Karnataka

StateCommission

A/789/2022

PNB Metlife India Insurance Co. Ltd., - Complainant(s)

Versus

Sumangala - Opp.Party(s)

I Gopalakrishna

12 Jul 2022

ORDER

BEFORE THE KARNATAKA STATE CONSUMER DISPUTES REDRESSAL COMMISSION, BANGALORE

 

DATED THIS THE 12^TH DAY OF JULY 2022

 

PRESENT

 

MR. K. B. SANGANNAVAR                                : JUDICIAL MEMBER

MRS. DIVYASHREE M.                                     : MEMBER

 

Appeal No. 789/2022

 

PNB MetLife India Insurance Co. Ltd. 701, 702 & 703, 7th Floor West Wing, Raheja Towers 26/27, M.G. Road, Bangalore 560 001   PNB MetLife India Insurance Co. Ltd. Taluk: Hubballi, Dist. Haveri   (By Sri. I. Gopalakrishna) V/s	……Appellants
Smt. Sumangala C/o. Veerabhadrappa Gonemmanavara R/o. Basaveshwara Nagara   Tq. & Dist. Haveri 581110   Karnataka Bank Ltd. P.B. Road, Haveri 581 110   (R1 by in-person R2 by Sri. Prashant T. Pandit)	…Respondents

 

O R D E R

BY MR. K. B. SANGANNAVAR,  JUDICIAL MEMBER

This is an appeal filed by OPs in C.C.No.33/2021 on the file of District Consumer Disputes Redressal Commission, Haveri aggrieved by the order dated 29.12.2021.

2. The Commission examined the impugned order, grounds of appeal and heard counsel for appellant, R2 and R1 who is party in person.
3. In view of rival contentions of parties to the appeal, short question for consideration would be whether insurer covers risk for the period for which premium paid and whether impugned order passed by forum below is sustainable?
4. It is an undisputed fact that complainant obtained Met Monthly Income Plan 10 Pay as per her proposal dated 22.02.2014.  She is a teacher of HPS Government School, Hirekerur, length of service 7 years, her earnings would be Rs.4,50,000/- p.a., her normal age of retirement would be 60 years.  She is a tax payer, as particulars of PAN could be seen in her proposal form.  In other words, she is a literate woman had paid Rs.1,24,980/- being first year model premium with service tax.  This premium paid is towards annual payment payable on or before 24^th of February of every subsequent year.  She has paid second premium on or before 24.02.2015, whereas, failed to pay 3^rd premium on or before 24.02.2016.  Thereafter, according to policy obtained by her lapsed from 25.03.2016 and to that effect on 25.03.2016 insured was notified.  It is to be noted herein, Met Monthly Income Plan 10 Pay policy premium paid, the date of maturity would be 24.02.2024, its commencement is from 24.02.2014, benefit pay out period 15 years, the factor applicable is 135, regular premium inclusive of service tax serves on or before 24^th February every year, total amount payable is Rs.1,24,980.29.  In such circumstances, her complaint has to be examined, whether she fits in to draw either under reduced plan at 1.28 or clause 3.4.1, having been paid 2 yearly premium and is entitled for Guaranteed Surrender Value equal to 30% of the total regular premiums paid excluding any extra premiums paid on account of adverse health condition or occupation of the insured or taxes, if surrendered between the third year and fourth policy year, both inclusive as per clause 3.5.2 (i).  Admittedly, clause 6.1 Free Look Period was bit exercised by complainant after obtaining policy from OPs.  The forum below held directing OP No. 3 to pay Rs. 2,49,960/- less 30% along with interest at 6% p.a. within 30 days and do pay Rs.5,000/- as compensation and on their failure to pay 12% interest on such amount, in exercise of powers vested under Section 35 of Consumer Protection Act, 2019 which in our view not only contrary to facts, but, law, since, Commission below has failed to examine whether she has to be fits in to seek refund under clause 3.5,  even to claim guaranteed surrender value equal to 30% of the total regular premiums paid.  The forum below has exercised clause 3.5.2 (iii) guaranteed surrender value equal to 70% total regular premiums paid which would be applicable to 8^th policy year. 
5. Learned Counsel for appellant placed reliance on decision reported in IV (2008) CPJ 156 (NC) in the case of LIC of India & others Vs. Siba Prasad Dash (Dr.) & others wherein held policy lapsed for non-payment of premium.  No provision exists for refund of premium of lapsed policy.  In such circumstances, in view of discussion made above matter requires to be remanded back to Commission below to examine whether complainant is entitled to claim guaranteed surrender value equal to 30% of the total regular premium as per Clause 3.5.2 of the terms and conditions Met Monthly Income Plan 10 Pay.  Accordingly, proceed to allow the appeal by condoning the delay if any for the reasons assigned by appellant followed by the decision of Hon’ble Apex Court dated 27.04.2021 and 10.01.22 in MA No.21/2022 in MA No.665/2021 in Suo-moto Writ Petition (Civil) 03/2020, consequently, set aside the order dated 29.12.2021 passed in C.C.No.33/2021 on the file of District Consumer Commission, Haveri with a direction to Commission below to decide the case afresh as observed affording opportunity to both parties as early as possible not later than three months from the date of receipt of this order.
6. The amount in deposit is directed to be transferred to the Commission below for needful.

 

MEMBER                           JUDICIAL MEMBER         

 

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