| Complaint Case No. CC/22/2018 | | ( Date of Filing : 05 Apr 2018 ) |
| | | | 1. Smt. Kanika Tikadar | | At. M.V.-12, Po. Tamasa,Ps. Malkangiri | | Malkangiri | | Odisha |
| ...........Complainant(s) | |
| Versus | | 1. In Charge, Malkangiri Satellite Office, LIC of India. SO | | At. Main Road, Near Bus Stand, Malkangiri | | Malkangiri | | Odisha | | 2. Branch Manager, LIC of India, | | NH.26, Near Bus Stand, Jeypore | | Koraput | | Odisha | | 3. Divisional Manager, LIC of India khodasingi | | Berhampur | | Ganjam | | Odisha |
| ............Opp.Party(s) |
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| Final Order / Judgement | - Brief fact of the case of the complainant is that as per personal approach of the O.P. No. 1, she opened an insurance policy named “BIMA GOLD” vide policy no. 571638965 commencing from 28.03.2006 for an amount of Rs. 832/- on quarterly mode basis for sum assured of Rs. 50,000/- with an assurance to get 15% of the sum assured on each interval of 4 years and on maturity she will receive balance deposited amount alongwith loyalty additions @ 10% and bonus @ 6% to 10% as per their projected illustrations report. It is alleged that the O.Ps have paid Rs. 7500/- for two times on each intervals of 4 year and on maturity they paid only Rs. 24,341/- but did not pay other benefits as assured by the O.P. No. 1. Thus showing deficiency in service and unfair trade practice, she filed this case with a pray to direct the O.Ps. to refund all her entitlements and Rs. 50,000/- and Rs. 10,000/- towards compensation and costs to her.
- After receipt the notice, the O.Ps represented through their Advocate and filed their counter wherein they have admitted the issuance of alleged insurance policy in favour of the complainant, but denied the allegations of the complainant contending that they have already paid 15% of the sum assured on each interval of 4 years and on maturity they also paid total premium excluding extra / premium (if any) plus Loyalty addition (if any) less money back amount paid earlier. Further they contended that they have paid an amount of Rs. 29,336/- on March, 2018 on maturity against the alleged insurance p0licy. Thus, showing their no liability, they prayed to dismiss the case against them.
- Complainant has filed certain documents in support of her allegations, whereas the O.Ps did not choose to file any documents in support of their contentions inspite of repeated adjournments were given to them. Heard from the complainant and A/R for O.Ps at length. Perused the case records and material documents available therein.
- Undisputedly, the alleged insurance policy was issued in favour of the complainant on quarterly premium mode of Rs.832/- for sum assured of Rs. 50,000/- named as “BIMA GOLD” policy commenced from 28.03.2006. It is also not disputed that the O.Ps have paid Rs. 7,500/- for twice in two intervals of 4 years each to the complainant. The allegations of complainant is that as per assurance of O.P. No. 1, she is entitled for the balance deposited amount alongwith loyalty additions @ 10% and bonus @ 6% to 10% as per their projected illustrations report, but she received only an amount of Rs. 24,341/- on maturity and the O.Ps did not pay other benefits against the alleged insurance policy. Whereas the contentions of O.Ps is that they have paid the interim benefits of Rs.7,500/- on each interval of 4 years and also paid an amount of Rs. 29,336/- on March, 2018 on the basis of the terms and conditions of the alleged insurance policy.
In this context, we have gone through the xerox copy of pass book from the period from 29.04.2010to 29.03.2018 filed by the complainant and ascertained that an amount of Rs. 7,500/- on 29.04.2010, Rs. 7,500/- on 29.03.2014 and Rs. 24,341/- on 29.03.2018 have been credited in her account through NEFT by the concerned bank from the account of O.P., but nowhere there it is mentioned that the payment amounting to Rs. 29,336/- was credited in her account by the O.P. as on March, 2018 as submitted by them. As such we think the O.Ps have paid only Rs. 24,341/- instead of Rs. 29,336/- on March, 2018. Whereas the O.Ps have not filed any single document to prove their submissions regarding payment of Rs. 29,336/- in favour of the complainant, inspite of several adjournments given to them.
- It is also ascertained from the para no. 2 of the counter version of the O.Ps, wherein they have stated that on March, 2018 they have paid Rs. 29,336/- which clearly indicates that the O.Ps are well aware and have fully knowledge about the actual payment on maturity against the alleged insurance policy issued in favour of the complainant, but without paying the actual payment on maturity, we think they have paid less amount of Rs. 24,341/- to the complainant instead of Rs. 29,336/-, which is not justified. Hence the complainant is entitled for the balance amount of Rs. 4,995/- (i.e. Rs. 29,336/ – Rs. 24,341/).
- Further from the allegations of complainant, it is also ascertained that on personal approach of the O.P.No.1 she has opened the alleged insurance policy with an assurance to receive loyalty additions @ 10% and bonus @ 6% to 10% as per their projected illustrations report is also not challenged or contradicted by the O.Ps, whereas the O.Ps are totally silent over the said matter, rather they have submitted that the said facts are beyond their knowledge, but never they have denied such allegations of the complainant.As such we feel, the O.P.No.1 must have assured the complainant to receive the loyalty additions and bonus in respect of the alleged insurance policy.Further it is ascertained from the record that the O.Ps have not filed any documents like the calculation sheet to prove the fact that they have paid the loyalty additions and bonus to the complainant and without any calculation sheet, it is quite impossible at present to hold that the O.Ps have paid all entitlements to the complainant. Hence, in our view, the complainant also entitled for loyalty additions and bonus from the O.Ps as applicable on the date of maturity.
- Further it is the duty of the O.Ps to calculate balance maturity amount payable to the complainant properly prior to disburse the said amount in her favour. But without doing so, the O.Ps have paid amount of Rs. 24,341/- instead of Rs. 29,336/- by lessening an amount of Rs. 4,995/- to the complainant on March, 2018 and so also they are supposed to release the loyalty addition and bonus as applicable in the alleged insurance policy, and in our view, the said activity of O.Ps is clear case of deficiency in service on their part, which is grave in nature. And due to non complying the actual payment to the complainant, the complainant must have suffered mental agony and physical harassment to get her legitimate benefits, for which she was compelled to file this case incurring some expenses, and in our view, the complainant is also entitled for compensation and costs from the O.Ps. Hence this order.
ORDER
The complaint petition is allowed in part. The O.Ps are herewith directed to pay balance amount of Rs. 4,995/- with interest @ 6% p.a. from the date of maturity to till the date of this order. The O.Ps are also directed to calculate the loyalty addition and bonus against the alleged policy properly and to pay the same to the complainant. Besides, the O.Ps are herewith directed to pay an amount of Rs. 3,000/- towards compensation and Rs. 1,000/- towards costs of litigation to the complainant and all the directions should be complied within 30 days from the date of receipt of this order, failing which, the balance maturity amount of Rs. 4,995/- shall carry interest @ 10% p.a. from the date of maturity to till the date of payment.
Pronounced in the open Forum on this the 2nd day of November, 2018. Issue free copy to the parties concerned.
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