Date of filing:24.01.2017 Date of disposal:19.03.2018
Complainant: Mr. Rabindra Nath Samanta, S/o. Late Dibakar Samanta, resident of Chandmari
Road, Badamtala, P.O., PS. & Dist.-Burdwan, Pin-713101, represented by its
power of attorney holder Mr. Sourav Samanta by virtue of Power of Attorney
dated 10.5.2016.
-VERSUS-
Opposite Party: 1. SBI Life Insurance Company Ltd., having its registered office at State Bank
Bhavan, Madame Cama Road, Nariman Point, Mumbai-400 021,
represented by its Chairman.
2. Branch Manager, SBI Life Insurance Company Ltd., having its branch office
at SBI Administrative Office, Hawkers Market, Last Floor, Near Curzon
Gate, Burdwan, P.O., P.S. & Dist.-Burdwan, Pin-713101.
Present: Hon’ble President: Smt.Jayanti Maitra(Ray).
Hon’ble Member: Miss Nivedita Ghosh.
Hon’ble Member : Dr. Tapan Kr. Tripathy.
Appeared for the Complainant: Ld. Advocate, Subrata Ghosh.
Appeared for the Opposite Parties: Ld. Advocate, Monalisha Banerjee.
JUDGEMENT
This is a case U/s. 12 of the C.P. Act for an award directing the O.Ps. to pay Rs.13,08,155.31/- towards the maturity amount of the policy, to pay Rs.10,000/- as compensation for mental pain and agony and to pay Rs.30,000/- as litigation cost to the complainant.
The complainants’ case in short is that he purchased a product namely SBI Life-Lifelong Pension-Plan-2 from the O.P. No.2 bearing policy No.07015770903 and customer No.19587588. The policy was commenced on 15.06.2009 and the date of maturity was 15.06.2014. The complainant paid Rs.10,00,000/- towards one time premium for future benefits. After receiving premium the O.Ps. issued premium receipt in favour of the complainant.
After maturity of the policy the complainant went to the office of the O.P. No.1 and requested to disburse the maturity amount of the policy after observing all the official formalities. But the O.P. No.1 denied to disburse the total maturity amount of the policy. The O.P. No.1 told that the complainant might withdraw one third of the maturity amount and the remaining amount would be given to the complainant as annuity. The complainant several times visited the office of the O.P. No.1 and requested to disburse the total maturity amount against the said policy to protect financial crisis of his family. The complainant was completely misguided and misrepresented by the Branch Manager of their Corporate Agent SBI, Burdwan. Not a single whisper of annuity in connection of the policy was communicated with the complainant by the O.P. No.1 at the time of inception of the policy. Thereafter, the complainant sent several mails to the O.Ps. requesting to disburse the maturity amount as early as possible. The O.Ps. through E-mail dated 21.03.2016 informed the complainant that as per the attached maturity/annuity discharge voucher, the complainant can withdraw one third of the commuted amount and the remaining amount shall be given to the complainant as annuity.
On 21.3.2016 the complainant again sent a mail to the O.Ps. stating that the insured was an NRI Person and for the treatment of his ailing mother, the complainant need to withdraw the maturity amount and he did not take to any pension. The complainant also stated that as per the policy schedule Part-4 guaranteed value, the complainant can withdraw 85% of the PPA for policy surrender on the 4th years onwards. In reply the O.Ps. stated that once the policy attained vesting date, so surrender request cannot be processed as annuity is payable for the policy and as such, the O.ps. are unable to accede the request of the complainant regarding disbursement of the maturity amount of the policy. On 21.3.2016 at about 8.56 PM the complainant again sent mail to the O.ps. stating the fact that he could not continue the policy nor he needed any annuity plan and as such the complainant requested the O.ps. to reimburse the total maturity amount. In reply the O.Ps. informed that they were unable to accede the request of the complainant. The complainant might commute one third of the maturity amount, which is illegal, arbitrary and beyond the provisions of law. As per law of the land as well as per provisions of Insurance Act, after expiry of maturity of the policy the insured/policy holder must be entitled to get the maturity amount of the said policy. After maturity, investment in the annuity scheme is optional and depend upon the choice of the insured. But in this case after maturity the O.Ps. refused to release the maturity amount of the policy to the complainant, which amounts to deficiency in service and unfair trade practice. Finding no other alternative the complainant filed this case before this Forum for relief as stated above.
The OPs. contested this case by filing written statement denying all the material allegations as alleged by the complainant. The O.Ps. further submits that Mr. Rabindranath Samantha had applied for SBI Life- Life Long Pension Plan vide proposal No.075282585 dated 06.05.2009 along with a premium of Rs.10,00,000/- towards the single premium. Accordingly, policy bearing No.07015770903 with the date of commencement as 15.06.2009 for a term of five years was issued. The complainant had opted for pension with the cover and the policy was issued with sum assured of Rs.55,39,369/-.
The policy matured on 15.06.2014. As per the Part-II, benefit payable and when payable under point No.1, Maturity Benefit it is stated that; ‘Subject to this Policy being in force, and the Life Assured surviving till the Vesting Date, the Life Assured shall have the option to withdraw up to a maximum of 33% of the balance outstanding in the PPA * in cash (or such limit as may be applicable under the relevant provisions of Income Tax Act, 1961, from time to time), and with the balance amount shall have the option of purchasing any one of the annuities as available on the Vesting Date from SBI Life, or annuity from any other life insurer by giving a notice at least six months, before the Vesting date’. These O.ps. had sent an intimation letter dated 31.03.2014 along with Annuity Option Sheet to the complainant, intimating him about the maturity of his policy and requesting to submit the documents like Original Policy Document, Discharge Voucher, Direct Credit Mandate, Proposal form duly completed in all respect, Identity proof (KYC documents), Residence proof and age proof for processing of the maturity payment. The complainant did not furnish the said documents instead he has preferred to file the present complaint. The demand of the complainant regarding full refund of the maturity amount ultra vires the terms and conditions of the policy which are duly approved by the IRDA.
That the PPA balance under the policy No.07015770903 as on the date of vesting of the policy was Rs.13,08,155.31/-, out of which the complainant can commute upto 33% of the maturity amount Rs.4,31,691.25/- and can opt for any of the annuities as per the Annuity Option sheet with the remaining 67% (Rs.8,76,464.06/-) of the maturity amount. The annuity payment will be initiated soon after the receipt of the mandatory requirements from the complainant.
That a contract has to be interpreted as per the terms and conditions of the document evidencing the contract. It is humbly submitted that the terms and conditions of the policy do not allow full withdrawal of the PPA amount on or after the vesting date. The complainant has the option to withdraw upto maximum of 33% of the amount in the PPA, and with the balance amount, the complainant has to purchase any one of the annuities as available on the vesting date from SBI Life or from any other life insurer. The product features do not provide for full refund of the accumulated amount after the vesting date. This is a product features as approved by the IRDA and cannot act in violation of the terms and conditions of the policy. Hence, there is no deficiency in service on the part of the O.Ps. The complainant approached this Forum instead of adhering to the terms and conditions of the policy. Thus, no cause of action has arisen to file this present complaint. The complainant is trying to distort the facts and thereby trying to mislead the Forum. There is no deficiency in service on the part these O.Ps. and prayed to dismiss this instant case.
DECISION WITH REASON
To prove the case the complainant filed examination in chief stating all the facts on affidavit as his evidence. O.Ps. filed authorization letter and prays for accepting written version filed by the O.Ps. and the same was accepted. O.Ps. also filed their evidence on affidavit. Thereafter, the case is fixed for hearing argument. Both sides tabled an elaborate evidence with their documents in support of their respective cases. The complainant filed the policy papers bearing No. 07015770903 and the same was commenced from 15.06.2009 and the date of maturity was 15.6.2014 (Annexure-A). Complainant stated that on attending the maturity the complainant visited the office of the O.Ps. several occasions for receiving the maturity amount but O.ps. denied to disburse the same. Thereafter on 14.3.2016 the complainant sent email to the O.ps. to disburse the maturity amount. Annexure-B, is filed to prove this fact. Then O.Ps. answered by sending email on 21.3.2016 along with a document and as per attached Annuity Discharge Voucher O.P. stated that the complainant can withdraw one third of the maturity amount and the remaining amount shall will be given to the complainant as annuity. Then complainant sent reply on 21.3.2016. The photocopies are filed (Annexure-D), where complainant stated that he neither continue the policy nor he needed any annuity plan and requested reimbursement of the total maturity amount of the policy. The complainant also stated that specifically the annuity scheme is optional and depends upon the choice of the insured. As the O.P. is not disbursing the maturity amount of the policy it amounts to deficiency in service and unfair trade practice. The copy of the email dated 21.3.2016 and 22.3.2016 is also filed by the complainant (Annexure-E). The complainant made further correspondences (Annexure-F series) and as the O.Ps. failed to disburse the said amount the complainant compelled to filed this petition before this Forum praying for maturity amount with compensation and litigation cost for harassment.
We have heard the arguments of the O.ps. The O.ps. stated that complainant did not provide KYC documents as per intimation of O.Ps. dated 31.3.2014 with annuity option sheet. On the other hand the complainant has proved that he has submitted the required papers to get his maturity amount of the policy. O.Ps. admit that the maturity value is Rs.13,08,155.31/-. However, O.ps. further submit that complainant can commute up to 33% of the maturity amount and can opt any of the annuity as per the annuity option sheet i.e. the remaining 67% of the maturity amount. But from the policy papers it is clear that after maturity investment in the annuity scheme is ‘optional’. The policy document filed by the parties and the document ‘Lifelong Pensions Version 02’ of SBI Life Insurance goes to show that maturity benefits is applicable for both the Plans subject to this policy being in force, and the Life Assured surviving till the Vesting Date, the Life Assured shall have the ‘option’ to withdraw up to a maximum of 33% of the balance outstading in the PPA* in cash (or such limit as may be applicable under the relevant provisions of Income Tax Act 1961 from time to time), and with the balance amount shall have the option of purchasing any one of the annuities as available on the Vesting Date from SBI Life, or annuity from any other life insured by giving a notice at least six months, before the Vesting date. So, the annuity scheme is not mandatory for the complainant. More over the O.ps. submit that the terms and conditions of the policy do not allow full withdrawal of the PPA amount on or after the Vesting Date. But there is no documentary evidence from the side of the O.Ps. nor there is any documents to show the complainant exercise his choice or option to purchase any one of the annuities as available on the date of vesting. There is nothing to prove that product features do not provide for full refund of the accumulated amount after the vesting date rather it is optional to the complainant though O.Ps. sent annuity option sheet to the complainant. It is not mandatory for the complainant to fill up the said form and complainant never opted for annuity. Therefore, the O.P. is deficient in service when after maturity the complainant claimed the total maturity value and O.P. refused to release the maturity amount and it is also unfair trade practice on the part of the O.Ps. Therefore, the complainant has been able to prove his case with sufficient documentary evidence and policy papers. We have gone through the policy documents carefully and find that complainant is entitled to get relief. C.F. paid is correct.
Hence, it is
Ordered
that the case be and the same is allowed in part on contest against the O.Ps. without any cost.
The O.Ps. are directed to disburse of Rs.13,08,155/- towards maturity amount of the policy along with interest @ 8% p.a. calculated on the maturity amount from the date of filing of this case i.e. on 24.01.2017 till realization to the complainant. The O.Ps. are further directed to pay compensation of Rs.5000/- towards mental pain, agony and harassment and also to pay Rs.2000/- as litigation cost to the complainant. The above all directions be complied within 45 days from this date of order. The complainant is at liberty to execute this order in accordance with law.
Let the copies of this order be supplied to the parties free of cost.
Jayanti Maitra (Ray)
Dictated and corrected by me. President
D.C.D.R.F., Burdwan
Jayanti Maitra (Ray)
President
D.C.D.R.F., Burdwan
(Nivedita Ghosh) (Dr. Tapan Kr. Tripathy)
Member Member
D.C.D.R.F., Burdwan D.C.D.R.F., Burdwan
