Order dictated by:

Sh. Anoop Sharma,Presiding Member

1.  Balkar Singh complainant has brought the instant complaint under section 11 & 12 of the Consumer Protection Act on the allegations that  complainant obtained life Insurance policy bearing No. 470913415 with commencement date 13.7.2001 with sum assured Rs. 1,00,000/- from the opposite party. The date of maturity of the said policy is 13.7.2016. As per policy the complainant was entitled to get sum insured amount of Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus on the full sum insured amount at the time of its maturity. Apart from this the opposite party was also under obligation to pay Rs. 25,000/- to the complainant after a gap of five years from the commencement of policy and thereafter another Rs. 25,000/- was to be paid to the complainant after a gap of 10 years  i.e. in total a sum of Rs. 50,000/- was to be paid to the complainant during existence of the policy. At the time of maturity of the policy, the opposite party was under obligation to pay sum insured Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus accrued on sum insured i.e. in all a total sum of Rs. 2,08,000/- to the complainant. As per policy the opposite party paid Rs. 25000/- on 5.8.2016 to the complainant vide cheque No. 0523433 and thereafter another Rs. 25,000/- was also paid by the opposite party on 13.7.2001 vide cheque No. 0166933 to the complainant.  It is pertinent to mention that in this policy the sum insured amount was Rs. 1,00,000/- only whereas the opposite party has received Rs. 1,50,000/- from the complainant as premium of this policy. In this way the opposite party has received Rs. 50,000/- in excess from the complainant.  The policy purchased by the complainant has been matured on 13.7.2016 and on maturity the complainant was entitled to Rs. 2,08,000/- i.e. Rs. 1,00,000/- as sum insured and Rs. 1,08,000/- as bonus on sum insured amount). But the complainant was surprised to receive a letter from the opposite party in which it has been mentioned that the opposite party is going to pay Rs. 1,58,000/-  only to the complainant instead of Rs. 2,08,000/-. In this way the opposite party is going to pay Rs. 50,000/- less to the complainant inspite of the fact that the opposite party has also received Rs. 50000/- in excess from the complainant . The complainant vide letter dated 18.7.2016 requested the opposite party to disburse the full amount, but to no avail. Thereafter the complainant served a legal notice dated 26.7.2016 calling upon the opposite party to disburse the full amount, but the opposite party neither denied nor replied by the opposite party and it tantamounts to the admission on the part of the opposite party. Vide instant complaint, complainant has sought for the following reliefs:-

1. Opposite party be directed to pay Rs. 1,00,000/- to the complainant i.e. Rs. 50,000/- paid less from sum insured amount and Rs. 50000/- received by the opposite party in excess from the complainant.
2. Opposite party be also directed to pay compensation as well as litigation expenses to the complainant.

Hence, this complaint.

2.       Upon notice , opposite party appeared and filed written version in which it was submitted that complainant himself mentioned that sum insured was Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus, which has to be paid at the time of maturity of the policy in question. It has further been admitted that a sum of Rs. 50000/- i.e. Rs. 25000/- each has been paid to the complainant, firstly after a span of five years from the date of commencement of the policy and secondly after a span of ten years from the date of  commencement of the policy. Meaning thereby that Rs. 50000/- of the sum insured has already been paid to the complainant in two installments of Rs. 25000/- each during the subsistence of the policy and  the remaining amount of Rs. 50000/- of the sum insured  has been paid alongwith a bonus of Rs,. 1,08,000/-. In total Rs. 1,58,000/- i.e. remaining of sum insured plus accrued bonus on maturity as per terms and conditions of the policy and the benefits under the policy in question has been duly paid to the complainant and the discharge voucher with regard to payment of benefits has been duly signed by the complainant without any protest of short payment. It was submitted that premium has been paid by the complainant as per the terms and conditions of the policy in question. It was denied that any excess payment of premium of Rs. 50000/- was made by the complainant. While denying and controverting other allegations, dismissal of complaint was made.

3.       In his bid to prove the case Sh.Neeraj Brahmi,Adv.counsel for the complainant tendered into evidence duly sworn affidavit of the complainant Ex.CW1/A alongwith documents Ex.C-1 to Ex.C-22 and closed the evidence on behalf of the complainant.

4.       To rebut the aforesaid evidence Sh.Subodh Salwan,Adv.counsel for the opposite party tendered into evidence affidavit of Sh.Rajinder Singh, Manager Legal Ex.OP1/A, copy of status report of policy Ex.OP1/1, copy of letter Ex.OP1/2, copy of discharge voucher Ex.OP1/3, copy of policy bond alongwith terms and conditions Ex.OP1/4  and closed the evidence on behalf of the opposite party.

5.       We have heard the ld.counsel for the parties and have carefully gone through the record on the file.

6.       Ld.counsel for the complainant has reiterated the facts narrated in the complaint and has submitted that complainant obtained life Insurance policy bearing No. 470913415 commencing from 13.7.2001 with sum assured Rs. 1,00,000/- from the opposite party. The date of maturity of the said policy is 13.7.2016. Under this policy the complainant was entitled to get sum insured amount of Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus on the full sum insured amount at the time of its maturity as well as  opposite party was also under obligation to pay Rs. 25,000/- to the complainant after a gap of five years from the commencement of policy and thereafter another Rs. 25,000/- was to be paid to the complainant after a gap of 10 years  . At the time of maturity of the policy, the opposite party was under obligation to pay sum insured Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus  on sum insured i.e. in all a total sum of Rs. 2,08,000/- to the complainant. The opposite party paid Rs. 25000/- on 5.8.2016 to the complainant vide cheque No. 0523433 and Rs. 25,000/- was also paid by the opposite party on 13.7.2001 vide cheque No. 0166933 to the complainant.  Complainant has alleged that under this policy the sum insured amount was Rs. 1,00,000/- only whereas the opposite party has received Rs. 1,50,000/- from the complainant as premium of this policy and in this way the opposite party has received Rs. 50,000/- in excess from the complainant.  The policy purchased by the complainant has been matured on 13.7.2016 and on maturity the complainant was entitled to Rs. 2,08,000/- i.e. Rs. 1,00,000/- as sum insured and Rs. 1,08,000/- as bonus on sum insured amount). However, the opposite party only paid Rs. 1,58,000/-  to the complainant instead of Rs. 2,08,000/- as assured by the opposite party. Ld.counsel for the complainant has alleged that all this amounts to deficiency in service on the part of the opposite party.

7.       On the other hand  opposite party has repelled the aforesaid contentions of the complainant on the ground that complainant himself mentioned that sum insured was Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus, which has to be paid at the time of maturity of the policy in question. It was admitted that a sum of Rs. 50000/- i.e. Rs. 25000/- each has been paid to the complainant, firstly after a span of five years from the date of commencement of the policy and secondly after a span of ten years from the date of  commencement of the policy. Meaning thereby that Rs. 50000/- of the sum insured has already been paid to the complainant in two installments of Rs. 25000/- each during the subsistence of the policy and  the remaining amount of Rs. 50000/- of the sum insured  has been paid alongwith a bonus of Rs,. 1,08,000/-. In total Rs. 1,58,000/- i.e. remaining of sum insured plus accrued bonus on maturity as per terms and conditions of the policy and the benefits under the policy in question has been duly paid to the complainant and the discharge voucher with regard to payment of benefits has been duly signed by the complainant without any protest of short payment. Ld.counsel for the opposite party has prayed for dismissal of the complaint.

8.       But, however, from the appreciation of the facts and circumstances of the case, it becomes  evident that the  complainant obtained the policy bearing No. 470913415 commencing from 13.7.2001 with sum assured Rs. 1,00,000/- with maturity date was 13.7.2016. It was the case of the complainant that the sum insured of the policy was Rs. 1,00,000/- alongwith Rs. 1,08,000/- as bonus on the full sum insured amount. It was further the case of the complainant that opposite party was also under obligation to pay Rs. 25000/- after a gap of  five years  and another Rs. 25000/- was to be paid to the complainant after a gap of 10 years.  The complainant has received Rs. 25000/- on 5.8.2016  as well as Rs. 25000/- on 13.7.2011.  However,  on  maturity of the policy the opposite party paid Rs. 1,58,000/- ( i.e. Rs. 50000/- as sum insured and Rs. 1,08,000/- as bonus of the sum insured) instead of Rs. 2,08,000/- as assured by the opposite party.  The opposite party has vehemently contended that the complainant was given Rs. 50000/- i.e. Rs. 25000/- after a span of five years from the date of commencement of the policy and secondly after a span of ten years  from the date of commencement of policy. As such, the complainant was entitled for the remaining amount of Rs. 50000/- of the sum insured alongwith a bonus of Rs. 1,08,000/-  and in total Rs. 1,58,000/-  as per terms and conditions of the policy. The complainant himself has placed on record copy of Insurance policy Ex.C-1  vide which under the heading Benefits, it is recorded that on death of the life assured during the term of the policy, the basic sum assured is payable irrespective of survival benefit/s already paid.  As such the complainant was given Rs. 1,58,000/- ( i.e. Rs. 50000/- as sum insured and Rs. 1,08,000/- as bonus of the sum insured) instead of Rs. 2,08,000/-. The complainant has received the amount of Rs. 1,58,000/- and signed the discharge voucher to the full and final satisfaction . The discharge voucher in this regard is Ex.OP1/3. The complainant never challenged this discharge/satisfaction voucher. It has been held by the Hon'ble West Bengal State Commission in case LIC & Ors. Vs. Jamuna Chanda III(2004) CPJ 181 that where the parties have entered into a full and final settlement of claim, failure to prove that signatures on discharge voucher of the complainant were taken by misrepresentation, fraud, undue influence etc, the complainant after receiving the amount in full and final settlement of claim, cannot approach the Consumer Court for payment of balance. Same view has been taken by the Hon'ble National Commission in case United India Insurance Co. Ltd.Vs. Srinivas Trading Company II(2002) CPJ 111(NC) that if the consumer executes satisfaction/discharge voucher, he cannot claim the balance amount unless he proves that the discharge/satisfaction voucher has been obtained from the complainant by way of coercion , undue influence or by using any other unfair tactis . Here in this case complainant has nowhere mentioned that this discharge voucher has been obtained by the opposite party by using any undue influence, mischief or coercion etc nor the complainant has executed this voucher exbt.OP1/3 under protest. Moreover the parties are bound by the terms and conditions of the policy and the complainant was made payment of the maturity amount as per terms and conditions of the policy. Reliance in this regard has been placed upon United India Insurance Co.Ltd. Vs. M.K.J. Corporation III(1996) CPJ 8 (SC)  of the Hon'ble Supreme Court of India that parties are bound by the terms and conditions of the policy. The insurance policy has to be construed having reference only to the stipulations contained in it and no artificial far-fetched meaning can be given to the words appearing in the policy.  So as per the terms and conditions of the policy, opposite party has rightly repudiated the claim of the complainant. Further reliance in this connection can be had in M/s. Suraj Mal Ram Niwas Oil Mills (P) Ltd-Appellant Vs. United India Insurance Co.Ltd. & another –Respondents  2010(4) RCR (Civil), wherein it has been laid down that in a contract of insurance , rights and obligations are strictly governed by the terms of the policy and no exception of relaxation can be given on the ground of equity. It has further been held in this judgement that  in construing the terms of a contract of insurance, the words used therein must be given paramount importance, and it is not open for the court to add,delete or substitute any words. In this judgement it has been further held  by the Hon’ble Supreme Court that where there is  breach of conditions of the insurance contract by the insured, the insurance company is not liable to pay compensation in case of loss. This position of law has been further fortified in the latest judgement of Hon’ble National  Commission titled as M/s. V.K. Karyana Store Vs. Oriental Insurance Co. Ltd. 2014(3) CLT page 47 wherein it has been held that it is well settled principle of law that parties are bound by terms and conditions of the insurance policy and none of the parties can seek any  relief beyond those terms and conditions.

9.       From the aforesaid discussion, it transpires that claim of  the complainant has rightly been sliced and no wrong  has been committed by the opposite party in deducting the amount of Rs. 50,000/-  which has already been paid to the complainant in two installments of Rs. 25000/- each after a span of five years as well as ten years. As such instant complaint fails and the same is ordered to be dismissed accordingly. Case could not be disposed of within the stipulated period due to heavy pendency of the cases in this Forum. Copies of the orders be furnished to the parties free of costs. File is ordered to be consigned to the record room.

Announced in Open Forum                                 

Dated : 30.5.2017