Delhi

New Delhi

CC/612/2008

Shri Mohan Singh Manral - Complainant(s)

Versus

M/S. Aviva Life Insurance Company India Ltd. - Opp.Party(s)

02 Apr 2019

ORDER

 

CONSUMER DISPUTES REDRESSAL FORUM-VI

(DISTT. NEW DELHI),

 ‘M’ BLOCK, 1^STFLOOR, VIKAS BHAWAN, I.P.ESTATE,

                                               NEW DELHI-110001

 

Case No.C.C.612/2008                                          Dated:

In the matter of:

Sh. Mohan Singh Manral,

S/o Sh. J.S. Manral,

R/o D-867, Ambedkar Nagar,

Sector-1(Tigri), New Delhi.

                 ……..COMPLAINANT

VERSUS

AVIVA LIFE INSURANCE,

Aviva Life  Insurance Co.India Pvt. Ltd.

Regd.  Office 2^nd Floor, Prakash Deep Building,

7, Tolstoy Marg, New Delhi-110001.

Opposite Party.

                

ARUN KUMAR ARYA, PRESIDENT

ORDER

       

The complainant has filed the present complaint against the OP under section 12 of Consumer Protection Act, 1986.  The gist of the complaint is that the complainant purchased a LIG policy bearing No.1174466 Life Long Unit Linked on 6.6.2005 for  Rs.5 lacs with half yearly premium of Rs.25,000/- each from the OP.  On 6.5.2005, the complainant deposited first installment of Rs.25,000/-, second installment of Rs.25,000/- on 3.8.2005 and third and fourth installments of Rs.50,000/- on 5.6.2006.  Due to some personal problems, the complainant could not continue to pay further installments, therefore, on 4.6.2007, the complainant sent a letter to the OP Co. for surrender of said policy and demanded the amount deposited by him. The OP Co. advised the complainant to surrender the policy after two years when the amount would be refunded to him.  the complainant surrendered the above original policy on 12.10.2007 at Mehrauli against proper receipt. 2. The complainant was verbally informed by the official of the OP  that he would get approx. Rs.1,21,000/- as surrendered value, whereas  the total fund values was shown on 5.6.2007 as Rs.1,17,501/- in the policy account statement.  After few days, on the request of complainant for surrender of policy, a letter dated 23.10.2007 was received by him along with a cheque of Rs.26,989/- as total refund amount against the amount of Rs.1 lac deposited by the complainant towards the policy.  The complainant visited the branch office of OP at Gurgaon to enquire about the deduction but the official of the OP  asked the complainant to approach the Customer Care Centre for his grievance.  When no positive response was received from the OP Co., a legal notice dated  20.3.2008 was sent to the OP Co. by the complainant but neither OP replied to the legal notice nor any  positive action was  taken by it, hence this complaint.

3.     Complaint has been contested by OP.  In its written statement O.P has not disputed that complainant had taken policy referred above.  It has been pleaded that after the expiry of  2 years, on 12.10.2007, the complainant submitted a duly signed Surrender Request Form to the OP Co. and informed that he would not be able to continue with the policy and desired to surrender the same.  On 16.10.2007, the OP Co. accepted the request of complainant for surrender of policy and issued a cheque for Rs.26,989/- against the surrender request  to the complainant.  The surrender value had been calculated strictly in accordance with the terms of the policy.

4.     Complainant has filed his evidence by way of affidavit wherein he has corroborated the contents of his complaint.  On the other hand, on behalf of OP, Sh. Ravi Bhandari, Co. Secretary and Associate Director-Legal  has filed his evidence by way of Affidavit.  

5.     We have heard argument advance at the Bar and have perused the record.

6.     Some facts are not disputed by the parties such as the policy documents, payment of premiums and the letter of surrender request.    Admittedly, the complainant received the policy in the year 2005.  He has also paid four premium against the policy in question.  The complainant was aware that the policy was issued in accordance with terms and conditions.  The complainant sent a surrender request to the OP vide letter dated 12.10.2007. 

7.     As per policy terms and conditions, The OP Insurance Co. accepted the request of the complainant, the OP cancelled the policy and sent the surrender value to the complainant vide cheque dated 18.10.2007.  The surrender value was calculated by the OP as per the terms and conditions of the policy.   Insurance is a contract between the insured and insurer and both the parties are bound by the terms contained therein. The Hon’ble NCDRC in the matter of National Insurance Co. Ltd. vs. Vinod Puri as reported in I [2014] CPJ 341 (NC) is pleased to hold as under:

Insurance contract has to be construed like any other contract on basis of its terms and conditions and outside aid for construction of insurance policy is impermissible.

 8.    The Hon’ble Apex Court in the case of Oriental Insurance Co. Ltd. versus Sony Cheryan reported in (1999) 6 SCC 451 is pleased to hold as under:

The insurance policy between the insurer and the insured represents a contract between the parties. Since the insurer undertakes to compensate the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability of the insurer. The insured cannot claim anything more than what is covered by the insurance policy.

 9.    Similarly in the case of General Assurance Society Ltd. vs. Chandumull Jain and Anr., reported in (1996) 3 SCR, 500, the Constitution Bench has observed that the policy document being a contract and it has to be read strictly. It was observed:

In interpreting documents relating to a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed by the parties, because it is not for the court to make a new contract, however, reasonable, if the parties have not made it themselves. Looking at the proposal, the letter of acceptance and the cover notes, it is clear that a contract of insurance under the standard policy for fire and extended to cover floor, cyclone etc. had come into being.

 

10.    The Hon’ble NCDRC in the matter of Ind Swift Ltd. versus New India Assurance Co. Ltd. reported in IV[2012] CPJ 148 (NC) is pleased to rule as under:

Construction of the policy is to be construed strictly as per the terms and conditions of the policy document which is binding contract between the parties and nothing can be added or subtracted by different meaning.

 

11.    Similarly in LIC versus Banwarilal Yadav reported in IV[2013] CPJ 38 (NC) the Hon’ble NCDRC observed as under:

“Forum has no jurisdiction to go beyond terms and conditions of the Policy.”

 12.   The NCDRC in yet another matter in the matter of Morien Chemicals Ltd. versus UCO Bank reported in III [2013] CPJ 261 (NC) is pleased to hold as under:

“Insurance Company is not liable to pay damages which are not covered under the policy.”

 13.   Having regard to the facts and circumstances of the case and  discussion heard, we are of the considered view that there exists no infirmity in the decision of the Insurance Company as the surrender value was calculated as per the terms and conditions of the policy and courts are not meant to add or delete the terms of contract.  The above cited judgments  are squarely applicable in the present case. 

14.    In view of the above discussion, we are inclined to hold that the disbursement of the claim of the complainant to the tune of  Rs.26,989/-  against the surrender value was justified.  If the complainant has not encashed the cheque of Rs.26,989/- , OP is directed to issue the fresh cheque against the said amount  ie. Rs.26,989/- .  The present complaint is disposed off with above directions..

A copy of this order each be sent to both parties free of cost by post.  This final order be sent to server (www.confonet.nic.in ). File be consigned to Record Room.

Announced in open Forum on 02/04/2019.

 

 

 

(ARUN KUMAR ARYA)

          PRESIDENT

(NIPUR CHANDNA)                                                  (H M VYAS)

       MEMBER                                                                 MEMBER