Delhi

New Delhi

CC/678/2012

Baby Vyomica Nanchahal - Complainant(s)

Versus

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

15 Jul 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.678/2012                              Dated:

    In the matter of:

Baby Vyomica Nanchahal,

Aged about 7 years

Through her father

Dr. Ashutosh

S/o  late Sh. Tarsem Kumar,

Through his mother

 

Smt.Sudershan Kumari,

W/o late Sh. Tarsem Kumar,

(earlier residing at A-53, R-Block),

Dilshad Grden,

Delhi-110095.

 

Presently residing at:

Gyatri Niwas, B-115, Preeti Vihar,

Delhi-92.

                            ……..COMPLAINANT

 

VERSUS

 

The Managing Director/Chairman,

Aviva Life  Insurance Co.India Pvt. Ltd.

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 had taken Life Insurance Policy bearing No.RPG1547870 with commencement date being 26.4.2007 from the executive of OP who intimated her that she had to pay Rs.16000/- p.a. for a period of 5 years and after completion of said five years she would get Rs.1.5 lakh as lump sum amount. The complainant paid the said amount regularly expecting the payment of Rs.1.5 lakh but she got only a sum of Rs.79,598/- after five years.  Despite her repeated request to the concerned executive and officials of OP, she had not got any favourable response till date against the policy bearing No.RPG1547870

2.     The complainant had also taken Life Insurance Policy No.REG 1560766 (Risk commencement dated 9.5.2007) in the name of her minor grand-daughter on the same terms but for a period of ten years. She decided to discontinue the said policy, after receiving a sum of Rs.79,598/-  against the policy bearing No.RPG1547870 instead of Rs.1,50,000/-.  Accordingly, she asked the OP Co. to refund the deposited amount along with the bonus and other benefits.  But this time also against the surrender of the policy, she  received only Rs.62,257/- instead of deposited amount of Rs.80,000/-. Despite her repeated request to the concerned executive and officials of OP, neither she was given any explanation regarding the short payment nor she was entertained properly.  The complainant sent legal notice dated 25/06/2012 to the OP but no response was given to her till date.  Complainant, therefore approach this Forum for redressal of her grievance.

3.     Complaint has been contested by the OP.  In its written statement OP stated that the  Insurance policy availed by the complainant is a Pension Plus Unit Linked Policy having death benefit of Sum Assured and the Fund Value, which is market linked.  It is further stated that under the said policy, a customer is entitled to the death benefits immediately upon issuance of the policy; thereby meaning that even if in the first year itself, the customer dies, he/she is entitled to Sum Assured and Fund Value as mentioned in Article 3 of the Terms and Conditions of the Insurance Policy.  It is submitted that the complainant is not entitled to any relief as the claim of complainant is barred by Law of Estoppel, since the complainant had already availed the benefits under the policy as per terms of the policy.  Admittedly, the complainant opted to exercise her right/option to surrender the policy.  After receipt of Surrender Request from the complainant, OP after completing necessary formalities has processed her claim and surrender amount had been  sent to the complainant’s account through NEFT and the same has been received by the complainant.  It is also submitted by the OP that it has complied with all its obligations under terms of the Insurance Contract.  Therefore, complainant is not entitled for any other relief and further prayed for the dismissal of present complaint.

4.     Both the parties have filed their evidences by way of affidavits.  

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 request of surrender of policy on behalf of complainant. The OP had placed on record the copy of standard terms and conditions of the policy in question. .    Admittedly, the complainant received the policy in the year 2007,  if she was not satisfied with the policy than he ought to have approached the OP for the cancellation of the policy.  On the contrary, she continuously paid five premiums against the policy in question.  Thereafter, she approached OP vide surrender request dt. 25.4.2012 to surrender the policy in question.  The OP Insaurance Co. honour her surrender request and transferred surrender value amounting to Rs.62,428/- through NEFT in the her account  which was duly accepted by  her. 

7.     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.    In view of the above discussion and judgments cited above, we are of the considered view that, as the complainant had already received the surrendered value of policy in question as per her surrender request, she failed to establish the case of deficiency in services against the OP, as alleged in her complaint.

14.    Moreover, perusal of the file shows that complainant has no Locus Standi to file the present complaint, as the policy in question was issued in the name of Sh. Ashutosh.

15.    We find no merits in the present complaint, same is hereby dismissed.  File be consigned to Record Room.

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 ).

Announced in open Forum on  15/07/2019.

 

 

 

(ARUN KUMAR ARYA)

PRESIDENT

(NIPUR CHANDNA)                                                                                          (H M VYAS)

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