Samaresh Kumar Mitra,  Presiding Member.

                This case has been filed U/s.12 of the Consumer Protection Act, 1986 by the complainant that the opposite party no. 3 emphasized to the complainant to buy a Wealth Plus Policy stating it would have a life cover and a good investment option for the complainant and the complainant and her husband believed the word of the opposite party no. 3 and sought information about the policy in Wealth Plus of Life Insurance corporation of India and the opposite party no. 3 informed the complainant and her husband that the complainant would have to invest and thus pay premium of Rs. 20,000/-  only for three years and after 8 years when the policy expires she would receive a minimum sum assured of Rs. 1,00,000/- only plus bonus which may vary to the extent of Rs.30,000/- to Rs. 40,000/- and having faith upon the opposite party no.3 they decided to buy the Wealth Plus Policy from Life Insurance Corporation of India and the complainant availed a Wealth Plus Policy from Life Insurance Corporation of India on 25.3.2010 being policy no. 496052583 through the opposite party no. 3 and the complainant has nominated her husband as her nominee in the said policy and the commencement date of the said policy was 25.03.2010 and the sum assured under the basic plan was Rs. 1,00,000/- and the complainant was to pay yearly premium to the tune of Rs.20,000/- only and the last due date of premium was 25.03.2012 and the date of expiry of the policy term was 25.03.2018 and the date of expiry of extended life cover is 25.03.2020 and  the complainant paid and the opposite party no. 1 received Rs. 20,000/- only on 25.03.2010 vide cheque and also issued receipt to the complainant and again on 28.3.2011 vide cheque no. 210875 the complainant paid and the opposite party no. 1 received Rs. 20,000/- only as premium and also issued renewal premium receipt dt. 28.03.2011 to the complainant and the complainant paid and the opposite party no. 1 received Rs. 20,000/- only vide cheque no. 237401 dt. 18.3.2012 as the last premium and the opposite party no. 1 issued renewal premium receipt to the complainant on 22.3.2012 and thus the Life Insurance Corporation of India received a total premium of Rs. 60,000/- from the complainant and the opposite party no. 3 has handed over a duplicate discharge voucher dt. 16.4.2018 to the complainant stating therein that the maturity of the policy availed by the complainant was 25.03.2018 and the bonus allotted to the complainant is Rs. 28,355/- only and having paid a premium to the tune of Rs. 60,000/- only in 3 installments from 2010 the complainant is to receive an amount of Rs. 28,355/- only and the complainant was given the impression by the opposite party no. 3 that she would get at least Rs. 1,00,000/- only as sum assured plus bonus to the tune of Rs. 30,000/- to Rs. 40,000/- only and the complainant through her Advocate had sent a demand notice dt. 4.5.2018 through speed post with A/D to all the opposite parties and the said notice was properly addressed and duly stamped and the opposite parties received the notice dt. 4.5.2018 on 5.5.2018 and the opposite party no. 3 through his Advocate had sent a reply dt. 13.5.2018 to the ld. Advocate of the complainant denying all the material facts of the above mentioned notice dt. 4.5.2018 and stated that the complainant purchased the policy in question on her own accord and the cause of action arose on 4.5.2018, 5.5.2018 and then on 13.5.2018 and is still continuing.

            Complainant filed the complaint petition praying directions upon the opposite party to pay sum of Rs. 1,00,000/- plus the bonus over it and to pay sum of Rs. 2,00,000/- for compensation and to pay sum of Rs. 40,000/- for litigation cost and to pay the cost of the case and to pass any other order deemed fit and proper in law and in equity.

            The opposite party No. 1 and 2 contested the case by filing written version denying inter-alia all the material allegations as leveled against them. These opposite parties submit that one insurance policy named as “Wealth Plus” Table no. 801 had purchased by the complainant and the complainant purchased one unit linked policy named “Wealth Plus” Table no. 801 and the policy offered guaranteed highest NAV (Net Asset Value) during 1^st 7 policy years or the NAV as applicable at the end of policy term which is higher at the date of maturity and the death benefit for the policy is extended free of cost for another two years after the date of the maturity of policy and the investment pattern of the Funds prescribed by IRDA before launching of the plan was described at Sl. No. 2 of the proposal for LIC’s wealth plus which the complainant signed and in the heading of the proposal form and also in the policy bond it is clearly written that “In this policy, the investment risk in investment portfolio is borne by the policy holder” and after understanding fully the terms and conditions of the plan the complainant had signed the policy proposal form and after receiving the proposal form clearly signed by the complainant and the first premium the LICI had issued the policy bond to the complainant and in this policy bond certain conditions and privileges has been printed and under such conditions and privileges it was written that the following charges shall be deducted at the applicable rate as per serial no. 5 of the policy bond by cancelling appropriate number of units out of the complainant’s fund value and the charges as follows:

1. Premium allocation charges,
2. Level mortality charges according to the age at entry,
3. Accident benefit charges (if opted for),
4. Policy administrative charges,
5. Fund management charges,
6. Guarantee charges,
7. Service tax (then prevailing)

and the level mortality charge per annum per thousand sum assured was high at the age of 65 years i.e. Rs. 44.45 and how the fund value has been allocated after considering the above charges is as shown below:

Fund value available (Rs.20000- Rs.3121.94) Rs.16,878.06 NAV on 25.03.2010 @ Rs.10.00/unit allotment = 1687.806 from the next month onwards units will be cancelled for the following charges:

NAV as on 28.04.2010 @ 10.00/unit cancellation=47.474

Balance Unit as on 28.04.2010=1687.806-47.474=1640.332.

Every month thereafter, units were reduced as per contract and inspite of that there was an option under the policy mentioned in serial no. 23 of the policy bond which is called “cooling off period” and the complainant might return the policy to the corporation within 15 days from the date of receipt of the policy and if the policy holder was not satisfied with such ‘terms and conditions’ but the complainant did not exercise the same and took such investment risk and as a result on the terms and conditions of the policy the available unit after deduction of prescribed charges at the time of maturity was 1841.405 and the net asset value (NAV) at the end of the policy term was more as compared to first seven policy years i.e. Rs. 15.3984 and the maturity payable was Rs. 1841.405*15.3984= Rs. 28354.69 and prays to reject the complaint with exemplary cost.

            The opposite party No. 3 contested the case by filing written version denying inter-alia all the material allegations as leveled against him.  This opposite party submits that the opposite party no. 3 designated Life Insurance Corporation of India agent having agency code no. 8788/156/443 has handed over a duplicate discharge voucher dt. 16.4.2018 to the complainant stating therein that the maturity of the policy availed by the complainant was 25.03.2018 and the bonus allocated to the complainant is Rs. 28,355/- only and the alleged policy was a unit linked policy and the return of the policy was subject to market risk and the return used to depend on the ups and downs of the share market and the policy term was for 8 years and premium paying term was for single i.e. at a time or for three years as per choice of the customer and the death sum assured or life coverage was 1.25 times of single premium or 5 times of annualized premium and mortality charges would be applicable as per the age of the customer, premium paying term and death sum assured and death coverage was extended upto 2 years after maturity and at the time of maturity customer would get higher of the followings:-

1. Fund value based on the highest,
2. Net asset value within first seven years of the policy term or fund value based on the NAV at the maturity date.

and in the case of death of the policy holder before maturity nominee would get death sum assured + fund value based on the net asset value at the time of death and the opposite party no. 3 explaining all the main features of the policy as per main policy term and condition published by LIC and after going through all the papers shown to them by the opposite party no. 3 the complainant was satisfy to the terms and conditions of the policy and the complainant called opposite party no. 3 and told him to open this policy and she had selected three years premium paying term to get tax exemption for three years and got maximum life coverage and the complainant had purchased the policy considering lucrative return of the equity market as this policy was an equity oriented based fund policy and there was a provision in the policy documents that is the policy holder is not satisfied with the policy condition she or he may return the policy bond to the branch officer and could demand for his or her money within 15 days on receipt of policy bond and now the complainant is misinterpreting the death sum assured as mentioned in policy bond as maturity sum assured like any other conventional policy saying such that the opposite party no. 3 explained her that at the time of her maturity she would get the sum assured of Rs. 1,00,000/- + Rs. 30,000/- bonus which is false, fabricated and concocted.

            The complainant filed evidence on affidavit which is nothing but replica of complaint petition and supports the averments of the complainant in the complaint petition and denial of the written version of the opposite parties.

            The answering opposite parties filed evidence on affidavit which transpires the averments of the written version so it is needless to discuss.

            Complainant filed written notes of argument. The evidence on affidavit and written notes of argument of complainant are taken into consideration for passing final order.

            Opposite party nos. 1 and 2 files evidence on affidavit. Opposite party nos. 1 and 2 files a petition to treat their written version as BNA. The evidence on affidavit of opposite party nos. 1 and 2 is taken into consideration for passing final order.

            Argument as advanced by the agents of the complainant and the opposite parties heard in full.

            From the discussion herein above, we find the following issues/points for consideration.

Issues/points for consideration

1. Whether the complainant is the consumer of the opposite party or not?
2. Whether this Forum has territorial/pecuniary jurisdiction to entertain and try the case?
3. Whether there is any deficiency of service on the part of the opposite party?
4. Whether the complainant is entitled to get relief or not?

DECISIONS WITH REASONS

All the points are taken together for easiness of the discussions of this case.

1. In the light of the discussion hereinabove and from the materials on record, it transpires that the complainants are Consumers as provided by the spirit of Section 2 (1) (d) (ii) of the Consumer Protection Act, 1986 and the complainant herein are consumers of the opposite parties.
2. Both the complainants and the opposite parties are resident/having their office addresses within the district of Hooghly. Considering the nature of claim as per prayer of the petition of the complaint of the complainant it appears that those are not exceeding Rs. 20,00,000/.  So, this Forum has territorial /pecuniary jurisdiction to entertain and try this case.
3. The opposite party being the largest Insurance Company of the Nation associated with the insurance of a lot of people of throughout the whole nation since a long back with self generated assets i.e. goodwill of the business. So, the credibility of the opposite party Insurance Company is unquestionable and that is why the complainant insured her life before the said company without any doubt.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              It is well settled proposition of law that a contract of insurance is based on the principles of utmost good faith-uberrimae fidei, applicable to both the parties. The rule of nondisclosure of material facts vitiating a policy still holds the field. The bargaining position of the parties in a contract of insurance is unequal. The insured knows all the facts; the insurer is unaware of anything which may be material to the risk. Very often, it is the insured who is the sole person who has this knowledge. The insurer may not even have the means to find out facts which would materially affect the risk. The law, therefore, enjoins on the insured an absolute duty to disclose correctly all material facts which is within his/her personal knowledge or which he ought to have known had he made reasonable inquiries. A contract of insurance, therefore, can be repudiated for non disclosure of material facts.

             The expression “material fact” is not defined in the Insurance Act, 1938 and therefore, as observed by the Supreme Court in Satwant Kaur Sandhu -vs- New India Assurance Company Ltd. 2013 (3) CPR 644 (SC), it has to be understood in general terms to mean as any fact which would influence the judgment of a prudent insurer in fixing the premium or determining whether he would like to accept the risk. Any fact, which goes to the root of the contract of insurance and has a bearing on the risk involved, would be “material” and if the proposer has knowledge of such fact, he is obliged to disclose it, particularly while answering questions in the proposal form. Any inaccurate answer will entitle the insurer to repudiate their liability because there is clear presumption that any information sought for in the proposal form is material for the purpose of entering into a contract of insurance. 

            The complainant in his evidence on affidavit averred that she availed a wealth plus insurance policy of Life Insurance Company of India on 25.03.2010 being policy no. 496052583 through agent being opposite party no. 3. The sum assured under the basic plan was   Rs. 1,00,000/- and she has to pay yearly premium to the tune of Rs.20,000/- and the last date of premium was 25.03.2012, the date of expiry of the policy term was 25.03.2018 and the date of expiry of extended life cover is 25.03.2020. She paid first premium of Rs.20,000/- on 25.03.2010, second premium of Rs.20,000/- on 28.03.2011 and third premium of Rs.20,000/- on 18.03.2012 and she received the premium receipt of opposite party. According to this complainant she paid opposite party Insurance Company a total premium of Rs. 60,000/- but the opposite party no. 3 being the agent of Life Insurance Company of India handed over a duplicate discharge voucher dt. 16.04.2018 to her stating that the maturity of the policy availed by her was 25.03.2018 and the bonus allotted to her is Rs.28,355/-. It is the case of the complainant that the opposite party no.3 during the period of initiation of the policy assured that she would get at least Rs. 1,00,000/- only plus bonus to the tune of Rs. 30,000/ to 40,000/- but after completion of the policy tenure she is assured to receive a sum of Rs. 28,355/- in total. After getting such information the complainant being perplexed sent a demand notice to the opposite party and after getting no satisfactory solution she preferred the recourse of this forum/ Commission praying directions as incorporated in the prayer portion of the complaint petition.

            The opposite party nos. 1 and 2 in their written notes of argument averred that the complainant purchased one unit linked policy named ‘Wealth plus’ table no.801. the said policy offered guaranteed highest NAV during 1^st 7 policy years or the NAV as applicable at the end of policy term which is higher at the date of maturity and the death benefit for the policy is extended free of cost for another two years after the date of the maturity of policy and the investment pattern of the Funds prescribed by IRDA before launching of the plan was described at Sl. No. 2 of the proposal for LIC’s Wealth Plus which the complainant signed and in the heading of the proposal form and also in the policy bond it is clearly written that “In this policy, the investment risk in investment portfolio is borne by the policy holder” and after understanding fully the terms and conditions of the plan the complainant had signed the policy proposal form and after receiving the proposal form clearly signed by the complainant and the first premium the Life Insurance Company of India had issued the policy bond to the complainant and in this policy bond certain conditions and privileges has been printed and under such conditions and privileges it was written that the following charges shall be deducted at the applicable rate as per serial no.5 of the policy bond by cancelling appropriate number of units out of the complainant’s fund value. Inspite of that there was an option under the policy mentioned in serial no. 23 of the policy bond which is called “cooling off period” and the complainant might return the policy to the corporation within 15 days from the date of receipt of the policy and if the policy holder was not satisfied with such ‘terms and conditions’ but the complainant did not exercise the same and took such investment risk and as a result on the terms and conditions of the policy the available unit after deduction of prescribed charges at the time of maturity was Rs.1841.405 and the net asset value (NAV) at the end of the policy term was more as compared to first seven policy years i.e. Rs.15.3984. So the complainant has invested her money after knowing the market risk and terms and conditions of the policy and now she can’t deny the same and the opposite party LICI shall pay the amount as per terms and conditions as mentioned in the policy bond and nothing more than that.

 After perusing the case record, documents and hearing the Ld. Advocates of the contesting parties it appears that the complainant purchased the impugned policy after knowing all the terms and conditions as envisaged and also availed of the cooling off period. After expiry when she was entitled a meager amount in comparison to her investment as the said policy was market oriented then she became perplexed and preferred the recourse of this Commission praying directions as incorporated in prayer portion of the complaint petition. The complainant further assailed that the opposite party no.3 assured her that she will get more money as stated in the complaint petition. But the actual scenario is quite different. The complainant being an educated lady fully aware of the terms and conditions of the policy and accepted the policy. And after getting the policy bond she could exercise the cooling off period. But she continued the policy till the maturity. So it may presume that she accepted the said policy in toto.  Subsequently she can’t deny the terms & conditions of the policy accusing the opposite party No.3 agent.  The deficiencies of service of the opposite parties are not established.

So we may safely conclude that the complaint petition has no leg to stand. As such  the complaint petition is liable to reject.

ORDER

                Hence, it is ordered that the complaint case being no. 94 of 2018 be and the same is dismissed on contest against the opposite parties.

Let a plain copy of this order be supplied free of cost to the parties/their Ld. Advocates/Agents on record by hand under proper acknowledgement/ sent by ordinary post for information and necessary action.