DISTRICT CONSUMER DISPUTES REDRESSAL FORUM  PALAKKAD

Dated this the  29^th day of June 2018

Present   : Smt.Shiny.P.R. President

              : Smt.Suma.K.P.  Member                          Date of filing: 09/06/2016

              : Sri.V.P.Anantha Narayanan, Member

                                                      (CC/80/2016)

Akhila,

W/o Krishnadas,

‘Lakshmisree’,

Parli Village, Parli Post,

Palakkad – 678 612.                                                                -         Complainant

(By Advs.Mathew Thomas, B.Sulfikar, K.Dhananjayan)

    Vs 

1.  M/S SBI Life Insurance Company Ltd,                             -        Opposite parties

     Central Processing Centre,

     Kapas Bhavan, Plot No.3A,

     Sector No.10,

     CBD Belapur,

     Navi Mumbai – 400 614.

2.  Represented by its Principal Officer or Authorized Signatory,

     Central Processing Centre,

     Kapas Bhavan, Plot No.3A,

     Sector No.10,

     CBD Belapur,

     Navi Mumbai – 400 614.

    (By Adv.P.Prasad)

3.  Ramachandran,

     Clerk, State Bank of India,

     Palakkad Branch.

    (By Adv.N.R.Mahadevan)

4.  The Manager,

     State Bank of India, Parli,

     Palakkad. 

5.  J.Ramachandran,

     Manager (SME), State Bank of Travancore,

     Main Branch, Tirupur – 641 601,

     Tamil Nadu.                                   

    (Adv.K.A.Stanly James)

O R D E R

By Smt.Shiny.P.R.  President.

Brief facts of complaint.

          Complainant had taken a life insurance policy having No.09001715207 issued by 1^st & 2^nd opposite parties. Annual Premium payable including service charge was Rs.8740/-.  The policy was commenced from March 12, 2006.  Maturity date of the policy was March 16, 2015.  Basic Sum assured was 10,00,000/- (Rupees ten lakhs). Complainant submitted that the said policy has been canvassed by the 3^rd & 4^th opposite party and have jointed through 4^th opposite party.  One of the staff of 4^th opposite party  had made telephone connection with complainant and boasted of that the SBI Life policy would be highly beneficially and would serve coverage of risk etc., and would also get full amount of the premium that the complainant have paid on attaining maturity of the policy.  The complainant has paid 1^st premium through SBT Parli.  The policy was matured on 16^th March, 2015. As per the terms and tenure of the policy on the date of maturity opposite parties have the liability to pay  90% of the total premium paid.    Complainant further submitted that when about to attain maturity, the complainant has got letters from 1^st opposite party dated 4.12.2014 asking him to submit the original policy documents, maturity form cum advance discharge voucher duly to be filled and signed, bank details etc. On that letter they have also stated that the net maturity amount on her policy will be Rs. 68,671/-. Complainant submitted that opposite parties have the liability to pay Rs.1, 04,175/- to the complainant. They have not settled the genuine grievance of the complainant. Then the complainant sent lawyer notice to disperse the full amount. Opposite parties sent reply notice stating that the complainant is legally entitled to get Rs. 68,671/-.  Complainant submitted that non disbursement of the full amount of Rs.1,04,175/- to the complainant amounts to deficiency of service and also unfair trade practice.  Hence the complaint.  Complainant prays for an order directing 1^st and 2^nd opposite party to pay Rs.1,04,175/- along with 12% interest from 16^th March 2015 till realization.

Complaint was admitted and notices were issued to opposite parties. All the opposite parties entered appearance and filed their version separately. 

          1^st and 2^nd opposite parties submitted that the policy has issued as per the proposal form signed by the complainant.  Further, the policy matured on 16.03.2015 and the requirements for paying the maturity value were intimated to the complainant vide letters dated.04.12.2014, 07.01.2015, 05.02.2015 and 02.03.2015.  The maturity value was calculated as per the terms and conditions of the policy and the maturity value.  The features and terms and conditions of the said insurance policy was duly approved by the Insurance Regulatory and Development Authority (IRDAI) and the 1^st  & 2^nd opposite parties  acted strictly as per the terms and conditions of the policy.  In the terms and conditions of the policy it is specifically mentioned that the survival benefit is calculated as per the basic premium.  While messaging the risk under the proposal form, the 1^st and 2^nd  opposite parties have conducted medical examination and based on the medical reports, have called for additional premium on account of health reports and have also called for consent from the complainant for regular health extra of Rs.2,980/.  The complainant had given his consent and additional premium for health extra of Rs.2,980/- and based on his consent and proposal form, Swadhan policy bearing no.09001715207 was issued with date of commencement as on 16.03.2006 for a basic sum assured of Rs.10,00,000/-.  The policy was issued for a term of 9 years and the date of maturity of the policy was 16.03.2015.  The installment premium payable under the policy was Rs.11, 577/-.  The policy was issued for a term of 9 years and the 1^st and 2^nd opposite parties have received the premiums for 9 years under the policy.  As per the clause no.1, survival benefits of the schedule part II, benefits payable and when payable under the policy, “subject to this policy in force for the full basic sum assured, and the life assured surviving to the date of maturity, basic premium paid by the life assured shall become refundable at a rate as appropriate shown below depending upon the

Term of this policy:

          In the instant case, the basic premium paid under the policy is Rs.8,478/- and the total basic premium received under the policy was Rs.8,478 x 9 = Rs.76,302/-.  As per the terms and conditions of the policy, 90% of the basic premium paid is refundable as on the date of maturity, i.e. 90% of Rs.76,302/- which approximate to Rs.68,671/-.  The date of maturity of the complainant’s policy is 16.03.2015.  Therefore the 1^st and 2^nd opposite parties vide a letter dated.04.12.2014 requested the complainant to submit the required documents to enable the 1^st and 2^nd opposite parties to release the survival benefits on maturity to the complainant.  The 1^st and 2^nd opposite parties had also sent reminder letters dated.07.01.2015, 05.02.2015 and 02.03.2015 to the complainant.  The complainant had not submitted the required documents till date to enable the 1^st and 2^nd opposite parties to pay the maturity value under the policy.  The 1^st and 2^nd opposite parties are ready to pay the maturity value under the policy on receipt of requirements from the complainant. 

          Counsel for 3^rd opposite party submitted that 3^rd and 5^th opposite party is one and the same person. This opposite party submitted that this opposite party is not a necessary party to these proceedings. The complainant has no cause of action against this opposite party and also not sought any relief from this opposite party.  The opposite party hereby adopts the contentions raised by the 4^th opposite party in their version.  This opposite party has not rendered any deficient service to the complainant and there is no unfair trade practice at the instance of this opposite party.  Hence this opposite party is not liable to compensate the complainant. 

          4^th opposite party filed version contended that this opposite party is not a necessary party to this proceeding.  The complainant has no cause of action as against this opposite party and also not sought any relief from this opposite party. There is no privity of contract between the complainant and this opposite party.  This opposite party has neither canvassed nor lured the complainant to take life insurance policy.  The policy is not issued through this opposite party.  This opposite party is not a serving office of the other opposite parties.  The contract between the complainant and the other opposite party is not binding on this opposite party and merely for the reason the premium was paid through this opposite party is not a ground to drag this opposite party to the cobweb of judicial proceeding of this nature.  This opposite party is not bound to pay any amount to the complainant.  The payment of premium through this opposite party will not give raise to any cause of action against this opposite party nor confer jurisdiction on this Forum to try this petition.  It is submitted that this opposite party is not at all necessary or proper party to the above proceedings.  Hence the complaint against this opposite party may be dismissed with costs. 

Complainant filed their chief affidavit. All the opposite parties filed their respective chief affidavits.  Complainant answered interrogatories served on her by the 1^st and 2^nd opposite parties.  Exts.A1 to A5 are marked from the side of complainant and Exts. B1 to B9 are marked from the side of 1^st and 2^nd opposite parties.  

The following issues that arise for consideration are.

1. Whether there is any deficiency of service from the part of opposite parties?
2. If so, what are the relief and cost?

Issues 1 & 2

We have perused the documents and affidavits filed by both the parties. Opposite party 1 & 2 admitted the policy taken by the complainant.  Complainant submitted that as per the terms and conditions of the policy the complainant is legally entitled to get 90% of the total premium paid on the attainment of its maturity. He admitted that he had paid annual premium is Rs. 8740/- including service charge. According to complainant 1^st and 2^nd opposite parties are liable to pay Rs.1,04,175/- to her. No calculation statement is produced to show how he arrived at such an amount of Rs. 1,04,175/-. On going through the terms and conditions of Ext. A2 policy schedule part II (1) survival benefits it is revealed that  on  attaining maturity period of 9 years complainant is entitled to get only 90 % of basic premium already paid.   Ext. A2 policy evident that the installment premium payable under the policy was Rs.11, 577/- including extra premium. Ext. B3 consent letter bearing the signature of complainant shows that 1^st and 2^nd opposite parties   have called for consent from the complainant for regular health extra of Rs.2,980/- on account of health reports and the complainant has given consent for that.  It clearly shows that complainant had taken additional risk coverage by paying extra premium. In the terms and conditions of Exts.A2 and B2 policy it is specifically mentioned that the survival benefit is calculated as per the basic premium. In the above circumstances we are of the view that complainant is entitled to get 90 % of total installment premium amount paid for nine years less extra premium paid. Complainant has not produced any document to show that he is entitled to get an amount of Rs.1,04,175/- from the opposite parties.  In Oriental Insurance Co. Ltd V Sony Cherian II (1999) CPJ 13 SC the apex court held 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. In the light of the above discussions we are of the view that complainant is entitled to get only 90 % of the basic premium paid for 9 years. In the version 1^st and 2^nd opposite parties submitted that they had sent letters and reminders to the complainant to submit the required documents to release the survival benefits on maturity to the complainant.  They also submitted that they were ready to pay the maturity value under the policy on receipt of requirements from the complainant. The complainant had not submitted the required documents till date to enable the 1^st and 2^nd opposite parties to pay the maturity value under the policy.    In the above circumstances we are not in a position to attribute deficiency in service on the part of 1^st and 2^nd opposite parties. No reliefs were sought against other opposite parties. Hence complaint is dismissed.

Pronounced in the open court on this the 29^th day of June 2018.

                                                                                       Sd/-

              Shiny.P.R.

               President 

                   Sd/-

              Suma.K.P.

                Member

Sd/-

V.P. Anantha Narayanan

                Member

Appendix

Exhibits marked on the side of complainant

Ext.A1          -  Photocopy of letter dated.20.03.2006 issued by Ravi Krishnamoorthy

             Sr.Vice President SBI Life to the complainant

Ext.A2          -  Photocopy of SBI Life Swadhan Insurance policy along with schedule

Ext.A3          -  Photocopy of letter dated.04.12.2014 issued by the authorized signatory of

             SBI Life to submit the advance discharge voucher along with specimen of

             advance discharge voucher

Ext.A4          -  Photocopy of letter sent by the complainant to the opposite party

             dated.7.2.15

Ext.A5          -  Photocopy of the reminder letterdated.05.1.15 issued by the opposite party       to the  Complainant to submit the papers

Ext.A6 series -  Photocopy of lawyer notice issued by the counsels of the

                       complainant to the opposite parties with original postal receipt and

                      acknowledgement card

Ext.A7          -  Photocopy of the reply and clarification issued by the opposite party (3

             pages)

Exhibits marked on the side of opposite parties

Ext.B1 -  Proposal form Annexure A – SBI Life Insurance Policy

Ext.B2 -  Policy Document Annexure B

Ext.B3 -  Consent of Swadhan Policy Annexure C

Ext.B4 -  Copy of the letter dated.04.12.2014 Annexure D

Ext.B5 series -  Copies of letter dated.07.01.2015, 05.02.2015 & 02.03.2015

                      Annexure E

Ext.B6 -  Copy of Reply Annexure F

Ext.B7 -  Copy of Reply Annexure G

Ext.B8 -  Copy of Legal Notice dated.12.03.2015 Annexure H

Ext.B9 -  Reply of legal notice dated.30.03.2015 Annexure I

Witness examined on the side of complainant

Nil

Witness examined on the side of opposite party

Nil

Cost

          Nil