The Complainant has filed this case alleging deficiency-in-service by the O.Ps, where O.P No.1 is the Branch Manager, Kalinga Gramya Bank, Bidu Branch, Bidu, Balasore, O.P No.2 is the Senior Regional Head, Bajaj Allianz Life Insurance Company Ltd., Balasore and O.P No.3 is the General Manager, Bajaj Allianz Life Insurance Company Ltd., Corporate Office, Pune.
2. The case of the Complainant in brief is that the Complainant had entered into a Bajaj Allianz Insurance vide master policy No.-0140000645 on payment of annual premium of Rs.5,000/- (Rupees Five thousand) only to O.P No.1, commencing on 23.08.2010 and maturity date is 22.08.2015. But, on receipt of said policy certificate, it is disclosed that Rs.1,000/- (Rupees One thousand) only is mentioned in the recital of certificate instead of Rs.5,000/- (Rupees Five thousand) only. Thus, the Complainant approached O.P No.1 and accordingly, the O.P No.1 handed over another certificate mentioning correct premium amount of Rs.5,000/- (Rupees Five thousand) only with two different application no. between policy certificate and premium paid receipt, issued by the O.Ps. The Complainant issued one Advocate notice to O.P No.2 and 3 on 13.05.2016 to rectify the same, but the O.Ps replied that “no such policy issued by them”. But, on maturity of above said policy, the O.Ps-Company issued a cheque of Rs.8,000/- (Rupees Eight thousand) only in the year 2015 though the Complainant deposited a sum of Rs.25,000/- (Rupees Twenty five thousand) only during 2010 to 2014. Thereafter, the Complainant approached to O.P No.1, where the O.P No.1 on receipt of said cheque, assured that the O.Ps-Company will issue full insurance amount, but the O.P No.1 denied to give any benefit of policy amount on 12.09.2016, which amounts to deficiency-in-service by the O.Ps, causing mental agony and harassment to the Complainant. Cause of action arose on 12.09.2016. The Complainant has prayed for payment of maturity value with interest along with compensation and litigation cost.
3. Though the O.P No.1 has appeared in this case through his Advocate, but has not filed his written version in this case. The O.P No.1 is also set ex-parte. Neither the O.P No.1 nor his Advocate was present at the time of hearing of this case.
4. Written Version filed by the O.P No.2 through his Advocate denying on the point of maintainability as well as its cause of action. The O.P No.2 has further submitted that the Complainant being a member under Master Policy bearing No.0140000645 having Application No.KGB035126 and Membership No.9995059797 had obtained a certificate of insurance having date of commence of 23.08.2010, yearly premium of Rs.5,000/- (Rupees Five thousand) only and sum insured of Rs.1,25,000/- (Rupees One lakh twenty five thousand) only for the period of five years from the O.P No.2 through O.P No.1. When the said certificate of insurance was matured after 5 years, the O.P No.2 verified the payment details of premium deposited in the name of the Complainant in system for payment of account value, which shown the total deposit of premium of Rs.10,000/- (Rupees Ten thousand) only and investment return of Rs.1,775.58 ps. (Rupees One thousand seven hundred seventy five and fifty eight paisa) only and accordingly, the O.P No.2 calculated account value of the certificate of insurance of the Complainant as maturity benefit after deduction of cost of insurance coverage with tax, scheme of administration fees and scheme fee amount and paid Rs.8,846.78 ps. (Rupees Eight thousand eight hundred forty six and seventy eight paisa) only to the Complainant vide cheque No.737370, dtd.05.11.2015. Thereafter, the O.P No.2 thoroughly verified the details of deposit of premium against the Membership No.9995059797 and Application No.KGD05126 and ascertained that the Complainant has paid total premium of Rs.25,000/- (Rupees Twenty five thousand) only within the period from 23.08.2010 to 22.08.2015 and the O.P No.2 has paid the account value of Rs.8,846.78 ps. (Rupees Eight thousand eight hundred forty six and seventy eight paisa) only on premium amount of Rs.10,000/- (Rupees Ten thousand) only inadvertently and the O.P No.2 is ready to pay the account value of the balance deposited premium of Rs.15,000/- (Rupees Fifteen thousand) only and its interest @ prevailing rate of interest of Bank. The compensation amount as claimed by the Complainant exceeds the claim amount and has no reason and rhyme. But, non-payment of balance deposited premium amount of Rs.15,000/- (Rupees Fifteen thousand) only came to the knowledge of the O.P No.2 after receiving the notice to show cause in this case for the first time and immediately, the O.P No.2 took sincere effort for payment of the account value on the balance deposited premium amount through the Advocate of the Complainant, who was initially agreed to receive the same and accordingly, the O.P No.2 prepared the draft. But, subsequently the Advocate for the Complainant refused to receive the said draft since the O.P No.1 has not returned back the cheque No.737370, dtd.05.11.2015 of Rs.8,846/- (Rupees Eight thousand eight hundred forty six) only to the Complainant and as such, the O.P No.2 had not done any such act by which the Complainant has sustained mental agony and harassment and the Complainant is not entitled to get any cost and compensation towards it. So, the case of the Complainant being devoid of merit is liable to be dismissed with cost.
5. Though sufficient opportunities were given to O.P No.3, but he has neither appeared nor filed his written version in this case. The O.P No.3 is set ex-parte.
6. In view of the above averments of both the Parties, the points for determination of this case are as follows:-
(i) Whether this Consumer case is maintainable as per Law ?
(ii) Whether there is any cause of action to file this case ?
(iii) To what relief the Complainant is entitled for ?
7. In order to substantiate their claim, both the Parties have filed certain documents as per list. Perused the documents filed. It has been argued on behalf of the Complainant that though she was depositing the premium amount of Rs.5,000/- (Rupees Five thousand) only per annum, in total Rs.25,000/- (Rupees Twenty five thousand) only, initially a wrong certificate has been given to her showing the deposit of Rs.1,000/- (Rupees One thousand) only per annum and after maturity, a sum of Rs.8,000/- (Rupees Eight thousand) only was given to her by way of cheque and on scrutiny by the O.P No.2 and on protest by the Complainant, it was found that wrong calculation was made and it was duly corrected and fresh correct certificate of insurance showing deposit of premium of Rs.5,000/- (Rupees Five thousand) only per annum. The Complainant met the O.P No.1 and as per his instruction, she handed over the said cheque of Rs.8,000/- (Rupees Eight thousand) only to the O.P No.1-Bank with a hope to get the correct matured amount. But, when she failed in her attempt, she took shelter of this Forum praying for her matured amount along with compensation and litigation cost. On the other hand, the O.P No.1 though appeared through his Advocate, did not file any written version and remained absent on the date of hearing and not took part on his behalf in the hearing. He is set ex-parte as mentioned earlier. Similarly, the O.P No.3 did not appear in this case and he is also set ex-parte as mentioned earlier. So, both O.P No.1 and 3 has nothing to say in this case. It has been argued on behalf of the O.P No.2 that as per certificate of insurance on an individual Member reaching to the maturity date, the individual member’s account value can be withdrawn. The minimum maturity guarantee is the total net premiums paid till maturity date less sum of Scheme Administration fees deducted till maturity date, provided all due premiums have been paid by the policy holder for the respective member. So, in the instant case, when the O.P No.2 has already paid a sum of Rs.8,846/- (Rupees Eight thousand eight hundred forty six) only by way of a cheque to the Complainant, he is only liable to pay rest of the amount by deducting the above amount from the due amount. So, in the instant case, there is discrepancy in the amount of cheque handed over to the Complainant. According to the Complainant, it is Rs.8,000/- (Rupees Eight thousand) only and according to the O.P No.2, it is Rs.8,846/- (Rupees Eight thousand eight hundred forty six) only, but no specific clarity evidence has been put forth before us for our verification and confirmation and on the other hand, a xerox copy of cheque of O.P No.2 in the name of the Complainant has been filed showing the amount of Rs.17,334/- (Rupees Seventeen thousand three hundred thirty four) only and it is submitted that the O.P No.2 is ready to pay that amount to the Complainant. The O.P No.1 as set ex-parte, for which what happened to the cheque deposited with O.P No.1 by the Complainant is unknown to the Forum. The O.P No.1 should not shift his responsibility and he is liable for such non-performance of duty properly. The O.P No.2 is silent whether the alleged cheque issued in favour of the Complainant has actually been encashed from the account of the O.P No.2. So, without getting such information it can be safely concluded that the said amount has not been encashed.
8. So, now on careful consideration of all the materials available in the case record, this Forum come to the conclusion that the Complainant is entitled to get the account value that is total net premium paid till maturity date less sum of scheme administration fee deducted till maturity date followed by interest of 9% from the date of maturity of the claim and the O.Ps No.2 and 3 are jointly and severally liable for it. Further, the O.Ps No.1, 2 and 3 are jointly and severally liable to pay compensation of Rs.5,000/- (Rupees Five thousand) only and litigation cost of Rs.1,000/- (Rupees One thousand) only to the Complainant. The entire due amount along with compensation and litigation cost be paid within 60 days from the receipt of this order, failing which it will carry interest @ 9% per annum as whole. Hence, Ordered:-
O R D E R
The Consumer case is allowed on ex-parte against the O.Ps No.1 & 3 and on contest against the O.P No.2 with cost. The O.Ps No.2 and 3 are jointly and severally directed to pay the account value that is total net premium paid till maturity date less sum of scheme administration fee deducted till maturity date followed by interest of 9% from the date of maturity of the claim to the Complainant. Further, the O.Ps No.1, 2 and 3 are jointly and severally directed to pay compensation of Rs.5,000/- (Rupees Five thousand) only and litigation cost of Rs.1,000/- (Rupees One thousand) only to the Complainant. The entire due amount along with compensation and litigation cost be paid within 60 days of receipt of this order, failing which it will carry interest @ 9% per annum on the whole amount from the date of order till realization. The Complainant is also at liberty to realize her claim from all the O.Ps under due procedure of Law, in case of failure by all the O.Ps to comply the Order.
Pronounced in the open Forum on this day i.e. the 18th day of August, 2018 given under my Signature & Seal of the Forum.