BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, MYSORE-570023

CONSUMER COMPLAINT NO.209/2020

DATED ON THIS THE 15^th September 2022

Present:   1) Sri. B.Narayanappa

M.A., LL.B., - PRESIDENT  

                     2) Smt.Lalitha.M.K.,

M.A., B.A.L., LL.B., - MEMBER  

                        3) Sri Maruthi Vaddar,

                                                B.A., LLB (Special)  - MEMBER

Sri MARUTHI VADDAR,

MEMBER

1.         This is a complaint filed by the complainant Nanjesh.A.G., resident of K.R.Nagara, Mysuru District under Section 35 of the C.P.Act, 2019 against the opposite party Nos.1 and 2 alleging deficiency in service and directing the opposite parties to refund Rs.3,04,289/- of policy bearing No.726655885 and also refund balance amount of Rs.1,50,852/- of policy bearing No.726805808 and to pay Rs.2,00,000/- towards deficiency in service and Rs.1,00,000/- towards mental agony and Rs.50,000/- bearing the litigation cost and Rs.20,000/- being cost of notice and to grant such other and further reliefs as this Hon’ble Commission deems fit and proper under the circumstances of the case, in the interest of justice and equity.         
2. The brief facts of the complaint is as here under:-

It is alleged in the complaint that the complainant was decided to purchase life insurance policy with the opposite parties on 26.12.2016, the complainant purchased a policy bearing No.726655885 and as per the benefits of the policy, the deposit sum assured of the said policy was Rs.30,00,000/- and the premium was Rs.16,825/- per month.The said policy was confirmed by 2^nd opposite party through RPAD on 07.01.2017 and further complainant decided to purchase one more policy during 2017 i.e. Pension Plan New Jeevan Akshaya policy on 28.10.2017 policy bearing No.726805808.The sum assured is Rs.15,00,000/- and the premium is Rs.8,425/- per month and the said policy was confirmed by 2^nd opposite party through RPAD on 15.11.2017.

It is further alleged that due to continuous health issues of the complainant, the complainant was approached the 2^nd opposite party for withdraw the polices mentioned above for the purpose of medical expenses on 28.03.2019.Hence, he approached the 2^nd opposite party branch and surrendered the policies.But, the branch officer rejected the application dated 10.04.2019 for the reasons that the main branch was reject the application of the complainant for the reason illness mentioned in the medical certificate does not come under the critical illness list.Due to the continuous ill health conditions of the complainant, the complainant was admitted to hospital and the doctor instruct the complainant to make arrangements for Lever transmutation.The complainant once again approached the opposite parties for refund and as per the request made by the complainant, opposite party approved the application made by the complainant.

It is further submitted that the opposite parties considered the application of the complainant and has refunded Rs.26,95,711/- out of Rs.30,00,000/- in the policy bearing No.726655885 and Rs.13,49,148/- out of Rs.15,00,000/- to the policy bearing No.726805808. At the time of purchase of the policy, the opposite parties had promised to return the entire amount when the complainant surrendered the policy.Hence, after discharge from the hospital, the complainant has issued legal notice to the opposite party Nos.1 and 2 and due to Covid-19 another notice was issued to both the opposite parties.After issuing the notice, the complainant has filed the present complaint.

3. After the registration of the complaint, notices were ordered to be issued to the opposite parties and in response to the notices, the opposite party Nos.1 and 2 have appeared through their respective counsel and filed the detailed version contending that the complaint filed is not maintainable either in law or on the facts of the case as the same is devoid of merits and also under Section 24(A) of C.P.Act, 1986 and liable to be dismissed.  But, the opposite parties have admitted the averments made in para 3 of the complaint.  It is true to submit that the complainant had taken LIC Jeevan Akshay VI policy bearing No.726655855 for purchase price of Rs.30,00,000/- with date of commencement as 26.12.2016.  The opposite parties have paid the annuity amount of Rs.16,825/- payable monthly from 26.01.2017 (Rs.3,256/-) for six days from 29.01.2017 to 31.01.2017 and Rs.16,825/- from 01.02.2017 to 30.09.2019.  The type of annuity opted by the complainant was ‘F’ – Annuity for Life with return of purchase price – under this option the annuity payments will be made in arrears for as long as annuitant is alive.  The annuity payments will cease on the death of the annuitant and the purchase price will be payable to the nominee, as mentioned in page No.3 of the policy bond.

It is further contended that it is true to submit that the complainant had taken LIC Jeevan Akshay Vi policy bearing No.726805808 for a purchase price of Rs.15,00,000/- with the date of commencement as 28.10.2017 and the opposite parties have agreed to pay the annuity amount of Rs.8,425/-, payable monthly from 28.10.2017 (Rs.1,087/-) for 3 months from 28.10.2017 to 30.10.2017 and Rs.8,425/- from 01.11.2017 to 30.09.2019. The type of annuity opted by the complainant was ‘F’ – annuity for life with return of purchase price under this option the annuity payments will be made in arrears for as long as annuitant is alive.The annuity payments will cease on the death of the annuitant and the purchase price will be payable to the nominee.As per the definition under part B definition under page No.2 of the policy bond – Free look period is the period of 15 days (30 days if this policy is purchased on line) from the date of receipt of the policy document by the policy holder to review the terms and conditions of this policy and where the policy holder disagrees to any of those terms and conditions her/she has the option to return this policy. As per the Free look period, the complainant had the option to withdraw the policy within the Free look period.

The opposite parties deny the allegations made in para 6 of the complaint.Surrender of the policy is allowed if the policy holder is suffering from any one of the critical illness mentioned Annexure-1 under the page No.7 of the policy bond.However, on receipt of supporting documents about the critical illness suffered by the complainant, the surrender was honoured and the amount was settled to the complainant under both the policies, as mentioned under para 4 and 5.The opposite parties strongly deny the allegations made in para 8 of the complaint that the opposite parties have agreed to refund the entire amount when complainant surrenders the policy.This opposite party had never made any assurance that in case of surrender, full purchase value will be refunded.As per the option F opted by the complainant, the purchase value is refundable only on the death of the annuitant.The opposite parties have considered the request letter dated 08.08.2019 to surrender both the policies, as he was suffering from severe infection and has to undergo liver transplantation which was costing about 25 lakhs.The opposite parties have paid surrendered value amount of Rs.26,95,711/- and Rs.13,49,148/- respectively.Only after getting written consent from the complainant. Under the policy bearing No.726655885, the complainant had received annuity of Rs.3,256/- for the first month from 26.12.2016 to 31.12.2016 and Rs.16,825/- per month from 01.01.2017 to 30.09.2019 amounting to Rs.5,59,481/- and final payment of Rs.26,95,711/-, totalling to Rs.32,54192/- and in the policy bearing No.726805808, the complainant had received annuity of Rs.1,087/- in the first month for 3 days from 28.10.2017 to 30.10.2017 and Rs.8,425/- per month from 01.11.2017 to 30.09.2019 amounting to Rs.1,94,862/- and final payment of Rs.13,49,148/-, totalling to Rs.15,44,010/-.The surrender value in case of the annuity policy is based on various factors like 1. Age of the Life Assured, 2. Mode of the Annuity and 3. Annuity factor etc., The opposite parties have guided by IRDA regarding surrender value payments if policy is surrendered prematurely.This opposite parties have settled the surrender value as per the terms and conditions of the policy based on the consent letter obtained from the complainant and hence, prays to dismiss the complaint with costs in the ends of justice and equity.

4. The complainant has filed his affidavit by way of examination in chief and the same was taken as P.W.1 and produced 10 documents.  On the other hand, the opposite party Nos.1 and 2 have filed their affidavit by way of examination in chief and same was taken as R.W.1. and got marked the documents as Ex.R.1 to Ex.R.6. 
5. Heard the arguments of both the sides and perused the materials placed on record.
6. The points that would arise for our consideration are as here under:-  

1. Whether the complainant proves the alleged deficiency in service on the part of the opposite parties and thereby he is entitled to the reliefs as sought for?
2.  What order?

7.       Our findings on the aforesaid points are as follows:

      Point No.1 :- In the negative.

      Point No.2 :- As per final order for the following

:: R E A S O N S ::

8.       Point No.1:- To substantiate the case of the complainant, the complainant himself has been examined as P.W.1 by filing his affidavit towards examination in chief and produced 10 documents.  The complainant has reiterated the averments of the complaint in his affidavit.  Document No.1 is the confirmation of the policy bearing No.726655885.  Document No.2 is the certificate of the policy bearing No.726655885.  Document No.3 is the confirmation of the policy bearing No.726805808.  Document No.4 is the certificate of the policy bearing No.726805808.  Document No.5 is the application filed by the complainant.  Document No.6 is the endorsement issued by the opposite party No.2.  Document No.7 is the acknowledgement issued by opposite party No.2 for policy bearing No.726805808. Document No.8 is the acknowledgement issued by the opposite party No.2 for policy bearing No.726655885.  Document No.9 is the legal notice.  Document No.10 is the legal notice dated 27.08.2020.  After the affidavit of complainant, the opposite parties have filed their affidavit towards their chief examination and the same was taken as R.W.1 and got marked the documents as Ex.R.1 to Ex.R.6.  Ex.R.1 is the certified copy of the proposal form accepting F-option policy bearing No.726655885. Ex.R.2 is the certified copy of the proposal form accepting F-option policy bearing No.726805808.  Ex.R.3 is the annexure Part A of policy bond Free Look period.  Ex.R.4 is the certified copy of policy bonds.  Ex.R.5 is the statement of pension paid to the annuitant.  Ex.R.6 is the copy of the consent letter obtained from the complainant for surrender.  After the affidavit of both parties, both parties have submitted their written arguments.  After carefully looking into the complaint averments and the documents and the version and Ex.R.1 to Ex.R.6, it is noticed that the complainant has taken the policy No.726655885 on 26.12.2016 for Rs.30,00,000/- and the premium is Rs.16,825/- per month and on 28.10.2017, the complainant has purchased another pension policy Jeevan Akshaya bearing No.726805808 for Rs.15,00,000/- and the premium is Rs.8,425/- per month.  The said two policies were confirmed by the opposite parties who sent the same through RPAD.  The same was admitted by the opposite parties in para 4 of its version.  But, it is the further case of the complainant that he surrendered the said policies for his continuous health issues.  But, the opposite party has rejected the application of the complainant.  But, later on complainant was admitted to hospital and doctor instructed the complainant to make arrangements for Liver transplantation and hence, the complainant once again approached the opposite parties for refund of the amount and as per the request of the complainant, the opposite parties approved the application and paid the damaged amount on both policies.
9. It is further case of the complainant that at the time of purchase of the policy, the opposite parties have agreed that they refund the entire amount when complainant was surrendered the policy.  But, the opposite parties contended that opposite parties paid the surrender value as mentioned supra in the version only after getting written consent from the complainant.  The complaint of the complainant is not fruitful as he has chosen the option F in the proposal form which reflects “Annuity during life time of the annuitant with return of purchase price on death of the annuitant”.  Further the opposite parties says that surrender shall be allowed after completion of at least one policy year only under the option F- Annuity for life with return of purchase price.  Under the diseases as mentioned in the terms and conditions of the policy. The surrender value payable shall depend on the age of the holder at the time of surrender.  Such being the contention of the opposite parties, the plea of the complainant that the opposite parties agreed to refund the entire amount when complainant willing to surrender the policy is not acceptable.  Moreover, the complainant has submitted his signed consent letter for deducting surrender charges from the opposite parties as per the Ex.R.6.  When he put his signature on the consent letter for deduction of the surrender charges, the contention of the complainant is holds no water.  The complainant has failed to prove the alleged deficiency in service on the part of the opposite parties within the meaning of Section 2(11) of C.P.Act, 2019.  When the complainant failed to prove his case against the opposite parties, he is not entitled for any of the reliefs as claimed in his complaint.  Hence, we are of the opinion that the complaint of the complainant is lacking merits and deserves to be dismissed.  Hence,  answer the point No.1 in the negative.
10. Point No.2:- For the aforesaid reasons, we proceed to pass the following

:: ORDER ::

1. The complaint filed by complainant is herby dismissed.
2. Parties shall bear their own costs.
3. Pending application if any shall stand disposed off with this final order.
4. Furnish the copy of order to both parties at free of cost.

(Dictated to the Stenographer transcribed, typed by her, corrected by us and then pronounced in open Commission on this the 15^th September, 2022)