Tamil Nadu

South Chennai

CC/65/2018

G Sathya - Complainant(s)

Versus

Relainace Nippon Life Insurance & Others - Opp.Party(s)

M/s R Karhtikeyan

06 Jun 2022

ORDER

                   Date of Complaint Filed :17.01.2018                                                            

                   Date of Reservation:10.05.2022                                                                      

                                                                                                   Date of Order : 06.06.2022

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION,

CHENNAI (SOUTH), CHENNAI-3.

 

PRESENT:    TMT. B. JIJAA, M.L.,                                               : PRESIDENT

                       THIRU. T.R. SIVAKUMHAR, B.A., B.L.,           :  MEMBER  I 

                       THIRU. S. NANDAGOPALAN., B.Sc., MBA.,     : MEMBER II

 

CONSUMER COMPLAINT No.65/2018

MONDAY, THE 6^th DAY OF JUNE 2022

G.Sathya,

W/o. V.Girirajan,

No.9/25, Meenakshi Street,

Karthikeyan Nagar, Maduravoyal,

Chennai – 600 095.                                                      …Complainant

…Vs…

1.Reliance Nippon Life Insurance Company Limited,

   Rep. by its Branch Manager,

   T.Nagar Branch,

   No.113, 114, MeenaKampale Arcade,

   4^th floor, B Wing, Sir Thyagaraya Road,

   Chennai – 600 017.

 

2. Reliance Nippon Life Insurance Company Limited,

   Rep. by its Branch Manager,

   Anna Nagar Branch,

   AC5, 2^nd Avenue, Anna Nagar,

   Chennai – 600 040.  

 

3.Reliance Nippon Life Insurance Company Limited,

   Head Office, Mumbai,

   Rep. by its Branch Manager,

   9^th floor, R-tech Park,

   Nirlon compound,

   Goregoan, Mumbai – 400 063.                            …Opposite Parties

 

******

Counsel for the Complainant          : M/s. R. Karthikeyan

Counsel for the Opposite Parties     : M/s. JP. Karunakaran

 

        On perusal of records and after having heard the oral arguments of the Counsel for Complainant and the Counsel for Opposite Parties, we delivered the following:

 

ORDER

Pronounced by the President Tmt. B. Jijaa, M.L.,

1.      The Complainant has filed this complaint as against the Opposite Parties under section 12 of the Consumer Protection Act, 1986 and prays to return the outstanding amount of Rs.25,622.90p with interest and to pay the compensation of Rs.1,75,000/- including compensation for mental agony and financial loss and expenses suffered by the Complainant.

2.     The facts of the complaint in brief are as follows:-

        The Complainant had taken child insurance policy vide policy No.5026283 from the 1^st Opposite Party on 20.07.2012 for her daughter. The Complainant has duly paid the premium amounts totaling Rs.1,48,354/-. As per the product brochure maturity benefit means and includes, 1) 25% of sum assured 2) Vested Bonus 3) Non Negative Capital Guarantee. The Opposite Parties has not purposefully included Non Negative Capital Guarantee as promised by them by their product brochure.  Further the Opposite Parties made the Complainant to believe that she will earn surplus amount on the premium paid. The product brochure of the Opposite Parties clearly states that the return of premium is guaranteed under the plan.  The premium receipt vide policy document clearly reveals the fact that the premium paid is with respect to the base sum assured. In order to qualify for the non-negative capital guarantee sum of all the benefits shall be lesser that 100.1 % of the total premium paid.  The sum of all the benefits totally amounted to Rs.1,22,731.16 which is lesser than Rs.1,48,354/-. But to the Complainant’s shock and surprise she has not even received the sum equal to that of the premium paid. The Complainant had raised the protest claim through e mail dated 11.09.2017 for which the 3^rd Opposite Party had sent a reply letter stating that the total sum of Rs.1,22,731.16 has been paid to the Complainant. Depicting by the means of terms and conditions of the policy document that the Complainant shall be receiving surplus amount in the form of vested bonus and other maturity benefit including non-negative capital guarantee clearly amounts to unfair trade practice and non issuance of the guaranteed return of premium in the form of non-negative capital guarantee and failure to issue the vested bonus amounts to deficiency in service. Hence the complaint.

3.   Written Version of the  Opposite parties in brief is as follows:-

At the outset the policy is a contract governed by the terms and conditions as mentioned in policy document  and not by the alleged brochure. The policy document is the subsequent document and forms a binding contract between the Complainant and the Opposite Parties. The alleged non negative capital guarantee was never committed to the Complainant as even on the brochure it is stated to be if any. As the same does not form part of insurance contract, the Complainant is not entitled for alleged benefit. The benefits under the policy at the time of maturity of policy has been passed on to the Complainant which has been received by him without any protest and demur. Oral commitment and alleged brochure cannot be read in evidence as barred by Section 91 and 92 of the Indian Evidence Act, 1872.

        The Complainant had subscribed a policy marketed in the name of Reliance Child Plan bearing policy no.50262831 by consenting signing the Proposal Form. The policy documents were sent to the Complainant and it was received on 26.07.2012. The terms and conditions of the policy are in strict adherence to norms set up by Insurance Regulatory and Development Authority. The Complainant was advised to examine the policy carefully and if not satisfied with the terms and conditions, she might have returned the policy for cancellation within 15 days from the date of receipt of policy and get back the premium paid.

        The Complainant signed the Proposal Form bearing No.0818915 with enforcement date being 20.07.2012 having policy term for 5 years and an annual premium  payment amounting to Rs.30,000/- for the sum assured of Rs.1,09,875/-. After 5 years when the policy got matured the Complainant was paid the Survival Benefit in the year 2014, 2015 and 2016 @ Rs.27,468.25 per annum in total Rs.82,406.25 and maturity benefit @Rs.27,468.75 + Rs.12855.40 (Revisionary Bonus paid every year) = Rs.40,324.15/-.  Hence the total amount paid to the Complainant was Survival Benefit of Rs.82,405.25 + Maturity Benefit of Rs.40,324.15 amounting to total of Rs.1,22,730.40/-.  As the total sum payable under the policy has been paid to the Complainant, which has been received without any protest and demur, the Complainant received the aforesaid sum in full and final satisfaction of all her claim under the policy.  Hence the Complaint deserves to be dismissed with cost.

4.    The Complainant had filed her Proof Affidavit and Written Arguments. On the side of Complainant Exs-A.1 to Ex-A.12 were marked. The Opposite Parties had filed their Proof Affidavit and Written Arguments. No document is marked on the side of Opposite Parties.

5.      The Points for consideration are:-

1. Whether there is unfair trade practice and deficiency in service on the part of the Opposite Parties?
2. Whether the Complainant is entitled to the reliefs as claimed in the complaint?
3. To what other reliefs, the Complainant is entitled?

 

6.      Point No.1:-

The undisputed facts are that the Complainant had taken a Child Insurance policy from the Opposite Parties vide policy No.5026283 dated 20.07.2012, which is Ex.A-1, for her daughter and had paid premiums from the year 2012 to 2016 totaling to a sum of Rs.1,48,354/- as found in Exs A-3 to A-7. It is averred in the complaint that the Opposite Parties has paid the Complainant Rs.27,468.75 each on various dates such as 25.08.2014 22.07.2015, 19.06.2016 and, and as per Ex.A-8 the Maturity Benefit for a sum of Rs.40,324.91 was paid by the Opposite Parties vide cheque dated 31.07.2017. Thus the total amount paid by the Opposite Parties amounts to Rs.1,22,731.61. The Complainant claims that the balance outstanding of Rs.25,622.9p which the Opposite Parties had promised for Non Negative Capital Guarantee in their product brochure, is to be paid by the Opposite Parties.

A perusal of Ex.A-2, the product Brochure the heading Maturity Benefit reads as

“At maturity of the policy, get

Guaranteed Sum Assured at maturity: 25% of Sum Assured

Vested bonuses which accrue every year

Non-Negative Capital Guarantee, if any.”

 

Further under the head Non-Negative Capital Guarantee reads as

 

“Return of premium is guaranteed under the plan.  In case the sum of all benefits (Periodic Lump Sum Benefit, Guaranteed Sum Assured at maturity. Vested Bonuses and Death Claim if any) is smaller than the 100.1% of the total premiums paid, the deficit will be paid.”

 

The Opposite Parties contended that the alleged Non Negative Capital Guarantee does not form part of the insurance contract, the benefits which was available under the insurance policy at the time of maturity was given to the Complainant and having received the sums without any protest and demur the Complainant is precluded from filing this Complaint. Further if the Complainant is not satisfied with the condition of the policy documents she could have returned the policy within 15 days of the receipt of the policy.

Though the Opposite Parties contend that the Non Negative Capital Guarantee does not form part of the insurance contract, the Opposite Parties vide product brochure Ex.A-2 has assured Non Negative Capital Guarantee, however the same does not find place in the Policy document and further the Complainant was made to believe that she will earn surplus amounts on the premium paid.

A reference was made by the Complainant to the Notification dated 14.07.2000 issued by the Insurance Regulatory and Development Authority, for the definition of “Unfair or misleading advertisement”.

The Opposite parties though guaranteed for Non Negative Capital Guarantee under the product brochure is taking shelter under the Policy document as there is no specific mention about the Non Negative Capital Guarantee in the Policy document. There is also no specific mention about the payment of the vested bonus assured to be paid on maturity date by the Opposite Parties at the time of payment of maturity benefit to the Complainant would amount to unfair trade practice. The act of the Opposite Parties in publishing the deceptive product brochure without meeting out the promises made by them only to attract the policy holders would amount to unfair trade practice, in as much as the over all benefits received by the Complainant is less than the premium paid by the Complainant.

The Opposite Parties has placed reliance on 3 Judgements  of the Hon’ble Supreme Court reported in AIR 1966 SC 1644, AIR 2000 SC 10 and AIR 2005 SC 286, wherein it was held that the insurance policy has to be construed having reference to the stipulations contained therein and no artificial farfetched meaning could be given to the words appearing in the policy document, which Judgments are not applicable to the case at hand, as the instant case deals with the publication of deceptive product brochure which would amount to unfair trade practice.

The paid up premium of the Complainant is Rs.1,48,354/-.  However the Opposite Parties had returned a sum totaling to Rs.1,22,731.61 at the time of maturity and the difference amount remaining unpaid being Rs.25,622.9p. The act of the Opposite Parties in guaranteeing return of premium in the form of Non Negative Capital Guarantee and making the Complainant to believe that she would get surplus amount on maturity and by not returning even the premium amounts paid by the Complainant as guaranteed in the form of Non-Negative Capital Guarantee under the product brochure, would clearly amounts to deficiency of service committed by the Opposite Parties having invited the insured to enter into Policy by providing their product brochure and denying the guarantee of Non-negative Capital guarantee mentioned in such brochures provided, cannot take shelter as the said guarantee does not form part of the terms and conditions of the policy, clearly amounts unfair trade practice adopted by the Opposite Parties, apart from having committed deficiency of service. Hence, we are of the considered view that the Opposite Patties have committed unfair trade practice as well as deficiency of service.

 

7.      Point Nos.3 and 4 :-

We have discussed and decided that the Opposite Parties 1,2 and 3 had committed unfair trade practice and deficiency in service on their part, hence the Complainant is entitled to get a sum of Rs.50,000/- towards compensation for deficiency of service on the part of the Opposite Parties and also for the mental agony suffered by the Complainant along with litigation costs of Rs.5,000/- Accordingly Point No.3 and 4 are answered.

In the result this complaint is allowed in part. The Opposite Parties 1,2 and 3 are jointly and severally directed to pay a sum of Rs.50,000/- (Rupees Fifty Thousand Only) towards compensation for the deficiency in service and also for the mental agony caused  to the Complainant. Further it is directed to pay a sum of Rs.5,000/- (Rupees Five Thousand Only) towards litigation costs.

 The Opposite Parties 1,2 and 3 are directed to pay the above amounts within 8 weeks from the date of this order, failing which the Complainant is entitled to recover the above amounts along with interest at the rate of 9% per annum from the date of this order  till the date of realization.

Dictated to Steno-Typist, transcribed and typed by her, corrected and pronounced by us in the Open Commission, on 6 ^th  day of June 2022.

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                     B.JIJAA

         MEMBER II                       MEMBER I                           PRESIDENT

 

 

List of documents filed on the side of the Complainant:

 

Ex.A1	20.07.2012	Policy document
Ex.A2		Product brochure
Ex.A3	27.07.2012	Bounced Premium receipt
Ex.A4	27.07.2013	Renewal premium receipt
Ex.A5	26.08.2014	Renewal premium receipt
Ex.A6	24.08.2015	Renewal Premium receipt
Ex.A7	09.08.2016	Renewal premium receipt
Ex.A8	31.07.2017	Cheque issued by the Opposite Parties as a maturity benefit
Ex.A9	26.08.2017	Mail sent by the Complainant to the 3rd Oppoiste Party
Ex.A10	30.08.2017	Mail correspondence of reply sent by the 3rd Opposite Party
Ex.A11	11.09.2017	Protest claim raised by the complainant
Ex.A12	14.09.2017	Reply sent by the 3rd Opposite Party

 

List of documents filed on the side of the Opposite Parties:-

 

NIL

 

 

 

S. NANDAGOPALAN               T.R. SIVAKUMHAR                     B.JIJAA

         MEMBER II                       MEMBER I                           PRESIDENT