Hon’ble Mr. Haradhan Mukhopadhyay, President.
The short history of the complaint case in few words is that the Complainant Smt. Gopa Talukdar intended to insure under IDBI Bank, Cooch Behar Branch under the IDBI Federal Incomesurence Guaranteed Money Back Insurance plan 7 Pay in the year 2016. At a time of opening this policy bearing No.4000925368 whose yearly premium amounting to Rs.36,000/-, the competent authority OP bank told the Complainant that the amount would be refunded after one or more instalments of the policy premium at any evil day if raised for the same. The Complainant paid first instalment of the premium for Rs.36,000/- against the said insurance policy but subsequently could not make successive instalment payment due to acute female disease. Thereafter, the Complainant contacted with the OP bank several times for obtaining her pre-matured money surrendering her policy due to her treatment but the OP did not response at any time. Subsequently, the Complainant submitted to the OP bank a prayer for getting back her policy money on 14.03.19 alongwith all documents which the OP bank received on 15.03.19. But all her efforts were in vain due to non co-operation of the OP. The Complainant presently is in hard need of money for treatment of her female disease. Therefore the Complainant submitted her surrender application to the OP bank but the latter did not respond to the same. Finally, the Complainant issued a legal notice through her Advocate to O.P. No.1 the Branch Manager IDBI bank and OP No.2 General Manager IDBI Bank, Kolkata Zone on 27.05.19 which they received on 28.05.19 and 04.06.19 respectively but the OP did not co-operate with the Complainant. The aforesaid activities of the O.Ps caused deficiency in service to the Complainant and mental pain and agony to her. The cause of action arose on 14.03.19 and on subsequent dates. The Complainant therefore prayed for an award for Rs.50,000/- towards mental pain and agony, Rs.50,000/- for deficiency in service, Rs.15,000/- towards cost of litigation and a direction to the O.Ps to return the surrender money of the said insurance policy and other reliefs as per the prayer of the complaint.
Both the O.Ps contested the case by filing written version wherein they have denied most of the allegations against them. The positive defence case of the O.Ps in brief is that the subscriber of the policy was made aware of the terms and conditions of the policy that surrender can be initiated at any time after payment of two full years premium from the date of commencement of the policy. Whenever the Complainant approached the branch regarding her query she was always given due respect. In all his meetings, the branch tried to resolve her queries and explained the features of the policy. Also The Branch facilitated smooth meeting/ interaction between the Complainant and the representative of the insurer. The welcome letter to the insurer Complainant clearly mentioned that the policy has to be continued for another six years for getting benefit apart from other terms mentioned in the policy document. There was also a “free look period” of 15 days in the policy terms and in case of any non-satisfaction with respect to the insurance policy terms the same may be returned for cancellation with mentioned terms in the welcome letter. The OP claimed that the case is liable to be dismissed with cost.
The conflicting pleadings of both the parties demand for adjudication of the dispute under the following points.
Points for determination
- Whether the case is maintainable in its present form and prayer?
- Whether the Complainant is entitled to get the relief as prayed for?
- To what other relief if any the Complainant is entitled to get?
Decision with reasons
Point No.1.
It is the admitted position that the Complainant purchased the insurance policy under the O.Ps bearing No. 4000925368 under the character of money back insurance plan 7 pay of 2016. The Complainant categorically stated that after making payment of first policy premium instalment for Rs.36,000/- she could not continue the policy due to an acute female decease. Whether failure to continue the policy would entail her to have any relief is to be decided through Point Nos. 2 & 3. But the relation between the Complainant and the OP being well established, they come within the purview of the CP Act. Both the parties are within the jurisdiction of this Commission. The relief claimed is also within the pecuniary jurisdiction of this Commission. Accordingly there is no bar to entertain the present case. Therefore, the complaint case is maintainable in its present form and prayer.
Point No.1 is thus decided in favour of the Complainant.
Point Nos. 2 & 3.
Both the points are very closely interlinked with each other and these are taken up together for convenience and brevity of discussion.
The Complainant categorically stated that she made payment for a sum of Rs.36,000/- against the IDBI Federal Incomesurence Guaranteed Money Back Insurance plan 7- 2016. She also stated in her complaint that after paying first instalment of the premium under the said policy for Rs.36,000/- she could not continue to make any payment against the said policy for an acute female decease detected within herself. There is no dispute as to the payment of the first insurance premium.
It is the specific case of the Complainant that despite failure to pay any other instalment the Complainant is entitled to get the pre-matured amount i.e. surrender amount of the said policy from the OP.
Ld. Defence counsel argued that without making all the insurance policy i.e. 7th policy no maturity money can be refunded. Ld. Advocate for the OP also argued that Annexure-A is the welcome letter wherefrom it can be found that the Complainant is not entitled to get any benefit without paying all the instalments premium.
After perusing Annexure-A it is found that it is enshrined therein inter alia that “To enjoy the full benefits of your Federal Incomesurence Guaranteed Money Back Insurance plan 7 pay, we request you to continue paying your premiums for the next 6 years. Your yearly on or before June,2021, until June,2022 premium is Rs.35,000/-“. It is also stated therein inter alia that “We offer you a free look period of 15 days from the date you receive this document”.
Thus it is found that eligibility for claiming the maturity money of the insurance premium is payment of seven instalments.
Ld. Defence counsel in course of argument grew attention of the Commission in regard to Annexure-A being the different clauses of the said insurance plan 7 pay. As per the said policy brochure the paid up value (Non forfeiture) clause discloses that the policy eligible to acquire a paid up value only after two full years annual premiums have been paid. Thereafter, if you fail to pay any due premium within the grace period, your policy will assume paid up value with reduced benefits.
Thus in the instant case the Complainant could not complete payment of two full years annual premium.
The most important clause which puts and embargo to the claim and the Complainant is the lapse clause. Under the said lapse clause it is inserted therein inter alia that “During the first two policy years, if you fail to pay any due premium before end of the grace period, your policy will lapse and no benefits will be payable”.
Thus after perusal of the said lapse clause it is found that the Complainant is entitled to get the relief as prayed for the instant case however there was a revival clause under the said policy wherein it is inserted inter alia therein under clause-B that under clause- A & B that revival can be done within two years if satisfactory evidence of health is furnished subject to approval of the board and charged of interest of the arrear for premium.
Annexure-B is a letter wherein the Complainant surrenders the policy stating inter alia that she had deposited all required documents to the Agent Miss Priyanka which was duly received by the OP bank. Thus after the said revival letter is considered the OP bank is at liberty the revived the said policy but the relief prayed for in the instant case cannot be allowed to the reasons stated herein above.
Accordingly, Point No. 2 & 3 are answered in negative and decided against the Complainant. In the result the complaint case fails.
Hence, it is
Ordered
That the complaint case No. CC/87/2019 be and the same is dismissed on contest without cost.
The Complainant however is at liberty to file application for revival of the said policy as per terms and conditions and the OP bank shall reconsider the said revival of the policy of the Complainant as per rules and regulations of the bank.
Let a plain copy of this Order be supplied to the concerned party by hand/by Registered Post with A/D forthwith, free of cost, for information & necessary action as per rule.
The copy of the Final Order be also available in the official website: www.confonet.nic.in.
Note the Trial Register.
Dictated and corrected by me.
