BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PONDICHERRY

C.C.No.48/2012

Dated this the 3^rd day of August 2015.

M. Madivanane, son of V. Manicassamy

No.49, Ponnambala Mudaliar Street

Muthialpet, Puducherry – 3.

                                                            ….       Complainant

Vs.

1. P. Narayanasamy, L.I.C. agent

    LIFE LINE INVESTMENT SHOPPING

    No.315, Thiruvalluvar Salai,

    Nellithope, Puducherry – 13.

2. The Branch Manager

     Life Insurance Corporation of India

     New Saram, Puducherry.

                                                            ….     Opposite Parties

BEFORE:

            THIRU.A.ASOKAN, B.A., B.L.,

            PRESIDENT 

Tmt. PVR. DHANALAKSHMI, B.A.,B.L.,

           MEMBER

FOR THE COMPLAINANT                      :  Thiru,M. Madivanane, Party in Person.

FOR THE OPPOSITE PARTIES               :  Tvl. S.P. Vassudevan and T. Gurumoorthy,   

                                                                        Advocates

O R  D  E  R

(By Thiru.A. ASOKAN, President)

This is a complaint filed by the complainant under section 12 of the Consumer Protection Act, 1986 praying to:

1. Direct the opposite parties to refund the amount paid by him to the tune of Rs.1,40,869/- as per tabular column (i.e. as per R.D. Rs.276969 – 136100 = 1,40,869.00)
2.  Direct the opposite parties to pay to the complainant a compensation of Rs.2,00,000/- for mental agony and harassment caused to him and
3. Direct the opposite parties to pay cost.

2.  The case of the complainant is as follows:

            The Opposite Party No.1 approached him when he was about 10 years of his retirement and canvassed him for a short term policy named Jeevan Anand (with profit) Table 149 for assured sum Rs.1,00,000/- and monthly premium of Rs.1210/-, and by that, he would get more benefit in addition to his retirement benefit by Government.  On the recommendations of Agent, he opted the said policy and paid premium of Rs.1,45,200/- without any gap till his retirement day i.e. on 31.8.2012,  but the LIC Office paid only Rs.1,36,100/- on the date of maturity of the policy  i.e. lesser amount of Rs.9100/- when he paid a sum of Rs.1,45,200/- and that when the same was enquired with the Opposite Party No.1, he had told that it was only for death, but on survival, he would be paid the entire amount which he paid and bonus that grew every year at rapid rate.  On enquiry with Opposite Party No.2,  they told that the terms and conditions of the policy were like that, accordingly, they have paid such amount.  Further, it was stated by the Opposite Party No.2 that he would be paid another Rs.1,00,000/-.  Further, it is stated by the complainant that if he invested such amount in Recurring Deposit, that will be covered Income Tax Benefit  or if he had gone for Janata Policy, one time payment a year for accident benefit.  As such, he was cheated by the Opposite Party No.1 by selling a policy designed only for the benefit of L.I.C. just like defective commodity and thereby the Opposite Parties caused mental torture and mental agony to him.

3.         The following are the averments narrated in the reply version filed by the Opposite Party No.2 and adopted by Opposite Party No.1:

            Apart from denying all the allegations by the Opposite Parties, they admitted that the Complainant had taken a Jeevan Anand Policy with premium of Rs.1,210/- per month based on 10 years according to the age of the complainant.  The said Policy is for Survival Benefit and also for Death Benefit.  Accordingly, the Opposite Party No.2 collected Rs.1,45,200/- for Survival Benefit of Rs.1,00,000/- along with the bonus amount of Rs.36,100/- and further as per Jeevan Anand Policy, the Policy holder will be paid Rs.1,00,000/- on survival of 100 years of age or if risk happens before 100 years.  The policy is still in force without collecting any premium from the complainant and risk cover of Rs.1,00,000/- upto the age of 100 years.  As per the policy contract, the Opposite Party had received the premium from the complainant and also settled the survival benefit to the complainant without any delay.  Hence, there is no deficiency service on the part of the Opposite Party.  Hence, prayed for dismissal of the complaint with exemplary costs.

4.         Points for determination are:

            1. Whether the complainant is the Consumer?

            2. Whether the Opposite Parties attributed unfair Trade Practice and it leads to deficiency in service?

            3. To what relief, the complainant is entitled for?

5.         Point No.1:

            The complainant availed an Insurance Policy of "Jeevan Anand" Table 149 from Opposite Party No.2 through Opposite Party No.1 for a sum assured for Rs.1,00,000/- and paid monthly premium of Rs.1,210/- for 120 months.  The Ex.C4 is the Certificate of Insurance.  Hence, the complainant is the Consumer to Opposite Parties.

6.         Point No.2:

            The Complainant filed Exs.C1 to C6, Calculation Memo, written arguments and adduced evidence.  The Opposite Parties filed reply version and adduced evidence and marked Ex.R1.  The complainant submitted that he has availed an Insurance Policy under Table 149 the "Jeevan Anand" from Opposite Party No.2.  The allegation of the complainant is that the Opposite Party No.1 has misrepresented him to take the policy and assured a huge return nearly 3 to 4 lakhs will come from the said policy.  The complainant further submitted that on contrary to the Opposite Party No.1's assurance, the Opposite Party No.2 has paid only Rs.1,36,100/- i.e. less than Rs. 9100/-what was paid by the complainant as premium to the Opposite Party No.2.

7.         The Complainant further alleged that if he invested such amount in Recurring Deposit, that will be covered Income Tax Benefit or if he had gone for "Janata Policy" onetime payment in a year is enough for accident benefit.

8.         The complainant further submits that he was cheated by the Agent, the Opposite Party No.1 by concealing the real facts of the policy and terms and conditions.  If the agent Opposite Party No.1 has told that "I would be paid only less amount than what I have paid on survival at the time of opting the policy, I would not had opted the policy.  The Complainant prays for returning the premium and for compensation.

9.         The Opposite Party No.2 filed the Reply Version and it was adopted by Opposite Party No.1.  The Opposite parties submitted that in the "Jeevan Anand" Policy so far collected by the Opposite Party No.2 is for Survival Benefit and also for Death Benefit for Rs.1,00,000/- and paid Rs.1,36,100/- for the Survival Benefit to the Complainant.  The Opposite Parties further contended that they have collected the premium and calculated the Benefit as per the Terms and Conditions of the said Policy.  The Opposite Parties further submits that the Policy is still in force without collecting any premium from the Complainant and risk covers of Rs.1,00,000/- upto the age of 100 years as per the agreed terms and conditions.  The Opposite Party No.1 submitted that he never misrepresented the complainant and no proof has been filed by the complainant for the same.  The Opposite Party No.1 further contended that Ex.R1 clearly shows that the complainant fully known about the terms and conditions before taking the policy.  The Opposite Parties denies all the allegations and submits that as per policy contract, the Opposite Parties have received the premium from the complainant and also settled the Survival Benefit without any delay.  Further Opposite Party alleged that the "Jeevan Anand" Policy is a unique plan which cannot be compared with any other mode of savings and it covers both savings and risk element.  The Opposite parties prays for dismissal of the complaint.

10.       From the above facts and materials, it is clear that the Ex.C4 the Certificate of Insurance of "Jeevan Anand" (with profits) with accident Benefit policy, the payments to be made and events on the happenings of which they are to be made i) On Life Assured surviving the premium paying term (Sum Assured together with accrued bonus);  ii) On Life Assured's death before the end of the stipulated premium paying Term (Sum Assured together with accrued bonus);  and iii) On Life Assured's death after the end of the stipulated premium payment term (Sum Assured)

11.       In this case, as per item No.1 the complainant is entitled during his life time, immediately after paying the entire premium i.e. after 10 years, the sum assured together with accrued bonus.  As per the terms and conditions, the Opposite Party No.2 has paid basic amount of Rs.1,00,000/-, vested bonus Rs.32,500/- and interim Bonus of Rs.3,600/- totally to the tune of Rs.1,36,100/- in his account. 

12.       Item No.2 is not applicable to the complainant.  As per Item No.3, the complainant's nominee entitled the Benefit without paying anything further.  On life assured by death after the end of the stipulated premium payment terms i.e. after 10 years the sum assured will be paid.  Hence, the Policy is still in force.  The complainant is entitled the future claim as per the terms and conditions.   Apart from the items listed in the first page of Ex.C4, there are some other facilities and benefits available under the policy.  The complainant being Educated and knowing fully about the terms and conditions and benefits of the policy entered into the proposal.  It is evident through Ex.R1. 

13.       The Calculation filed by the complainant is not supportive of any tangible evidence.  The Life Insurance Policy is different from other investments.  The Policy "Jeevan Anand" with profit and Accident Benefit is unique in nature  The plea taken by the complainant and the calculations are not acceptable and justifiable one.  

14.       It is clear that an insurance contract has to be construed like any other contract on the basis of its terms and conditions.   The Insurance Policy is issued under LIC Act 1956.  It is an established legal proposition that the contract of Insurance is a contract of utmost good faith.  The Doctrine of "uberimma fides"  is fully applicable in this case.  In this regard, the Hon'ble Apex Court in II (2009) CPJ 34 (SC)=IV (2009) SLT 35 [VIKRAM GREENTCH (I) LTD., AND ANOTHER vs NEW INDIA ASSURANCE COMPANY LTD.,: has held that

            "An insurance contract, is a species of commercial transactions and must be construed like any other contract to its own terms and by itself.  In a contract of insurance, there is requirement of uberimma fides i.e. good faith on the part of the insured.  Except that, in other respects, there is no difference between a contract of insurance and any other contract.  The four essentials of a contract of insurance are, (i) the definition of the risk, (ii) the duration of the risk, (iii) the premium, and (iv) the amount of insurance.  Since upon issuance of insurance policy, the insurer undertakes to indemnify the loss suffered by the insured on account of risks covered by the insurance policy, its terms have to be strictly construed to determine the extent of liability of the insurer……"

            "……The insured cannot claim anything more thatn what is covered by the insurance policy."

The complainant misconceived about the policy.  Even though the Opposite Party has banned the particular policy latter, the complainant is entitled for his future claim as per the terms and conditions.  The Opposite Parties are also assured to sanction the sum assured on life Assured's death after the end of the stipulated premium payment terms.  Hence, there is no negligent, deficiency in service and Unfair Trade Practice attributed against the Opposite Party.  The complainant has failed to prove his claim.

15.       Point No.3:

            In view of the above discussion and decision arrived in Point No.2, this complaint is hereby dismissed. No cost.

Dated this the 3^rd day of August 2015.

1. ASOKAN)

PRESIDENT

(PVR. DHANALAKSHMI)

MEMBER

COMPLAINANTS' WITNESS:  

CW.1              15.05.2014                M. Madivanane.

OPPOSITE PARTY'S WITNESS:  NIL

COMPLAINANTS' EXHIBITS:

OPPOSITE PARTY'S EXHIBITS:

LIST OF COURT EXHIBITS:   NIL

( A. ASOKAN )

PRESIDENT

(PVR. DHANALAKSHMI)

MEMBER