Tamil Nadu

North Chennai

CC/92/2016

S.MohanaRangam - Complainant(s)

Versus

LIC of India - Opp.Party(s)

Party In Person

10 Apr 2018

ORDER

 

                                                            Complaint presented on:  25.05.2016

                                                                Order pronounced on:  10.04.2018

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHENNAI (NORTH)

    2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

        PRESENT: THIRU.K.JAYABALAN, B.Sc., B.L.,        PRESIDENT

              THIRU. M.UYIRROLI KANNAN B.B.A., B.L.,      MEMBER - I

 

TUESDAY THE 10^th   DAY OF APRIL 2018

 

C.C.NO.92/2016

 

 

S.Mohanarangam,

6/177, “A” 69^th Street,

Sidco Nagar, Villivakkam,

Chennai – 600 049.

                                                                                    ….. Complainant

 

..Vs..

 

1.Chief in Charge(Actuarial),

Life Insurance Corporation of India,

Annasalai, L.I.C.Buildings,

Chennai – 600 002.

 

2.Manager, (Claims),

CBO-27 (70U),

Life Insurance Corporation of India,

Royapuram branch,

Royapuram,

Chennai – 600 013.

 

3.Manager (CRM),

LIC of India, Divisional Office,

C-47, II Avenue, Annanagar Plaza,

Anna Nagar, Chennai – 600 040.

4. Regional Manager, Grievance Redressal,

L.I.C.of India, Zonal Office,

Annasalai, L.I.C.Buildings,

Chennai – 600 002.

 

5. The Insurance Ombudsman,

O/o the Insurance Ombudsman,

Fathima Akhtar Court, 4^th Floor,

453 (Old No.312) Anna Salai, Teynampet,

Chennai – 600 018.

.....Opposite Parties

Date of complaint                                 : 06.06.2016

Counsel for Complainant                      : Party in Person

Counsel for1 to 4 Opposite Parties          : M.B.Gopalan Associates,

                                                                   N.Vijayaraghavan, M.B.Raghavan

 

Counsel for 5^th opposite party                 : Ex – parte (on 26.09.2016)

 

 

O R D E R

 

BY PRESIDENT THIRU. K.JAYABALAN B.Sc., B.L.,

          This complaint is filed by the complainant to direct the 2^nd opposite party to pay the balance sum of Rs.58,547/- towards Maturity amount and also to pay compensation of Rs.41,453/- towards mental agony with cost of the complaint u/s 12 of the Consumer Protection Act.1986.

1.THE COMPLAINT IN BRIEF:

          The complainant availed Jeevan Saral Policy from the opposite parties and for the same he had submitted proposal application on 31.01.2006. The sum assured of Rs.1,00,000/-. The premium amount of Rs.1,225/- payable on quarterly basis for a term of 10 years. The complainant fully paid the premium and the policy matured on 28.01.2016.

          2. On maturity of the policy, the 2^nd opposite party remitted a sum of Rs.41,453/- in the complainant account through ECS, after deducting a sum of Rs.58,547/- out of the Matured sum assured Rs.1,00,000/-. The complainant remitted a sum of Rs.49,000/- towards premium alone and however less than the premium amount paid by the complainant was only paid to him. Thereafter, the complainant wrote to the 3^rd and 4^th opposite parties about his grievance. The 3^rd opposite party wrote to the complainant requiring him to furnish copy of the policy and email address. The complainant also sent those particulars to him and however no reply from them.

          3. The complainant received a letter dated 05.05.2016 from the 2^nd opposite party  that in Jeevan Saral Policy, the Maturity Sum Assured is entirely different from the Death Sum Assured which is wrongly typed in the policy bond and the error intimated to the complainant by registered letter dated 30.09.2015 well before the date of Maturity Payment. The complainant approached the 5^th opposite party for redressal and no relief granted by him. The opposite parties failed to pay the Maturity Sum of Rs.1,00,000/- to the complainant is deficiency on the part. Hence the complainant filed this complaint to direct the 2^nd opposite party to pay the balance sum of Rs.58,547/- and also to pay compensation of Rs.41,453 towards mental agony with cost of the complaint. 

4. WRITTEN VERSION OF THE  OPPOSITE PARTIES 1 TO 4         IN BRIEF:

          The opposite parties admits that the complainant had availed Jeevan Saral Policy on the basis of a proposal dated 31.01.2006 for a sum assured of Rs.1,00,000/-. The premium amount of Rs.1,225/- for quarterly for a term of 10 years. The life insurance policy is intended to cover the life of the assured for a specified sum in the event of death during the policy period. There can be no legitimate expectation of return of policy in the event of survival of the policy holder. In respect of the Jeevan Saral Policy, the scheme was laid down under circular dated 17.02.2014 would reveal the death benefit applicable.

          5. The complainant was aged 51 at the time of availing the policy for a period of 10 years. The death benefit being 250 times, it was correctly mentioned as  Rs.1,00,000/-  in the policy. The Maturity Benefit sum assured corresponding to age 51 and term of 10 years is 8128 x 400 / 100 = 32,512/-. The said amount was wrongly mentioned as Rs.1,00,000/- while issuing the policy. The policy issued to the complainant contains a genuine mistake. The error in the policy was noticed and by letter dated 29.09.2015; the complainant was informed to handover original policy document to make necessary endorsement. The correct sum assured was paid to the complainant’s bank account on 17.02.2016. The complainant cannot take unfair advantage of the typographical mistake in the policy to claim amount which is not payable. The opposite parties had not committed any deficiency in service and pray to dismiss the complaint with costs. 

          6. The 5^th opposite party called absent and he was set ex – parte.

7. POINTS FOR CONSIDERATION:

          1. Whether there is deficiency in service on the part of the opposite parties?

          2. Whether the complainant is entitled to any relief? If so to what extent?

8. POINT NO :1 

          The admitted facts are that the complainant had availed Jeevan Saral Policy on the basis of a proposal dated 31.01.2006 for a sum assured of Rs.1,00,000/- and  the premium of Rs.1,225/- for quarterly for a term of 10 years and the policy issued by the 2^nd opposite party is marked as Ex.A2 and the complainant also paid the quarterly premium for all the 10 years and on Maturity of Policy, the 2^nd opposite party paid a sum of Rs.41,453/- through ECS to the complainant bank account.

          9. The complainant would contend that he had paid a sum of Rs.49,000/- towards premium and in Ex.A2 policy the Maturity sum assured is 1,00,000/- and without paying the said Maturity Assured Sum and paid only a sum of Rs.41,453/- towards the policy is deficiency on their part and therefore the 2^nd opposite party is liable to pay the Maturity amount to him.

          10.  The opposite parties 1 to 4 would contend that the  Maturity Benefit sum assured corresponding to age 51 and term of 10 years is 8128 x 400 / 100 = 32,512/- and the said amount was wrongly mentioned as Rs.1,00,000/- while issuing the policy and hence the policy issued to the complainant contains a genuine mistake and the error in the policy was noticed and by letter dated 29.09.2015 to the complainant was informed to handover original policy document to make necessary endorsement and the correct sum assured was paid to the complainant’s bank account on 17.02.2016 and the complainant cannot take unfair advantage of the typographical mistake in the policy to claim amount which is not payable.

          11. Admittedly the 2^nd opposite party issued Ex.A2 policy to the complainant. The said policy contains Matured Sum Assured Rs.1,00,000/-, Death Benefit Sum Assured Rs.1,00,000/- and Accident Benefit Sum Assured Rs.1,00,000/-. The Death Benefit and the Accident Benefit is not applicable to the complainant and he is entitled only Matured Benefit. The opposite parties would argue that the policy was issued by mistake mentioning Matured Sum Assured Rs.1,00,000/- and as per Jeevan Saral Policy circular dated 17.02.2004, the complainant is entitled only a sum of Rs.32,512/- which was already paid to him. In the policy, it has been clearly stated Matured Sum Assured Rs.1,00,000/-. The opposite parties 1 to 4 are expected to issue the policy according to their terms and conditions. Hence in this case also the policy issued to the complainant subject to their terms and conditions. After issuing the policy they cannot say that the maturity amount was mentioned by mistake.

12.  Further the opposite parties also would contend that to rectify the error in the policy wrote a letter dated 29.09.2015 by registered post to the complainant. The complainant specifically denies that he had not received any such letter. The alleged letter marked as Ex.B4 by the opposite party. However the opposite parties have not filed any acknowledgement of the complainant that he had received the said letter. Therefore, we accept that Ex.B4 letter was not delivered to the complainant. The complainant relied on an order of the National Commission reported in III (2012) CPJ 250 (NC) (Life Insurance Corporation & anr vs Sunil Kumar Paliwal) to support his case. The National Commission held in that case in para 6 as follows:

Even if there was a typographical mistake as claimed by the petitioner corporation, the same was committed by the employees of the petitioner corporation and it cannot be used to the disadvantage of the Respondent/ complainant by unilaterally changing the terms of the contract after a gap of 12 years. Undoubtedly, the petitioner corporation is likely to suffer some under recovery but in all fairness, the petitioner corporation must bare it accepting the responsibility for mistake of its employees.

13. In the case in hand also the policy was commenced on 28.01.2006 and matured on 28.01.2016. According to the opposite parties only on 29.09.2015 they wrote to the complainant after a gap of 9 years. Therefore following the above ratio of the National Commission for the mistake committed by the opposite parties they have to suffer. Hence the policy is very clear about the Matured Sum Assured Rs.1,00,000/- and failure to pay said amount to the complainant after maturity period is deficiency on the part of the opposite parties and therefore we hold that the 2^nd opposite party has committed deficiency in service to the complainant. No relief sought against the opposite parties 1,3 and 4 in the complaint.

14. POINT NO:2

The complainant is entitled for the Matured Sum Assured Rs.1,00,000/- as per Ex.A2 policy from the 2^nd opposite party. The complainant was paid only sum of Rs.41,453/- in respect of  the policy, leaving that the balance sum is Rs.58,547/-. Hence the 2^nd opposite party can be directed to pay the balance sum of Rs.58,547 to the complainant. Due to the deficiency committed by the 2^nd opposite party the complainant suffered with mental agony is accepted and for the same, the 2^nd opposite party can be directed to pay a sum of Rs.25,000/- towards compensation, besides a sum of Rs.5,000/- towards litigation expenses. No relief sought against the opposite parties 1,3,4 and 5 in the complaint.

In the result the Complaint is partly allowed. The 2^nd Opposite Party is ordered to pay a sum of Rs.58,547/- (Rupees fifty eight thousand five hundred  and forty seven only) towards the maturity amount to the Complainant and also to pay  a sum of Rs. 25,000/- (Rupees twenty five thousand  only) towards compensation for mental agony, besides a sum of Rs. 5,000/- (Rupees five thousand only)  towards litigation expenses. No relief sought against the opposite parties 1,3,4 and 5 in the complaint.

The above amount shall be paid to the complainant within 6 weeks from the date of receipt of the copy of this order failing which the above said maturity amount and compensation amount shall carry 9% interest till the date of payment.

Dictated to the Steno-Typist transcribed and typed by her corrected and pronounced by us on this 10^th  day of April 2018.

 

MEMBER – I                                                                PRESIDENT

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1 Dated 28.01.2006                  Copy of First Premium Receipt

 

Ex.A2 dated 08.08.2006                   Copy of LIC Jeevan Saral Policy Agreement

 

Ex.A3 dated 30.09.2015                   Copy Status Report of Policy No.717797158

 

Ex.A4 dated 01.03.2016                   Grievance Redressal Officer, LIC of India

                                                       Division II Anna Nagar.

 

Ex.A5 dated 02.03.2016                   Acknowledgement

 

Ex.A6 dated 14.03.2016                   Copy ofReply letter from Regional Manager, LIC

                                                      of India, Anna Nagar.

 

Ex.A7 dated 21.03.2016                   Grievance Redressal Officer, LIC of India

                                                     Division II Anna Nagar.

 

Ex.A8 dated 31.03.2016                   Letter  addressed to ombudsman

 

Ex.A9 dated 06.04.2016                   Reply from the ombudsman

 

Ex.A10 dated 07.04.2016                 Letter addressed to the 2^nd opposite party

 

Ex.A11 dated 08.04.2016                 Annexure VI- A addressed to ombudsman

 

Ex.A12 dated 25.04.2016                 Grievance Redressal Officer, LIC of India

                                                     Division II Anna Nagar.

Ex.A13 dated 25.04.2016                 Letter addressed to the 2^nd opposite party

 

Ex.A14 dated 30.04.2016                 Reply by the 2^nd opposite party

 

Ex.A15 dated 02.05.2016                 Letter addressed to the ombudsman

 

Ex.A16 dated 05.05.2016                 Letter addressed to the 2^nd opposite party

 

Ex.A17 dated 05.05.2016                 Ombudsman Award

 

Ex.A18 dated 06.05.2016                 Letter addressed to the ombudsman

                   

LIST OF DOCUMENTS FILED BY THE 1 TO 4  OPPOSITE PARTIES :

 

Ex.B1 dated 12.02.2004                   Master Circular and Chart

 

Ex.B2 dated 31.01.2006                   Proposal

 

Ex.B3 dated 08.08.2006                   LIC Jeevan Saral Policy

 

Ex.B4 dated 29.09.2013                   Letter to the complainant

 

Ex.B5 dated 30.04.2016                   Reply to the complainant

 

Ex.B6 dated 23.05.2016                   Reply to the complainant

 

 

 

MEMBER – I                                                               PRESIDENT