1. The brief history of the case of the complainant is that he obtained a policy vide No.18562529 under Reliance Child Plan of Ops commencing from 15.2.2011 for 6 years, the maturity date being 15.2.2017. It is submitted that he paid Rs.3, 02,440/- towards yearly premiums during the above 6 years period and received money back long with maturity value under the policy amounting to Rs.2, 62,659/- having deficit of Rs.39, 782/- from the deposits. It is further submitted that he requested the Ops to get refund of deficit amount but in vain. Thus alleging unfair trade practice on the part of the Ops, he filed this case praying the Forum to direct the Ops to refund Rs.39, 782/- with interest @ 12% p.a. along with other benefits and to pay Rs.35, 000/- towards compensation and costs to the complainant.
2. The Ops filed counter in joint denying the allegations of the complainant but admitted about the Policy bearing No.18562529 taken by the complainant w.e.f. 15.2.2011 and receipt of deposits for 6 years. It is contended that they have given Survival Benefits (SB) to the complainant in the year 2014, 2015 & 2016 @ Rs.57, 550/- each and also paid Rs.90, 009/- on maturity dt.18.2.2017 and hence nothing is either due or legally recoverable by the complainant from the Ops. The Ops further contended that the complainant is trying to make mala fide gains from the Ops after receipt of SB and maturity benefits as per the terms of the policy and the complainant has failed to establish any deficiency in service on the part of the Ops. Thus denying any fault on their part, the Ops prayed to dismiss the case of the complainant.
3. Both the parties have filed certain documents in support of their cases. The complainant has filed affidavit. Heard from the parties through their respective A/Rs and perused the materials available on record.
4. In this cased subscription to Policy No.18562529 under Reliance Child Plan for 6 years commencing from 15.2.2011 by the complainant till 15.2.2016 on yearly mode for a total amount of Rs.3, 02,440.54 is an admitted fact. It is also an admitted fact that as per policy terms, the complainant has received money back in the year, 2014, 2015 & 2016 @ Rs.57, 550/- and on maturity has received Rs.90, 009/- on 18.2.2017. The case of the complainant is that he has received Rs.39, 782/- less against his deposit of Rs.3, 02,440/- and in order to get back the deficit amount, he has approached the Ops but in vain.
5. The Ops on the other hand submitted that as per policy terms and conditions SB in the year, 2014, 2015 & 2016 and maturity benefit in the year, 2017 have been paid to the complainant and nothing is payable under the policy. It is seen that, the Ops in this case did not file the details of benefits paid to the complainant after maturity of the policy but simply submitted that as per rule they have paid the benefits to the complainant. The complainant has filed details of Child Plan Scheme and the benefits attached thereto.
6. We have carefully gone through the policy details available on record. It is a traditional participating child plan which guarantees child’s future. It is also a non negative capital guarantee and high SA additions that increase corpus besides bonus. The benefits as per terms of the policy are given below:
- 25% of the assured sum amount is paid as Guaranteed Periodic Benefits in the last 3 policy years before maturity even if the policyholder does not survive the policy term.
- Under the Non-Negative Capital Guarantee feature, the benefit paid on maturity is never less than the total premiums paid and if it is less, the Company funds the deficit.
- On maturity, 25% of the SA + Non-Negative Capital Guarantee Additions + High SA Addition Benefit + Bonus is paid to the policyholder.
7. The terms of the policy being thus, it is seen that the complainant has received 25% of the assured sum as guaranteed periodic benefit for 3 years before maturity and on maturity he has received a sum of Rs.90, 009/- and thus in total the complainant has received Rs.2, 62,659/- out of deposit of Rs.3, 02,440/- which is 39, 782/- less than that of his deposits. If this is so, Term No.II above fails. In the said term, the policy shows that under the non-negative capital guaranteed feature, the benefit paid on maturity is never less than the total premiums paid and if it is less, the Company funds the deficit. In this case, the deficit amount is Rs.39, 782/- as compared to the premium deposits and receipt on maturity.
8. The Condition No.III as stated above shows that on maturity, 25% of the SA + Non-Negative Capital Guarantee Additions + High SA Addition benefits + Bonus is paid to the policyholder. It is seen that on maturity the complainant has received Rs.90, 009/- which includes 25% of SA. The SA under the policy is Rs.2, 30,200/- and its 25% is Rs.57, 550/-. That means the complainant gets (Rs.90, 009/- minus Rs.57, 550/-) = Rs.32, 459/- as benefits on different heads as mentioned above from the Ops on maturity and in total he gets Rs.2, 62,659/- out of his deposit of Rs.3, 02,440.54 towards premiums.
9. The counter of the Ops has no clarity regarding guaranteed fixed benefits offered to the complainant on maturity under the plan and simply disowned the liability stating that as per terms of the policy, they have paid benefits to the complainant. A child is the future of this country. Reliance child plan is meant for the parents who want to see their child succeed without any trouble and achieve all that a parent has ever dream for his child. Thus being the intention of the child plan, a parent is getting the benefit very much less than what he had deposited under the said plan. When the intention of the plan could not be materialized, then what is the use of opting the plan by a parent?
10. From the above discussions, we come to the conclusion that the Ops have paid lesser amount to the complainant than the premiums paid which itself violates its own terms and conditions. For appraisal of the Forum, the learned A/R for the complainant has filed copy of Reliance Child Plan – Check Policy details with illustration of one case. In that case, the Policy term is for 16 years and the SA is Rs.4, 05,405/- with annual premium of Rs.30, 000/- and the policyholder has received the following benefits.
Periodic Benefits Amount received.
Guaranteed periodic benefits Rs. 3, 04,662/-
Guaranteed sum assured at maturity Rs. 1, 01,554/-
Vested bonuses Rs. 1, 94,594/-
Total : Rs. 6, 00,810/-
In the above policy, the policy holder has received Rs.6, 00,810/- on deposit of Rs.30, 000/- X 16 = Rs.4, 80,000/- in the same Reliance Child Plan. Likewise the present complainant is entitled to get the policy benefits in the same manner and rule to which the Ops have not offered to pay and as such in our opinion this activity of the Ops certainly amounts to unfair trade practice. As per above rule, we are inclined to calculate the actual benefits to be received by the complainant against his Child Plan.
Periodic Benefits Amount received.
Guaranteed periodic benefits
@ 25% of SA of Rs.2, 30,200/-
For 3 years @ Rs.57, 550/- Rs.1, 72,650/-
Guaranteed SA on maturity Rs. 57, 550/-
Non-guaranteed capital Guaranteed:
(Premium paid minus cash Received
(Rs.3, 02,440/- minus Rs.2, 30,200/) Rs. 72, 240/-
Vested Bonus @ 3% on Rs.2, 30,200/-
for 6 years. Rs. 41, 436/-
Total maturity benefits Rs.3, 43,876/-
Amount received on maturity (-) Rs.2, 62,659/-
Deficit Amount: Rs. 81, 217/-
11. From the above calculation it came to the light that the complainant is to get Rs.81, 217/- more than what he has received and the Ops are to pay the same to the complainant towards benefit with interest @ 12% p.a. from the date of maturity till payment. While quantifying the compensation, it is seen that the Ops by adopting unfair trade practice have not offered the actual benefits to the complainant and for such inaction of the Ops; the complainant must have suffered some mental agony and also has come up with this case incurring some expenditure for which he is entitled for suitable compensation and costs. Considering the sufferings of the complainant we feel that a sum of Rs.5000/- towards compensation and costs in favour of the complainant will meet the ends of justice.
12. Hence ordered that the complaint petition is allowed in part and the Ops being jointly and severally liable are directed to pay Rs.81, 217/- towards unpaid benefits with interest @ 12% p.a. from 15.02.2017 and to pay Rs.5000/- towards compensation and costs to the complainant within 30 days from the date of communication of this order.
(to dict.)