Chandigarh

DF-II

CC/379/2016

Mr. Baldev Singh Jassal - Complainant(s)

Versus

M/s Bajaj Allianz Life Insurance Company Limited - Opp.Party(s)

In Person

19 Jan 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-II, U.T. CHANDIGARH

======

Consumer Complaint  No	:	379 of 2016
Date  of  Institution	:	30.05.2016
Date   of   Decision	:	19.01.2017

 

 

 

 

Mr.Baldev Singh Jassal s/o Sh.Hardit Singh, R/o H.No.2676, Phase-7, Mohali.

             …..Complainant

Versus

1]  M/s Bajaj Allianz Life Insurance Company Limited, SCO No.215-217, 4^th Floor,  Sector 34-A, Chandigarh.

2]  M/s Bajaj Allianz Life Insurance Company Limited, West Hub, 2^nd Floor, Bajaj Finserve, Survey, House No.208/1-B, Behind Weikfield IT Building Viman Nagar, Nagar Road, Pune 411014

….. Opposite Parties 

 

BEFORE:  SH.RAJAN DEWAN                 PRESIDENT

         MRS.PRITI MALHOTRA             MEMBER

                                SH.RAVINDER SINGH             MEMBER 

        

 

For complainant(s)      : Complainant in person. 

 

For Opposite Party(s)   : Sh.Varun Chawla, Counsel for OPs.

 

 

 

PER PRITI MALHOTRA, MEMBER

 

 

          As per the case, the complainant on the allurement of representative of OPs, purchased one Life Insurance Policy from OPs vide Membership No.0218302411 on 18.3.2011 (Ann.C-1) under Group Master Policy’ Sarvshakti Surkasha Scheme.  It is averred that the complainant purchased the said policy for 5 years with annual premium of Rs.10,000/- commencing from 18.3.2011 and accordingly, paid all five premiums annually to the authorised agent of the Opposite Parties. It is averred that after 5 years, when the complainant visited OPs, he was shocked to know that the maturity/surrender value of his policy is only Rs.47,750.60p and was intimated about the same vide letter dated 16.3.2016 (Ann.C-3).  It is also averred that the complainant told the OPs that at the time of purchasing the policy, he was made to understand that he will get the minimum maturity guarantee amount equal to total premium amount paid.  The complainant took the matter with OPs and requested to pay at least the total premium amount paid plus some bonus.  However, the OPs sent letter dated 25.4.2016 (Ann.C-5) mentioning therein that cheque No.893747, dated 22.3.2016 of HDFC Bank has been dispatched to the complainant on 15.4.2016 for Rs.47,766/-.  It is pleaded that neither the OPs letter dated 25.4.2016 is satisfactory nor the cheque in question sent by the OPs has been received by the complainant.  Hence, this complaint has been filed. 

 

2]       The OPs have filed joint reply and stated that the complainant himself opted to be enrolled as member of the “Swayam Shakti Suraksha” Group Master Policy administered by Punjab & Sind Bank, after understanding terms & conditions thereof and opted for premium payment and benefit term of 5 years. Accordingly, the complainant was enrolled as Member under said policy with date of commencement as 18.3.2011 and date of maturity as 18.3.2016 for basic sum assured of Rs.2,50,000/- with additional accidental rider cover of Rs.2,50,000/-. It is also stated that the complainant had enjoyed the risk cover to the tune of Rs.2.50 lakh and additional accident benefit cover of Rs.2.50 lakh for whole of the term for 5 years. It is submitted that the answering OPs have made the payment of maturity value strictly in accordance with the terms of the cover/certificate of insurance, which have never been disputed by the complainant. It is also submitted that the terms & conditions of the “Swayam Shakti Suraksha” master policy are standard for all the insured members and are in accordance with the approvals of the IRDA. Pleading no deficiency in service and denying rest of the allegations, it is prayed that the complaint be dismissed.

 

3]       Replication has also been filed by the complainant thereby reiterating the assertions as made in the complaint and controverting that of the OPs in the reply.

 

4]       Parties led evidence in support of their contentions.

 

5]       We have heard the complainant in person, ld.Counsel for the OPs and have also perused the entire record.

 

6]       There is no denial to the factum that the complainant opted to be enrolled as Member of the ‘Swayam Shakti Suraksha’ Group Policy No.0218302411 administered by Punjab & Sind Bank for a term of 5 years against an annual premium amount of Rs.10,000/-.  It is disputed by the complainant that against the assurance of minimum maturity guaranteed amount equal to the total premium amount plus bonus, the OPs on the date of maturity of the policy calculated the maturity benefits amounting to Rs.47,766/-. The complainant submitted that the above amount was calculated on the total premium amount of Rs.50,000/- paid annually by way of Rs.10,000/- each. The complainant alleged that the amount calculated by the OPs is not in terms of the policy in question. The complainant also disputed that the above maturity benefits wrongly calculated by the OPs still remained unpaid despite the fact that several requests, telephonic reminders were sent and despite being served with the legal notice dated 15.4.2016. Hence, the present complaint.

 

7]       The Opposite Parties in its defence/reply though claimed that they have already dispatched the permissible maturity benefits amounting to Rs.47,766/- under Membership No.0212723114 vide cheque NO.893747, dated 22.3.2016 but during the course of arguments, the counsel for the OPs admitted that the disputed amount still has not been paid or credited to the account of the complainant.  From the admission of the OPs, the issue regarding the non-payment of the disputed amount, is yet to be resolved meaning thereby that the disputed amount still has not been paid. 

 

8]       Now the question left for determination is the allegation of wrong calculation of the maturity value by the OPs. To resolve this issue, we hereby prefer to reproduce the specific term & condition applicable in case of maturity benefit as committed under the policy:-

 

                   5.       The Benefits Payable are as given below

                   a)      On Death of an individual Member: xxxx

b)      On Member reaching to Maturity Date: On an individual Member reaching to the Maturity Date, the individual members account value can be withdrawn.  The minimum maturity guarantee is the total net premiums paid till maturity date less sum of Scheme Administration Fee deducted till maturity date, provided all due premiums have been paid by the policyholder for the respective Member.”

         

9]       In addition to the above clause, we deem it proper that reference be made to the letter issued by the OPs dated 25.4.2016 (at page 18) and chart of maturity value calculation is reproduced here for the sake of convenience:-

Policy Number	218302411
Member name	MR BALDEV SINGH JASSAL
Premium	10000
Amount Paid	50000
COI deducted	6483.05
Scheme admin fee	4403.32
Investment return	10359.28
Scheme fee Amount	1706.6
Account Value	47766.31

 

From the above Maturity Value Calculation, it is revealed that the Opposite Parties not only made certain deductions in contradiction to the above referred term & condition regarding maturity benefit, but also wrongly stated that due to the non-payment of the premium by the complainant, they have initiated the foreclosure action, as the complainant had paid all the premiums on due dates.  It is clear from referred clause that the OPs were entitled only to deduct ‘Scheme Administration Fee’, but their letter dated 25.4.2016 reveals that they also made wrong deductions on other accounts despite Scheme Administration Fee, the only amount which they were entitled to deduct.  Thus it is proved that the deductions made by the OPs are not inconsonance with the term & condition of the policy, as referred above.  Therefore, the OPs are liable to pay the maturity amount of Rs.50,000/- less scheme administrative fee of Rs.4403.32 to the complainant under the policy in question.

 

10]      For the wrong deductions and for not disbursing the maturity amount as per the policy to the complainant in time and also for causing harassment to the complainant as well as thrusting litigation upon him, the OPs are held liable for deficiency in service as well as for indulging into unfair trade practice. 

 

11]      In the light of above observations, the present complaint of the Complainant is allowed qua OPs jointly & severally. The Opposite parties are jointly & severally directed as under:-

 

[a]      To refund the maturity amount of Rs.50,000/- less scheme administrative fee of Rs.4403/-;

 

[b]      To pay Rs.20,000/- to the complainant as consolidated amount of compensation for causing mental agony and harassment for the deficiency in service and indulging into unfair trade practice;

 

[c]      To pay Rs.7,000/- as litigation expenses.

 

         The above said order shall be complied within 45 days of its receipt by the Opposite Parties jointly & severally; thereafter, they shall be liable to pay an interest @18% per annum on amount as mentioned in sub-para [a] & [b] above from the date of this order till it is paid, apart from paying litigation expenses.

         The certified copy of this order be sent to the parties free of charge, after which the file be consigned.

Announced

19^th January, 2017                                                                           Sd/-

(RAJAN DEWAN)

PRESIDENT

 

 

Sd/-

 (PRITI MALHOTRA)

MEMBER

 

Sd/-

(RAVINDER SINGH)

MEMBER