maintaining the paid amount as suspense for three years. In 2008 when he came for Vacation he had visited the 2nd Opposite Party’s office again along with their agent and conducted the medical tests as required by them and paid a sum of Rs.24,752/- based on their advise.
3. Again When he was on vacation in 2009 he had visited the 2nd Opposite Party’s office, where he was told that all his payment of about Rs.1,15,961/- was kept in suspense and policy was not revived, and the reasons which was quoted that he had not paid the premium since 2003 and policy was lapsed over 4-5 years. He was quite surprised by the attitude and irresponsible behaviour of the 2nd Opposite Party and he did not want to continue with their service. Hence he had requested the 2nd Opposite Party to return all the suspense money 1,15,961/- since policy was lapsed as per their version. As they did not returned his deposit money he was forced to borrow money by pledging his Security and Jewels on their failure which was not acceptable.
4. Once he returned to India, he had visited the 2nd Opposite Party’s office during August, 2011 and requested to return the suspense money, but the 2nd Opposite Party had never bothered to refund the suspense money despite his request. He had requested to Docket to check the status but it was told that the same was not available. The above facts and irresponsible service strongly felt bad that LIC, the Opposite parties had cheated him as a policy holder and he did not know how many people suffered like this. It would clear that his money was intentionally held on their failure and to protect their staff with ulterior motive without refunding his hard-earned money over a period of 10 years. They have forced him to borrow money from outside on their failure with higher interest rate, due to their irresponsible service they have forced him to suffer huge financial losses as well as mental agony over a period of 10 years.
5. As advised by their Agent before end of maturity date he had visited the 2nd Opposite Party’s office in April 2018 and again on 24thAugust, 2018 he was told that only deposit money would be refunded no other payment nor interest would be paid for the long lapsed policy on their utter failure to refund. When he asked about his deposit payment status, the deposit status was issued vide receipt no. 2881315 and the last payment of 24,752/- was not reflected which he had made in 2008, Once again when he had requested docket to cross check the same and the status of policy, they had reluctant to show the docket and they have told me nothing was available as everything with scanning department and cannot be provided. Having fed up on their failure service and struck his hard earned money due to their failure and deliberately held with irresponsible manner. He had worked out on 28th August, 2018 and 4thOctober, 2018 by three options so that prior to fag end of policy maturity the issue can be settled and the same was send to the 2nd Opposite Party as well Regional/Divisional Manager. As the 2nd Opposite Party had not responded to his communication and workings at the end of the Policy maturity, he had again visited the 2nd Opposite Party’s Office and Divisional Office but due to their irresponsible behavior, he was running pillar to post for a week on every day to 2nd and 3rd Opposite Parties Office.
6. Due to his expenses and continuous travel to their office fed up with distressed and surrendered all his documents on 06.12.2018 vide inward no. 4991 as suggested by their agent by anticipating the money proposed by him in any of the option, would be deposited by the 2nd Opposite Party. But even after lapse of policy maturity date, there was no response from them and their seniors, he was forced to move to Ombudsman and the Ombudsman did not considered his request of reasons for holding my money over a period of 10 years without returning, option given by him with three proposal and Interest payment for illegally holding money as a deposit with prevailing rates for the every particular years together over the period of 10 years, if these money which he could have deposited his return also could have in three fold. Ombudsman also with unjustified manner awarded by adjusting the deposit as a premium after maturity of policy by suffering the policy holder with a financial losses. It was noticed that they have settled the amount as a Loan Quotation issued by them on 28.10.2004 without considering the facts or Order. As he felt bad on their part of deliberation again he had approached with Ombudsman on 11.07.2018 it was advised that there was a mistake by LIC, since their role of jurisdiction is over, the only way is to write a letter to LIC or approaching consumer Forum as an alternate.
7. On receipt of their payment of Rs.1,53,180/- into his bank, he had totally disagreed by mail dated 08.07.2019 and requested the details of payment and its working calculations for the Payment made by them, but there was no response from their end as usual till date fling of this compliant. He had visited the 2nd and 3rd Opposite Parties office over dozen time by spending Rs.15000/- to Rs.20000/- on each time and got irresponsible answers and behaviours from them, which caused him huge financial loss and for their failure the same had to be reimbursed. From the above facts, he was huge financial loss and mental agony for the last 10 years because of the failure of the Opposite Parties including Ombudsman which was not acceptable. Even on the lapsed policy they have intentionally and illegally held as deposit without returning in time, if at all would have returned in time he would have deposited in other choice of FD etc and would have earned tripled, returning after 10 years had not fetched him anything. He had also issued notice on 13.07.2019 to the 1st Opposite Party and to the 4th Opposite Party, but left with no response. Hence this complaint.
II. Written Version filed by the Opposite Parties are in brief:
8. The above complaint is not maintainable either in law or on facts as such should be dismissed in limine. Having referred the dispute to the Insurance Ombudsman and participated in the enquiry the complainant cannot reopen the dispute before this Hon'ble Forum after an award was passed by the Ombudsman. The complainant has raised the same points raised in this complaint before the Ombudsman which was thoroughly examined after giving every opportunity to the complainant before passing the Award by the Ombudsman. The proceedings before the Ombudsman is quasi Judicial and is not open to the complainant to invoke the consumer Protection Act. The very object of Ombudsman proceedings would become mockery if the complaint is preferred under Consumer Protection Act after an Award was passed by the Ombudsman on a complaint by the same complainant. The proceedings before the Ombudsman is similar as that of this Hon'ble Forum. If the complainant is aggrieved by the Award, the remedies lies elsewhere but not before this Hon'ble Forum.
9. They have already complied with the award passed by the Ombudsman by transferring a sum of Rs.1,53,163/- by way NEFT to the bank account of the complainant on 03.07.2019. The complainant has claimed the amount of Rs.2,00,000/- the sum assured before the Ombudsman but now he has made a claim for a higher amount which is nothing but speculative. Policy No.880731491 was issued to the complainant under plan and terms 88.20 for a sum assured of Rs.2,00,000/-, the complainant had discontinued the payment of premium as it was evident from his own statement as he was not in India for some years. It is nothing but passing the buck and blaming the agents and officers of the Corporation for his discontinuance of the payment of premium.
10. They are not responsible for the discontinuance of the policy by the complainant. The complainant has made a payment of Rs.28,104/- on 17.03.2003 for the revival of the lapsed policy but without the medical report as required as such the policy remained lapsed. Again in 2005 a sum of Rs.35,000/- was paid by the complainant on 14.10.2005 for revival of the lapsed policy but again without the medical report which is essential for the revival of the lapsed policy.
11. They have not received any payment of Rs.28,105/- as claimed by the complainant. The complainant was called upon to submit the proof of this payment by the Ombudsman but the complainant failed to produce the same. They deny that have received a sum of Rs 24,752/- as claimed by the complainant and the same was not proved before the Ombudsman inspite of having called upon to produce the proof. They deny that the complainant had visited their office in 2009 and the question of asking to return the suspense account amount of Rs.1,15,961/ would not arise and the allegations made in this regard was utterly falsehood. Any amount in deposit which is required to be refunded is always refunded with applicable interest as per I.R.D.I.A. guidelines The letter dated 04.10.2018 by the complainant addressed to CRM Mumbai Division-II after telephonic conversation with the complainant, the branch was directed to proceed with the refund. The amount having been transferred to another account needed sanction of higher office, the same was communicated to the complainant requesting him to bear with them vide e-mail dated 12.11.2018, which was replied by the complainant on 16.11.2018 containing unparliamentary language. When the refund of the deposited amount by the complainant was about to materialize, he has made the legal demand for the Maturity amount of the policy. Further the complainant moved the Ombudsman after he was informed about the refund of his deposit with applicable interest vide e-mail dated 11.11.2018. Having participated in the entire proceedings before the Ombudsman, calling it as unilateral, is nothing but flimsy and figment of imagination.
12. All the allegations of the complainant about the failure of the Corporation including Ombudsman is totally wrong and baseless. The complainant is indulging in witch hunting in order to gain when he has committed default and discontinued the policy thereby became lapsed. The Corporation has always considered the grievances of the policy holders in a humanitarian way, refunded all the deposit along with applicable interest. The complainant has chosen to refer the matter without accepting the refund offered to him. The Ombudsman has given a clear finding to all the issues referred to him by the complainant and passed an award and the same was complied with by them. There is no deficiency of service on their part and the complainant alone is responsible for the state of affairs. They reiterate that the complainant is not entitled to the amount claimed by him and it is totally not in accordance of the Rules and Procedure. The opposite parties are not able to pay any amount to the complainant as they have already complied with the Award passed by the Ombudsman. Hence prayed to dismiss the complaint.
III. The complainant has filed his proof affidavit, in support of his claim in the complaint and has filed documents which are marked as Ex.A1 to A13. The opposite parties had submitted his proof affidavit and Ex.B1 to Ex.B7 were marked on the side of Opposite Parties. Both side written arguments filed.
IV. Points for Consideration:-
1.Whether there is any deficiency in service on the part of the Opposite Parties?
2.Whether the Complainant is entitled for the reliefs sought for?
3. To what other relief, the Complainant is entitled to?
Point No.1 :
13. It is an undisputed fact that the Complainant had availed a Policy bearing No.880731491 for a sum assured of Rs.2,00,000/-on 02.10.1998 which matures on 02.10.2018.
14. According to the Complainant he had paid the premium regularly until 2003, thereafter due to poor service he had not continued to pay the premiums and thereafter during 2005 as assured and advised by the 2nd Opposite Party for better service he had intended to revive the said policy and accordingly had paid a sum of Rs.28,104/- and as the said amount was not updated he was asked to undergo medical test and had collected a sum for Rs.35,000/-. He again visited the 2nd Opposite Party’s office along with their agent and due to outstanding payment, his policy was not renewed and again he had paid a sum of 28,105/-. He was with the impression that their agent would have deposited the said sum and when he had contacted their agent he was told that his policy was not renewed/revived and the amount was kept as suspense and no information nor reasons for maintaining the paid amount as suspense for three years, i.e., till 2008. In 2008 when he came for Vacation he had visited the 2nd Opposite Party’s office again along with their agent and conducted the medical tests as required by them and paid a sum of Rs.24,752/- based on their advise. Again When he was on vacation in 2009 he had visited the 2nd Opposite Party’s office, where he was told that all his payment of about Rs.1,15,961/- was kept in suspense and policy was not revived, and the reasons which was quoted that he had not paid the premium since 2003 and policy was lapsed over 4-5 years. He was quite surprised by the attitude and irresponsible behaviour of the 2nd Opposite Party and he did not want to continue with their service and requested the 2nd Opposite Party to return all the suspense money of Rs.1,15,961/- since policy was lapsed as per their version. As they did not returned his deposit money he was forced to borrow money by pledging his Security and Jewels on their failure which was not acceptable. Once he returned to India, he had visited the 2nd Opposite Party’s office during August, 2011 and requested to return the suspense money, but the 2nd Opposite Party had never bothered to refund the suspense money despite his request. He had requested to Docket to check the status but it was told that the same was not available. The above facts and irresponsible service strongly felt bad that LIC, the Opposite parties had cheated him as a policy holder and he did not know how many people suffered like this. It would clear that his money was intentionally held on their failure and to protect their staff with ulterior motive without refunding his hard-earned money over a period of 10 years. They have forced him to borrow money from outside on their failure with higher interest rate, due to their irresponsible service they have forced him to suffer huge financial losses as well as mental agony over a period of 10 years. As advised by their Agent before end of maturity date he had visited the 2nd Opposite Party’s office in April 2018 and again on 24thAugust, 2018 he was told that only deposit money would be refunded no other payment nor interest would be paid for the long lapsed policy on their utter failure to refund. When he asked about his deposit payment status, the deposit status was issued vide receipt no. 2881315 and the last payment of 24,752/- was not reflected which he had made in 2008, Once again when he had requested docket to cross check the same and the status of policy, they had reluctant to show the docket and they have told me nothing was available as everything with scanning department and cannot be provided. Having fed up on their failure service and struck his hard-earned money due to their failure and deliberately held with irresponsible manner. He had worked out on 28th August, 2018 and 4thOctober, 2018 by three options so that prior to fag end of policy maturity the issue can be settled and the same was send to the 2nd Opposite Party as well Regional/Divisional Manager. As the 2nd Opposite Party had not responded to his communication and workings at the end of the Policy maturity, he had again visited the 2nd Opposite Party’s Office and Divisional Office but due to their irresponsible behavior, he was running pillar to post for a week on every day to 2nd and 3rd Opposite Parties Office.
15. Due to his expenses and continuous travel to their office fed up with distressed and surrendered all his documents on 06.12.2018 vide inward no. 4991 as suggested by their agent by anticipating the money proposed by him in any of the option, would be deposited by the 2nd Opposite Party. But even after lapse of policy maturity date, there was no response from them and their seniors, he was forced to move to Ombudsman and the Ombudsman did not considered his request of reasons for holding my money over a period of 10 years without returning, option given by him with three proposal and Interest payment for illegally holding money as a deposit with prevailing rates for the every particular years together over the period of 10 years, if these money which he could have deposited his return also could have in three fold. Ombudsman also with unjustified manner awarded by adjusting the deposit as a premium after maturity of policy by suffering the policy holder with a financial losses. It was noticed that they have settled the amount as a Loan Quotation issued by them on 28.10.2004 without considering the facts or Order. As he felt bad on their part of deliberation again he had approached with Ombudsman on 11.07.2018 it was advised that there was a mistake by LIC, since their role of jurisdiction is over, the only way is to write a letter to LIC or approaching consumer Forum as an alternate. On receipt of their payment of Rs.1,53,180/- into his bank, he had totally disagreed by mail dated 08.07.2019 and requested the details of payment and its working calculations for the Payment made by them, but there was no response from their end as usual till date fling of this compliant. He had visited the 2nd and 3rd Opposite Parties office over dozen time by spending Rs.15000/- to Rs.20000/- on each time and got irresponsible answers and behaviours from them, which caused him huge financial loss and for their failure the same had to be reimbursed. From the above facts, he had huge financial loss and mental agony for the last 10 years because of the failure of the Opposite Parties including Ombudsman which was not acceptable. Even on the lapsed policy they have intentionally and illegally held as deposit without returning in time, if at all would have returned in time he would have deposited in other choice of FD etc and would have earned tripled, returning after 10 years had not fetched him anything. He had also issued notice on 13.07.2019 to the 1st Opposite Party and to the 4th Opposite Party, but left with no response.
16. The Contentions of the Opposite Parties are that the complainant has raised the same points raised in this complaint before the Ombudsman which was thoroughly examined after giving every opportunity to the complainant before passing the Award by the Ombudsman. Having referred the dispute to the Insurance Ombudsman and participated in the enquiry the complainant cannot reopen the dispute before this Hon'ble Forum after an award was passed by the Ombudsman. The proceedings before the Ombudsman is quasi Judicial and is not open to the complainant to invoke the consumer Protection Act. If the complainant is aggrieved by the Award, the remedies lies elsewhere but not before this Hon'ble Forum. They have already complied with the award passed by the Ombudsman by transferring a sum of Rs.1,53,163/- by way NEFT to the bank account of the complainant on 03.07.2019. The complainant has claimed the amount of Rs.2,00,000/- the sum assured before the Ombudsman but now he has made a claim for a higher amount which is nothing but speculative. The complainant had discontinued the payment of premium as it was evident from his own statement as he was not in India for some years. It is nothing but passing the buck and blaming the agents and officers of the Corporation for his discontinuance of the payment of premium. They are not responsible for the discontinuance of the policy by the complainant. They admits that the complainant has made a payment of Rs.28,104/- on 17.03.2003 for the revival of the lapsed policy but without the medical report as required as such the policy remained lapsed. It was also admitted that the Complainant again paid a sum of Rs.35,000/- on 14.10.2005 for revival of the lapsed policy but again without the medical report which is essential for the revival of the lapsed policy. And they deny that they have not received any payment of Rs.28,105/- as claimed by the complainant. The proof for the said payment was called upon by the Ombudsman but the complainant failed to produce the same. They deny that have received a sum of Rs.24,752/- as claimed by the complainant and the same was not proved before the Ombudsman inspite of having called upon to produce the proof. They deny that the complainant had visited their office in 2009 and the question of asking to return the suspense account amount of Rs.1,15,961/ would not arise and the allegations made in this regard was utterly falsehood. Any amount in deposit which is required to be refunded is always refunded with applicable interest as per I.R.D.I.A. guidelines. The letter dated 04.10.2018 by the complainant addressed to CRM Mumbai Division-II after telephonic conversation with the complainant, the branch was directed to proceed with the refund. The amount having been transferred to another account needed sanction of higher office, the same was communicated to the complainant requesting him to bear with them vide e-mail dated 12.11.2018, which was replied by the complainant on 16.11.2018 containing unparlimentary language. When the refund of the deposited amount by the complainant was about to materialize, he has made the legal demand for the Maturity amount of the policy. Further the complainant moved the Ombudsman after he was informed about the refund of his deposit with applicable interest vide e-mail dated 11.11.2018. Having participated in the entire proceedings before the Ombudsman, calling it as unilateral, is nothing but flimsy and figment of imagination. All the allegations of the complainant about the failure of the Corporation including Ombudsman were totally wrong and baseless. The complainant is indulging in witch hunting in order to gain when he has committed default and discontinued the policy thereby became lapsed. The Corporation has always considered the grievances of the policy holders in a humanitarian way, refunded all the deposit along with applicable interest. The complainant has chosen to refer the matter without accepting the refund offered to him. The Ombudsman has given a clear finding to all the issues referred to him by the complainant and passed an award and the same was complied with by them. There was no deficiency of service on their part and the complainant alone was responsible for the state of affairs. The complainant is not entitled to the amount claimed by him, as it is totally not in accordance of the Rules and Procedure. The opposite parties were not liable to pay any amount to the complainant as they have already complied with the Award passed by the Ombudsman.
17. On discussion made above and on perusal of records, it is clear that the Complainant had availed a policy in the year 1998, ie., on 02.10.1998 and the premiums to be paid in half yearly basis ie., during April and October of every year and the date of last premium to be made was on 02.04.2018 and the date of maturity was on 02.10.2018 as evidenced from Ex.A-1, Policy bearing No.880731491. Further it is clear from Ex.A-2, Loan Quotation that the Complainant had paid half yearly premiums of Rs.6,411/- on 31.03.1999, 09.06.1999, 09.03.2000, 11.05.2000, 22.01.2001, for 2 ½ years under the said policy. As per Ex.A-2, a payment of Rs.28,104/- was found to be made by way of cheque on 17.03.2003, towards recovery of premium for the period April 2001 to October 2004. It is be noted that the Complainant was aware of the fact that his policy was not revived on payment of Rs.28,104/- made on 17.03.2003 for want of medical report and he had also admitted that he had again paid a sum of Rs.35,000/- for reviving his policy as found in Ex.A-3. It is also to be noted that even after making payment of Rs.35,000/- his policy was not revived and thereafter he had paid a sum of Rs.24,752/- in the year 2008, for which no proof has been produced by the Complainant. It is also to be noted that in the year 2009 he was aware of the fact that his policy was not revived as he had requested for refund of the amounts paid by him, which was said to be kept in suspense account by the Opposite Parties. From Ex.A-10, Insurance Ombudsman Award dated 31.05.2019, it would be clear that the averments made in the complaint were similar to that of the Complaint presented before the Insurance Ombudsman, it is also to be noted from Ex.A-10 that the Insurance Ombudsman had discussed the issues raised and dealt with the same in detail and had passed an award following the terms and conditions of the Policy. Though the same issues were placed before the Insurance Ombudsman and decided it will not restrain the Complainant to approach this Commission to decide about any deficiency of service committed by the Opposite Parties. Hence it is necessary to find out whether the Opposite Parties had committed any deficiency of service to the Complainant.
18. It is an admitted fact that the Complainant had not paid the premiums regularly and as per the Complainant he had paid premium till 2003, but whereas as per Ex.A-2 he had paid premium under the policy only till 22.01.2001 covering for a period of 2 ½ years and in spite of the payments made for revival during 2003, 2005, for a sum of Rs.28,104/- and Rs.35,000/- the Complainant was aware that his policy was not revived due to non-submission of medical reports, further the Complainant had not produced any documentary proof to show that he had submitted the medical reports and also to show that he had made further payments in respect of his policy getting revived, even otherwise the same could not be appreciated as when the Complainant’s policy was not revived in spite of having paid a sum for Rs.28,104/- and Rs.35,000/- in the year 2003 and 2005, respectively. As per Condition No.3 of the Policy the Opposite Parties reserved their rights to accept or decline the revival of discontinued policy. The revival of discontinued policy shall take effect only after the same is approved by them and is specifically communicated to the life assured. Further with regard to the request for refund of the amounts paid by the Complainant made in the year 2008 and 2011, which was said to be kept in suspense account, no material evidence has been produced before this Commission to show for the claim made for refund, by the Complainant. Further the Complainant had produced the communications sent from 28.08.2018 to 29.11.2018, Exs A-4 and A-5. As per Ex.B-4, Page no.16, Reply mail dated 12.11.2018 sent by the 2nd Opposite Party to the Complainant, it was clearly mentioned that “the process at Division office level was nearly over, the same was put up for sanction to the competent authority, on sanction the payment would be released by the branch. Kindly bear with us for few more days”. And it was also clearly mentioned that “only two amounts were to be refunded i.e., Rs.28,104/- paid on 17.03.2003 and Rs.35,000/- paid on 14.10.2005 and a sum of Rs.28,104/- received on 17.03.2003 was wrongly credited on 21.11.2005”, for which a rejoinder was sent by the Complainant through mail dated 16.11.2018 mentioning the payments made and declared as a sum of Rs.1,15,961/- kept in suspense account. It is to be noted that as per Condition No.7 of the policy as found in Ex.A-1 under “Guaranteed Surrender Value; This policy can be surrendered for cash after the premiums have been paid for at least three years. The minimum surrender value allowable under this policy is equal to 30 percent of the total amount of the within-mentioned premiums paid excluding the premiums for the first year and all extra premiums and/or additional premiums for accident benefit that may have been paid. The cash value of any existing vested bonus additions will also be allowed”. It is also to be noted that the Complainant was informed about the reasons for the delay in making the payments under the policy as per page no.16 in Ex.B-4 and as thereafter the Complainant had approached the Insurance Ombudsman, the Opposite Parties had made to wait for the decision and thereafter had complied the award by making the eligible payments as per the terms and conditions of the policy. The Claim of the Complainant that the Opposite Parties had illegally held his amounts in suspense account for about 10 years without any interest, inspite of his request of refund was not considered by the Opposite Parties, otherwise he would have invested the said amounts which would have fetched him higher interest, are not sustainable, as the Complainant had failed to produce material evidence for the payments alleged to have been made to the Opposite Parties, except for a sum of Rs.28,104/- on 17.03.2003 and a sum of Rs.35,000/- on 14.10.2005 and also had not produced any material evidence for having made a claim of refund of the said amounts kept in suspense account. Further, it is to be noted that the Opposite Party had transferred a sum of Rs.1,53,163/- by way of NEFT to the bank account of the Complainant on 03.07.2019 as per the award passed by the Insurance Ombudsman, which is not denied by the Complainant. Having received the above said amount as per the agreed terms and conditions of the policy for the lapsed and non-revival of the Complainant’s policy, based on which the Insurance Ombudsman has passed the award, the Complainant is estopped from making any further claim that has been already considered and decided. Hence it is clear that there is no deficiency of service on the part of the Opposite Parties. Therefore this Commission is of the considered view that the Opposite Parties had not committed any deficiency of service. Accordingly Point No.1 is answered.
Point Nos. 2 and 3 :
19. As discussed and decided Point No.1 against the Complainant, the Complainant is not entitled for the reliefs claimed in the complaint and also not entitled for any other relief/s. Accordingly Point Nos. 2 and 3 are answered.
In the result, the complaint is dismissed. No costs.
S. NANDAGOPALAN T.R. SIVAKUMHAR B.JIJAA
MEMBER II MEMBER I PRESIDENT
List of documents filed on the side of the Complainant:-
Ex.A1 |
| LIC Policy issued copy |
Ex.A2 | 28.10.2014 | Loan quotation with vested Bonus |
Ex.A3 | 28.08.2018 | LIC payment confirmation of Rs.117,380/- |
Ex.A4 | 28.08.2018 | Policy maturity 3 option to release payment |
Ex.A5 | 4, Oct & 29.11.2018 | Letter reminder to CRM |
Ex.A6 | 24.08.2019 | Policy surrender Documents & Bank Details for NFT |
Ex.A7 | Aug.28, Sep.15, 04.10.2018 | Reminder mails |
Ex.A8 | 03.12.2019 | Ombudsman complaint acknowledgement |
Ex.A9 | 15.04.2019 | Ombudsman hearing letter |
Ex.A10 | 03.06.2019 | Ombudsman award letter dated June 3, 2019 |
Ex.A11 | 03.07.2019 | Settlement issued by LIC received on 8th July 2019 |
Ex.A12 | Mail dated July 05, & 9th 2019 | Disagreement of Settlement |
Ex.A13 | Notice dated 13.07.2019 | Notice to LIC for claims of Interest workings |
List of documents filed on the side of the Opposite Parties:-
Ex.B1 |
| Policy Documents Bearing No.880731491 |
Ex.B2 |
| Premium History |
Ex.B3 |
| Ombudsman award |
Ex.B4 |
| Email Correspondence to Complainant |
Ex.B5 |
| Settlement of Maturity claim |
Ex.B6 |
| Letter from Agent Yashwant Madhar Pate |
Ex.B7 |
| Memo of Maturity claim as per award |
S. NANDAGOPALAN T.R. SIVAKUMHAR B.JIJAA
MEMBER II MEMBER I PRESIDENT
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