THE CONSUMER DISPUTES REDRESSAL FORUM, KOZHIKODE.
C.C.480/2013
Dated this the 2nd day of February, 2017
(Smt. Rose Jose, B.Sc, LLB. : President)
Smt. Beena Joseph, M.A : Member
Sri. Joseph Mathew, M.A., L.L.B. : Member
ORDER
Present: Rose Jose, President:
This petition is filed under Section 12 of Consumer Protection Act, 1986.
The crux of the petition is that, the petitioner had taken an Insurance Policy of the opposite party, SBI Life Unit Plus II having Policy No. 24051084307 from their Nadakkavu branch. The first premium installment was remitted on 27/05/2008. The mode of payment was quarterly and he had remitted the other three installments on 03/06/2008, 13/09/2008 and 25/09/2008 respectively. Thus he had remitted a sum total of Rs.99,600/- towards the policy. On 19/11/2011 his nominee submitted a surrender application before the opposite party for getting the surrender value of the policy. After receiving his application opposite party informed him that only after maturity period of the policy they can consider the application. On 26/08/2013 when he again approached them, they told him that policy was lapsed and so they could not give any amount.
It is alleged by the petitioner that the opposite party ought to have pay the surrender value at the day of his first submission of surrender application itself and the non-payment of the amount is only with the malafied intention to cheat him and to make undue enrichment to the company. Petitioner had issued lawyer notice dated 27/08/2013 to the opposite party demanding repayment of the remitted amount and compensation to the tune of Rs.1,00,000/- for his sufferings but they have not complied with his demands. Petitioner further submitted that it is not true that the opposite party had sent a letter dated 17/03/2013 requesting the revival of the policy. He had not received any such letter. He had remitted the full annual amount towards the policy and so the opposite party is bound to pay the surrender value of the policy on 19/07/2011 itself and the rejection of his legitimate claim amounts to unfair trade practice and also deficiency in service on their part and that caused much hardship mentally and physically to him. Hence this petition is filed to direct the opposite party to pay him the remitted policy amount along with Rs.1,00,000/- as compensation and also cost of the proceedings.
The opposite party filed version denying all the allegations of the petitioner as false and frivolous. Admittedly they have issued a policy with date of commencement as 03/06/2008 for a term of 5 years with periodicity of premium as quarterly and the sum assured was Rs.4,98,000/-. But they have received only 3 premium including initial premium under the policy and have not received any written request for surrendering the policy on 19/07/2011 as alleged by the petitioner. When the nominee of the petitioner visited their Calicut branch with request for surrender he was advised to pay one full year premium, as surrender value under the policy will be acquired only if one full years premium is paid as per the terms and conditions of the policy ie. Schedule II – Clause 10. The policy has been lapsed with effect from 03/03/2009 due to non-payment of renewal premium. As per the policy conditions Schedule II, Clause 10 “The policy acquires a surrender value provided at least one entire policy year’s premium have been paid.” The statement of the petitioner that they have assured him that the amount will be paid after the maturity of the policy was denied by the opposite party as false because, the policy has not acquired any surrender value and so nothing is payable towards maturity value.
They further contended that the proposal deposit receipt dated 29/05/2008 was issued on receipt of the proposal form and the amount of Rs.24,900/- paid vide D.D. No.208516 dated 27/05/2008 was adjusted towards initial premium on issuance of the policy. Further the renewal premium amount of Rs.24,900/- due on 03/09/2008 was revived on 25/09/2008 vide D.D. No. 53434 and the next premium amount was due on 03/12/2008 and that was revived on 13/02/2008 vide cheque No 830803. The allegation of the petitioner that he had remitted Rs.24,900/- by cash on 03/06/2008 towards premium installment was denied as not true or correct. They have not received any such amount as alleged. They have sent a letter dated 17/03/2013 to remind the petitioner regarding the renewal of policy so that he can get maturity benefit, even though they are not legally bound to send the same. The statement of the petitioner that the surrender value was payable on 19/07/2011 itself was denied as not correct, as the policy will acquire surrender value only if one full year premium is paid. The petitioner had paid only 3 installments and hence he is not entitled for any surrender value.
It is further stated that the sum assured is Rs.4,98,000/- and this means that if any unfortunate events happens, the company is liable to pay the full assured amount to the nominee of the petitioner even if he had remitted only one premium amount. Having availed this service and enjoyed the risk cover, the demand for refund of the paid amount is outrageous and does not have the sanction of law. The lawyer notice issued by the petitioner was replied stating true and correct facts. The petitioner is not entitled to get any amount as surrender value as he has not remitted one full year premium amount ie. 4 installments and hence the policy was already lapsed as per the terms and conditions of the policy. They have acted only as per the terms of the policy and hence there is no deficiency in service or any unfair trade practice on their side as alleged. Hence prayed to dismiss the petition with their cost.
The points for considerations are:
Whether there is any unfair trade practice or deficiency in service on the part of the opposite party?
Reliefs and cost if any?
Evidence consists of the affidavit filed by the power of attorney holder of the petitioner, the opposite party, Ext. s A1 to A9, B1 to B6 and deposition of PW1 and RW1.
Point No. 1: According to the petitioner he had remitted one full year premium amount ie. total amount of Rs.99,600/- by 4 equal installments towards the policy and so he is entitled to get the surrender value of the policy. The policy term is 5 years. When he surrendered the policy after maturity period on 26/08/2013, claim was rejected due to the reason that policy was already lapsed. This is deficiency in service on their side and hence he is entitled to get the policy amount along with compensation. Petitioner produced the receipts of payment and were marked as Ext. s A5, A6, A7 and A8.
According to the opposite party petitioner opted the policy for a basis, sum assured of Rs.4,98,000/- for a term of 5 years, with periodicity of premium as quarterly ie. Rs.24,900/- each in every 3 months. They produced the copy of the policy document and marked as Ext. B1. As per policy document Schedule II, Clause No. 2 Sub Clause (b) “If within the 1st three years following the date of commencement of policy, the premium is not paid within the grace period, all insurance cover (including rider cover if any) will automatically lapse. Further no maturity value is payable as the policy has not acquired any surrender value. Hence nothing is payable under the policy.” It is further submitted that for keeping the policy alive without being lapsed at least one full year payment should be done. Petitioner has paid only 3 installments instead of 4 installments and thereafter stopped payment. He had paid the three installments by way of DD No. s 208516, 053434 on 29/05/2008 and 25/09/2008 respectively for Rs.24,900/- each and cheque No. 830803 for Rs.24,900/- on 13/02/2009. So the policy was lapsed with effect from 03/03/2009 onwards. Though they have issued a letter dated 17/03/2013 (Ext. B3) requesting him to revive the policy before maturity date of 03/06/2013, so that the maturity benefits can be payable as per the policy terms, but the petitioner has not paid any amount or revived the policy. So nothing is payable under this policy.
The payments of amounts dated 29/05/2008, 25/09/2008 and 13/02/2009 was admitted by both the parties. The dispute is with regard to the payment of Rs.24,900/- dated 03/06/2008. According to the petitioner this amount has been remitted at the office of the opposite party by cash. In their version and also in the deposition of RW1, the Manager, Operations, SBI Life Insurance, Kozhikode branch, the opposite party, denied the said statement of the petitioner and clearly stated that, they have not receive any direct cash payment and the payments will be accepted only through cheques or drafts. (deposition of RW1). Here it is pertinent to note that all other 3 payments are made by the petitioner by way of drafts and cheque only. Then why he had remitted the alleged Ext. A6 payment directly by cash was not satisfactorily explained by the petitioner. So also admittedly the mode of payment was quarterly. The first premium ie. the initial premium was accepted on 29/05/2008 and commencement date of policy was on 03/06/2008. As such the 2nd installment will fall due only on 03/09/2008. Then the question why the petitioner had paid the 2nd installment on 03/06/2008 much earlier ie. within 5 days of payment of the initial premium stands unanswered. If he had remitted the said amount in advance towards the 2nd premium which falls due only on 03/09/2008, then why he had paid the 2nd installment on 25/09/2008 instead of informing the opposite party the matter of remittance of 2nd installment much earlier on 03/06/2008 itself showing the receipt dated 03/06/2008 is also remains unanswered. All these makes doubts regarding the genuiness of the statement of the petitioner.
A perusal of Ext. A6 document shows that it is not a receipt issued by the opposite party for receipt of the amount shown there from the petitioner, but a Benefit Illustration Document given to the petitioner informing how much is the allocation charge debited from the initial amount of Rs.24,900/- and how much amount the opposite party had invested in the share and how many numbers of shares (units) the petitioner had acquired by that amount etc. Here Ext. A6 document shows that the policy taken by the petitioner is a ULIP (Unit Linked Insurance Policy) and not a traditional policy. As per this documents, date of unit allocation was 03/03/2008 ie. the date of commencement of policy risk. The premium allocation charge is shown as Rs.6,356.42 and the net amount remained for investment in share (unit) is shown as Rs.18,543/58. The fund opted by the petitioner is Equity Fund, the number of units acquired by the petitioner is 591.12 and the fund value as on 03/06/2008 is Rs.18,543.58.
The petitioner had mistakenly considered that Ext. A6 document is the receipt for payment of Rs.24,900/- as premium installment, but actually it is not so.
So from the evidence it is found that the petitioner had remitted only 3 installments towards the policy amount instead of minimum 4 installments hence the policy became lapsed with effect from 03/03/2009 onwards as stated by the opposite party. As the petitioner made default in payment, he is not entitled to get the surrender value as per the policy conditions. So the disputes with regard to the acceptance or rejection of Ext. A4 surrender application became immaterial because even if the opposite party had received the application it will not do any good to the petitioner as the policy was already lapsed.
In view of the said findings we are of the view that there is no necessity to consider the other points or documents produced in this case.
It is to be noted that in every policy there is a ‘risk factor’ also. Here the petitioner was insured for an assured amount of Rs.4,98,000/-. This means that if any unfortunate event happens, the company is liable to pay the full assured amount to the petitioner or his nominee even if he had remitted only one installment towards the policy amount. Having availed this service and enjoyed the ‘risk cover’ during the policy period, the demand for refund of the paid amount in a lapsed policy is outrageous and does not have the sanction of law also.
Considering the facts of the case and perusal of documents on record, we found that the opposite party has not committed any deficiency in service in rejecting the claim of the petitioner and they have acted only as per the terms and conditions of the policy. Point No. 1 found against the petitioner.
Point No. 2: In view of the finding in Point No. 1, this petition is liable to be dismissed and the petitioner is not entitled to get the reliefs sought for in the petition.
In the result, this petition is dismissed without cost.
Dated this the 2nd day of February, 2017
Date of filing: 24/10/2013
SD/-MEMBER SD/-PRESIDENT SD/-MEMBER
APPENDIX
Documents exhibited for the complainant:
A1. Copy of lawyer notice sent to the opposite party
A2. Reply received from the opposite party
A3. Policy Document
A4. Surrender application form
A5. Proposal Deposit Receipt dated 29/05/2008
A6. First premium receipt dated 03/06/2008
A7. Unit plus renewal premium receipt dated 25/09/2008
A8. Unit plus renewal premium receipt dated 13/02/2009
A9. Power of Attorney
Documents exhibited for the opposite party:
B1. Policy document
B2. Policy terms and conditions
B3. Letter sent to the complainant
B4. Reply sent to the complainant
B5. Proposal deposit receipt dated 29/05/2008
B6. Copy of DD bearing No. 208516
Witness examined for the complainant:
PW1. Gopalan (POA Holder)
Witness examined for the opposite party:
RW1. Ashish Philip, SBI Life Insurance, Nadakkavu, Kozhikode
Sd/-President
//True copy//
(Forwarded/By Order)
SENIOR SUPERINTENDENT
