Passed  by Shri Atul D. Alsi, Hon’ble President.

1. The complainant filed complaint case against non disbursement of insurance amount of new policy bearing no. 4001387222 and thereby claiming the disbursement of amount above policy along with compensation for mental torture 2 corers.

Facts  of  the case  in short

2. The complainant and family members have their saving  account  with O.P.NO.2 bank and as per recommendation from op no. 2 the complainant availed a policy bearing no.4000169869 for the sum assured amount of Rs.5,00,000/- 19.3.2010 to be matured on 18.3.2020. Before maturity on 23.01.2020 and 24.1.2020 the complainant submitted the documents before the closer on maturity of policy and the O.P.NO..1 assured the full amount will be credited in complainant account. But before the date of maturity the O.P.NO.1 insisted the complainant to have another insurance policy for 2/3 matured value of previous policy and told that the entire maturity amount could not be credited as bound by terms and conditions of previous policy. The O.P.No.1 told this fact for the first time. The op one also told failing to deposit 2/3 amount in another policy from matured policy the matured amount will be forfeited, therefore the complainant was forced to purchase another new policy for the 2/3 maturity amount of Rs.4,48,903.89 bearing no.4001387222. The complainant issued letter not to accept the new policy within reasonable lock in period but the O.P.No.1 and 2 failed to disburse the maturity amount, hence it is deficiency of service therefore the complaint has been filed.

3. After filing of complainant notices were issued to the O.P. No.1 and 2. The O.P. No.1 has appeared through their counsel and filed their written statement. The case is proceeded exparte against the O.P. No.2 as per order dated 28.6.2021.

4. The O.P.No.1 filed reply and denied allegation and admitted the two policies bearing No.4000169869 and policy No.4001387222 issued to the complainant. The complainant in accordance with clause NO.6(2) of IRDA regulation 2002 has not been duly complied to review the policy decision to return within 15 days free lock period has not been availed in respect of  subsequent policy and chooses to retain the policy issued for the entire term which clearly prove that he was satisfiied with said policy. As per terms and condition of policy on maturity of old policy the complainant had option either release 1/3 of the value and the balance fund would be utilised to purchase the annuity or to utilise the entire fund to purchase annuity.   The complainant has been paid 1/3 maturity value of 224418.08 by NEFT in his account and balance amount of 4,48,903/- has been invested to purchase annuity as per choise of complainant.  At the time of purchase of  new policy bearing No. 4001387222 the complainant was provided free look period of 15 days after receipt of documents to review the  policy and return the policy with 15 days  look in period and thereafter the complainant is receiving regular monthly payout every month till date and no protest and dispute has been raised in respect of payouts. The complaint want to receive balance funds of 4,48,903.89 which clear contravention of regulations and circulars issued by IRDA as well as conditions of policy in question.  In view of terms and condition the commission has no jurisdiction to entertain the present complaint therefore complaint deserve to be dismissed with cost.
5. The counsel for complainant argued that the complainant issued letter of cancellation of policy issued subsequently bearing no 4001387222 after receipt of policy within look in period and after maturity of first policy by issuing letter dated 20.3.2020 filed as annexure-3 with complainant that complainant shall get full amount of maturity therefore non payment of maturity amount to the complainant does amount to deficiency of service. At the time of availing first policy on 19.3.2010 bearing policy no 400169869 and after expiry of 10 years he was put under completion to avail new policy for which the maturity amount of 4,48,903.89  was retained  and  proper literature to that effect has not been given therefore it amounts to deficiency  and negligence of service on the part of O.P.No.1.

6. The counsel for op no.1 submitted that the sole grievance is limited to the extent that he wants to receive the balance fund instead of regular monthly payout which is clear contravention of regulation and circulars issued by IRDA as well as terms and condition of policy  the complaint has not raised any grievance within free lock period of 15 days in respect of the new policy bearing no.4001387222  the subsequent policy was issued on 14.5.2020 and the complainants grievance for cancellation of policy was received by O.P. on dated 29.6.2020 therefore no request for cancellation was made by complainant during free look period and therefore the complainant choose to receive regular monthly payouts every month which clearly shows the complainant was satisfied with policy.  Demand of complainant to refund entire amount of annuity in lumsum is beyond the scope of insurance contract and regulation laid down by IRDA as per clause no.7 of first policy wherein it is clearly mentioned that on maturity of policy the complainant has option to either to receive 1/3 of fund value and remaining fund would be utilised to purchase  the annuity by any annuity provider, therefore the complaint has no merit in his submission and liable to dismissed with cost.

                                                                        Reasoning

7. The complainant purchase first policy bearing No.400169869 on dated 19.3.2010 which is matured after 10 years of policy terms and the op no.1 has paid 1/3 maturity value of 2,24,418.89 to the complaint on 23.3.2020 and remaining 2/3 amount has been invested in another policy bearing no. 4001387222 on 14.5.2020. The complainant issued letter to O.P on dated 20.3.2020  before maturity of first  policy to pay full amount of maturity and not to invest 2/3 amount in another insurance policy. The complainant has also issued the letter of refusal to accept the new policy as soon as the receipt of subsequent policy by post within reasonable  time but the O.P. has failed  to consider the request of cancellation  of policy as per terms and condition No.2 of policy “ free look period “,  the compliant issued a letter on dated 20.3.2020 in respect of release of full amount before maturity of 1^st policy and subsequently after receipt of documents of new policy bearing No. 4001387222 on dated 29.6.2020. It is practise of insurance company to send the documents of policy after gap of some period of time from the date of actual commencement of policy.  The insurance company has not filed any evidence of date of receipt  of documents of new policy on record to read the period of 15 days “ look –in-period”   to prove its defence that the complainant has not opted to cancel the subsequent new policy within free look in period , therefore non disbursement of 2/3 matured amount of the old policy bearing No. 400169869 does amount to deficiency of service hence O.P.No.1 is directed to pay the 2/3 amount of maturity of the old policy bearing No. 400169869 which is invested in new policy bearing No. 4001387222 to the complainant alongwith Rs.10,000/- towards mental torture and Rs.10,000/- as per  following order.

                                                            O R D E R

1. Complaint is partly allowed.
2. O.P.Nos.1 is directed to pay  2/3 amount of maturity of  the old policy bearing No. 400169869 to the complainant which is invested in new policy bearing No. 4001387222.
3. O.P.Nos.1 is directed to pay Rs.10,000/- towards mental torture and Rs.10,000/- towards the cost of litigation.
4. No order against O.P.No.2.

Copy of order be furnished to both the parties free of cost.