Order by:
Smt. Aparana Kundi, Member.
- The complainant has filed the instant complaint under section 35 of the Consumer Protection Act, 2019 on the allegations that on the allurement of Opposite Party No.3 in the month of January 2011 complainant purchased one policy namely "Reliance Super Five Plus" and paying term of the said policy was 6 years and the policy term is of 11 years and basic sum assured under the said policy was Rs.115800/-. Opposite Party No.3 assured the complainant that in case of death of complainant at any time prior to 31.1.2022 i.e. before maturity of the policy then the company will pay Rs.28950/- as vested Bonus besides the sum assured to the nominee of complainant. On survival of complainant on 31.01.2022, the company will further pay Rs.1,15,800/- to complainant. As per assurance given by opposite party no.3 the complainant signed the requisite papers and purchased the insurance policy and paid the premium to the Opposite Party no.3. The opposite parties no.1 and 2 issued policy No.18481185 in the name of complainant for the period from 31.01.2011 to 31.01.2022. Further alleged that at page no.3 of above noted policy it is categorically mentioned that on survival of complainant on 31.01.2017 the company will pay Rs.1,15,800/- and vested bonus to complainant and on survival of complainant on 31.01.2022 the company will further pay RS.1,15,800/-. The complainant paid all the premiums of the policy to Opposite Parties in time. So, as per the term of the policy, the Opposite Parties no.1 and 2 paid amount of Rs.115800/- to complainant on 31.01.2017. Then complainant requested Opposite Parties no.1 and 2 to pay vested Bonus to him as per the policy. Thereafter on 31.01.2022 the Opposite Parties paid Rs.47949.75 to complainant on account of vested bonus. In the month of February 2022 the complainant requested Opposite Parties to pay Rs.1,15,800/- to complainant as per assurance given by them and as per benefits payable as per page no.3 of the policy. Then Opposite Parties started lingering on the matter on one pretext or the other. Thereafter in the second week of March Opposite Party no.3 refused to pay the said amount to complainant, by saying that Opposite Party No.1 has flatly refused to the pay the said amount to complainant and told the complainant to approach Opposite Party No.2. When the complainant approached to Opposite Party No.2, they refused to pay the above noted amount by saying that there is there is no such policy. When complainant asked about benefits payable at page no.3 of the policy, then Opposite Party No.2 refused to pay the said amount by saying that it is a printing error in the policy at the time of issuing the policy. The complainant sent legal notice to the Opposite Parties, but all in vain. Thereafter repeated requests were made, but Opposite Parties refused to release any amount. Due to the acts of the Opposite Parties complainant suffered mental tension and harassment. Hence this complaint. Vide instant complaint, the complainant has sought the following reliefs:-
a) Opposite Parties may be directed to pay an amount of Rs.1,15,800/- with regard to policy no.18481185.
b) To pay an amount of R.80,000/- as compensation on account of mental tension, harassment and agony.
c) To pay an amount of Rs.25000/- as costs of litigation expenses.
d) And any other relief which this Commission may deem fit and proper be granted to the complainant in the interest of justice and equity.
2. Upon service of notice, none appeared on behalf of Opposite Parties No.1 & 3, hence Opposite Parties No.1 & 3 were proceeded against exparte.
3. Opposite Party No.2 appeared through counsel and contested the complaint by filing written reply taking preliminary objections therein inter alia that the complaint being frivolous and vexatious is liable to be dismissed as the complainant has failed to make out a case of "Deficiency of Service" as alleged or otherwise within the meaning of Consumer Protection Act, 2019, hence the present complaint is not maintainable. The complainant has not come to the court with clean hands and has suppressed true & correct facts from this Commission with regard to issuance of letter dated 28.04.2011 vide which it was intimated to the complainant that due to printing error incorrect benefit value has been mentioned in the policy. It has been claimed that the Opposite Parties also issued the revised policy schedule to the complainant, but the complainant very cleverly concealed the said letter as well as the revised policy schedule and filed the present complaint on wrong and false facts. Claimed further that the Opposite Parties have already paid the admissible maturity benefits to the complainant as per terms and conditions of the policy and nothing is due against the answering Opposite Parties as per terms and conditions of the policy. The complaint has been filed with malafide and dishonest intention and complainant has not only concealed the material facts from the Commission but has also twisted and distorted the same to suit his own convenience. Further alleged that the contract of the Insurance between the answering opposite parties and complainant is governed by its Policy terms and conditions. On merits, all other allegations made in the complaint are denied and a prayer for dismissal of the complaint is made.
4. Complainant also filed replication to the written reply of Opposite Parties, denying the objections raised by the Opposite Party no.2 in their written reply.
5. In order to prove his case, complainant tendered in evidence his affidavit Ex.C1 alongwith copies of documents Ex.C2 to Ex.C7.
6. To rebut the evidence of the complainant, Opposite Parties tendered in evidence affidavit of Sh.Nirmal Khurana, Authorized Signatory, Reliance Nippon Life Insurance Ex.OP2/1 along with copies of documents Ex.OP2/2 & Ex.OP2/3.
7. We have heard the counsel for the complainant and gone through the written arguments submitted on behalf of the Opposite Parties and also gone through the documents placed on record.
8. All the facts as told by the complainant were admitted by the Opposite Parties except the benefits, which were to be given by the Opposite Parties to the complainant as per the policy on the survival of the complainant on 31.01.2022. On the other hand, Opposite Parties denied the said benefits on the ground that the maturity benefit was mis-printed in the policy document issued to the complainant and thereafter they informed and issued the revised policy schedule to the complainant, but the complainant refused the receiving of the revised policy or any letter as claimed by Opposite Parties. Moreover, the Opposite Parties could not produce any evidence to prove that the said letter dated 28.04.2011 and revised policy schedule were ever supplied to the complainant. No postal receipt or other record to show the genuineness of the averments qua dispatching of the disputed letter dated 28.04.20211 has been made part of the file. It has been observed that before issuing any revised policy schedule as claimed by Opposite Parties the consent of the complainant was never obtained from him and unilaterally the Opposite Party’s Company decided to change the existing terms and conditions of the policy in question, which nonetheless amounts to unfair trade practice Moreover, in the revised policy schedule Ex.OP2/3 so relied upon by the Opposite Parties there is nowhere mentioned that it is a Revised Policy Schedule.
10. In view of the above discussion, we are of the view that complainant is entitled for the benefits as per the policy schedule placed on record by the complainant alongwith Ex.C3. Hence, the present complaint stands partly allowed and Opposite Parties, jointly and severally, are directed to pay a sum of Rs.1,15,800/- (Rupees One Lakh Fifteen Thousand Eight Hundred only) alongwith interest @ 8% p.a. from the date of filing of the complaint till its actual realization to complainant. Opposite Parties are further directed to pay compository amount of Rs.10,000/- (Rupees Ten Thousand only) towards compensation and litigation costs to the complainant. The compliance of this order be made by the Opposite Party within 30 days from the date of receipt of copy of this order, failing which, the complainant shall be at liberty to get the order enforced through the indulgence of this Commission. Copies of the order be furnished to the parties free of costs. File is ordered to be consigned to the record room.
Announced on Open Commission
