O R D E R<br /> <br /> <br /> <br /> SRI.D. KRISHNAPPA, PRESIDENT:<br /> <br /> <br /> The grievance of the complainant against the Op in brief is, that he had taken 25 years Insurance Policy from the respondents. That the sum assured was Rs.2,98,000/- with annual premium of Rs.10,213/-. That he had paid a total amount of Rs.70,017/- through 7 premiums and the Ops have issued receipts for those payments. That he during March 2009 stopped payment of premium and approached Op for payment on the amount due under the policy, against which Op offered to pay Rs.35,000/- only. This satisfied with the offer made by the ops he got issued a legal notice claiming Rs.1,28,847.59 for which the Ops have replied that they cannot pay any amount in addition to Rs.35,000/- That he is entitled for the paid up amount added with guaranteed additions and vested bonus if any and the bonus is not less than Rs.500/-. Therefore, stated that he is entitled to the paid up sum together with guaranteed additions and vested bonus and therefore he has become entitled for paid up amount and thereby has prayed for a direction to Ops to pay him Rs.1,28,847.59.<br /> <br /> Ops have appeared through their advocate and filed version denying deficiency in their service and the complainant is not entitle for amount claimed in the complaint. The Ops by referring to clause 3 and 4 of the conditions of the policy have reproduced those clauses in the version and stated that the complainant is entitled for amount under those clauses. Ops have admitted that the complainant has paid premium up to March 09 and thereafter has failed to continue the policy by paying further premiums. The Ops by denying the claim of the complainant have prayed for dismissal of the complaint.<br /> In the course of enquiry into the complaint, the complainant and the Senior Manager of the first Op have filed their affidavit evidence. The complainant has reproduced what he has stated in the complaint in the form of affidavit evidence. The first Op has also reiterated the contentions, raised in the version. The complainant along with the complaint has produced premium paid receipts and letter of the Op addressed to him. Ops have produced copy of the proposal form given by the complainant and copy of the policy document containing terms and conditions of the policy. We have heard counsel for both parties and perused the records. <br /> <br /> On the above contentions, following points for determination arise.<br /> <br /> 1. Whether the complainant proves that the Ops have caused deficiency in their service by not paying the paid up insurance amount with accruable benefits.<br /> 2. To what relief the complainant is entitled to?<br /> <br /> Point No.1 : In the affirmative<br /> Point No.2 : See the final order.<br /> <br /> Answer on point No.1: As could be seen from the contentions of the parties, there is not much dispute between them with regard to the issue of the policy, paid up amount and discontinuation of the policy. Admittedly, the complainant after taking policy for a period of 20 years paid only 7 premiums for a period of 7 years. Thereafter, discontinuance of the policy and then sought for payment of the paid up amount with other benefits. The Ops without denying these facts by referring to clause 3 and 4 of conditions of the policy claimed to have restricted the payment to Rs.35,000/- and offered to pay only that amount. In the version filed by them they except referring to clause 3 and 4 they have not justified their offer to pay Rs.35,000/- and not paying paid up amount with ny other benefits that would be accrued. Clause 3 of the conditions of the policy speaks of paid up policy. Clause 4 refers to guaranteed surrendered value which is not applicable to the facts of the case. Clause 3 of the policy conditions, in our view refers to the paid up sum, to be an amount appearing to be the sum assured, the sum proportion as the number of premium which have been paid bars to the total number of premiums payable under the policy with guaranteed conditions and the vested bonus, if any provided with such paid up sums together with the guaranteed conditions and vested bonus is not less than Rs.500/-. On considering the claim of the complainant and the condition 3 of the policy condition, we are of the view the complainant is entitled to the paid up amount with other benefits like guaranteed additions and bonus. Opponents before us in this proceedings have not demonstrated as how they have only offered to pay Rs.35,000/- as against paid up policy amount of Rs.70,070/-. Though their counsel has also filed written arguments he has not invited our attention to any exclusion or bar under the conditions of the policy for paying the paid up amount with accruable other benefits. Therefore, we are of the view that the Ops are deficient in not paying the paid up amount with other benefits, therefore their refusal to pay paid up amount amounts to deficiency in their service.<br /> <br /> The complainant has claimed Rs.1,28,847.50 but he has also not substantiated before us as how he has arrived to this amount on the basis on which he is claiming that amount. Therefore, claimed by the complainant in our view is nothing to an imaginary one and he is not entitled for that amount. With the result, we answer point No.1 in the affirmative and pass the following order.<br /> <br /> O R D E R<br /> <br /> Complaint is allowed in part. Ops are jointly and severally are held as liable to pay Rs.70,070/- with other benefits like guaranteed additions and bonus on it and that they shall pay that amount arrived within 60 days from the date of this order. Failing which, they shall pay interest @ 9% p.a from the date of this complaint till the date of payment.<br /> <br /> Ops shall also pay cost of Rs.1,000/- to the complainant.<br /> <br /> Dictated to the Stenographer. Got it transcribed and corrected. Pronounced in the Open forum on this the 27th May 2010.<br /> <br /> <br /> <br /> MEMBER MEMBER PRESIDENT<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />