Per Shri Dhanraj Khamatkar, Hon’ble Member
1. Complainant-Mr.Gangadhar Vaikunth Revankar has filed a consumer complaint on 06/05/2010 under the Consumer Protection Act, 1986. The complaint was subsequently numbered as ‘Consumer Complaint No.73/2010’.
2. The facts in brief leading to the complaint can be summerised as under :-
3. Opponent No.2-Agent of opponent No.1 proposed an insurance plan popularly known as “Nav Prabhat Policy Plan No.137-15” for a sum of `5 Lakhs. Opponent No.1 has issued a policy No.921161906 dated 10/10/1999 for a sum of `4 Lakhs and the plan mentioned in the policy document is ‘Plan 137-15’. Accordingly, opponent No.1 issued a policy which is at Exhibit-D. Perusal of the policy shows that the annual premium amount stated in the policy is `34,561/- and the date of maturity is 10/10/2014. On 07/12/2000, opponent No.1 had issued a letter to the complainant stating that while completing the proposal, term of policy was left to be reduced to 10 years through an oversight. As a result, policy document was also issued for the term of 15 years for `4 Lakhs charging yearly premium applicable to 15 years i.e. `34,561/-. They further stated that in fact yearly premium for Plan-137 for term 10 years for `4 Lakhs comes to `40,154/- as against `34,561/-. Hence, opponent No.1 requested him to pay `11,186/- towards difference of two yearly premium @ `5,593/- each. The letter is at Exhibit-E. Accordingly, the complainant has paid the amount as stated in the aforesaid letter.
4. Thereafter, the complainant has requested the opponent No.1 physical extra of `30.60 per thousand and change in the sum assured accordingly. As per request of the complainant, opponent No.1 reduced the sum assured from `4 Lakhs to `3,50,000/- and the annual premium amount raised from `34,561/- to `35,765/- and requested the complainant to pay the amount of `2,480/- for difference made in the policy term. Accordingly, the complainant has paid the annual premiums.
5. After maturity of the said policy, the complainant had received a letter dated 15/07/2009 from the opponent No.1 informing the complainant that policy No.921161906 due for payment on maturity claim on 10/10/2009 directing the complainant to submit the original policy papers for cancellation of said policy. With the said letter, complainant also received details of maturity benefits of `2,64,550/-. It is the contention of the complainant that he was shocked to read the figure of maturity benefits. According to him, maturity amount is less than `5 Lakhs. It is even lesser than the principal amount which the complainant regularly paid. The complainant sought information pertaining to his policy from the opponent No.1 under the Right to Information Act, 2005. He received the reply from the opponent No.1 along with all the copies which he has requested and hence, the complainant has filed a consumer complaint making following prayers :-
“a) That the Hon’ble Forum be pleased to hold and declare that the Opposite Parties guilty of deficiency of service and unfair trade practice under the provisions of the Consumer Protection Act, 1986;
b) That the Hon’ble Forum be pleased to order and direct the Opposite Parties to pay the complainant a sum of `4,00,000/- (Rupees Four lac only) being the claim amount with interest thereon at the rate of 24% p.a. from the date of complaint till payment and or realization;
c) That the Hon’ble Forum be pleased to order and direct the Opposite Parties to pay the complainant a sum of `50,00,000/- (Rupees Fifty Lac only) being the damages for causing harassment, mental agony and stress to the complainant;
d) That the Hon’ble Forum be pleased to order and direct the Opposite Parties to pay the complainant the cost including legal costs incurred by the complainant for this complaint;
e) That the Hon’ble Forum be pleased to expedite the hearing of the above complaint and dispose of the same at an early date as the complainant is 71 years old;
f) That the Hon’ble Forum during the pendency and final disposal of this complaint, the Hon’ble Forum may please grant the complainant and his family member a police protection in view to protect the complainant from Opposite Party No.2.
g) For such further and other reliefs as the Hon’ble Forum deems fit and proper.”
6. Accordingly, notice before admission was issued to the opponents. Upon hearing Advocate for the complainant, complaint was admitted and the opponents were directed to file written version.
7. Opponent No.1 in their written version stated that complaint does not disclose any cause of action and is barred by limitation. The basic relief of the complainant is only `4 Lakhs and he has prayed for damage of `50 Lakhs. Hence, relief sought by the complainant is grossly inflated. The opponent No.1 pleaded that the complaint involves complicated issues and hence, complaint may please be tried by the Civil Court. The opponent No.1 further stated that the initial proposal of the complainant was for `5 Lakhs for term of 10 years. The complainant has given consent for physical extra @ `30.60 per thousand and the opponent No.1 had erroneously issued a policy document for ‘Policy Plan No.137-15 for a sum assured of `4 Lakhs’ instead of ‘Policy Plan No.137-10 for a sum assured of `4 Lakhs’. The opponent No.1 contended that the complainant was informed this by letter dated 07/12/2000 and the Branch Office has corrected the policy document. Further, the assured sum was revised and reduced to `3,50,000/- with premium of `35,765/- with reference to letter of the complainant dated 22/01/2001. Opponent No.1 has further contended that the complainant sickness benefits as per the policy conditions during the policy term and at the time of maturity, premiums received plus royalty addition excluding extra premiums are refunded and accordingly, opponent No.1 informed the complainant. They further contended that there is no deficiency on the part of opponent No.1 and hence, requested to dismiss the complaint.
8. Opponent No.2 remained absent and hence, he was proceeded ex-parte.
9. The complainant had filed an affidavit of evidence. Similarly, opponent No.1 had also filed evidence on affidavit. On the basis of pleadings of both the parties, we frame following points for our consideration :-
Points Findings
(1) Whether there is deficiency on the part No
of opponent No.1?
(2) What order ? Complaint is dismissed.
REASONS
10. Admittedly, through opponent No.2, the complainant had submitted a proposal for insurance to opponent No.1. In the proposal, the plan mentioned is 137-15 and the sum assued is `5 Lakhs. Opponent No.1 had issued Policy No.921161906 on 10/10/1999 for Plan 137-15 and the sum assured is shown as `4 Lakhs. The annual premium is shown as `34,561/- and the maturity date is 10/10/2014. On 07/12/2000 the opponent No.1 had issued a letter to the complainant stating that they have completed the case of `4 Lakhs as desired by the complainant. However, while completing the proposal, the term of policy was left to be reduced to 10 years through an oversight. As a result, policy document was also issued for term of 15 years for `4 Lakhs charging yearly premium applicable to 15 years i.e. `34,561/-. They further stated that in fact yearly premium for Plan 137 for term of 10 years for `4 Lakhs comes to `40,154/- and they have charged `34,561/-. Hence, the complainant was requested to pay `11,186/- towards difference of two yearly premium i.e. @ `5,593/- each. Accordingly, the complainant has paid the amount as requested by opponent No.1. Further the policy is revised on the request of the complainant by his letter dated 22/01/2001. Accordingly, a fresh policy has been issued by opponent No.1 which is in the case papers at Exhibit-D. As per the policy, the insured amount is `3,50,000/-. The complainant has paid all the premiums. Accordingly, by letter dated 15/07/2009 opponent No.1 had sent a letter to the complainant requesting that the policy has become due for payment of maturity claim on 10/10/2009 and hence, comply with the following requirements at an early date to enable to make payment early :-
1) Original policy document for cancellation
2) Enclosed Discharge Voucher duly executed as per instructions printed thereon.
3) Let them know to which address the cheque should be dispatched.
11. As per Discharge Voucher the amount of claim is `2,64,550/-. From the aforesaid facts, it will be clear that the original proposal was for `5 Lakhs. While accepting the proposal, opponent No.1 has reduced the amount of the insurance to `4 Lakhs for Plan 137-15 and thereafter, finding discrepancy they have informed to the complainant about the discrepancy and the outstanding amount and revised amount of the premium, the complainant has accepted the same. Thereafter, on the request of the complainant himself the insured amount was reduced from `4 Lakhs to `3,50,000/-.
12. The insurance policy is a contract between both the parties and once the complainant has accepted the terms of contract, now he cannot say that said terms are not acceptable to him. Further, the maturity amount is payable according to the terms and conditions of the policy. Prima-facie, it is seen that the complainant has paid an amount of `3,50,000/- to the opponent No.1 and now after maturity, he is getting the amount of `2,64,550/-. However, the complainant is not taking into consideration the insurance cover and medical cover provided by the policy. Complainant cannot change terms and conditions of the policy once he has accepted the same.
13. Under the aforesaid facts and circumstances, we do not find any deficiency in the services of the opponents and hence, we answer point No.1 in negative. We hold accordingly and we pass the following order:-
-: ORDER :-
1. Complaint is dismissed.
2. No order as to costs.
3. Copies of the order be furnished to the parties.
Pronounced
Dated 31st March 2011.
