DATE OF FILING : 21.7.2010
BEFORE THE CONSUMER DISPUTES REDRESSAL FORUM, IDUKKI
Dated this the 30th day of November, 2010
Present:
SRI.LAIJU RAMAKRISHNAN PRESIDENT
SMT.SHEELA JACOB MEMBER
SMT.BINDU SOMAN MEMBER
C.C No.157/2010
Between
Complainant : George Mathew,
Thuruthel House,
Thodupuzha P.O.,
Idukki District.
(By Adv : K.M. Sanu)
And
Opposite Parties : 1. The Manager,
Bajaj Alliance Life Insurance Company Ltd.,
Temple Byepass Road,
Thodupuzha P.O.,
Idukki District.
(By Adv: Babichen V. George) 2. The Manager,
Bajaj Alliance Life Insurance Company Ltd.,
3rd Floor, Ravees Arcade,
M.G. Road, Pathma Junction,
Ernakulam,
Ernakulam District.
O R D E R
SRI. LAIJU RAMAKRISHANAN (PRESIDENT)
The complainant has availed a life insurance policy of the opposite party on 18.3.2005 by paying a premium of Rs.25,000/- and a policy was also given to the complainant by the opposite party. The opposite party assured Rs.2,50,000/- after the maturity of the policy which is 3 years and the premium was to be paid in 3 yearly instalments of Rs.25,000/- each. Because of the financial crisis, the complainant was not able to pay the premium in 2nd and 3rd year. After that the complainant approached the opposite party on 15.4.2008 for revival of the premium and an application was submitted with the same to the opposite party. But the opposite party never received the same or never revived the same. If the complainant was not able to continue the policy by paying the premium of the future years, the opposite party should revive the policy of the complainant and the complainant has the right to receive the paid premium amount with all benefits. So the complainant approached the opposite party to return the amount paid by the complainant which is Rs.25,000/- with all benefits. But the opposite party rejected the application. So this petition is filed for getting back the premium paid by the complainant which is Rs.25,000/- with all benefits.
2. As per the written version filed by the opposite party, it is admitted that the complainant availed a policy bearing No.0007274721 from the opposite parties and he paid Rs.25,000/- as first premium. The policy document was also delivered to the complainant. In case on review of the
terms and conditions of the policy, the complainant was not satisfied with the policy, he had given an option to return the policy within 15 days of the date of receipt of the policy documents. The
customer never raised any grievance as against any of the terms and conditions of the policy. But (cont...2)
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the complainant was satisfied with the policy as issued and the complainant continued to enjoy insurance cover. The allegation of the complainant that if the complainant pays Rs.25,000/- for 3 consecutive years from the date of commencement of policy and on completion of such 3 years the opposite parties has guaranteed Rs.2,50,000/- is absolutely wrong and contrary to the terms and conditions of the policy. The non-payment of the premium in the following years is a serious lapse from the part of the complainant which is exclusively held liable by the complainant. The complainant never approached the opposite party to revive the policy on 15.4.2008. The revival of the lapsed policy is a new contract and the insurance company cannot be forced to enter into a new contract as per the revival condition of the policy. The policy may be revived with the consent of the company within 5 years from the date, the policy has terminated/lapsed subject to the insurance company, receiving documents as mentioned in policy document. Accordingly the complainant is eligible to revive the current policy within 5 years from the date of lapse, that is, 18.3.2006 subject to all the mandatory requirements including medicals to be fulfilled as required by the insurance company. As per the terms and conditions of the policy, there is no fixed maturity date as the policy is an open ended policy. The terms and conditions of the policy does not prescribe any fixed maturity value. The complainant has violated the terms of contract of insurance voluntarily by the non-payment of premium. The complainant is not eligible for any refund as he has not paid the 2nd and 3rd premium. This is expressly stated in clause 6(1)(a) of the terms and conditions of the policy. As per the policy terms and conditions the complainant is not entitled to get Rs.25,000/- along with any benefits as prayed for and there is no deficiency in the part of the opposite party.
3. The point for consideration is whether there was any deficiency in service on the part of the opposite party, and if so, for what relief the complainant is entitled to ?
4. The evidence consists of the oral testimony of PW1 and Exts.P1 & P2 marked on the side of the complainant.
5. The POINT :- The complaint is filed for getting revival of the policy of the complainant or getting back the amount paid. The complainant paid Rs.25,000/- on 18.3.2005 as the first premium of the policy bearing policy No.0007274721 and the sum assured was Rs.2,50,000/-. Ext.P1 is the copy of the policy schedule. The opposite party offered that if the complainant pays a premium of Rs.25,000/- each for 3 years and he will get a benefit of Rs.2,50,000/-. But because of financial crisis, the complainant was not able to pay the premium after that. Even though the complainant approached the opposite party for the revival of the policy on 15.4.2008 the opposite party rejected the same. So PW1 is entitled to get the revival of the policy or get back the premium paid which is Rs.25,000/- with all benefits after 3 years. But it was not done by the opposite party. Ext.P2 is the copy of the revival letter. As per the opposite party, it is admitted that the complainant availed a policy of the opposite party by paying a premium of Rs.25,000/-. But the complainant never paid the further premium and never approached the opposite party to renew the same. The opposite party never guaranteed Rs.25,000/- after 3 years to the complainant. As per the terms and conditions of the policy there is no fixed maturity date as the policy is an open ended policy. The terms and conditions of the policy are also does not prescribed any fixed maturity value. The complainant has violated the terms of contracts of the insurance by non-payment of the premium. The complainant is not eligible for refund of any amount as he has not paid the 2nd and 3rd premium. It is expressly stated in clause 6(1)(a) of the terms and conditions of the policy.
So it is admitted by the opposite party that the complainant paid the premium of Rs.25,000/- to the opposite party. But the complainant never renewed the policy. As per the complainant it was a policy for a period of 3 years and the benefit offered was Rs.2,50,000/- after 3 years. But as per (cont....3)
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the opposite party, there was no maturity period for this policy. As per the opposite party, the complainant never approached the opposite party to renew the policy. Learned counsel of the opposite party argued that if the complainant is ready to pay balance instalments, the opposite parties are ready to revive the policy as per the terms and conditions. And also that the complainant is not eligible for any benefits as per the clause 6(1)(a) of the conditions of the policy issued by the opposite party which is Ext.P1. It is admitted by the opposite party that they are ready to revive the policy as per the terms and conditions if the complainant approaches them. As per the clause 6(1)(a) of the conditions of the policy, it is stated that if a premium is not paid during the “days of grace” in the first 3 years, the policy shall lapse and no benefit shall be payable. It means that if any person is not paying the premium continuously, he will not get any benefit as per the policy. But there is no bar in the return of the premium amount after the policy period. But the benefits are barred by the policy conditions. The complainant was not able to continue with the policy because he was in financial crisis. But he has the right to get back the premium amount paid by him after 3 years.
Hence the petition partially allowed. The opposite parties are directed to revive the policy of the complainant without charging any interest within 15 days, if the complainant approaches the opposite parties with the due instalments, or give back the first premium Rs.25,000/- to the complainant within 30 days as per the application of the complainant, failing which the amount shall carry 12% interest per annum from the date of default.
Pronounced in the Open Forum on this the 30th day of November, 2010
Sd/-
SRI. LAIJU RAMAKRISHANAN (PRESIDENT)
Sd/-
SMT. SHEELA JACOB (MEMBER)
Sd/- SMT. BINDU SOMAN (MEMBER)
APPENDIX
Depositions :
On the side of the Complainant :
PW1 - George Mathew
On the side of the Opposite party :
Nil.
Exhibits :
On the side of the Complainant :
Ext.P1 - Copy of the policy schedule.
Ext.P2 - Copy of the revival letter.
On the side of the Opposite Party :
Nil.
