For Complainant : Sri Pravat Kumar Padhi, Advocate.
For Ops 1 & 2 : Sri Santosh Kumar Mishra, Advocate & associates.
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1. The brief history of the case of the complainant is that she being persuaded by the OP.1 and its agent (Mrs. Sagarika Panigrahi) agreed to propose for a Child Plan for premium and policy paying term of 6 years with premium of Rs.1, 99,953/- p.a. for a sum assured of Rs.9, 30,000/-. It is submitted that a cheque of Rs.2.00 lacs along with proposal form and documents were sent to OP.2 who in turn sent Policy No.19861589 dt.23.02.2012. From the policy schedule the complainant could know that the Ops will pay financial benefit on 23.02.2015, 2016, 2017 and 2018 @ Rs.2, 32,700/- and on 23.02.2018 the vested bonus will be paid. It is further submitted that she being confused with the tricky language regarding vested bonus, contacted OP.1 and the concerned agent and they clarified that the vested bonus is equal to one financial benefit of Rs.2, 32,700/-. The complainant also further submitted that for all 6 years long period she has deposited premium amount of Rs.11, 99,718/- but after 3 years of return @ Rs.2, 32,700/-, the Ops paid Rs.3, 59,381/- towards last dose of return which includes bonus of Rs.1, 26,681.89 and thus the complainant has received Rs.10, 57,481.89 on her deposit amount of Rs.11, 99,718/- i.e. short payment of Rs.1, 42,237/- than the deposited amount with the Ops towards premium. The complainant submitted that the policy taken by her was a traditional child plan and the complainant had deposited her money for future of her child and the Ops in the name of child plan has grabbed her hard earned money by making short payment of Rs.1, 42,237/- than that of the deposited premiums. Thus alleging unfair trade practice on their part, the complainant has filed this case praying the Forum to direct the Ops to return Rs.1, 42,237/- with interest @ 18% p.a. from 23.02.2018 and to pay Rs.3.00 lacs towards compensation which includes bonus and cost of this litigation to the complainant.
2. The Ops filed counter denying the allegations of the complainant but admitted the child plan policy bearing No.19861589 dt.23.02.2012 taken by the complainant for 6 years premium paying term with a Sum Assured of Rs.9, 30,000/-. It is further admitted that all the premiums have been received from the complainant and she has got life risk cover for the entire period and received survival benefit of Rs.10, 61,112/- which includes revisionary bonus of Rs.1, 30,312/-. It is further contended that the insurance is a contract and the Ops have provided proper service and covered risk of the life of the complainant from the date of commencement of the policy. It is also further contended that upon giving consent, the OPs processed the said proposal form of the complainant and issued the policy and hence the complainant is estopped in challenging the terms and conditions of the concluded contract and denying the contentions of the proposal form. Even if the complainant was not satisfied with the terms and contentions of the policy, she could have applied for cancellation of the policy within free look period as all documents were delivered to her. Thus denying any deficiency in service or unfair trade practice on their part, the Ops prayed to dismiss the case of the complainant with costs.
3. The complainant has filed certain documents along with affidavit in support of her case. The Ops only filed affidavit. Heard from the parties through their respective A/Rs and perused the materials available on record.
4. In this case the policy issued in favour of the complainant and the premiums received are all admitted facts. It is also an admitted fact that upon maturity of policies, the Ops have effected maturity amount in total of Rs.10, 57,481.89/-. It is seen that under the above policy, the complainant has deposited Rs.11, 99,718/-. No doubt the policy covers the insurance on the life of the complainant but the deposits of the complainant are a type of investment for future savings also and the Ops cannot deny that. The policy taken by the complainant accrues maturity value and other attached benefits on maturity but what did the complainant get from the Ops? Out of deposit of Rs.11, 99,718/- the Ops only paid Rs.10, 57,481.89/- leaving a deficit of Rs.1, 42,237/-. Then where did the money of the complainant go in a traditional policy like Child Plan?
5. It is seen from the record that the policy obtained by the complainant is a traditional policy but not invested in share market. If this is so, the money so deposited by the complainant must accrue interest. So why such less payments should made by the Ops? The Ops have not clarified as to how much amount was paid towards insurance and expenditure towards establishment charges. Not a piece of paper has been filed by the Ops to substantiate their contentions that the complainant is entitled for the amount so offered by them. Therefore, in our opinion, the Ops have not made a fair payment under the policy.
6. The Ops stated in their counter at para-11 that they have paid a revisionary bonus of Rs.1, 30,312/- to the complainant. The said contention of the Ops is not supported by any document. The complainant has filed copy of statement analysis issued by the OPs in which it is clearly stated that on 12.03.2018 the Ops have deposited a sum of Rs.3, 59,381.89 in the accounts of the complainant vide Cheque No.189051 which means Rs.2, 32,700/- towards last financial benefit plus bonus of Rs.1, 26,681.89. Hence bonus of Rs.1, 30,312/- given to the complainant by the Ops is not correct.
7. The complainant had deposited Rs.11, 99,718/- under the above policy with hope that her money will grow and fetch a good return but the Ops in the guise of their terms and conditions of the policy have grabbed the hard earned money of the complainant. It purely violates natural justice. The Ops have not categorically mentioned that how much money has been invested towards insurance for those 6 years and how much money have they earned as interest out of that deposit. Without mentioning the details of their expenditure, they cannot retain the money of the complainant in a policy like child plan meant for the future of a child. Moreover, it is a traditional policy but not invested in the share market. In this case the Ops stated that for the entire period of the policy the life of the complainant was insured. If that is true, then the Ops have kept the money of the complainant with them for the six years also which acquires interest etc. In the above circumstances, how the Ops could pay lesser than the deposited amount. In the name of insurance cover and terms and conditions of the policy the Ops cannot offer lesser amount than that of the deposited one. Further the complainant stated in his complaint petition that the OP.1 and its agent had assured the complainant at the time of receiving the policy bond that the bonus would be equal to a financial benefit but what is the result now? Had the OP.1 and its agent tell truth, the complainant would have surrendered the policy.
8. We remember a recent decision dt.30.05.2020 of this Commission vide C.C.No.70 of 2019 between Laba Bissoi and Maxlife Insurance, New Delhi. In the above case, the complainant had deposited only two premiums and upon surrender of policy, the Ops denied any surrender value with a plea that the policy does not acquire any surrender value. During course of trial, the said insurance company intimated this Commission that they are ready to return the deposits of the complainant. Accordingly order was made and the complainant gets return of his deposited amount.
9. In this case the Ops effected payment at a lesser rate. In our opinion, this is unfair and the Ops cannot grab the hard earned money of the complainant and they are to return at least the premiums received by them. They have also kept the deposits for long 6 years and the deposits certainly accrue interest. Let the interest amount be enjoyed by the Insurance Co. Considering the facts and circumstances of the case, we feel that, return of deposited premium amount by the Ops in favour of the complainant will meet the ends of justice. In this case, the complainant has deposited Rs.11, 99,718/- and has received Rs.10, 57,481/- and hence entitled for rest of the amount of Rs.1, 42,237/-. The amount bears interest @ 6% p.a. from the date of last payment i.e. 23.02.2018. In the peculiar circumstances of the case, we are not inclined to award any compensation in favour of the complainant as prayed for except a sum of Rs.10, 000/- towards cost of this litigation.
10. Hence ordered that the complaint petition is allowed in part and the Ops being jointly and severally liable are directed to return Rs.1, 42,237/- with interest @ 6% p.a. from 23.02.2018 and to pay Rs.10, 000/- towards cost of litigation to the complainant within 30 days from the date of communication of this order.
(to dict.)
