Date of Filing:14.12.2021

Date of Disposal:06.08.2024

BEFORE THE IV ADDL DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION BENGALURU

1^ST FLOOR, BMTC, B-BLOCK, TTMC BUILDING, K.H ROAD, SHANTHINAGAR, BENGALURU – 560 027.

ORDER

SMT.NANDINI.H.KUMBHAR, MEMBER

1. The Complaint is filed by the complainant under section 35 of the C.P. Act, 2019 against the OP alleging deficiency of service  seeking direction to the OP to refund  all the paid premium amounts along with accrued bonus  upto date, along with loyalties/benefits of the policy and interest in respect of policy No.102463148 and such other reliefs.

2. The brief facts of the case is as follows:

           This is the case of the complainant that the complainant  availed insurance policy from OP on 07.03.2002 bearing No.102463148 and same was commenced vide benefit description/plan-Whole life participating age 100 years policy along with rider term by premium fixed p.a. of Rs.5,618/- and policy is in force as per complainant knowledge. The complainant submits that during the policy period, on 16.06.2014 the complainant availed loan as against the policy from OP by depositing all original bonds back to the custody of OP and complainant paid loan interest regularly up to   2016, but in the year 2017 & 2018 the premiums were not paid due to ill health and shifting of house premises.  The complainant submits that on 15.07.2019 the complainant sent mail to OP stating that the complainant is ready and willing pay the balance premium along with loan dues, but the OP refuses to accept the payment and refused to give statement of accounts, bonus, premium paid details and complainant was not aware of the pending premiums and loan principal dues and interest details. The complainant again approached OP  on 07.08.2021 to regularize the policy and to pay back the interest and principle, but surprisingly the OP have informed the complainant that the said policy was closed/surrendered by the OP for the reasons best known to the OP company. The complainant submits that, on the other hand instead of keeping the policy in force, the OP had treated some of the amount in paid premium as unclaimed amount and remitted the said amount back to the complainant bank account and again the complainant also  requested not to send any refunds to the complainant bank account, and also the complainant given letter i.e. “Cheque Stop Payment” on 07.08.2021. The complainant also issued legal notice on 10.08.2021, calling upon the OP to comply the demands made in the notice,  but even after service of notice, the OP have not complied to the notice.  Aggrieved by the act of OP the complainant filed the present complaint seeking  relief as prayed in the complaint.

3.  Notice to the OP duly served, OP  represented by counsel filed written version along with documents and also filed chief examination affidavit and got marked Documents as annexures-R1 to R3.

4. Complainant filed chief examination affidavit by re-iterating the complaint allegations and also filed relevant documents in support of their plea.

5.  Heard arguments and matter is reserved for orders.

6. The points that arise for our consideration are;

1. Whether the Complainant prove that there is deficiency of service on the part of the OP as alleged in the complaint and thereby prove that she is  entitled for the relief sought?
2. What order?

8. The findings on the above points are as under:

Point No.1           :       Negative

Point No.2           :       As per final order.

REASONS

9. POINT NO.1:-  The OP represented by counsel filed their written version and chief examination affidavit along with documents. They denied entire complaint allegations and also denied any deficiency in service on their part. The specific  contention of the OP is that, the complainant had availed Whole Life Policy bearing No.102463148 on 15.03.2002. As per the terms of policy, the complainant was required to pay annual premium of Rs.10,991/- every year to the age of 100 years and on maturity or on the death of the insured the policy holder/ nominee was entitled to get a sum of Rs.4,67,247.16/- and accrued bonus. As per clause-15 of the policy document, after the policy had acquired a cash surrender value it would be eligible for loan under the scheme. The complainant had availed loan to the tune of Rs.85,088.48/- on 17.06.2014 and the same has to be repaid along with interest.  Pursuant to the availing the policy, the complainant had paid the premium from 15.06.2002 till 15.06.2017. OP  further submits, that the complainant failed to pay any amount towards the loan availed as well as the complainant stopped paying further premiums. The copy of loan details produced by the OP marked as Annexure-R3 in which  accumulated interest  exceeds the surrender value, being the excess  amount,  after deducting the loan amount from the surrender value  was credited to the complainant account on 26.02.2020. By invoking the terms of the policy, the OP has adjusted the same from the surrender value and recovered its dues, as the complainant is not entitled for any reliefs and prays for dismissal of the complaint against them for the above reasons.

10. The complainant has filed chief examination affidavit by re-iterating the complaint averments. Wherein, the complainant states that, the complainant having policy with OP company from 07.03.2002, the same was commenced vide benefit/plan for the whole life participating to 100 years policy, for premium fixed as Rs.5,618/-p.a. During the policy term, the complainant had availed loan on 16.06.2014 by depositing all original bonds to OP company. Further, the complainant regularly paying the loan and interest upto 2016, but in the year 2017 and 2018 premium were not paid due to health issues. On the other hand without informing the complainant, the OP company surrendered the policy. On 15.07.2019, the complaint sent email to OP  stating that he is willing to pay the premium along with loan dues, but the OP refuses to accept the payment. Instead of keeping the policy in force, the OP company had treated the some of the amount in paid premium as unclaimed amount and remitted the said amount to the complainant account. The complainant had issued a letter for stop payments and legal notice to the OP despite of received legal notice, but there is no reply from OP company.

11. Considering the contentions of the complainant and version filed by the OP along with documents with sworn affidavit, the commission perused the documents filed by the complainant as well as the OP. As per the terms of policy on maturity the complainant would be  entitle to get Rs,4,67,247.16/- and accrued bonus. As per the policy scheme, the complainant availed loan amount of Rs.85,088,48/-. The copy of loan document submitted by the OP as Annexure-R2. After loan sanctioned, the complainant had failed to pay any amount towards the loan availed and also premiums. The copy of statement  has produced and marked as Annexure-R3. As per the terms of the policy, the complainant had paid premium up to 2016, but in the year 2017 & 2018 the complainant was failed to pay the premiums, which is admitted by the complainant in para-3 of complaint. The statement of document, it is reflecting the loan details and accumulated interest  exceeded and  the cash surrender value, which the policy lapsed on 15.03.2017 and a loan amount from the surrender value was credited to the complainant account on 26.02.2020.  On failure of repay the loan amount or breach in the terms and conditions of the policy, the OP has adjusted the same from the surrender value and recovered its dues etc.

12. Looking at the terms of policy and the loan sanctioned, after knowing the illustration properly explained by the OP, the complainant had failed to repay the loan dues as well as premium. The action taken by the OP as per the terms and conditions prescribed in the loan documents, the statement of  interest accumulated is as per law. In view of the conditions prescribed in the loan sanction letter as above, despite OP has provided sufficient opportunity to the complainant  to pay the loan, but the complainant has failed to pay the  loan dues as well as premium. Therefore, the act of the OP is found as just and reasonable. As per  policy terms, the OP has  adjusted the same from the surrender value and recovered its dues.

13. In view of the above discussion and upon perusal of facts and contention of both parties, the commission is of the clear view that, the complainant has failed to prove the deficiency as alleged in the complaint, on account of that the complaint deserves to be dismissed. Accordingly, we answer Point No.1 in Negative.

14. POINT NO.2:- In the result,  for the forgoing reasons, we passed the following:

ORDER

1. The complaint  filed by the complainant is hereby dismissed. No costs.
2. Furnish free copy of this order to both the parties.

(Dictated to the Stenographer, got it transcribed, typed by him and corrected by me, then pronounced in the Open Commission on 06^th August  2024)

(RAMACHANDRA M.S.)

PRESIDENT

     (NANDINI H KUMBHAR)                (SAVITHA AIRANI)            

Witness examined on behalf of the complainant by way of affidavit: Smt.G.Sunitha- Who being the complainant.

Documents produced by the complainant:

Witness examined on behalf of the OP way of affidavit:- Sri Richard-Who being the Deputy Manger-Operations of OP.

Documents produced by the OP:  

(RAMACHANDRA M.S.)

PRESIDENT

     (NANDINI H KUMBHAR)                (SAVITHA AIRANI)            

            MEMBER                                  MEMBER