By Sri. Ananthakrishnan. P.S,  President:

            This is complaint filed under section 35 of the Consumer Protection Act 2019.

            2. The complainant’s case in brief is as follows:-       The Complainant took an LIC policy on 21.2.2014 through third Opposite Party. The assured sum of the policy is Rs.15,00,000/-  and maturity date is 21.2.2031. The Complainant had to pay quarterly premium at the rate of Rs.26,464/- and he had paid 7 instalments.  At the time of these payments, the Complainant was working at Saudi and due to the treatment of his father, he was compelled to return to his native place.  Thereafter, he failed to remit subsequent premium.  The third Opposite Party assured that the policy can be renewed at any time if, he remitted all arrears of premium with interest. Therefore, the Complainant contacted first Opposite Party in the year 2017 to remit the arrears in order to renew the policy. But, he was informed that the policy becomes lapsed.  Thereafter, the Complainant submitted a written letter to renew the policy to which second Opposite Party sent a reply dated 14.03.2018 stating that the policy cannot be renewed.  The Complainant had paid Rs.1,86,765/- towards 7 instalments of the premium. Therefore, he requested to refund this amount. But, they have not given the amount. The Complainant wants to get this amount for the treatment of his father who was suffering from cancer and Covid.  He wants huge amount for the treatment of his father. He is a coolie worker. Hence, there is deficiency in the service of Opposite Parties. Thus, this complaint to get Rs.1,86,765/- with 12 % interest, Rs.10,000/- towards compensation and  Rs.5,000/-  for litigation expenses.

            3. Opposite Parties No. 1 and 2 filed version which in short is as follows:-  They admitted that the Complainant joined in an LIC policy and he paid Rs.1,82434/- towards premium under the policy.  They also admitted that Complainant had approached them to renew the policy and thereafter to get refund of policy amount which he paid. But, as per the policy condition, the policy of Complainant has been lapsed and so, it is to be revived during the life time of the Complainant within a period of two consecutive years from the date of the first unpaid premium before the date of maturity.  Since, the insurance policy is in the nature of contract, all the parties are bound by the terms of the contract. As per condition No.4 of the policy, the paid up value of the policy could be refunded only if, the insured had paid the premium for 3 years. But, the Complainant approached the Opposite Party to renew the policy after two years and he has not paid premium for 3 years.  Hence he is not entitled to get refund of the paid up value of the policy. So, there is no deficiency  in service on the part of the Opposite Party.  So the complaint is liable to be dismissed.

         4. Third Opposite Party  is ex parte. 

            5.  On the above pleading the points to be considered are:-                                                                      

              1.  Whether there is any deficiency in service on the part of Opposite

                Parties?

                      2. Reliefs and cost.

6. The evidence in this case consists of oral testimony of PW1, Ext. A1 to A4 from the side of the Complainant. Ext.X1 and X2 were also marked.  There is no evidence from the side of Opposite Party

7. Point No.1:-  The Complainant joined in a policy of L.I.C namely Jeevan Anand on 21.2.2014 through third Opposite Party.  It is an admitted fact that the Complainant was bound to pay the premium quarterly at the rate of Rs.26,464/-  and he paid 7 instalments only. The total amount which he paid is Rs.1,86,765/-. Though, there is a simple difference in this amount, admittedly, the Complainant defaulted the payment after the 7^th instalment and two years thereafter, he approached LIC  to renew the policy.  It also an admitted fact that the third Opposite Party did not allow him to renew the policy and so, he approached them to get refund of the remitted amount. The grievance of the Complainant is that the third Opposite Party has not given the amount.  So according to him, there is deficiency in their service.

8. Opposite Party contented that since, the Complainant failed to pay the

insurance premium for 3 years, he is not entitled to get  the  amount he paid because the policy becomes lapsed.

9. To prove the case of the Complainant, he has given evidence as PW1.

Ext.A1 is the Policy Certificate, Ext.A2 is the reply from the third Opposite Party to Ext. A4 letter of the Complainant.  Ext.A3 series are treatment records of his father, Ext.X1 is the original policy certificate which contains terms and condition of the policy.  Ext.X2 is the original of Ext.A2.

10. As already stated, it is an admitted fact that the Complainant has not remitted the policy for 3 years and he approached the Opposite Party to renew the policy only after 2 years from the date of last payment.  According to first and second Opposite Party, this is the reason for not giving the refund. As per clause 3 of the policy condition in Ext. X1, the Opposite Party is not bound to revive the discontinued policy if, the insured has not approached them within a period of 2 consecutive years from the date of the first unpaid premium and before the end of the policy term.  As per clause 4, if, less than 3 years premium have been paid in respect of the policy and any subsequent premium be not duly paid, all the benefits under the policy shall seize after the expiry of grace period from the date of first unpaid premium and nothing shall be payable. Taking an insurance policy is a contract between the insurers and insured who are Complainant and L.I.C. here. So both have to obey the terms and conditions contained in Ext. X1. So, the denial of refund by the first and second Opposite Party can be justified.  Therefore, there is no deficiency in their service. So Complainant is not  entitled to get any reliefs prayed. Thus, the point answered against the Complainant.

11. Point No.2:- Since, we found point No.1 against the Complainant, the Complainant is not entitle to get any relief.

In the result, the complaint is dismissed, but without costs.

Dictated to the Confidential Assistant, transcribed by him and corrected by me and pronounced in the Open Commission on this the 21^st day of November 2022.

Date of filing :31.08.2021.                                                                     

PRESIDENT    : Sd/-

                                                                                    MEMBER       : Sd/-   

APPENDIX.

Witness for the complainant:-

PW1.              Jobins Joy.                                        Daily Wage.

Witness for the Opposite Parties:-

                        Nil.     

Exhibits for the complainant:

A1.                  Copy of Policy document No.798833322.

A2.                  Copy of Letter.                                                        Dt:14.03.2018.

A3(a).                        Discharge Summary.

A3(b).                        Copy of photos issued from Sushrutha Institute of Plastic,

Reconstructive and Aesthetic Surgery.

A3(c ).            Quarantine Certificate.                                         Dt:08.07.2021.

A3(d).                        Discharge Summary.                                            

A3(e).                        MRI Scan Report.                                                   Dt:27.09.2012.

A3(f).             Copy of Discharge Summary.                             Dt:25.09.2012.

A3(g).                        Copy of Test Report.                                             Dt:23.09.2012.

A4.                  Copy of Letter.                                                        Dt:31.08.2019.

X1.                  Policy document No.798833322.

X2.                  Letter.                                                                        Dt:14.03.2018.

Exhibits for the Opposite Parties:-

Nil.

PRESIDENT   :Sd/-

MEMBER       :Sd/-

/True Copy/

                                                                                        Sd/-

                                                                                             ASSISTANT REGISTRAR

                                                                                                  CDRC, WAYANAD.