CONSUMER DISPUTES REDRESSAL COMMISSION – X
GOVERNMENT OF N.C.T. OF DELHI
Udyog Sadan, C – 22 & 23, Institutional Area
(Behind Qutub Hotel)
New Delhi – 110016
Case No.165/2021
BRIJ BHUSHAN JHA
S/O LATE KANAI JHA
R/O I-21-A, 1781,
SANGAM VIHAR,
NEW DELHI- 110080 …..COMPLAINANT
-
LIFE INSURANCE CORPORATION OF INDIA,
THROUGH
THE GENERAL MANAGER
AT 11-J, Ist FLOOR, 25,
K.G. MARG,
NEW DELHI - 110001 .…..RESPONDENT
Date of Institution-27.07.2021
Date of Order- 27.03.2023
O R D E R
RAJ KUMAR CHAUHAN-PRESIDENT
The present consumer complaint relates to deficiency of service in not refunding sum assured at the time of maturity.
Brief facts are stated in complaint by the complainant in nutshell are that the complainant purchased a policy bearing No. 114128303 on 10.0.2005 for assured sum of Rs. 1,00,000/- on half yearly premium of Rs. 2,426/- for a period of 15 years.
The complainant had deposited total amount of Rs. 72,780/- with OP but he received only Rs.50,718/- from OP. The complainant thereafter visited the office of OP and raised the issued before the insurance ombudsman. He received a reply from the insurance ombudsman vide letter dated 8.12.2020. The complainant sent a legal notice dated 4.1.2021 to OP to pay the assured amount of Rs.1,00,000/-. The complainant prays for payment of assured amount of Rs.1,00,000/-, compensation of Rs.1,00,000/- for mental pain.
OP in its reply has raised the preliminary objection that the complainant has filed the complaint before insurance ombudsman that was rejected vide order dated 7.12.2020 and the present complaint is barred by Section 11 of CPC.
OP submits that complainant has taken a Jeevan Saral Plan vide policy bearing No. 114128303. OP has given the details of the policy:-
PAYMENTS | DEDUCTIONS |
Basic Amount | 34620.00 | Unpaid Prem. | 00.00 |
Vested Bonus | 00.00 | Int. On Prem. | 00.00 |
Interim Bonus | 16098.00 | Loan Amount | 00.00 |
F. Add. Bonus | 00.00 | Loan Interest | 00.00 |
Extra Refund | 00.00 | X-Charge | 00.00 |
Deposit Refund | 00.00 | Other Deduct | 00.00 |
Any other Ref. | 00.00 | Prop. Deposit | 00.00 |
S.R. Debit | 00.00 | S.R.Debit | 00.00 |
Total Payable | 50718.00 | Net payable | 50718.00 |
OP submits that on account of data mistake of a computer system, the maturity sum assured as mentioned in the policy was Rs.72,780/- instead of Rs. 34,620/-. This error occurred in nearly 3 lakhs policy documents of DO-1 Delhi. OP states that it had issued a notice dated 4.1.2016 to the complainant about this error.
OP alleges that complainant has ignored the main feature of the LIC policy i.e. Death covered that is being offered by OP.
The complainant has filed its rejoinder reaffirming the facts in the complaint. The complainant denies intimation of discrepancy in the policy by OP. The complainant further submits that OP liable to pay a sum of Rs.1,45,560/- along with other remedies.
Complainant has filed its evidence by way of affidavit and exhibited the following documents:-
- Copy of aadhar Card of the deponent is exhibited as EX.CW-1/1.
- Copy of LIC Bond is exhibited as Ex.CW-1/2 (OSR).
- Copy of legal notice and postal receipt are exhibited as Ex.CW-1/3.
OP1 has filed its evidence by way of affidavit and exhibited the following documents:-
- Copy of the award dated 7.12.2020 is exhibited as Exhibit OW1/1.
- Copy of the letter dated 4.1.2016 is exhibited as Exhibit OW1/2.
- Copy of declaration of Policy is exhibited as Exhibit OW1/3.
Both the parties are filed written submissions and OP has filed an internal letter dated 25.8.2013.
The Commission has given thoughtful consideration the material on record. The policy namely LIC JeevanSaral (with profits) taken by the complainant is admitted by both the parties. Perusal of this policy shows :-
- Maturity sum assured Rs. 72,780/-.
- Death Benefit Sum Assured under main plan Rs. 1,00,000/-
- Accident Benefit Sum Assured Rs. 1,00,000/-
- Term Rider Sum Assured.
- Premium to be paid Rs.2426/-.
- Date of commencement 10.2.2005.
- Date of last payment 10.8.2019.
- The date of maturity is given as 10.2.2020.
- Maturity Benefits: In the event of the Life Assured surviving the date of maturity a sum equal to Maturity Sum Assured in force after partial surrenders. If any, along with the corresponding Loyalty Additions, “If any, shall be Payable.”
The receipts for 15 years is annexed with the complaint and not denied by OP.
Relevant portion of OP’s letter dated 4.1.2016 is reproduced as follows:-
“We have noticed at in the policy document issued to you, there has been an inadvertent typographical error in the Maturity Sum Assured. As per the plan conditions, the correct Maturity Sum Assured is Rs.34620/-.”
Perusal of the policy document shows that maturity sum assured is Rs.72,780/-. Account statement dated 15.2.2020 by OP shows basic amount as Rs.34,620/-, interim bonus Rs.106,98/- and total payable as Rs.50,718/-.
The figure of Rs. 34,620/- as mentioned in OP’s letter dated 4.1.2016 and account statement dated 15.2.2020 is conspicuously absent in the policy. The maturity sum assured is shown as Rs.72,780/-. It is clear that the complainant purchased a policy after being persuaded that the maturity sum assured is Rs.72,780/-. He started paying premium in the year 2005, on half yearly premium of Rs.2,426/-. He continued payment till year 2009-10. He paid Rs.2426/- for 15 years bi-annually. The amount is come to 2426*2*15 is Rs.72,780/-. If the bonus and other loyalty benefits are added, the amount be much more than Rs.34,620/- as claimed by OP. This contention of OP is neither reasonable nor justifiable.
Hon’ble National Commission in a similar matter of LIC Vs Parvati Bai decided on 02.03.2020 petition No. 2282 of 2018 has held as follows:
Moreover, the question is whether the complainant would have gone for the policy, had he known that on maturity he will get only Rs.38,970/- after paying regular premium of Rs.1,225- quarterly for 10 years. During the currency of the policy, the insurance company did not point out any mistake in the policy, nor sent any corrected policy document. Now, that the policy has matured and the claim became due on maturity, the insurance company is claiming the defect in the initial contract. The mistake or typographical error in the contract does not seem to be obvious and even if the mistake is justified on the basis of table 165 of the LIC, it is seen that this table was not part of the policy and was not supplied along with the policy document, therefore, the complainant may not be bound by this table, rather the complainant and the insurance company both are bound by the written contract of insurance as mentioned in the policy document. The policy contract has to be interpreted in the terms as agreed in the contract by the contracting parties.
…
Based on the above authoritative judgments of the Hon’ble Supreme Court, it is clear that the contract conditions of the policy cannot be changed or interpreted differently by any forum and therefore, the alleged typographical error cannot be accepted for changing the same after 10 years of the initial agreed contract i.e. after expiry of the contract period.
It is also to be observed that the above relied upon judgment is also of ‘Jeevan Saral’ policy Table. Hence, it is evident that OP was deficient in not refunding the sum assured at the time of maturity. We therefore, hold the OP liable for deficiency in service and direct the OP
- To pay the maturity amount of Rs.72,780/- along with loyalty benefits amounting to Rs.16,098/- after deducting the amount already paid to the complainant.
- To pay 9% interest on the amount from the date of maturity till realisation.
This order be complied within 30 days from the date of uploading the order. Copy of the order be supplied/sent to the parties free of cost as per rules.
File be consigned to record room.
