C.F. CASE No. : CC/10/34
COMPLAINANT : Mr. Samir Mondal,
S/o Sri Santosh Mondal,
Vill & P.O. Kastadanga,
Nagarukhra, Dist. Nadia
OPPOSITE PARTIES/OPs : 1) Superintendent of Post Offices,
Nadia South Division, Kalyani,
P.O. & P.S. Kalyani, Dist. Nadia
2) Department of Posts, India
Being represented by the Chief Post
Master General, West Bengal Circle,
Yogayog Bhawan, 1st Floor, P-36,
Chittaranjan Avenue, Kolkata – 700012
PRESENT : SHRI KANAILAL CHAKRABORTY PRESIDENT
: SMT SHIBANI BHATTACHARYA MEMBER
: SHRI SHYAMLAL SUKUL MEMBER
DATE OF DELIVERY
OF JUDGMENT : 15th March, 2011
: J U D G M E N T :
In brief, the case of the complainant is that he purchased two Rural Postal Life Insurance Policies being No. R-WB-CA-EA-93096 & 93093 from the OP No. 2 on 30.08.05 and till July, 2008 he paid the policy premiums for a period of 36 months. It is his further case that due to some family problems he was unable to continue his policies and on 18.11.08 he filed an application to the Superintendent of Post Office, Nadia South Division, Kalyani for surrendering the said policies and for withdrawal of the total paid up policy amount together with up to date bonus accrued thereon. By a letter dtd. 07.09.09 the Chief Post Master General, West Bengal Circle intimated the complainant that as per P.O.I.F. rules she was not entitled to get the entire amount paid up for 36 months together with the bonus accruing therefrom. But as per brochure supplied by the Postal Department at the time of taking the policy and also as per clause 14 of the terms and conditions of contract of policy the complainant is entitled to get back the entire amount paid together with bonus accruing up to date. Thereafter the complainant again approached the Superintendent of Post Office, Nadia South Division, Kalyani in December, 2009 with a request to assess the amount which the complainant was entitled. But the OP turned down the approach which is a deficiency in service on his part. So having no other alternative this case is filed praying for reliefs as stated in the petition of complaint.
On the side of the OPs written version is filed in this case, inter alia, stating that the complainant has no cause of action to file this case. It is also submitted that as per D.Le. No. 29-14/98-LI dtd. 18.11.03, 11.12.03 and 06.08.04 a) Surrender of a policy is not admissible before completion of 36 months of the policy. b) On surrender the policy shall attract proportionate bonus on reduced sum assured up to the date for which premium has been paid, but no bonus shall be payable before the completion of 5 years of the policy. (c) The reduced sum assured shall be calculated by multiplying the sum assured with the number of instalments paid and dividing the same with the total number of premiums to be paid. As per rule 14 on reverse of the PLI Certificate it is categorically stated that surrender/paid up quotations are liable to change from time to time. So the complainant is not entitled to get back the premium amount paid together with bonus accruing up to date for a period of 36 mounts. Accordingly, the complainant was intimated by a letter dtd. 07.10.09 that if the policy was surrendered he would get much less of the deposited amount as per P.O.I.F. rule. After full calculation in this case as per P.O.I.F. rule this complainant is entitled to get Rs. 3,992/- & Rs. 18,436/- as surrendered value and he is not entitled to get back bonus as he did not continue his policies up to 5 years since the date of inception. Therefore this case has no merit and the same is liable to be dismissed.
POINTS FOR DECISION
Point No.1: Has the complainant any cause of action to file this case?
Point No.2: Is the complainant entitled to get the reliefs as prayed for?
DECISION WITH REASONS
Both the points are taken up together for discussion as they are interrelated and for the sake of convenience.
On a careful perusal of the petition of the complaint and the written version filed by the OPs along with the annexed documents filed by the parties and oral evidence also and after hearing the arguments advanced by the ld. lawyer for the parties it is available on record that this complainant purchased one PLI policy from the OPs on 30.08.05 which is not denied by the OPs also. It is also admitted case that the complainant paid up premium up to July, 2008 for a period of 36 months and the total amount being Rs. 10,800/- & Rs. 27,360/-. Thereafter, this complainant applied before the OPs with a prayer to surrender the policies and to pay his the entire deposit amount along with accrued bonus at which the OP by a letter dtd. 07.09.09 intimated that as per the P.O.I.F. rules he was not entitled to get the entire deposit premium amount. It was also endorsed that as he did not continue the policy for 5 years, so he was not entitled to get bonus. Rather he was entitled less amount as per the above rule than the amount paid by him. On the other hand, the complainant has relied on the brochure of the postal department as well as clause 14 of the policy condition. In the brochure it is stated that on surrender after 36 & 37 months the policy holder is entitled to get the entire deposited premium amount along with bonus. From the rule 14 on the reverse of the policy certificate it is laid down that “An endowment assurance policy may be surrendered for an immediate payment in cash provided the said policy is in force and has completed 3 years from the date of commencement / acceptance. Surrender / paid up quotations are liable to change from time to time.” Ld. lawyer for the OPs has drawn our attention on this condition of the policy which speaks that a policy can be surrendered after completion of 36 months since the date of acceptance and in that case the surrender or paid up quotations are liable to be changed from time to time. So the OPs have relied upon the rules framed by the postal department for payment of surrender value. From this document it is clear that no bonus is available on surrender of a policy after completion of 36 months. As per Dte. Lr. No. 29-14/98-LI dtd. 18.11.03, 11.12.03 and 06.08.04 surrender cases will be regulated as under 1) Surrender of a policy is not admissible before completion of 36 months of the policy and if discontinued the amount deposited shall be forfeited. 2) The policy paid up before 5 years shall not earn any bonus on paid up sum assured/reduced sum assured. 3) The surrender value shall be calculated by multiplying the sum assured with the number of instalments paid and dividing the sum with the total number of premiums to be paid. The surrender value shall also be calculated by multiplying the sum of reduced sum assured with the surrender factor (Appendix IV) as applicable on the attained age as on the date of surrender of the policy.
Ld. lawyer for the complainant submits that all the rules and regulations are submitted by the OPs at the time of argument, but the complainant purchased the policy relying on the condition as laid down in the brochure supplied by the OPs. So as per terms of the brochure the complainant is entitled to get the entire premium amount paid by her along with proportionate bonus on surrender. Admittedly, at the time of making the policy the rules and regulations were not supplied by the OPs to this complainant. Practically, these are the internal rules and regulations made by the OPs, but it is their duty to enlighten the insurer about the rules and regulations at the time of making the policy, but in this case we find that is not done at all.
In a decision of Himachal Pradesh State Commission, Simla referred from II (2010) CPJ, page 104 the Hon'ble State Commission decided, “Exclusion clause not explained to the insured by the official of Insurance Company when policy given to insured – Appellant’s conduct in complete violation of provisions of Insurance Regulatory and Development Authority Act.” It is further decided by the Hon'ble State Commission that “A prospectus of any insurance product shall clearly state the scope of benefits, the extent of insurance cover and in an explicit manner explain the warranties, exceptions and conditions of the insurance cover and, in case of life insurance whether the product is participating (with profits) or non participating (without profits). An insurer or its agent or other intermediary shall provide all material information in respect of a proposed cover to the prospect to enable the prospect to decide on the best cover that would be in his or her interest.” The Hon'ble State Commission further decided that “Unnoticed exclusion clauses would not be binding to the insured.”
On a careful perusal of the above cited decision of the Hon'ble State Commission, we hold that the principles laid down by the Hon'ble State Commission are applicable in the instant case also as in the present case the rules and regulations were not at all explained or supplied to the insured at the time of making the policy. Rather we find that the insured purchased the policy relying on the terms and conditions as laid down in the brochure published by the OPs. So the OPs cannot deny the conditions as laid down in the brochure. In no way the complainant will be affected or guided by the rules and regulations which are subsequently produced by the OPs at the time of argument.
Here we find that as the exclusions clauses were not explained to the complainant at the time of purchasing the policy, so those are not binding to the insured. Rather as per provision of the brochure the complainant is entitled to get the entire policy premium amount paid by her up to 36 months. From the policy at No. 14 terms of contract, it is stated that an endowment assurance policy may be surrendered for an immediate payment in cash provided the said policy is in force and has completed 3 years from the date of commencement /acceptance. Among the terms of the contract there is no whisper regarding payment of bonus proportionately on surrender value. The terms of contract were already disclosed to the complainant after having the policy. So we hold that there is nothing stated regarding payment of bonus on surrender on policy after 36 months. So this complainant is not entitled to get any proportionate bonus.
In view of the above discussions our considered view is that the complainant has become able to prove his case partly. So he is entitled to get a decree in part. In result the case succeeds in part.
Hence,
Ordered,
That the case, CC/10/34 be and the same is decreed on contest against the OPs. The complainant is entitled to get Rs. 10,800/- + Rs. 27,360/- plus Rs. 2,000/- as compensation and Rs. 1,000/- as litigation cost, in total Rs. 41,160/- which the OPs are jointly or severally liable to pay to the complainant within a period of one month since this date of passing this judgment, in default, the decretal amount will carry interest @10% per annum since this date till the date of realization of the full amount.
Let a copy of this judgment be delivered to the parties free of cost.
