Haryana

Ambala

CC/42/2018

Ravi Vohra - Complainant(s)

Versus

LIC - Opp.Party(s)

04 Jun 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM AMBALA

 

 

                                                          Complaint case no.        :  42 of 2018

                                                          Date of Institution         :  01.02.2018                                                       

                                                          Date of decision   :  04.06.2019

Ravi Vohra son of Late Sh. Jai Ram Vohra r/o H.No.7642/4, Naddi Mohalla, Ambala City.

…. Complainant.

                                                          Vs.

1.       Branch Manager, Life Insurance Corporation of India, L.I.C Building, Ambala City.

2.       The Manager (C.R.M) LIC of India, Divisional Office “Jeevan Parkash” 489, Model Town, Karnal.

         .…. Opposite Parties  

Complaint Under Section 12 of the Consumer Protection Act

Coram:       Ms. Neena Sandhu, President.

Ms. Ruby Sharma, Member.

Sh. Vinod Kumar Sharma, Member.                            

Present:       Sh. Avtar Singh, Advocate, counsel for complainant.

Sh. Shubham Aggarwal, Advocate, counsel for the OPs.

 

Order:         Smt. Neena Sandhu, President.

Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties(hereinafter referred to as ‘Ops’) praying for issuance of  following directions to them:-

1. To pay sum assured of Rs.1,00,000/- along with  up to date interest. 
2. To pay Rs. 50,000/- as compensation for mental agony and physical harassment suffered by him. 
3. To pay Rs. 11,000/- as litigation expenses.

Or

any other relief whichthis Hon’ble Forum may deemfit.

The brief facts of the complaint are that the father of the complainant namely Jai Ram Vohra during his life time had taken a life insurance policy “JEEVAN SARAL (WITH PROFITS)” vide policy no.1740507777 dated 15.03.2004  through OP No.1. The policy commenced on 15.03.2004 and was to mature on 15.03.2019 with insured/maturity amount of Rs.1,00,000/-. The father of complainant late Shri Jai Ram Vohra had paid Rs. 1225/- as quarterly premium to the OPs up to 15.01.2014, amounting to Rs.49,500/-. In the month of March, 2014, the father of complainant visited the office of OP no.1, to deposit the premium for next quarters but the official of OP No.1 refused to accept the same. The father of the complainant vide letter dated 21.09.2016, requested the OP No.1 to accept the premium but it replied that the date of commencement of the policy was 15.03.2004 and the policy has already been matured on 15.03.2014. So, the premiums are not required to be paid beyond that date. The father of complainant visited the office of OPNo.1 and made the concerned officer/official to understand that as per terms and conditions, the policy was to mature on 15.03.2019 and after maturity the Ops were liable to pay Rs. 1,00,000/- as insured /maturity  amount. He further  requested the OP No.1, to accept the premium, but it flatly refused. On 10.10.2016, the father of the complainant made a complaint against the Ops to Insurance Ombudsman. He received a letter on 25.10.2016 from Insurance Ombudsman that complaint had been forwarded to Nodal Officer. The father of the complainant had provided all the documents and fulfilled all the formalities required by Insurance Ombudsman and the matter is still pending there. Unfortunately, the father of the complainant had died on 22.11.2017. After the death of his father, complainant being nominee wrote a letter to the OP No.1 regarding the above said policy but it neither replied nor paid the insured/maturity amount of the policy to the complainant. The said act and conduct of the OPs amounts to deficiency in service. Hence, the present complaint.

2.               Upon notice OPs, appeared through counsel and filed written version raising preliminary objections qua complaint is not maintainable being false and frivolous; concealed the true material facts and no cause of action. On merits, it is stated that the father of the complainant late Sh. Jai Ram Vohra had proposed for the LIC Policy “JEEVAN SARAL-WITH PROFITS” at the age of 60 years. As per the term no.6 of the policy, which reads as under:

6. ELEGIBILITY CONDITIONS AND OTHER RESTRICTIONS:

6.1.            Minimum age of entry:  12 years (complete)      

                  Maximum age of entry:  60 years (nbd)

                  Maximum age of maturity:70 years.

                  Term                              : All terms from 10 to 35 years.

Premium                        : Minimum premium of Rs.250/-            per

 Month for entry age upto 49 years and Rs.400/- per month for entry age of 50 years and above. The premium shall be multiples of Rs.50/- per month. There will be no limit on maximum premium per month.    

Mode                : Yearly, half-yearly and quarterly. Monthly mode will be allowed under the salary saving scheme of the corporation.

                    The maximum term that can be allowed was 10 years as the maximum maturity age was 70 years. The father of complainant took the policy on 15.03.2004, at the age of 60 years and it had matured on 15.03.2014, on attaining the age of 70 years, so there was no question of accepting further premiums for the said policy. Intimation of the Maturity of the claim, was sent  to the life  assured Sh. J.R.Vohra well before the date of maturity vide letters dated 03.12.2013, 14.12.2013 and 05.03.2014 respectively. Vide said letters, he was requested to submit necessary documents and to complete the necessary formalities, so that the maturity claim amount can be paid on due date of maturity i.e. on 15.03.2014. It was also informed vide letter dated 29.04.2014 that “Maturity sum assured payable as per terms and conditions under the policy will be Rs.12,236/- (This amount is excluding loyalty addition which is added on the date of maturity) and not Rs.1 lacs as wrongly mentioned on the policy bond. The total payable amount under this policy comes to Rs.15,295/-. It is further stated that during his life time Late Sh.J.R.Vohra lodged a complaint before Insurance Ombudsman and reply was filed by the Ops alongwith supporting documents. The said complainant was disposed of by the Insurance  Ombudsman vide order letter dated 15.05.2018. There is no deficiency in service on their part, therefore, the present complaint may be dismissed with heavy costs.  

3.               To prove his version complainant tendered affidavit Annexure C/A alongwith documents as Annexure C-1 to C-9 and closed the evidence. On the other hand, Counsel for the OPs tendered affidavit Annexure OP/X alongwith documents as Annexure OP-1 to OP-9 and closed the evidence.

4.                We have heard the learned counsels for the parties and carefully gone through the case file the case laws given by the learned counsel for the parties. Written arguments filed by the learned counsel for the  OPs.

5.                 The learned counsel for the complainant has contended that after the death of the father of the complainant late Sh. Jai Ram Vohra, the complainant being the nominee had wrote a letter dated 05.12.2017 to the OP No.1, Annexure C-8, to inform the OPs about death of his father and also requested to pay the insured amount of Rs.1,00,000/- to him. However, the OPs did not pay him  the claim amount.

On the contrary, the learned counsel for the Ops has argued that the Deceased Life Assured (herein after referred to as DLA) had taken the policy in question, at the age of 60 years. As per the terms and conditions of the policy maximum term that can be allowed was 10 years, as the maximum maturity age was of 70 years. Whereas, due to typographical error the policy in question was issued for 15 years. Typographical error can be corrected at any stage. The date of commencement of the policy taken by the DLA was 15.03.2004 and as per terms and condition of the policy, after the completion of 10 years, the policy matured on 15.03.2014. Vide letter dated 26.09.2016, the DLA, during his life time, was duly informed that he had taken the policy in question at the age of 60 years and as per terms and conditions of the policy, maximum term can be allowed is 10 years and the policy had matured on 15.03.2014 and premiums were not required to be paid beyond that date. Vide letter dated 29.04.2014 the Ops informed the DLA that the correct maturity sum assured was Rs.12,236/- (This amount was excluding loyalty addition which has to be added on the date of maturity). The total payable amount under the policy was Rs.15,295/-. Since the policy in question had been issued for 15 years, due to typographical mistake and the said mistake was rectifying after coming to know about it during life time of the life assured. Therefore, OPs cannot be said to be deficient in providing services. In support of this contention, the learned counsel for the Ops has placed reliance on the order dated 19.3.2014 of the Hon’ble National Commission in the case titled as Virupaxappa I. Vs. The Senior Branch Manager, L.I.C. of India.

6.                From the perusal of the proposal form, it is revealed that DLA had opted to take the policy for sum assured of Rs.1,00,000/- for 15 years. The said fact has been found mentioned in the policy document. Keeping in mind the promise made by the OPs, the DLA started making payment of the premium and had paid the premium for a long period of ten years. He in total had paid Rs.49,500/- up to 15.01.2014. It is of a common knowledge that the insurance companies do give free look period to the insured to go through the terms and conditions of the insurance policy, resultantly, the agreed Rules/Regulations of the insurance policy cannot be one sided. As such if the insurance company expect that the insured go through the terms and conditions provided to him/her within free look period and once the said period expired, the insured cannot re-write or regal out of the same, same law is also applicable to the insurance company. As such, after a long period of 10 years when the complainant had paid the premium amount of Rs.49500/-, the insurance company cannot be heard to say that the policy was for 10 years only and the DLA was entitled to get only Rs. 15,295/-.In the case of Virupaxappa I. Vs. The Senior Branch Manager, L.I.C. of India (Supra), reliance where upon has been made by the learned counsel by the OPs, the same is related to a typographical error in the policy documents, which was not in- line with the information provided in the proposal form, whereas in the present case, the policy was issued as per the proposal form.  Meaning thereby, the policy in question was issued in line with the information provided in the proposal form. Even otherwise from the policy documents, Annexure-C1, it is evident that same has been filled in manually, so question of typographical mistake does not arise. It is not out of place to mention here that if any mistake had been made by the official of the OPs then the concerned person cannot be left to bear the consequences of the mistake/fault committed by the official of the OPs. Taking these facts into consideration, we are of the view that the Ops cannot get benefit of their own fault thus we hold that they liable to pay the sum assured of Rs. One lac to the complainant. However, OPs at liberty to deduct the amount of due premium(s). They are also liable to compensate to complainant for mental agony physical harassment caused to the complainant alogwith litigation expenses.

7.                In view of the aforesaid discussion, we hereby allow the present complaint and direct the OPs in the following manner:

1. To pay Rs.1,00,000/- along with interest @ 7% per annum from the date of filing of complaint till realization. However, from the aforesaid amount the Ops are at liberty to deduct the amount of premium fell due for the next quarters till the death of the DLA i.e. 22.11.2017.
2. To pay Rs.5,000/- as compensation on mental agony and physical harassment suffered by the complainant.
3. To pay Rs. 3,000/- as litigation expenses.

 

The Ops is further directed to comply with the aforesaid directions within the period of 30 days from the date of receipt of the certified copy of this order failing which the awarded amount shall carry interest @ 9% per annum thereafter. Certified copies of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced on : 04.06.2019

 

    (Vinod Kumar Sharma)             (Ruby Sharma)                 (Neena Sandhu)

              Member                           Member                               President