Delhi

East Delhi

CC/190/2021

MANJU KALA - Complainant(s)

Versus

LIC OF INDIA, THROUGH ITS BRANCH MANAGER - Opp.Party(s)

RAJEEV KUMAR KHARE

06 Feb 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110092

 

C.C. NO. 190/2021

 

	SMT. MANJU KALA W/O LT. DR. R.P. KALA R/O 120(TF) CGHS DUPLEX, VASUNDHARA ENCLAVE COLONY, DALLUPURA WARD,  DELHI-110096.	….Complainant
Versus
	LIC OF INDIA, JHANSI BRANCH THROUGH ITS CHIEF BRANCH MANAGER B.O. 1, JHANSI-284003.                        LIC OF INDIA, HEAD OFFICE MUMBAI, TRHOUGH ITS CHAIRMAN, YOGAKSHEMA, NARIMAN POINT, MUMBAI-400021	……OP1           ……OP2

Date of Institution: 12.04.2021

Order Reserved on: 13.12.2022

 Order Passed on: 06.02.2023

                       

QUORUM:

Sh. S.S. Malhotra (President)

Sh. Ravi Kumar (Member)

Ms.Rashmi Bansal(Member)

 

 

Order by : Sh. S.S. Malhotra (President)

 

 

JUDGMENT

 

            By this judgment the Commission shall dispose off the complaint of the Complainant with respect to deficiency in service & unfair trade practice by the OP in not giving the complete amount on maturity of the policy, which she had bought from OP.

Brief facts stated by the Complainant in the complaint are that she, purchased an LIC policy from the OP called ‘Jeevan Saral’ on 28/08/2009 and she was initially paying Rs. 30,625/- p.a. at quarterly intervals, which plan was subsequently changed to Rs. 1,20,100/-  and she paid this amount for 10 years and she paid total amount of Rs. 12,05,800/- to the OP. The maturity value/sum assured was 25,00,000/- and the policy was to mature on 28/08/2019, however the OP paid only 4,51,208/- to the Complainant  towards maturity amount against the promised maturity amount of 25 Lakh which is unfair trade practice under section 2(47) Consumer Protection Act, 2019 and also deficiency in service. Various letters were written to OP but it did not pay maturity amount at all. Legal notice was served in which the judgment of the Life Insurance Corporation of India Vs Consumer Welfare Association & decided on 11/12/2018, by Hon’ble National Commission was mentioned which was a case with respect to the ‘Jeevan Saral Policy’ itself and it was interalia ordered in that case by the Hon’ble National Commission that OP has to pay the maturity amount to the complainant. Although OP had replied that legal notice yet, OP did not pay complete/matured amount of the claim which amounts to deficiency in service and as such she has filed the present complaint interalia praying that OP be directed to pay complete insured amount/maturity amount with interest @12% P.A., Compensation or Rs. 50,000/- and legal expenses Rs. 50,000/-.

            OP filed its written statement alleging various relevant facts with respect to its status, functioning number of policy it had issued and the features of the policy as preliminary objection but ultimately stated that the maturity benefit under the policy is provided in the policy documents itself which explains that life insured, who would survive on the date of maturity, is paid sums equal to maturity sum assured and in this matter, the amount Rs. 25 Lakh was death sum assured and not the maturity sum assured. It is further stated that written policy documents was given to policy holder immediately after the issuance of policy and the column against maturity sum assured, was blank/not printed inadvertently and it was for the policy holder to bring the same to the notice of policy issuing office to get the same corrected and since the column of amount sum assured at the time of maturity is blank, there is no deficiency in the service of the OP. It is further stated that ‘Jeevan Saral Policy’ was introduced for the sale only after complying all the requirements of insurance regulators i.e. IRDAI and the premium applied for providing insurance coverage is as per settled principles In the present case the maturity sum assured with bonus came to Rs. 4,51,208/- payable to policy holder and was paid and therefore complaint of the Complainant is liable to be dismissed.       

            The replication was filed by the Complainant in which facts of written statement were denied & the facts of complaint were reiterated. Both the parties have filed their respective evidence & written submission. The Commission has heard the arguments and perused the record.

            It is not disputed that complainant had paid Rs. 1,20,100/- per year and has paid a total sum of Rs. 12,05,800/- to OP and this amount was not returned to the Complainant by the OP. Before coming to the facts, the relevant para of the judgment Life Insurance Corporation of India Vs Consumer Welfare Association is necessary to be reproduced & it reads as follows.

“I have given a thoughtful consideration to the arguments advanced by the learned counsel for the appellant and have examined the material on record. First of all, it is seen that the Policy was issued on 28.03.2004 and was valid upto 28.03.2015. It may be true that the policy is issued under table 165 of the LIC, however, it has been admitted that the table was not supplied along with the policy document and therefore the insured may not be having any inkling that he may not get the amount mentioned in the policy. There was no communication made during the policy period by the insurance company mentioning the mistake in the policy document. It is only after the policy has matured and question of payment of maturity amount cropped up, the insurance company has raised the issue of typing error in the policy document. Policy is a contract of utmost good faith and parties are bound by this contract. If any typing error is brought to the notice of the other party by any party before the claim becomes due, it can definitely be considered with the consent of both the parties. The judgment of this commission in LIC versus Anil Kumar Jain (supra) does not seem to be applicable in the present case as the typographical error in LIC versus Anil Kumar Jain (Supra) was in respect of the amount of premium and not in respect of the amount of claim. Similarly, the other judgment relied upon by the appellant in respect of the amount of claim where a '0' was typed beyond the figure of 2,50,000/- to make it 25 lacs also does not seem to help the appellant as in this case, the single premium of Rs. 104975/- was only Paid and an amount of rupees 25 lacs was claimed on the basis of the figure quoted in the policy. This Commission accepted the typing mistake and observed that the figure of 2,50,000/- was wrongly typed as 25 lacs. Obviously, a One Time Premium of 104975/- cannot yield a payment of rupees 25 lacs and Rs.2.5 lacs was found to be reasonable. Therefore, the typographical error was accepted in the matter. In the present case, first of all, the typing error is not with respect to any particular figure but the mistake is in respect of two figures which have been allegedly interchanged due to typing mistake. Though the learned counsel for the appellant has tried to justify his assertion on the basis of table 165 of the LIC, however, one has to see the comparative logic for the places of these figures. The complainant has paid Total premium of Rs. 13,65,100/- and therefore it stands to logic that the complainant may get about rupees 25 lacs. Further this does not stand to logic that after paying Rs. 13,65,100/-, one gets only Rs.3,94,900/- as maturity amount along with some loyalty addition which in the present case is only Rs. 1,67,832/- Moreover, the question is whether the complainant would have gone for the policy, had he known that on maturity he will get only Rs.3,94,900/- after paying regular premium of Rs.1,24,100/- per year. During the currency of the policy. The insurance company did not point out any mistake in the policy, nor sent any corrected policy document. Now that the policy has matured and the claim becomes due on maturity, the insurance company is claiming the defect in the initial contract. The mistake or typographical error in the contract does not seem to be obvious and even if the mistake is justified on the basis of table 165 of the LIC, It is seen that this table was not part of the policy and was not supplied along with the policy document, therefore, the complainant may not be bound by this table, rather, the complainant and the insurance company both are bound by the written contract of the policy as mentioned in the policy document. The policy contact has to be interpreted in the terms as agreed in the contract by the contracting parties.”

The Commission apart from the going through this judgment also has gone through the policy. OP has raised contention that amount of sum assured was left blank inadvertently and it was the duty of the Complainant to get it rectified. This contention of the OP is not well found, in view of the judgment as relied upon by the Complainant here in above. Particularly when the above judgment was also with respect to ‘Jeevan Saral Policy’ and the contention w.r.t. typographical mistake has already been dealt with by the Hon’ble National Commission and therefore this contention of OP cannot be appreciated at all. The Commission is also of the opinion that if column was left blank then why the OP has paid 4,51,208/- and if paid, then on what basis & how he calculated the said amount, as the OP, then have to pay nothing to the complainant, as per ‘Blank Space’. Further no one would pay Rs. 1,20,100/- per year or would pay total amount of Rs. 12,05,800/- in 10 years, if he/she would have been told in the beginning that she would receive Rs. 4,51,208/only after 10 years. It is not disputed at all that the policy of the OP, were not Unit Linked Investment Policy and its sum assured was depending on the fluctuation of share market from time to time. It is nowhere mentioned in the pleadings. Had this fact would have been clarified and had there been any alleged mis-printing, then this policy would not have been sold what to talk about, of having received same appreciation in the form of awards as claimed. The OP has no explanation as to why an incomplete policy has been issued. It cannot come in the mind of Complainant that the Policy Paper is incomplete. The OP is huge concern having multiple office & official & might have sold number of such policies. All such officer/official are at the better footing than that of the complainant and can realize timely that a mistake has happened. High handedness and negligence & inaction on the part of OP is writ large on the face of it as despite the fact that Hon’ble National Commission as decided the controversy, the OP neither is filing any documents on record inter-alia stating that they have challenged that judgment nor they have placed any judgment to show that the case of Hon’ble National Commission i.e. judgment has been set aside or why that judgment is not being complied with. There is total silence of the OP on that aspect.

Therefore in view of the judgment has relied upon by the Complainant, and there being no rebuttal of that judgment, this Commission is of the opinion that there is deficiency on the part of the OP w.r.t. tendering the service of the OP to the policy holder and it also amounts to unfair trade practice being adopted. It is fit case where exemplary cost should be imposed upon the OP however the Commission is restraining itself.  Accordingly it is ordered that OP would pay Rs. 25 Lakh to the Complainant along with vested bonus interest @ 9 % from the date of filing the complaint till actual payment along with compensation of Rs. 40,000/- and legal charges of 25,000/-. This amount is payable to the Complainant within one month of date of receiving this order, failing which the OP would also pay the interest @ 9 % on the compensation and legal expenses part also.     

Copy of this order be sent to both parties free of cost as per law.

The order contains 09 pages each bears our signature.

File be consigned to Record Room after necessary compliance.