The complaint case is that the complainant purchased one policy from OP No. 1, through OP No. 2, policy of TATA AIG Life Insurance. The policy was given by OP  No. 2, Agent. The complainant had to pay Rs. 3,749/- as semi-annual premium for 12 years, i.e. total payable amount is Rs. 89,976/- the policy was initiated on 10.09.2003 being policy no. C201092639 in the name of the petitioner. Thus, petitioner paid total money of Rs. 26,243/- as he continued policy for 3 years. Thereafter, he was unable to continue the policy due to non availability of OP No. 2.

2)  The policy was for 12 years which was matured in the year 2015. After waiting for 12 years that till the maturity date, now the complainant surrenders his policy. But the OP refused to pay the sum paid by complainant to OP. The OP TATA AIG paid only Rs. 2,646/- as surrender value. The complainant made correspondence with OP but no result.

3)  It is specifically stated that without knowing the present terms and conditions, the complainant purchased the policy on good faith upon the Agent of OP No. 1. The complainant approached to the OP for getting back his money but did not get the same. This case has been filed on 14.01.2016. So, the period of continuation of policy was 10.09.2003 to 29.09.2015 i.e. for 12 years.

4)  OP No. 1 & 3 filed written statement denying, inter alia, all material allegations. It is specific case of OP that on 10.09.2013 all the contents of application form were fully explained to the complainant before filling up of proposal form and same were understood by them and upon receipt of the duly filled up proposal form semi-annual premium of Rs. 3,749 was paid to OP. It is admitted that complainant approached the TATA AIG of OP No. 3 to avail the surrender value of TATA AIG Mahalife and the same was accepted by the Opposite Party No. 3 and thereafter, surrender value amounting to Rs. 2,649/- was offered to the complainant. OP No. 1 & 3 are willing to provide surrender value but the OP did not state what is the basic formula of surrender value or OP did not cite any clause wherein the description of surrender value method of calculation of surrender value have been shown. It is also stated the terms of the contract have to be construed strictly without altering the nature of the contract etc. So there is no deficiency in service on the part of the OPs and the case is liable to be dismissed.

5)  Complainant has filed photocopy of insurance policy, print out email transaction between petitioner and OPs, photocopy of all premium receipt, Bank draft of Rs. 200/-, 6 receipts of payment each of amount Rs. 3749/-

OP has filed photocopy of Insurance policy.

Complainant has filed Affidavit-in-Chief.

Opposite Party No. 1 has filed Brief Notes of Argument.

POINTS FOR DECISIONS

1.   Whether the complainant is a consumer?

2. Whether complainant paid the money as stated by him at the time of purchasing?

3.  Whether the complainant is entitled to get any relief?

DECISIONS WITH REASONS

  All the points are taken together for brevity and convenience of discussion.

6)  It is admitted position that complainant purchased TATA AIG policy, there is no dispute on this point. It is also admitted that after 3 years complainant did not pay the policy amount. The complainant paid 6 instalments of the policy. The matured period of policy is 12 years. Type of coverage of Mahalife amount of benefit          Rs. 1,00,000/-, premium Rs. 3,749/-, number of years of premium payable is 12 years, policy holder name is the complainant, Amitava Dhar. It is fact that after 3 years complainant did not proceed with the policy and after completion of 12 years he demanded the money paid by him total amounting to Rs. 26,243/- during 3 years. The complainant wanted that sum. The complainant went several times to the Office of the OP, situated at Khadinamore, Chinsurah. But nothing was done. The OP told him that they will return only Rs. 2,646/- but the OPs did not file any account on which basis they did not pay Rs. 26,243/-. The amount already paid by the complainant to the OP proved by the receipt.

7)  Basic definition has been laid down in the policy itself wherein the meaning of the term has been explained. Cash value means the gross amount before any deduction that is to be refunded to the policy holder upon the termination of the policy while it is enforced any indebtedness will be deducted from the cash value of the policy before payment. The cash value of the policy before any deduction is subject to the guaranteed surrender value.

8)  Guaranteed surrender value refers to the minimum guaranteed amount of cash value of the policy, provided that the premium of the policy had been paid for at least 3 consecutive years. The guaranteed surrender value when allowable under the policy is equal to the per cent as shown in the policy information page, of the total amount of the premiums of the basic policy paid excluding the premium for the first policy year and all extra premiums of the basic policy.

9)  So, as per the guaranteed surrender value, wherein at least 3 years have been mentioned the petitioner is entitled to get that money deposited before the TATA AIG as per their provision laid down as basic definition on the first page. There is also provision of non-forfeiture provisions. And there are two options, Option 1 and Option 2.

10)  Herein in this case the complainant paid the total amount during 3 consecutive years, but OP offered him Rs. 2646.61 as a maturity surrender value. But within this document after imparting close eyes we find no procedure of calculation or we find no formula of such calculation which raised the amount for paying to complainant. The agent who contacted the complainant also did not make cooperation to fulfil the loss of the consumer, policy holder. It has become general practice of the agent of different companies to take signature and money for first time or second time. Thereafter, they did not consider the future action of the complainant.

11)  So, it is palpably clear on the document that the complainant paid the money for 7 times at the rate of Rs. 3,749/- for 3 years. There is no provision in the Insurance Policy, there complainant is not entitled to get that amount and there is no stated reason in the policy document. In the Written Notes of Argument the OP argued that the complainant is entitled to get Rs. 2,646/- but no reason has been stated i.e. the reason of deduction from the total amount paid. The WNA filed by the OP deviates from the natural law of explaining the reason of deduction. Rather the policy itself shows that if the policy holder pay policy for 3 years is entitled to get return the same.

12)  So, by not returning or by not proposing to return the aforesaid money after 9 years from taking the money because policy was started in the year 2003 and continued to 2006 after which complainant did not continue the policy. Even at the time seeing non-continuation of policy the OP did not react and showed no vigilancy. It is reflected in the record that when in the year 2015 the complainant approached for money the OP refused and did not ameliorate the sufferings of the complainant for money paid by complainant before 9 years. If the complainant would have deposited that amount in any bank complainant would have every chance to get more amount than he deposited before OPs.

13)  So, the act of the OPs is a flagrance violation of the dictum of law and dictum of public and moral policy and against the public policy, not to act for the benefit of the policy holder. This is a clear negligency and deficiency and without due care and attention towards the consumer like this case.

14)  So, after a deliberation over the nature of the case and admission of the parties and after surfacing the document before us we are of opinion that complainant case succeeds. The complainant is entitled to get the money which he had deposited along with compensation and litigation cost.

Therefore,

                                                               IT IS ORDAINED

               That the CC Case being no. 06/2016 the same is allowed on contest, OP No. 1, 2 & 3 are jointly and severally liable to pay the amount to the complainant. The complainant is also entitled to get interest @ 9 % from 01.01.2007 till date of final payment of Rs. 26,243/- Complainant is also entitled compensation for causing harassment by coming before this Forum only to get his little amount of money. And it is OP 1, 2 & 3 who have done this mischievous act. So, the complainant shall entitle to get compensation Rs. 50,000/- from the OP 1, 2 & 3 and they are jointly and severally liable to pay the amount to the complainant as he stated above. The OP 1, 2 & 3 are also directed to give litigation cost of Rs. 10,000/- to the complainant. The OP 1, 2 & 3 are directed to pay A/c. payee cheque of total amount as ordered before to the complainant by 60 days, failing which the complainant is at liberty to execute the order by taking legal recourse.

Order accordingly. 

Let a copy of this order be supplied free of cost to the parties at once.

Dictated and corrected by me.