Orissa

Rayagada

CC/7/2019

Sri Nabin Chandra Jena - Complainant(s)

Versus

The Manager, Birla Sun Life Insurance Company Ltd., - Opp.Party(s)

Self

24 Feb 2021

ORDER

DISTRICT   CONSUMER DISPUTES REDRESSAL COMMISSION,

POST  /  DIST: Rayagada,  STATE:  ODISHA,  Pin No. 765001.

                                                      ******************

C.C.case  No.     0 7      / 2019.                            Date.      24    . 2. 2021

P R E S E N T .

Sri   Gadadhara  Sahu,                                                      President.

Smt.Padmalaya  Mishra,.                                                 Member

 

Sri Nabin Chandra Jena, At/Po: Chekaguda, Womens College Road,  Goutam Nagar,  Po/Dist: Rayagada, State:Odisha, Pin No. 765 001,  Cell No.88955-18216..                                                                                                                                                                                                      …..Complainant.

Versus.

1. The  Manager,  , Birla Sun life Insurance Ltd., G crop Tech. Park, 6^th. Floor, Kasar Wadavali, Ghodbunder Road, Thane- 400 601.
2. The Branch  Manager, Birla Sun life Insurance Ltd.,   Branch Office, At/Po/Dist:Rayagda,  (Odisha) [pin Nl. 765 001..                                                                                                      …Opposite  parties.

Counsel for the parties:                         

For the complainant: - Self.

.For the O.Ps  :- Sri  J.K.Mohapatra, Advocate, Rayagada(Odisha).

 

JUDGEMENT

1.The  crux of the case is that  the above named complainant alleging deficiency in service  against  afore mentioned O.Ps    for  non payment  maturity amounts  over the said   policy No. 005940180  with up-to-date   usual   interest  till realisation for which  the complainant  sought for redressal of the grievances raised by the complainant. 

Upon  Notice, the O.Ps  put in their appearance and filed written version through their learned counsel  in which  they 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. The facts which are not specifically admitted may be treated  as denial of the O.P. 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.

Undisputedly  the   complainant is a    Empower Pension plan   holder vide policy No. 005940180 towards pay term 6 years Annual policy  premium  for the period from  31.1.2013 to 31.1.2019. The complainant had    deposited   5(five)  Annual  policy  premium  @ Rs. 20,500/- through  the O.P. No.2  total a sum of Rs.1,02,500/-. Undisputedly  the complainant had made correspondence  on  Dt.1.6.2018   to the O.Ps for  disburse  the above  claim  at an early  date.

The main grievance of the complainant  is that   due to non payment of  deposited amounts with  eligible  benefits the complainant  has filed this  case before this forum. Hence this case.

The  O.Ps contended in their written version that    the policy No.005940180  has completed five  policy years, under the said policy there is  an outstanding disbursement amount i.e.  Rs.1,24,879.56.  The complainant is entitled to receive  1/3^rd. of its  i.e. Rs.41,626.52 under the plan  “Guaranteed vesting benefit 5 policy years and the remaining 2/3^rd. i.e. Rs. 83,253.04 will be invested according to the  norm of the policy terms and conditions.  The complainant is liable to be reverted    stating that the locking period  was for 5 years  hence  any payout will be as per the policy  terms and the same will be processed after 5 years once the complainant applies for an annuity policy plan as per  the terms and conditions of the  captioned   policy as well as according  to the  Insurance Regulatory and Development Authority circular dated. 8^th.  November, 2011 bearing Ref.   No. IRDA/ACT/GDL/LIF/248/11/2011.

The O.Ps  in their written version  relied  citations which are mentioned here under.

It is held and reported in C.P.R-2011((4) Page No. 86 the Hon’ble State C.D.R.Commission, Chandigarh where in  observed “Unit linked schemes cannot bring any fixed amount to investors”.

          This forum further observed  that the policy namely  Unit Gain Plus which was issued  in favour of the complainant, was directly related with the share  market and because of economic melt down  in the International  market, which also adversely affected the share market of India, price of shares of even  big  companies fell down. Similarly, the price of units issued  to the complainant , under  the  policy, in question, also reduced, which was  not   under the control of any particular individual. More over, the  unit price fluctuates day by day and sometimes it goes up and sometimes it becomes very low. Due to instability in the market, it can not  be said what would be the rate of unit at the time of  surrender by the complainant, if he choses so. 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.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 157 in the case of  Life Insurance Corporation of India Vrs. Shiva Prasad Dass 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.”

The District Commission  has seen the age of the complainant  i.e. 60  year  plus  during the course of hearing.  At  this age money is highly  essential for medicine and at this age he could not  put forth their grievance to the  O.Ps from time to time

 

Thus, in context of maintaining good relationship,  between bonafied  policy holder-  insurance authority, this District  Commission feel  it is just and proper that the O.Ps should refund  the deposited amount a sum of Rs.1,02,500.00   to the complainant.

Considering the facts and circumstances, we are of the opinion that the  O.Ps  agent had exercised undue influence and compelled the complainant to open this policy  in the fag end of age. This amounts to unfair trade practice  on the part of the  agent.

The  O.Ps have every right to earn profit from its customer, but it should  be reasonable or  acceptable one.  The O.Ps should not be a commercial  business centres for profiteering  from the exploitation of such type customer.

At  this stage this District Commission observed   the interest of justice  would met if  the O.Ps.   refund  the deposited amount a sum of Rs.1,02,500.00   to the complainant with in 60 days.

.In view of the above discussion relating to the above case and  In Res-IPSA-Loquiture  as well as  in the light of the settled legal position  discussed  as above referring citations the plea of the  O.Ps to avoid the claim  which is Aliane Juris.  Hence  we allow the above complaint petition  in part.

Hence  to  meet the  ends of justice, the following order is passed. 

                                                                                                  ORDER.

            In  resultant   the complaint petition is allowed  in  part  on  contest against  the O.Ps. 

The O.Ps  ordered  to refund  deposited amount  a sum of  Rs.1,02,500/- to the complainant without   any  benefits.  Parties are left to bear their own cost.

The OPs     ordered to make compliance the aforesaid Order within  60 days from the  date of  receipt  of this order      .

   Serve the copies of above order to the parties free of cost.

 

Dictated and corrected by me

Pronounced on this         24^th.   Day of    February  ,   2021.

                                                               

Member.                                                             President