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Sri T.Satish Babu filed a consumer case on 25 Sep 2021 against The Branch Manager Reliance Life Insurance Co. Ltd., in the Rayagada Consumer Court. The case no is CC/43/2018 and the judgment uploaded on 04 Dec 2021.
DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, RAYAGADA,
STATE: ODISHA.
C.C. Case No. 43 / 2018
P R E S E N T .
Dr. Aswini Kumar Mohapatra, President.
Sri Gadadhara Sahu, Member.
Smt. Padmalaya Mishra, Member.
Sri T.Satish Babu, S/O: Sri T.Mohan Rao, Vikrampur, Via:Gunupur, Dist:Rayagada (Odisha). …. Complainant.
Versus.
1.The Manager, Reliance life Insurance Company Ltd., Mumbai
2.The Branch Manager, Reliance life Insurance Company Ltd., Rayagada(Odisha). .…..Opp.Parties
Counsel for the parties:
For the complainant: - Self.
For the O.P No.1 :- Sri Biraja Prasad Patra, Advocate, Rayagada.
.
JUDGEMENT
The crux of the case is that the above named complainant alleging deficiency in service against afore mentioned O.Ps for non refund of balance deposited amount along with bonus accrued against policy No.50781337 from 2013 till its final payment 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. 50781337 opted for Reliance child plan.. Further there is no disputes the above policy term and premium payment term was 05 years. Again there is no dispute the complainant had paid total amount a sum Rs2,31,740/- for the period from Dt.23.02.2013 to Dt. 23.02.2017 towards 05 Nos. yearly premium Rs. 46,855,43 each premium. (copies of the policy schedule is in the file marked as Annexure-I)
The main grievance of the complainant is that he has received a sum of Rs.1,92,124/- against the payment of Rs. 2,31,740/- less than the amount paid by him i.e. Rs. 39,616.00 interalia has not received accrued bonus and when asked the reason the O.P. No.1 had stated that it is the survival and maturity benefit 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 submitted that the complainant had paid 5 (five) yearly premiums Rs.46,855..43 each premium total a sum of Rs. 2,31,740/- paid towards policy bearing No. 50781337. The complainant is under solemn obligation and legally duty bound to abide the terms and conditions of the insurance policy document ( copies of the policy documents are in the file which are marked as Annexure-2).
The O.Ps in their written version stated about facts of the case contended that the O.Ps had paid upon survival and maturity benefit of the life assured as per terms and conditions of the policy documents,
The O.Ps in their written version contended that the Survival benefit payout was made to the complainant by the O.Ps and the details of the same are given below. Towards policy No. 50781337 Survival Benefit was paid to the complainant payout cheque No. 276724 Dt.23.2.2015 an amount of Rs. 43,000/- was dispatched in shape of speed post vide postal receipt No.EA631424730IN on Dt. 18.2.2015 Further Survival benefit was paid to the complainant payout cheque No.871413 Dt.23.2.2016 an amount of Rs. 43,000/ was dispoatched in shape of speed post vide Postal reeipt No. EA062554132 IN on Dt. 22.2.2016 Again Survival benefit was paid to the complainant payout cheque No.510532 Dt.23.2.2017 an amount of Rs. 43,000/- was dispoatched in shape of speed post vide Postal reeipt No. RM 687445245 IN on Dt. 27.2.2017. Again maturity benefit along with Revisionary Bonus paid to the complainant an amount of Rs.63,124.00 was transferred on Dt.27.2.2018 through on line TRF vide HDFC NEFT ref No. N 059180483039044 from RLIC bank account No. 145415. The O.Ps as per terms and conditions of the above policy has paid the Survival benefits and maturity benefits of the policy No. 50781337 to the complainant total amount Rs.1,92,125/ which was admitted by the complainant in his petition.
The O.Ps follows the rules and regulations passed by the IRDA and further functions of the business is carried in accordance with the settled principle of law.
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.P. cited citation in their written version. It is held and reported in CPJ 2006 (Iv) 239 in the case of Prema&orsvrs. Life insurance Corporation of India the Hon’ble National Commission, New Delhi where in observed The O.Ps do not authorize the agents to source policies based on any allurements or false assurances and the O.Ps have acted as per the terms and conditions of the policy. It is further submitted that the IRDA has administrative control over the agents and that the O.Ps do not authorize the agents to source policies based on any allurements of false assurances. Any act of the agent can not be fastened on the O.Ps and they can not be held liable for the act and omissions of the agent.
Another citation cited by the O.Ps in their written version It is held and reported in SCC 2010 10 567 in the case of Suraj Mala Ram Niwas Oil Mills P Ltd. Vrs. United India Insurance Co.Ltd where in the Hon’ble Supreme Court observed That the terms of policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion or substitution.
This forum observed the complainant has not substantiate any evidence that the O.Ps have not acted pursuant to the terms and conditions of the policies. In absence of any evidence the present petition shall be dismissed.
The O.Ps in their written version cited citation. It is held and reported in 1999(6) SCC 451 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
Similarly in the case of General Assurance Societ Ltd. Vrs. Chandumull Jain and Anr. Reported in 1966 (3) SCR 500 the Constitution Bench has observed that the policy document being a contract and it has to be read strictly It was observed “In interpreting documents relating to a contract of insurance, the duty of the court it to interpret the words in which the contract is expressed by the parties because it is not for the court to make a new contract, however reasonable if the parties have not make it themselves.
Again this forum observed the O.Ps disputes and deny their liability to pay any amount and compensation to the complainant as alleged beyond what has been already paid and admittedly received by the complainant. It is stated that policy is a legal contract between the policy holder and the insurance company and the parties to the said contract are bound by its terms and conditions. That the terms of the policy are in the nature of the contract and their interpretation has to be made in accordance with the strict construction of the contract. Thus, the words in an insurance contract must be given paramount importance and interpreted as expressed without any addition, deletion of substitution more so when the parties have already accepted and acted on the same. The law in this regard is very well settled and one may conveniently referred to recent judgement of the Hon’ble Apex Court in case of Surajmal Ram Niwas Oil Mills Pvt. Ltd. Vrs. United India Insurance Company Ltd. Reported in 2010(10) SCC 567 the same has clearly stated in the case of Reliance Life Insurance Company Ltd. Vrs. Madhavacharya (Revision petition No. 211 of 2009 wherein it was held by the Hon ble National Commission observed That since the insurance between the insurer and the insured is a contract between the parties, the terms of the agreement including applicability of the provisions and also to its exclusion had to be strictly construed to determine the extent of the liability of the insurer.
It is held and reported in 2008(4) CPJ 156 in the case of Life Insurance Corporation of India Vrs. Shiva Prasad Das and others where in the Hon’ble National Commission observed The premium is given by an insured, to cover the risk for a given period, and the insurer covers the risk for the period for which the premium has been paid. It is not the case of the complainant that the risk was not covered for the period for which the premium was given. If after that the policy lapsed under no provision of terms of policy or law, could any for a direct for refund of any premium for the simple reason, as already started, that the risk stood covered for the period for which premium had been paid.
The Hon’ble State C.D.R.Commission,Cuttack, Odisha in F.A. No. 162/2010 in the case of Smt. Abanti Kumar Sahu Vrs. Bajaj Allianz where in observed In as much as the policy which was invested in the share market which is no doubt a speculative gain. The speculative investment matter does not come under the C.P. Act, 1986. Since the funds of this policy are also invested in the share market which is subject to speculations.
Again it is held and reported in CPJ 2003(1) 393 in the case of United India Insurance Co. Ltd., Vrs. HarchandRaiChandanial and in the case of VikramGreentech(I) Ltd. And Anr. Vrs. New India Assurance Co. Ltd-II 2009(2) CPJ-34 where in the Hon’ble Supreme Court observed An insurance policy is to be construed strictly as per the terms and conditions of the policy document which is a binding contract between the parties and nothing can be added or subtracted giving a different meaning to the words mentioned therein
Further it is held and reported in 2010(4) CPJ 38 in the case of Ram Niwas Oil Mills (P) Ltd. Vrs. United India Insurance Co. Ltd and Anr. where in tne Hon ble Supreme Court observed It is title that in a contract of insurance the rights and obligations are governed by the terms of the said contract. Therefore the terms of a contract of insurance have to be strictly construed and no exception can be made on the ground of equity.
Again it is held and reported 2000(1) SCC-66 in the case of Ravneet Singh BaggaVrs. KLM Royal Dutch Airlines the hon’ble Supreme Court observed The deficiency in service can not be alleged without attributing fault imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service in upon the person who alleges it.
Further It is held in Revision petition No.3271 of 2013 decided on 7.10.2013 in the case of Mohan Lal Benal Vrs. ICICI Prudential life insurance Co. Ltd. Where in the National Commission observed If the insured is not safisfied with policy taken, then he/she should avail option of returning policy within 15 days of receipt i.e. within free-lock-period.
Again It is held and reported in CPC 2006(2) page No. 668 in the case of Oriental Insurance Co. Ltd. Vrs. Munimahesh Patel where in the Hon’ble Apex court observed the proceedings before the National Commission were essentially summary in nature. It ws further held that in view of the complex factual position, the matter could not be examined by the Consumer Forum and the appropriate forum was the Civil court.
Further It is held and reported in Revision petition No.2479 of 2008 decided on 24.7.2013 in the case of UCO Bank Vrs. S.D. Wadhwa the Hon’ble National Commission where in observed Complaint involves complicated and complex questions which require elaborate evidence hence dispute not adjudicable in summary jurisdiction therefore complainant not maintainable
Again It is held and reported in CPJ 1992(2) page No.487 in the case of Panalal Vrs. Bank of India & others where in the Apex Court observed It is evident from the above that the complainants is not a simple case of deficiency in service rendered by the bank. It involves a determination of complex questions of facts and law which can not be satisfactorily determined by this commission in the time frame provided under the Act. It would be better for the complainant to seek redress of his grievances in Civil Court if so advised.
Further it is held and reported in SCC 2000(1) page No.66 where in the Hon’ble Apex court observed The deficiency in service can not be alleged without attributing falt imperfection, shortcoming or inadequacy in the quality nature and manner of performance which is required to be performed by a person in pursuance of a contract or otherwise in relation to any service. The burden of proving the deficiency in service is upon the person who alleges it.
This forum completely agreed with views taken and the documents, citations of the Apex court 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. In the circumstances there is no order as to cost. The complainant is free to approach the court of competent having its jurisdiction Accordingly the case is disposed of
Dictated and corrected by me
Pronounced on this 25th Day of September, 2020.
Member. Member. President
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