Hon'ble Mr. Haradhan Mukhopadhyay, President.
Complainant lodged the case ventilating his grievance with prayer for relief stating inter alia that the Complainant Swapan Kumar Bhattacharya is an Ex. Employee of Tufanganj Municipality. The O.P. No.1 Branch Manager, LICI, Cooch Behar and the O.P. No.2 marketing Manager LICI are agent of LIC. The Complainant accepted the policy under the O.P. No.1 LICI having policy No.450419327 vide Table No.165-15 with maturity sum assured Rs.2 Lakh. During accepting the policy the OP LICI and his agent assured that after maturity on 28.03.19 OP shall pay of Rs.2 Lakh as maturity amount for which a certificate of policy was issued. The Complainant paid the total premium money. On 18.12.18 the O.P. No.1 issued maturity benefit claim letter mentioning the maturity amount of Rs.94,614/- in lieu of Rs.2 Lakh. The Complainant raised complaint immediately to the OP but the letter did not give any reply. Subsequently the Complainant filed a written complaint to the OP on 14.12.19 and subsequently on 15.02.19 by registered post, both of which the OP received but did not reply. The OP also did not disburse the maturity amount of Rs.2 Lakh. The activities of the OP thus amounts to deficiency in service and unfair trade practices. The Complainant is a consumer under the OP and entitled to get Rs.2 Lakh from the OP with up to date interest. The cause of action arose on 28.03.19, 18.12.18 and 14.02.19 and is stilled continuing. The Complainant therefore prayed for an award for Rs.2 Lakh against the OP as matured money, Rs.50,000/- for deficiency in service and Rs.10,000/- as litigation cost.
The OP No.1 & 2 contested the case by filing W/V. The OP denied each and every allegation of the Complainant. The positive defence case of the OP in brief is that the Complainant is not a consumer under the OP. Complainant purchased LIC Jeevan Saral policy No.450419327 on 28.03.2004, maturity date 28.03.19 with monthly premium of Rs.408/-. That policy is a mixed product of term insurance and conventional insurance. There is differences in death sum assured(DSA) and maturity sum assured (MSA) which is mentioned for the policy bond. The policy holder has to decide the monthly premium. Once it is chosen the DSA and the MSA is automatically calculated. As per policy condition the DSA may be 250 times of the monthly premium paid while the MSA is dependent on the age of the policy holder. The Complainant chosen monthly premium of Rs.408/- which included accident benefit premium. The policy holder paid Rs.408/- x 12x 15 years i.e. Rs. 73,440/- during the period of the policy. The age of the policy holder on the date of commencement of 45 years. As per actual calculation the MSA of the policy comes to Rs. 64,804/-. The OIC has correctly issued maturity discharge voucher of Rs.94,614/- including Rs.29,210/- as loyalty addition of the amount of premium paid. The Complainant being a regular customer of the policy knows the policy regulations. The policy paper also contains instruction. He could draw attention of the Branch for any discrepancy. Policy holder is duly informed with all the regulations at the time of entering into the policy agreement. So he is estopped from any contrary fact to the policy. Unfortunately due to typographical error it was erroneously printed as maturity sum assured. The maturity claim could not be paid as the policy holder did not submit the discharge voucher. The LICI has right to correct the typographical error. The Complainant would not be allowed to take benefit by such typographical error. The OP therefore prayed for dismissal of the complaint case.
The pleading of the Complainant and the counter defence case of the OP led this Commission to ascertain the following points for proper and just decision of the case.
POINTS FOR DETERMINATION
- Whether the Complainant is a consumer under the C.P. Act?
- Whether the policy certificate contains typographical error and it is inadvertent or intentional?
- Whether Acts activities of the OP amounts to deficiency in service?
- 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.
Although the OP denied the status of the Complainant as a consumer yet Ld. Defence Counsel did not advance any argument on the point that the Complainant is not a consumer.
So far as the relation of the Complainant and the O.Ps are concerned it transpired that the Complainant purchased one policy against payment of sum money and the OP issued a certificate and agreed to pay the maturity sum after a particular period on the happening on some contingent incident. Having considered the ingredients required for becoming a consumer under the C.P. Act the Commission finds that all the ingredients are subsisting for the status of the Complainant and the relation between the Complainant and OP is consumer and service provider. Accordingly the Complainant is a consumer under the C.P. Act.
Thus issue No.1 is decided in favour of the Complainant positively.
Point Nos.2 & 3.
Both the issues are closely interlinked with each other and accordingly these are taken up together for convenience and brevity.
After perusing the pleading of the parties and the evidence on record it is revealed that the Complainant purchased one insurance policy from the OP which was proved by Complainant as Annexure- A having policy No.450419327 on 28.03.2004 under the table and term 165-15 with maturity sum of Rs.2 Lakh in the name of the Complainant Swapan Kumar Bhattacharya having nominee Smt. Rekha Bhattacharya (Wife). Excepting the maturity sum the other condition of the said policy certificate is not disputed by the OP. In the matured sum it is wrongly written as Rs. 2 Lakh whereas the OP defended the allegation of the Complainant that due to inadvertent error and typographical mistake it has been recorded Rs.2 Lakh instead of the actual amount.
In order to establish the defence plea the OP pleaded in para-7 of the W/V and their evidence on affidavit by the Branch Manager of LICI, Cooch Behar as to how the actual value of the policy ought to have been Rs.64,804/-.
The OP also led evidence of the Branch Manager stating inter alia that the policy holder paid Rs.408/- x 12 x15 years= Rs.73,440/-. The age of the policy holder at the time of commencement was 45 years as per actual calculation the maturity sum assured MSA of the policy comes to Rs.64,804/-. It is the specific evidence of the OP that the OIC issued the maturity discharge voucher correctly for Rs.94,614/-“i.e. Rs.64,804/- + Rs.29,810/-” as loyalty addition on the amount of premium paid.
The Complainant did not cross-examine the OP in regard to the said evidence of calculation of MSA to the extent of Rs.94,614/-. As per order No.9 dated 13.01.20 both the parties verbally submitted to the Commission that they were not willing to file questionnaires for cross-examination. Accordingly the evidence of the OP about their defence case stands unchallenged.
However, the evidence of Complainant also stands unchallenged but the fact remains that the Complainant filed the receipt of the monthly premium wherein it is mentioned that the sum assured for the said policy is Rs.1 Lakh. The said original premium receipt for the month of 3- 2018 dated 22.05.18, premium is Rs.4804/- wherein it is categorically stated that the sum assured(SA) is Rs.1 Lakh. The Complainant deposited several premium knowing from well that the sum assured for the policy is Rs.1 Lakh. The said document clearly establish that the Complainant had prior knowledge of the fact that the sum assured for the said policy is Rs. 1 Lakh but despite knowing the same the Complainant did not raise any complaint previously with malafide intention for unlawful gain from the OP Company which runs from the public money.
The Ld. Advocate for the Complainant argued that LIC may have power to rectify the typographical error but why did they not inform it to the Complainant earlier. He raised a question as to how the OP detected and inform the said error after lapse of maturity.
In fact the error ought to have come within the notice of both the parties. Had the said error not brought to the notice of the OP, it is no doubt a lapse on the part of OP and its concerned Officers or Staff and appropriate legal steps should be taken against the responsible Officers and Staff of the OP Company. But the Complainant cannot take undue advantage of the error on the part of the OP at the cost of the public money.
The said error is a contributory negligence on the part of the Complainant and both the O.Ps.
Having taken into consideration the materials in the case record vis-à-vis the discussion made here in above the Commission is of the view that the present imbroglio in the dispute between the parties is nothing but simply a typographical mistake. The Commission does not find any malafide intention on the part of the OP in regard to the disputed sum of Rs.2,000/-. It is the settled position of Law that in case of sale of anything the consumer/ purchaser must follow the “caveat emptor” (buyer be caucus). Accordingly issue Nos. 2 & 3 are answered in negative and are decided on behalf of the Complainant.
Point Nos. 4 & 5.
While deciding the points of relief prayed for by the Complainant regard being to the discussion made in point No. 2 & 3 as above previously we have find that mistake was absolutely inadvertent and as such the Complainant cannot claim any special benefit due to the said lapse on the part of the particular Officers/ Staff of the OP. The Complainant had opportunity to rectify the error or take appropriate steps by informing by OP before maturity, which he did not do.
In the back drop of the aforesaid assessment factual and documentary evidence on case record vis-à-vis the discussion made in the foregoing paragraphs I am of the view that the Complainant failed to establish the claim up to the hilt. Consequently both the issues are answered against the Complainant. Issue Nos. 4 & 5 are answered negatively against the Complainant.
In the result the complaint case fails without cost.
Hence, it is
Ordered
That the claim case CC/69/2019 be and the same is dismissed on contest without cost. However OP Branch Manager LICI, Cooch Behar is directed to take appropriate steps as per the provisions of Insurance Laws to ascertain the fault on the part of the Officers/ Staff for which necessary legal expenses had to be incurred from the public exchequer.
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.
Dictated and corrected by me.
