Order-14.
Date-31/08/2015.
Complainant Mrs. Anamika Vyas by filing this complaint has submitted that complainant took a Life Insurance Policy vide No. 415636164 on 23.12.2002 for sum assured of Rs. 1,00,000/- on monthly premium of Rs. 570/- from the op no.2 and the date of maturity of the policy was 23.12.2012 and the last payment of premium was 23.11.2012. On the expiry of 16 years as per the plan of Assurance the complainant shall have to receive the matured amount of Rs. 1,00,000/- with bonus and interim bonus.
Complainant has submitted that he paid all premiums within due date and after due date with late payment surcharge. But the last premium of Rs. 570/- was however could not pay in time and complainant tendered the last premium after the due date the collecting Branch the client to accept the premium and replied that as the policy has been matured the computer is not accepting collection of premium with interest after due date for which complainant lodged a complaint and was surprised to find that a sum of Rs. 68,436/- was credited to his Bank account after deducting a sum of Rs. 31,564/-.
On enquiry by the complainant she was understood that if the last premium is not paid within the due date there will be heavy deduction. But no such intimation or advance information was given to the complainant cautioning to pay the last installment in time and as valued customer, the complainant is entitled to get such caution notice and the lapse or negligence on the part of the LIC for not cautioning the complainant to pay the last premium in time and practically for the laches on the part of the op, complainant has suffered much and in the above circumstances after accepting the last premium op must have to refund the balance amount of Rs. 31,564/- and other compensation.
On the other hand op by filing written statement submitted that the present policy is not an Insurance Policy. But it is a Capital Redemption Assurance Plan No. 51 without profit along with necessary details of the plan was annexed but that has not been filed by the complainant.
It is further submitted that when it is a Capital Redemption Assurance Plan, there is mandatory provision about the maturity is that if any premium (last year’s premium) has not paid on policy term then also the surrender value will be settled as maturity claim not sum assured by deducting the premium and if the premiums have been paid fully for the policy term, the maturity claim sum assured only and paid within the maturity date otherwise not. Accordingly as per said term practically complainant did not pay the premium for which after maturity as per said Policy term was transmitted to the account of the complainant treating it as surrender value. But not sum assured by deducting the premium because there is no provision to deduct any premium out of the total deposit treating it as a matured amount.
Moreover it is submitted that the purpose of the plan is to provide for the capital cost of anasset during its useful lifetimeand the plan does not cover any risk on the life of the life assured. The premiums are payable throughout the term of the policy and does not cease on the death of the policy holder and if all the premiums during the policy terms have been paid and life assured is alive as on the date of maturity then full sum assured is payable as maturity claim. Since, the policy is not having any risk cover, accident benefit is also not available and the plan is under without profit plan, no bonus or Interim Bonus is payable under policy.
Further it is submitted that complainant during that period defaulted to pay installment per month and at a time paid on 6 occasion up to October-2012 we find. But as per clause of the said Capital Redemption Assurance Plan, last premium must be paid before maturity and there is no scope to allow any such Capital Redemption Assurance holder to accept his/her last premium after maturity, we find and that is mandatory clause of the said policy and as because complainant did not pay the last installment before maturity. So, that policy was treated as closed as surrender and for which after maturity no doubt complainant went to the op for accepting the same with fine but computer did not accept because the policy terms are there and automatically it was not accepted.
So, there was no fault on the part of the op and as per mandatory clause, complainant entitled to that amount which had been transmitted to his bank account as per policy condition. So, the complaint should be dismissed.
Decision with reasons
On comparative study of complaint and written version and also considering the policy terms and conditions, it is found that it is not a Life Insurance Policy. But this product was sold by the LIC no doubt. But policy is Capital Redemption Assurance Plan without Profit having Plan No. 51was withdrawn on 24.12.2002 though it was introduced on 01.09.1956 and fact remains that complainant purchased this plan just on 23.12.2002 prior to withdrawal of the plan on 24.12.2002 and complainant was aware of the fact that whatever it may be the plan would be matured on 23.11.2012 and last premium must be paid prior to 23.11.2012 otherwise she shall not get the benefit of the plan as per mandatory provision of the clause as mentioned in the maturity column-H.
In fact complainant has admitted that she failed to pay the said amount within maturity date and complainant wants to pay it after maturity date but it was not accepted by the computer that means fault was on the part of the complainant. Complainant did not follow the terms and conditions of the said Capital Redemption Assurance Plan and truth is that it is not a Life Insurance policy but it is falsely stated in the complaint that it is a Life Insurance Policy.
So, we are convinced to hold that complainant is guided by the terms and conditions of Capital Redemption Assurance Plan without profit – Plan No.51 and this Forum has no jurisdiction to introduce any new clause or to give any special relief by directing the op to accept last premium and to give full benefit of the said plan as per judgement passed by Hon’ble National Commissionreported in 2013 (4) CPR 165 N.C. and the purpose of this policy are strictly governed by the said policy conditions and no exception and relaxation can be made on the ground of equity and further in this case we have failed to search out any sort of deficiency on the part of the op. On the other hand it is found that complainant has failed to comply the terms and conditions of the said Capital Redemption Assurance Plan.
In this regard already Hon’ble Supreme Court in its judgement Ravneet Singh Bagga – Vs – Klm Royal Durch Airlines and Anr. Passed on 02.11.1999 has observed that the deficiency in service cannot be alleged without attributing fault, imperfection, shortcoming or inadequate in the quality, nature and manner of performance which is required to be performed by a person in pursuance of contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the person who alleged it and in fact relying upon the observation of Hon’ble Supreme Court and also National Commission, we are convinced to hold that complainant defaulted to pay last premium within maturity period but did not pay what iswillful fault in performing the contract by the complainant.
The deficiency in service has to be distinguished from the tortuous acts of the op and in absence of deficiency in service the aggrieved person may have a remedy under the common law to file a suit for damages but cannot insist for grant of relief under this Act for the alleged acts of commission and omission attributable to the op which otherwise do not amount to deficiency in service. In case of bonafide disputes no willful fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance in the service can be informed. If on facts it is found that the person or authority rendering service had taken all precautions and considered all relevant facts and circumstances in the course of the transaction and that their action or of the final decision was in good faith, it cannot be said there had been any deficiency in service. If the action of the op is found to be in good faith, there is no deficiency of service entitling the aggrieved person to claim relief under the Act. The rendering of deficient service has to be considered and decided in each case according to the facts of that case for which no hard and fast rule can be laid down. Inefficiency, lack of due care, absence of bonafide, rashness, haste or omission and the like may be the factors to ascertain the deficiency in rendering the service.
But anyhow this complaint miserably failed to prove that op is responsible for deficiency in service and for op’s fault, complainant has suffered but on the contrary it is proved that it is the fault of the complainant and for complainant’s fault, complainant has failed to get such benefit of the said Assurance Plan and truth is that as per said policy Capital Redemption Assurance Plan complainant got correct amount when she/he failed to pay the last installment as per mandatory provision of that plan. So, as per clause of the Capital Redemption Assurance Plan being No. 51, complainant’s liability is fixed but she has failed to pay last premium within maturity period for which as per maturity clause-H of the Plan No. 51 the amount which was payable to the complainant has already been paid against his account by the op and that amount was assessed as per Tabular Premium read in Plan No. 51 Capital Redemption Plan for the period properly treating that the last premium was not paid by the complainant within the maturity period.
So, the calculation was made by the op treating it as surrender value as settled amount and not sum assured by deducting the premium and practically plan is guided by that clause-H of the policy and for which complainant is not entitled to get any relief when fault imperfection is on the part of the complainant. There is no fault no imperfection, no deficiency in service on the part of the op and last but not the least we want to say that is it is not an insurance policy but it is Capital Redemption Assurance Plan without profit – Plan No. 51 and this paper are within the custody of the complainant, but complainant has not disclosed it and falsely stated that it is the liability of insurance company. It is no doubt a plan on the part of complainant to grab more money and that plan has also failed before this Forum when complainant has failed to establish the deficiency and negligence on the part of the op and policy is not a Life Insurance Policy.
In the result, the complaint fails.
Hence, it is
ORDERED
That the complaint be and the same is dismissed on contest without any cost against the ops.
