IN THE CONSUMER DISPUTES REDRESSAL FORUM, KOLLAM
DATED THIS THE 5th DAY OF JUNE , 2013
Present: Smt. G.Vasanthakumari,President
Adv.Ravisusha, Member
CC.248/2011
Sri. D. Harilal,
Koliyil Veedu,
Vadakkevila, Karunagappally,
Kollam-691010, Kerala,
Now residing at pattathil Koliyilil Veedu,
P.K. Nagar- 173, Vadakkevila. P.O,
Kollam- 691010, Kerala.- -Complainant
(By Adv. M. Sathyavrathan, Kollam)
V/S
HDFC Standard life Insurance
Co. Ltd, 13th Floor, Lodha Excellus,
Appollo Mills Compound , N.M Joshi Road, Mahalekshmi,
Mumbai- 400011, Maharashtra.
Represented by
The Branch Manager,
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HDFC, Narayanan Manager, HDFC,
Narayanan Shopping Complex,
2nd Floor, Opp. Dhayana Theatre,
Kadappakkada, Kollam-691001. - Opposite Party
(By Adv. Saji Isaac K.J, Cochin )
ORDER
SMT. G. VASANTHAKUMARI, PRESIDENT
Complainants case is that the complainant approached the opposite party at his office at Narayan Shopping Complex, Kadappakkada, Kollam on March 2008, that the opposite party gave the details of HDFC Unit linked endowment Suvidha Plus Policy Schedule, that the complainant agreed to join the policy and necessary forms were signed by him and the first installment premium of Rs. 50,000/- was paid, that the opposite party made the complainant as a Policy Holder with Policy No. 11780722 and the date of commencement of the Policy is 31st March, 2008 and the date of issue of Policy also 31st march 2008, that the sum assured by the opposite party was Rs. 2,50,000,/- that it is further assured that the petitioner has to deposit two more installments of Rs. 10,000/- each, that was also paid in time, but without giving any notice or further
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communication, the opposite party closed the Insurance Policy unilaterally and sent Rs. 36,618.62 to the petitioner as the full and final settlement, that the above said act of the opposite party is illegal, irregular and opposed to public policy, that the opposite party made deficiency of service and hence this complaint to award the Balance amount of Rs. 2,50,000/- covered under the Insurance Policy, to award an amount Rs. 50,000/- as compensation for metal agony suffering, inconvenience etc caused to the complainant and to award a cost of Rs. 10,000/- as cost of this proceedings.
Opposite party filed version contending that the above complaint is not maintainable either in law or on facts, that the averment in the complaint that it was assured that the petitioner has to deposit two more instalments of Rs. 10,000/- each is false and hence denied, that the complainant had joined the HDFC Unit Linked Endowment Suvidha Plus Policy, that the complainant had taken the policy based on the proposal form and the complainant himself had opted for the payment interval of the policy, that the policy will lapse if the premium is not paid as stated in the policy, that as is admitted by the complainant, the policy was given to the complainant on March 31,2008 along with a letter, that the letter
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attached to the policy has an option to return, that the complainant is given an option to return the policy within 15 days if he is not agreeable
to any of the provisions stated in the policy, that the complainant inspite of obtaining the policy and the letter, did not exercise his option to return, that by accepting the policy, the complainant has agreed to the terms and conditions of the policy, that contract of insurance is a contract based on the terms and conditions of the policy which are binding on the parties, that according to the policy if premium remains unpaid, the policy will lapse and the unitized fund value at the date of lapse less the surrender charge and other charges as specified in the policy will be paid to the policy holder, that the policy of the complainant lapsed due to non payment of premium as agreed to by the complainant and hence the unitized fund value as on the date of the lapse of the policy was paid to the complainant, that as admitted by the complainant in page 2, the complainant had accepted the amount sent to the complainant in full and final settlement, that having accepted the amount in full and final settlement, the complainant cannot claim any further amount from the opposite parties, that the averment in the complaint that the act of the opposite party is illegal, irregular and opposed to public policy is false and
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hence denied, that the further averment in the complaint that the opposite party made deficiency in service thereby occasioned heavy loss of money to the petitioner is false and hence denied, that the averment that there is gross violation of the agreement and thereby damages was caused to the petitioner is false and hence denied, that the averment in the complaint that even if impossibility comes that has to be intimated to the petitioner and must pay the deposit amount with compound interest is false and hence denied, that there has been no deficiency in service on the part of the opposite parties, that the policy of the complainant lapsed due to the default of the complainant himself and hence the opposite parties in accordance with the terms and conditions of the policy which is the contract between the parties paid the unitized fund value as on the date of the lapse to the complainant , that the complainant is also not entitled to the compensation and cost and prayed to dismiss the complaint with cost.
The points for consideration are:-
(1) Whether there is any deficiency of service on the part of the opposite party?
(2) Reliefs and costs?
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The evidence in this case consists of the oral testimony of PW1 and documentary evidence Exbts P1 , P2 and D1.
The Points:- It is the admitted case of the parties that the complainant had joined the HDFC Unit Linked Endowment Suvidha Plus Policy Ext.P1 is the policy documents with terms and conditions. The complainant accepted the offer made by the opposite party and the policy was issued to him on 31.03.2008 along with a letter receiving the 1st instalment premium of Rs.50,000/-. As per the policy, the instalment premium was Rs. 50,000/- and the premium was payable annually for a term of 10 years. Final premium due on 31.03.2017. In letter dated 03.04.2008 attached to the policy there is an option to return. Option to return reads as “ In case you are not agreeable to any of the provisions stated in the policy and the details in the proposal form, you have the option of returning the Policy to us stating the reasons thereof, within 15 days from the date of receipt of the Policy. On receipt of your letter along with the original policy documents, we shall arrange to refund the premium paid by you, adjusted for any decrease in the value of units allocated to your policy, and subject to deduction of the proportionate risk premium for the period on cover and stamp
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duty. A policy once returned shall not be revived, reinstated or restored at any point of time and a new proposal will have to be made
for a new policy”. Complainant as PW1 would swear before the Forum that “Policy condition agree
“. It follows that he has not exercised his option to return since he is agrreable to provisions stated in the policy. After having accepted the policy and the terms and conditions the contract is binding on the complainant. It is stated in condition 4 (11) of the policy that if any premium remains unpaid 15 days after Due Date, the policy will become lapsed or paid-up as described in provision 5. Condition 5 (ii) (c) states that of the lapsed policy is not revived, the unitized fund value at the date of lapse less surrender charge as specified in the schedule of charges would be paid to the policy holder. Our Hon’ble apex court has in Export Credit Guarantee Corpn. Of India Ltd V M/s Garg Sons International, 2013 (1) KHC SN 16 (SC) held that the terms of the insurance policy have to be strictly construed to determine the extent
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of the liability of the insurer and it is not permissible for the Court to substitute terms of the insurance policy have to be strictly construed to determine the extent of the liability of the insurer and it is not permissible for the court to substitute terms of the contract itself, under the garb of construing terms incorporated in the agreement of insurance. The same must certainly not be extended to the extent of substituting words that were never intended to form a part of the agreement.
Complainant has a case that at the time when he joined in the scheme of policy , it is further assured that he has to deposit two
more instalments of Rs. 10,000/- each and he has remitted the same as per Ext. P2 series renewal premium receipts and he is to get the sum assured ie, Rs. 2, 50,000/- but opposite party breached the policy condition and unilaterally closed the insurance policy and on 02-05-2011 sent Rs. 36618.62 to the complainant and thereby committed deficiency of service. But from his interested testimony as PW1 there is no evidence to show that there is an assurance that he has to remit only two more instalments of Rs. 10,000/- each apart from the 1st
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premium of Rs. 50,000/- and he will get the sum assured Rs. 2,50,000/-
But it is the specific case of the opposite party that the policy of the complainant lapsed due to non payment of premium as agreed to by the complainant and hence according to the conditions of the policy, the unitized fund value as on the date of the lapse of the policy was paid to the complainant. Complainant as PW1 admitted that he had accepted the amount sent to him. He would swear before the Forum that “
.” The complainant had accepted the amount in full and final settlement without any protest. Hon’ble National Commission in 2006 (4). CPJ 319 has held that “ When amount is paid in full and final satisfaction no further amount is payable”. It follows that there is no deficiency in service and the complaint is only to be dismissed.
In the result, the complaint is dismissed but without costs.
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Dated this the 5th June 2013.
G. VASANTHAKUMARI
Adv.RAVI SUSHA
APPENDIX
Documents of the complainant
Exbt. P1-Policy Schedule
Exbt. P2- Series – Premium Receipt
Exbt. D1- Policy Documents with terms and conditions
Witness of the complainant
PW1- Sri. D. Harilal (Comlainant )
