Orissa

Rayagada

CC/31/2016

Smt.Alaka Rani Panda - Complainant(s)

Versus

The Branch Manager, Bajaj Allianz Life Insurance - Opp.Party(s)

Self

16 Apr 2018

ORDER

DISTRICT   CONSUMER  DISPUTES REDRESSAL    FORUM, RAYAGADA,

STATE:  ODISHA.

C.C. Case  No. 31 / 2016.                                              Date.     16    .     4  . 2018

P R E S E N T .

Dr. Aswini  Kumar Mohapatra,                       Preident.

Sri  GadadharaSahu,                                                                       Member.

Smt. Padmalaya  Mishra,                                                              Member.

 

Smt. Alaka Rani  Panda, C/O: Sri Aleka Chandra Panda, New Colony,   Po/   Dist:Rayagada  (Odisha). Cell No.9437782678.                                     …. Complainant.

Versus.

1. The Branch Manager,  Bajaj Allianz life Insurance Company, Branch Office, Jeypore, M.G.Road, Dist:Koraput, Pin No. 764 001.
2. The Managing Director, Bajaj Allianz life Insurance Company, Regd. Office,  Air port road, Jerawada, Pune, Maharastra.   ……...Opp.Parties

For the Complainant:-Self.

For the O.Ps.  :-  Sri Basanta Kumar Patra, Advocate,Jeypore.

.

JUDGMENT

                The  curx of the case is that  the above named complainant alleging deficiency in service  against  afore mentioned O.Ps for  non receipt  of balance surrender  amount a sum  of Rs.49,067/-   against deposited amount  a sum of Rs.1,98,000/- from  April, 2008  till August, 2010 respectively 3  Nos.  premium paid by the complainant towards policy No. 0097655705  for which  the complainant  sought for redressal of the grievances raised by the complainant. The brief facts of the case  has summarised here under.

 

On being noticed the O.Ps appeared through their learned counsel and filed written version refuting allegation made against them.  The O.Ps taking one and another pleas in the written version   sought to dismiss the complaint as it is not maintainable  under the C.P. Act, 1986. The facts which are not specifically admitted may be treated  as denial of the O.Ps. Hence the O.Ps  prays the forum to dismiss the case against  them  to meet the ends of justice.

  Heard arguments from the learned counsel for the    O.Ps and from the complainant.    Perused the record, documents, written version  filed by the parties. 

This forum  examined the entire material on record  and given  a thoughtful consideration  to the  arguments  advanced  before us by  the  parties touching the points both on the facts  as well as on  law.

                                                         FINDINGS.

On perusal of the record it is revealed that there is no dispute that the complainant was a policy holder bearing No. 0097655705 opted for unit linked policy namely product Century Plus.   Further  there is no disputes the  above  policy  term and premium payment term   is 10 years.   Again  there is no dispute the complainant had  invested  total amount a sum Rs. 1,98,000/- on different dates mentioned  Dt.26.4.2008 Rs.97,020/- Dt.26.4.2009 Rs. 49,500.00, Dt.26.4.2010 Rs.49,500.00 towards  03  Nos.  premium  (copies of the deposit slip is in the file marked as  Annexure-I to Annexure-III).  

The O.Ps in their written version contended that   the complainant was required to pay the yearly premiums term of 10 years but he did not pay the yearly regular premiums due falls  on Dt.26.04.2011 and onwards. The policy stands surrendered strictly in accordance with the terms and conditions  of the policy and surrendered value was refunded to the insured. The complainant  has also enjoyed the risk cover for a period of 3 years from commencement of the policy.

 The main grievance of the complainant is that  she has received a sum of Rs.1,58,933.00 against the  payment of Rs. 1,98,000/- less than the amount paid by him i.e. Rs. 49,067.00 and when asked the reason the O.P. No.1  had  stated  that it is  the surrender value of the said policy and the complainant  is  not entitled anything more. Hence the  C.C. petition filed by the complainant  to get  the  balance amount.

          The  O.Ps in their written version preliminary objection  clearly  mentioned that  the complainant  has  paid  premium 03 times  yearly premium  after which the complainant approached the O.P. for surrendering  the policy  by submitting the  payout form for interim surrender of the said policy as on Dt. 21.12.2012 and final settlement on Dt.08.04.2014.  It is pertinent  to note  here  that the pay out form clearly mentioned the terms and conditions stating that the surrender amount of the said policy will be payable after deduction of the allocation charges based on the effective NAV rates and also mentioned the total  surrender amount of Rs.1,58,933/- that will be payable to the complainant.  The complainant while submitting  the said payout form had duly signed it as on Dt. 21.12.2012 and on Dt.. Dt.08.04.2014. Hence when a person signs any document, it is presumed that he had read and understood the document and consented to its content .  

Further  the O.Ps submitted  that  upon receipt of the request   for surrender of the policy from  the  complainant on Dt. 21.12.2012 and on Dt.. Dt.08.04.2014,  the full  surrender amount Rs. 1,58,933.00  of the  policy  had  transferred to  the  complainant vide on line UTR No. SIN00101Q3832078  State bank of India account of  the policy holder  payment date on Dt. 28.12.2012 a sum of Rs.50,000/- and UTR  No. SIN00101Q6471536 on Dt.12.5.2014 a sum of Rs1,08,933/- total amount a sum of Rs.1,58,933.00  in the account of the complainant. Again the O.Ps argued  that the allegation of the complainant regarding less surrender amount paid is  groundless and against the policy terms and  conditions,.

          It is to reiterate that the policy documents as  well as  the payout form clearly stated that the surrender amount will be payable after  deduction of the allocation  charges and the O.Ps had duly  paid the  appropriate surrender value of Rs. 1,58,933.00  to the complainant.   Afore-mentioned facts establish  that nothing  is either  due or legally recoverable by the complainant from the O.Ps and O.Ps have duly complied with the terms and conditions of the policy  contract.  In the ligjht of above facts and contract no cause of action ever arose against  the O.Ps as the present  complaint does not  raise any “Consumer Dispute” and there is no deficiency  on the part of the O.Ps.  The  complainant  has neither a legal  basis nor a  valid cause of action  against the O.Ps to file the present complaint before the  forum as the  O.Ps rightly calculated the Surrender value and paid to the complainant in time. Hence this forum has not  warranted to interfere in to  the present complaint. That the modus operandi of the O.Ps  is different from any insurance sectors and it earnestly follows the rules and  regulations passed by the IRDA and further  functions of its business are carried in accordance with the settled principles of law.  The grievances of the complaint is unworthy of credence.

          It is held and reported in C.P.R-2011((4) Page No. 86 the Hon’ble State C.D.R.Commission, Chandigarh where in  observed “Unit linked schemes cannot bring any fixed amount to investors”.

          This forum further observed  that the policy namely  Unit Gain Plus which was issued  in favour of the complainant, was directly related with the share  market and because of economic melt down  in the International  market, which also adversely affected the share market of India, price of shares of even  big  companies fell down. Similarly, the price of units issued  to the complainant , under  the  policy, in question, also reduced, which was  not   under the control of any particular individual. More over, the  unit price fluctuates day by day and sometimes it goes up and sometimes it becomes very low. Due to instability in the market, it can not  be said what would be the rate of unit at the time of  surrender by the complainant, if he choses so. Again this forum observed  In fact, the original policy bond was with the  complainant, it was mentioned that the policy was related  to the share market.  As per the terms and conditions of the policy, 15 days time was given to the complainant, which is known  as “Free Look period” as per the guidelines of IRDA and if he want to say anything  with  regard to the terms and conditions, and if those were not  acceptable to him, he could ask for the cancellation of the policy but the complainant failed to exercise that option.

          The O.Ps  in their written version cited citation.  It is held and reported  in 1999(6) SCC 454 in the cases The oriental Insurance Co. Ltd  Vrs. Sony   Cheriyan where in the Hon’ble Supreme Court  observed  “The insurance policy between the insurer and the insured represents a contract between the parties. Since the  insurer undertakes to compensate the loss suffered  by the insured  on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed to determine the extent of liability   of the insurer. The insured  can not claim any thing more than what is covered by the  insurance policy”.  

In a recent judgement on Dtd. 23.4.2013  the Hon’ble National Commission has held that “such policies involve speculative gains through trading in shares in the stock market and hence are commercial in nature. So a consumer complaint for a grievance regarding such policies would not be maintainable”.   In Ram LalAggarwalla Vrs. Bajaj Allianz life insurance Co. Ltd. &ors   it has been held that  “the investment made by the complainant was to gain profit.  Hence, it was invested  for commercial purposes and therefore, the complainant is not consumer under  the O.Ps”.   In another case of  Smt. AbantiKumariSahoo Vrs. Bajaj Allinz Life Insurance Co. Ltd. the Hon’ble State Commission, Odisha where  in observed in First Appeal No. 162/2010 held that the money if the complainant invested in the share market is not doubt a speculative gain and the speculative investment does not  come under the C.P. Act., 1986.   It is submitted that the present policies in question are Unit Linked policies and law is well settled that such policies are speculative in nature and the same are taken  for  investment purpose.  Therefore the policy holders of such policies are not consumers and disputes relating to such policies are not sustainable before the consumer forum.

          The Hon’ble Supreme Court in the case of Vikram GreentechIndia  Ltd Vrs. New India Assurance Co. Ltd reported in  SCC 2009  (5) page No. 599   where  in  observed  that “An insurance contract, is a species of commercial transactions and must be construed like any other contract to its own terms  and by itself.   In a contract of insurance,  there is requirement of  uberrima fides  i.e. good faith on the part of insured .  Except that, in other  respects, there is no difference between a contract of insurance and any other contract.  The four essential of a contract of insurance are (i) the definition of the risk (ii) the duration of the risk (iii) the premium and (iv) the amount of  insurance. Since  upon issuance of insurance policy, the insurer  undertakes to indemnify the loss suffered by the insured on account of risks   covered by the insurance  policy, its terms have to  be strictly construed to  determine the extent  of liability of the insurer.  The endeavor of the court must always be to interpret  the words in which the contract is expressed by  the parties. The  court while  construing the terms of policy is  not  expected to venture in to extra liberalism that may  result in re-writing the contract or substituting  the terms which were not intended by the  parties. The insured  cannot  claim anything more than what is covered by the insurance policy”.

          In the case of General Assurance Society Ltd. Vrs. ChandmullJain  1966 (3) SCR 500 where  in observed “ In interpreting documents relating to  a contract of insurance, the duty of the court is to interpret the words in which the contract is expressed  by the parties, because   it is snot for the court to make a new contract, however  reasonable, if the parties have not make it themselves.

          Similarly, in the case of Oriental Insurance C.o. Ltd. Vrs. Samaynallur Primary   Agricultural Co-op. Bank  AIR 2000 SC 10 it was observed  “The insurance policy has to be construed having reference only to the stipulations contained in it and no artificial farfetched meaning  could be given to the words appearing it .

          Again in the case of Polymat India P. Ltd and Anr. Vrs. National Insurance Co. Ltd. and ors. AIR 2005 SC 286 where in observed  “The terms of the contract have to be construed strictly without altering the nature of the contract as it may affect the interest of parties adversely.”

          We are completely agreed with views taken  and the documents filed by the O.Ps in  the present case. Hence  this forum  feel the complainant is not entitled any  relief from this forum and   liable to be dismissed. To meet the ends of justice the following order is passed.

ORDER.

In  resultant the complaint petition stands  dismissed. Parties are left to bear their own cost.    Accordingly the case  is disposed of.

Dictated and corrected by me.               Pronounced on this          16^th.   Day of   April,  2018.

 

Member.                                             Member.                                                             President