Tamil Nadu

North Chennai

CC/426/2018

Adella Paul, - Complainant(s)

Versus

LIC of India - Opp.Party(s)

S.W.Kanagaraj

26 Sep 2022

ORDER

Complaint presented on  :20.11.2012         

Date of disposal             :21.09.2022

                                                                                  

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (NORTH)

@ 2^ND Floor, T.N.P.S.C. Road, V.O.C. Nagar, Park Town, Chennai -600003.

 

PRESENT: THIRU. G.VINOBHA, M.A., B.L.                            : PRESIDENT

                    TMT. KAVITHA KANNAN,M.E.,                          : MEMBER-I

                              THIRU V. RAMAMURTHY, B.A.B.L., PGDLA    : MEMBER II

 

C.C. No.426/2018

 

DATED THIS MONDAY THE 26^th  DAY OF SEPTEMBER 2022

Ms.Adella Paul,

Flat No.B-7, V.J. Flats,

No.101, Baracha Road,

Kilpauk, Chennai-600 010.

                                                                                               .. Complainant.                                                                ..Vs..

 

M/s. Life Insurance Corporation of India,

Branch 23, rep.by its Chief Manager,

No.55, Kalki Krishnamurthy Road,

Thiruvanmiyur, Chennai-600 041

                                                                       ..  Opposite party.

 

Counsel for the complainant                      : M/s. S.W.Kanagaraj and 2 other.

 

Counsel for    opposite party                    : M/s.K.Kumaran

 

 

 

 

 

ORDER

THIRU. G.VINOBHA, M.A., B.L.       : PRESIDENT

          This complaint has been filed by the complainant against the opposite parties under section 12 of the Consumer Protection Act, 1986 prays to directing the Opposite party to pay a sum of Rs.1,00,000/-without any deductions together with interest at 18% per annum from 24.03.2007 till the date the amount is paid, towards compensation for issuing a wrong policy and to pay a sum of Rs.25,000/- towards compensation for the loss of income tax rebate of Rs.25,000/- and to pay a sum of Rs.25,000/- towards damages for the physical hardship and mental tension due to delay issued of policy bearing no. 715230414 and to pay a sum of Rs.1,00,000/- towards damages for the harassment and mental tension to the complainant in respect of the policy bearing No.711815773.

This complaint was originally filed before the District Commission, Chennai (South) and taken on file in C.C. No. 279/2018.  Thereafter, the said complaint has been transferred to this Commission as per the proceedings of the Hon’ble S.C.D.R.C. and taken on file as C.C. No.426/2018.

1.THE COMPLAINT IN BRIEF:

The complainant paid a sum of Rs.1,00,000/- with the opposite party by cheque dated:24.03.2007 bearing no.045813 to obtain a ‘Money Plus Policy’ vide proposal number 10412.  The receipt of the payment and the proposal was acknowledged by the opposite party herein on 30.07.2007. The policy was not issued for months and as advised by the agent, the complainant approached the opposite party  and her attempts proved futile.  The complainant suffered a good deal in making the trips to the offices of the opposite party involving mental tension. The complainant has paid for the above policy among other benefits to get income tax rebate.  Due to the non-issue of the policy the complainant lost the income tax rebate to the tune of Rs.25,000/- for the financial year 2006-2007.  By letter dated 27.06.2008 the complainant brought to the notice of the opposite party the loss of income tax rebate of Rs.25,000/- as a result of the delay in providing the policy demanded that the opposite party pay to her interest at 8%.  The opposite party furnished the policy on 21.02.2008 bearing no.715230414.  The complainant accepted the policy not suspecting any fraud or foul play.  The complainant had no reason to believe that the terms of the policy were different from those in the policy for which she paid for initially in 2007. The complainant letter to opposite party on 20.03.2012 for the surrender of the policy bearing no.715230414 for the refund.  The policy thus issued was to cover up the delay.  The complainant receive a reply on 19.04.2012 from the opposite party.  In this policy the investment risk in investment portfolio is borne by the policy holder and further that ‘Incorrect incomplete and overstated requests will be rejected’. The opposite party dealings amounted and in respect of this the complainant claims a sum of Rs.1,00,000/- with 18% per annum from the date of investing on 24.03.2007 till the date of compensation is paid to the complainant.  Further the complainant alleged that in respect of policy No. 711815773 for Rs.1,000,000/- the opposite party sent a letter on 22.11.2011 claiming Rs.40125/- which was excessively paid to the complainant by falsely stating that the premium of June 2005 which was paid by cheque was dishonored but in fact the premium was paid in cash and therefore contended that the claim to refund excess amount is illegal and deficiency in service on the part of opposite party.

2.WRITTEN VERSION OF  OPPOSITE PARTY IN BRIEF:

The opposite party deny each and every averments made by the complainant as false and put the complainant in to strict proof of the same. The opposite party submitted that the claim of the complainant is based on her allegation that the opposite party has issued a wrong policy against her demand in the year 2007.  As per Sec 24A Consumer Protection Act the complainant if at all aggrieved ought to have filed a complaint for her alleged grievances if any within two years from the date of issue of the policy i.e. on or before 23.03.2009, but whereas the above complaint has been filed on 20.11.2012 as such above the complaint is barred by limitation.  Further submitted that the opposite party received a sum of Rs.1,00,000/- dated:24.03.2007.  Further the proposal was registered on 23.03.2007.  The opposite party required some questionnaire from the complainant on 28.03.2007.  It is submitted that the said requirements were not complied, the proposal submitted  by the complainant could  not be completed and hence the policy was not received.  The opposite party submitted that as required by the complainant a fresh proposal was received for issuing for Market Plus policy from complainant dated 21.02.2008 and policy no.715230414 was issued on 21.02.2008. It is submitted that the fresh proposal obtained for policy no. 715230414 contained the words ‘INVESTMENT RIST IN INVESTMENT PORTPOLIO IS BORNE BY THE POLICYHOLDER’.  The opposite party submitted that the complainant surrender the policy as per the terms and conditions of the policy after 5 years of the date of issue and she has expressed about her dissatisfaction regarding the functioning of the opposite party. It is submitted that the complainant ought to be aware of the rules of the policy proposal form.  Further the complainant submitted that the maturity claim for policy no.711815773 sum assured of Rs.1,00,000/- was settled on 24.12.2008 and claim amount of Rs.111550/- was paid on 28.12.2008. Further submitted that by letter dated 22.11.2011 the opposite party has claimed a sum of Rs.40375/- being the excess amount paid to the complainant under the policy no.711815773.  In respect of the policy no. 711815773 the premium due June 2005 was paid on 22.06.2005 of Rs.6845/- dated 22.06.2005 at Purasaiwalkam branch.  The same got dishonoured as per our records. Hence as per policy condition the policy was treated as paid-up due to non-payment of June 2005 premium. The paid up value was settled on maturity.  The amount of Rs.40,000/-(Survival Benefit due 12/2005) was settled on 28.12.2005. It is further submitted that the Cheque no.458305 dated 22.06.2005 Rs.6845/- paid at Purasaiwalkam branch got dishonoured.   Further the policy no.715230414 was submitted for surrender with discharge duly stamped and signed by the complainant.  Regarding the policy no. 711815773 audit recover of the excess payment of Rs.40375/- informed to the complainant vide letter dated 22.11.2011, 28.02.2012 and 14.09.2012.  Hence the opposite party for recovery for excess payment made to the complainant is valid and sustainable.  Hence there is no deficiency in service on the part of the opposite party.

3. POINTS FOR CONSIDERATION:

1. Whether there is any deficiency of service on the part of the opposite party as alleged in the complaint?

2. Whether the complainant is entitled to the reliefs prayed in the complaint. If, so to what extent?

The complainant had filed proof affidavit and documents Ex.A1 to Ex.A10 were marked on his side.The opposite party had filed written version, proof affidavit, written argument and Ex.B1 to B23 documents was marked on their side.

4. Point No.1:-

The complainant paid a sum of Rs.1,00,000/- by way of cheque dated 24.03.2007 in favour of opposite party to obtain a Money Plus Policy but the policy was not issued for several months on the after making many trips to the opposite party office and finally on 21.02.2008 a policy bearing no. 715230414 was issued and the complainant attention was not drawn to any portion of the terms of the policy and further stated that no separate payment was demanded for the policy as it was issued in replacement of original one proposed by the complainant and when the complainant opted to surrender the policy by letter dated 20.03.2012 the complainant came to know that the policy issued was market plus policy instead of money plus policy and thereby the complainant lost the income tax rebate of Rs.25,000/- for the financial year 2006-2007 and further the complainant stated that he has obtained a policy bearing no.; 711815773 for Rs.1,00,000/- with effect from 28.12.1993 and maturing on 28.12.2008 and the maturity amount was settled on 24.12.2008 and further stated that on 22.11.2011  the opposite party sent a letter claiming Rs.40125/- was excessively paid as survival benefit since the premium due for June 2005 which was paid by way of Cheque by the complainant on 23.06.2005 was dishonored and therefore the complainant alleged deficiency in service by stated that June 2005 premium was paid by cash and the claim of opposite party is false one and hence claimed various reliefs inrespect of above said policy no.715230414 and 711815773 as claimed in the complaint. 

5. But the opposite party contended that the claim is barred by limitation and further stated that the money plus policy was not issued since the complainant failed to submit the required documents like proof of residence income  and further the divisional office on 03.05.2007 required treatment details regarding Thyroidectomy of the year 1985 and Motor accident in the year 1985 with operation details which was not submitted by the complainant and hence instead a market plus policy was issued on 21.02.2008 in policy no. 715230414 and further stated that the said policy was surrendered by the complainant and the discharge was duly stamped and processed by the opposite party and further stated in respect of  policy no. 711815773 the claim amount of Rs.111550/- was paid on 28.12.2008 on maturity to the complainant and since the premium amount of June 2005 of Rs.6845/- was paid by cheque dated 22.06.2005 which was dishonoured and as per the audit report the excessive payment of Rs.40375/- was ordered to be recovered from the complainant for which the opposite party has legal right to set off against the amount due to the complainant from the opposite party and which cannot be said to be illegal or deficiency of service.

6. It is found from Ex.A1 that a sum of Rs.1,00,000/- was received from the complainant on 24.03.2007 for issue of Money Plus policy, it is found from Ex.A2 that on 21.02.2008 a market plus policy was issued for Rs.1,00,000/- instead of Money Plus Policy under Ex.A3 the complainant sent a letter to the opposite party stating that due to non  issue of money plus policy he has lost Rs.25000/- towards  income tax rebate and further stated he has not requested Market Plus Policy and claimed interest for the delayed period it is found from Ex.A4 on 20.03.2012 the complainant surrender the Market Plus Policy for which under Ex.A5 the opposite party issued a reply stating that the investment risk is borned by the policy holder.  Though the complainant stated that premium receipt for June 2005 was paid by cash and Ex.A6 receipt was issued for the same but Ex.A6 does not state the amount was paid by cash or Cheque under Ex.A7 the opposite party requested the complainant to repay the excess payment of Rs.40125/- while making maturity payment in respect of Policy No. 711815773 since the cheque paid on 23.06.2005 was dishonoured.  It is found from Ex.A9 which is status report of policy no. 711815773 that June 2005 premium was paid by cheque which was dishonoured and entire maturity payment was settled on 24.12.2008 without deducting Rs.40125/-  which has to be collected from the complainant. It is found from Ex.B3 that the said letter requesting to submit the documents regarding Thyroidectomy and motor accident in 1985 along with the operation details and the said communication was referred to only Divisional Office and there is no proof to show that the complainant was requested to submit those documents for issue of policy.  Ex.B4 is the market plus policy proposal dated 21.02.2008.  The amount paid by the complainant on 24.03.2007 is utilized by the opposite party for issue of market plus policy on 21.02.2008.  There is no explanation by the opposite party for keeping this Rs.1,00,000/- from 24.03.2007 till 21.02.2008 without returning the said amount to the complainant and hence it amounted to deficiency in service on the part of opposite party.  If really the opposite party requested the complainant certain documents and if the same was not submitted by the complainant within a reasonable time the opposite party ought to have returned the amount to the complainant which was not done by it and there was no proper explanation for the same by the opposite party.  Though the complainant has stated he has lost Rs.25,000/- as rebate in Income Tax due to non issue of policy in the year of 2006-2007 there is no documentary proof  filed to prove such contention.

7.In respect of policy No. 711815773 it is found from Ex.B23 that the premium for June 2005 was not paid by the complainant but without deducting Rs.40,125/- a  sum of Rs.111550/- was paid to the complainant as maturity benefit amount which has to be collected from the complainant for which a letter was  issued by opposite party under Ex.B19 on 28.02.2012 and such claim by the opposite party cannot be said as illegal and further the opposite party has right to set off the amount claim from the amount due to the complainant and hence that will not amount to deficiency in service in respect of Policy No. 711815773 as claimed by the complainant.

8. The complainant counsel relied upon a decision reported in (2019)1CPR 16 (SC) and contended that the medical examination must take place prior to premium being debited from the bank account of the proposer.  Further also relied upon a decision reported in (2017) 5 SCC 776 and contended that the provision of limitation Act cannot be strictly construed to disadvantage a consumer in a case where supplier of goods or service itself is instrumental in causing a delay in the settlement of the consumer’s claim.  Hence in the present case also though the amount was paid on 24.03.2007 it is found from Ex.B3 the referral date was 04.07.2010 and Ex.A3 is dated 27.06.2008 and Ex.A7 is dated 22.11.2011 and by virtue of Ex.A7 dated 22.11.2011 and by virtue of Ex.A8 and A9 the complaint is found to in time and  there is no force in the contention of the opposite party that the claim of the complaint is barred by limitation.

9. From the above said discussion it is found that in respect of policy no. 711815773 there is no deficiency in service on the part of opposite party as alleged in the complaint and the opposite party is entitled to legally set off the amount claimed by it from the amount payable to the complainant as per the principles of natural justice and as per the Law of Contract which cannot be termed as illegal or  deficiency in service.  But, it is found that in respect of Policy No. 715230414 it is found that the opposite party  has committed deficiency in service by having Rs.1,00,000/- from 24.03.2007  and instead of issuing Money Plus Policy by issuing a Market Plus Policy that too on 21.02.2008 without any valid reason or explanation except by saying that the complainant has not submitted that require documents even for which there is no proof of communication from the opposite party to the complainant and hence it amounted to deficiency in service on the part of opposite party. Point No.1 is answered accordingly.

10. Point No.2.

            Based on findings given to the Point.No.1 since there is deficiency in service on the part of Opposite party in respect of Policy No.715230414, the opposite party is liable to pay interest at 9% per annum for Rs.1,00,000/- from 24.03.2007 till  20.02.2008  and also liable to pay Rs.25,000/- towards damages for hardship mental agony caused to the complainant  due to delayed issue of Policy No. 715230414 and also Rs.5,000/- towards cost of the complaint. Point no.2 answered accordingly.

               In the result the Complaint is partly allowed.  The Opposite Party is  directed to pay interest alone at 9% per annum for Rs.1,00,000/- from 24.03.2007 till 20.02.2008 and also liable to pay Rs.25,000/- /-(Rupees Twenty Five Thousand) towards damages and mental agony caused to the complainant due to the delayed issue of Policy No. 715230414, and also Rs.5000/- towards cost of this complaint. The above amount shall be paid to the Complainant within one months from the date of receipt of the copy of this order, failing which the above said amount shall carry 9% interest from the date of order till the date of payment. 

Dictated  by President to the Steno-Typist taken down, transcribed and computerized by him, corrected by the President and pronounced by us in the open Commission on this the 26^th day of September 2022.

 

MEMBER I                                  MEMBER – II                           PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1	30.07.2007	Letter from the opposite party to the complainant regarding the ‘Money Plus Policy applied by the complainant
Ex.A2	21.02.2008	‘Market Plus’ policy No.715230414 issued by the opposite party.
Ex.A3	27.06.2008	Letter from complainant to the opposite party.
Ex.A4	20.03.2012	Letter from the complainant surrendering her ‘Market Plus’ Policy No.715230414.
Ex.A5	19.04.2012	Letter from the opposite party to the complainant in respect of the ‘Market Plus’ Policy No.715230414.
Ex.A6	23.06.2005	Renewal premium receipt issued to the complainant by the opposite party in respect of the Policy no.711815773.
Ex.A7	22.11.2011	Letter from opposite party to complainant in respect of Policy No. 711815773..
Ex.A8	06.01.2012	Letter from the counsel of the complainant in respect of Policy No. 711815773.
Ex.A9	18.01.2012	Letter from the opposite party to the complainant in respect of Policy No. 711815773.
Ex.10	28.02.2012	Letter from the opposite party to the complainant in respect of Policy No. 711815773.

 

LIST OF DOCUMENTS FILED BY THE   OPPOSITE PARTY:

 

Ex.B1		Proposal form with Agents report.
Ex.B2		Proposal review slip.
Ex.B3		Actuarial Department report.
Ex.B4		Proposal of Market Plus Policy.
Ex.B5		Market Plus Policy no.715230414 with terms and conditions.
Ex.B6		Surrender letter sent by the complainant for Money Plus Policy
Ex.B7		Surrender application sent by the complainant.
Ex.B8	19.04.2012	LIC letter of acknowledgement
Ex.B9	28.04.2012	Surrender voucher prepared by LIC.
Ex.B10	30.04.2012	LIC letter.
Ex.B11		Proposal form for Money Back Policy.
Ex.B12		Proposal Review Slip and certificate for Money Back Policy.
Ex.B13		Policy Bond for Money Back Policy.
Ex.B14		1st Survival Benefit voucher cum acknowledgment.
Ex.B15		2nd  Survival Benefit voucher cum receipt.
Ex.B16		3rd  Survival Benefit payment letter and claim forms.
Ex.B17	06.01.2012	Lawyer notice.
Ex.B18	18.01.2012	Reply sent by LIC.
Ex.B19	28.02.2012	Letter sent by LIC
Ex.B20	14.09.2012	Letter sent by LIC
Ex.B21		Premium History transaction of the complainant.
Ex.B22		Status report of the policy no.711815773.
Ex.B23		Corporation Bank account statement of LIC.

         

                                               

MEMER – I                           MEMBER – II                       PRESIDENT