Delhi

East Delhi

CC/48/2016

GANGA - Complainant(s)

Versus

SBI LIFE INS - Opp.Party(s)

29 Nov 2017

ORDER

           DISTRICT CONSUMER DISPUTE REDRESSAL FORUM EAST Govt of NCT Delhi

           CONVENIENT SHOPPING CENTRE, 1^st FLOOR, SAINI ENCLAVE, DELHI 110092  

 

                                                                                                   Consumer complaint no.        48 /2016

                                                                                                   Date of Institution              29/01/2016

                                                                                                   Order reserved on              29/11/2017

                                                                                                   Date of Order                      30/11/2017                                                                                     

 

In matter of

Mrs. Ganga Lalwani, adult   

w/o Sh Vasdev Lalwani 

C-2, Takshshila Apptt.  

Plot no. 57, I P Extn., Delhi 110092……………..…………………..…………….Complainant

                                                                    Vs

The SBI Life Insurance Co. Ltd.

RO – ‘Natraj’, MV Road, Western Express High way Junction,

Andheri East, Mumbai -69

Also at-

The SBI Life Insurance Co. Ltd.

507, 5^th Floor, Plot no. 4,

DDA Building, District Centre, Laxmi Nagar, Delhi 110092………………..Opponent

 

Corum      Sh Sukhdev  Singh    President

                  Dr P N Tiwari             Member

 

Order by Dr P N Tiwari, Member

Brief Facts of the case                                                                                             

Complainant took insurance policy under the name of SBI Life - Shubh Nivesh Whole life Plan vide policy no. 35005811404 on 15/11/2010 from OP (Delhi Office) having yearly premium of Rs 50,000/- per annum to be paid for five years.  

Complainant paid all the five premiums regularly up to 17/12/2014 vide premium receipt no. 12261512 and total Rs 2.5 Lakh with OP. This policy was taken by the complainant before her retirement in the month of Oct. 2010 when she was working at BHEL. OP had assured that after payment of five regular premiums, insured/complainant would get total sum assured (Rs 2.5 Lakh) and her life cover would be till 100 years with bonus (Rs 1,56,000/-) and she had not to pay any further premium thereafter. If there was any mishappening to life (death) before attaining 100 year of her age, she would get all vested bonus.  

Before maturity date of the policy, OP informed complainant vide letter no. Ops/claims/UMat./Int/347035/2015-16 dated 11/08/2015 to submit certain documents before time so that OP could complete all the claim process and complainant would get the maturity amount a sum of Rs 1,81,684/ (Ann. A1, but OP never intimated about retaining Rs one lakh for whole life (up to 100 years) and balance amount Rs 1,56,000/-would be paid on the date of maturity at the time of issuing policy, so complainant wrote letter to OP for clarification about retaining a sum of Rs one lakh out of full maturity amount with benefits (Ann. A2).

 

When she did not get any reply, again letter was sent on 26/11/2015 for cancellation of policy and refunding entire premium paid with interest within 15 days as complainant was not interested in retaining Rs one lakh for whole life by OP and waiting for 100 years. She had annexed letters dated 04/12/2015 and 10/12/2015 (Ann. A5 & A6). Complainant sent all the required documents and discharged voucher ‘under protest’ in advance as required by OP for release of maturity amount on dated 19/12/2015 (Ann.A7). It was stated that OP released ‘Maturity Amount’ a sum of Rs 1,56,000/- plus other vested benefits to Rs 1,81,684/-, but not as promised and mentioned on first premium receipt. When OP failed to release the maturity amount sum of Rs 2,50,000/-as deposited by complainant in five years with all the future benefits, filed this complaint and claimed for refund of total amount paid by complainant with all the benefits under policy no. 35005811404-UIN-111No55V01 with 18% interest from Dec 2015 till realized and also claimed compensation of Rs 2 Lakh for harassment.

 

After scrutinizing the complaint and documents filed by complainant, notice was served. OP filed their written statement and denied all allegations as wrong and incorrect.

OP stated that the complainant had submitted all the facts wrongly before this Forum, intentionally. OP submitted that present complaint was not maintainable under this Forum jurisdiction as no cause of action had arisen because policy was issued from Mumbai office and also barred by time on the facts as cause of action had arisen in the month of Nov. 2010 and complaint was filed in Jan 2016. Also delay was not condoned. So this complaint may be dismissed u/s 24 A of the Consumer Protection Act. OP had relied on several judgments where a complaint beyond jurisdiction cannot be entertained. Some of the citations were as under-

1. Kandimalla Raghavaih vs National Insurance Co. Ltd. , CA 4962/2002 (SC)
2. UP Awas Evam Vikas Parishad vs Brij Kishore Pandey & other, RP 3186/2009 (NCDRC)
3. SBI vs M/s Agriculture Industries, CA-2067/2002 (SC)
4. Rajendra Singh vs State of Haryana, RP 2945/2010 (NCDRC)
5. OIC vs M J Khanna, FA 279/2010, (NCDRC)

OP also stated that recent judgment from NCDRC dated 23/01/2015 in New India Assurance Co. vs Sanjay, RP 2386/2013 was also submitted where it was laid down that …. “if suit, appeal or application is beyond limitation, court or adjudicating authority has no jurisdiction, power or authority to entertain the matter and decide it on merits. The court has an independent duty to look in to aspect of limitation even though limitation has not been set up as a defence….”

It was submitted by OP that the said policy got matured on 12/11/2015 and as per terms and condition, a sum of Rs 1,81,684/- were directly credited in the account of complainant’s account in Indian Overseas Bank on 16/02/2016 vide UTR no. SBIN916047219241 bearing account no. 1534010000009205.

Thus, OP had discharged their contractual obligation under the policy and paid the maturity value. So, there was no cause of action to arise any dispute between complainant and OP. She had read all the terms and condition of the policy and had filled policy proposal forms and signed declaration also. OP also relied in case of ‘Grasim Industries Ltd. vs Agarwal Steel, CA-5994/2004 and held that –‘when a person signs a document, there is a presumption, unless there is proof of force or fraud, that he has affixed his signature thereon, otherwise no signature on a document can ever be accepted.’ 

 

OP stated that maturity benefit of Rs 1,81,684/- were directly credited in the complainant’s account (Anne. D) which was in reference to their earlier letter to complainant for the payment of survival benefit on maturity (Ann. C).

It was also submitted main points of issues of the policy as –

1. Payable Benefits—Survival Benefits- Endowment Assurance with whole life plan- Basic sum assured along with the vested simple reversionary bonus shall be paid at the Endowment Maturity date: and on the Endowment Assurance with whole life date, an additional amount equal to the basic sum assured will be paid.
2. Endowment Maturity Date- is the date on which the basic sum assured plus vested bonus becomes payable if the life assured is alive on the said date.
3. Endowment Assurance with Whole Life maturity Date – the date of policy anniversary immediately following the date on which the life assured completes 100 years of age;
4. Policy Anniversary Date - is the date on which policy commence date each year during the policy term.   

Hence, OP stated that they had followed all the terms of the policy and there was no deficiency in their services toward the complainant and complaint maybe dismissed.

 

Complainant submitted in her rejoinder that OP has branches in Delhi and all her correspondence was done from Delhi besides having regional director’s office at New Delhi. It was also stated by complainant that OP had assured to get full maturity amount with accrued benefits and would continue accidental death/permanent disability cover sum of Rs.1,56,000/- up to survival for whole life. Complainant was informed after maturity tenure of five years through Ann. A1 of OP and was replied for clarification too. Complainant replied in detail for every points of written statement. It was strongly expressed in writing also by complainant that she would take Rs one lakh as retained amount with all benefits (Ex CW1/A) from OP, legally. Complainant filed her evidences on affidavit and stated on oath that OP had promised to return entire deposited premium amount in five year as Rs 2.5 lakh with all the benefits, but OP paid only Rs 1,56,000/- plus bonus (Rs 1,81,684/-) on 12/11/2015. (Ann. A1). Seeing the attitude of OP, complainant asked OP to cancel the policy and refund all the benefits (Rs 2.50,000/- + bonus) Ann. A4.

OP also filed their evidences on affidavit through Mrs Dhanya KP, w/o Sh Unnikrishnan KP working as Manager Legal with OP who reaffirmed on oath that all the facts in their written statement and evidences were as per the terms and condition of the said policy and complainant being a graduate and working class, had properly read all the contents and benefits of the policy and thereafter she had signed the declaration form. More so, this complaint was not maintainable under the jurisdiction of this Forum.

 

It was also stated that all the terms and conditions were formulated by IRDA and OP had acted in accordance to it, so the terms and conditions neither changed nor altered by any person.  The Anne.A&B were the clear policy documents, well readable and it showed that sum assured/insured value was a sum of Rs 1,56,000/- plus Accidental total permanent disability and Accidental Death covers under the same insured value. These values were up to the policy tenure of five years. So, OP had paid basic sum assured plus vested bonus and terminal bonus to a sum of Rs.1,81,684/-(Anne. C&D). Thus it was clear that after complainant get her sum assured amount as per policy terms, her life would remain secured for whole life (up to age of 100 years) or under any unforeseen condition leading to death or disability, would get further 1,56,000/-(Ann.E). Hence, there was no deficiency on the part of OP, so the complaint deserves dismissal.

 

Before the arguments date, complainant filed amended complaint for release of all benefits and cancellation of her policy, which was taken on record as a right of complainant.      

Arguments were heard from both the Ld. Counsels and after perusing the case file, order was reserved.

 

After hearing arguments, scrutinizing all the facts and evidences submitted before us, we have scrutinized all the evidences on record and specifically –

• Anne. A-

1.  SBI Subh Novesh policy proposal form (UIN111N055V01) under Proposal no. 351096687 and Policy no.- 35005811404—where it showed details about salary, pension benefits and residential address of complainant(page 21 of 24).
2. Clause 3.1 - BASIC PLAN DETAILS”-(page 22 of 24) where it is clearly mentioned as under A- Policy term- 5 years, B- Premium frequency –Yearly, C-Model Payment- Rs 50,000/-, D- Sum Assured- Rs 1,56,000/-, E- Do you want to apply for Whole Life Cover—YES,   
3.  Clause 3.2- Differed Maturity Income option- 15 years.
4. Clause 3.3- Riders Options- SBI-Life-Accidental death benefits Riders(UIN111BO16V01) SA- 1,56,000/- 5 years and SBI Life Accidental total and Permanent Disability Benefit Rider-(UIN111BO16Vo1)-SA 1Lakh -5 years.
5. Clause 11- Declaration by the Proposer/ Life to be Assured- Complainant had put her signatures on dated 31/10/2010 read as ‘Ganga’.

• Anne. E of OP under dotted point 5 which stated about terms and conditions of the policy, on payment of premium for the entire term of the policy (5 years in this case), the sum assured along with declared bonus would be payable to the life assured on maturity.

This facility becomes beneficial to the customers especially at the higher ages, when the option for a new life insurance becomes unavailable or if available, very costly.  

So, by going in details about the points raised in this case, we have come to the conclusion that OP has not done any wrong by extending their services as per the terms and conditions of the policy taken by the complainant.

By analyzing policy proposal form, where policy seeker has to express and write correctly all facts asked by the insurer which becomes backbone of contract and cannot be altered or changed by any clarifications or by any orders or judgments as these are formulated by the IRDA. Here, complainant being a graduate and was in service had read all the terms and conditions carefully before signing the policy proposal form.

After getting maturity sum assured amount with vested bonus, raised her own grievances which cannot be accepted. No doubt complainant is completing her good health at the age of 67 years at present and may be able to avail all such benefits as mentioned in her policy at the time of attaining 80 years of age as per the policy terms.   

Hence, we are of the opinion that there is no merit in this case and the same deserves to be dismissed so dismissed without any order to cost.  

The order copy be sent to the parties as per Section 18 of the Consumer Protection Regulations,2005 (in short the CPR) and file be consigned to the Record Room under Section 20(1) of the CPR.

 

 (Dr) P N Tiwari – Member                                                                             Sukhdev Singh - President