By Sri. Chandran Alachery, Member:
The complaint is filed under section 12 of Consumer Protection Act for an order directing the Opposite party to pay the insurance amount in a matured policy of the complainant.
2. Complaint in brief:- The Complainant joined in a insurance policy with Opposite party in Kottayam Division wide policy No.391353501 named “Jeevan Viswas” dated 19.12.2001. The said policy is matured in the year 19.12.2011. Before maturity, the Complainant shifted his residence to Wayand with family. The Complainant shifted the policy to Bathery. The premium amount of the policy is Rs.2,968/- half yearly. As per assurance, the Complainant is entitled to get the policy amount with all benefit. When the Complainant approached the Opposite party to get the policy amount, the Opposite Party did not pay the amount but changed the policy amount to another scheme and deposited in it. After such change, the Opposite Party gave Rs.4,000/- to the Complainant in 2012. The Opposite Party changed the policy amount to another scheme without getting the consent of the Complainant. The Complainant is in urgent need of money to meet her and her mentally retarded daughter's day to day livelihood. The Complainant send a lawyer notice to the Opposite Party to get the policy amount, but Opposite Party did not reply. Aggrieved by this, the complaint is filed.
3. On receipt of complaint, notice was issued to Opposite party and Opposite party appeared before the Forum and filed version. In the version, the Opposite Party contended that the Complainant had voluntarily and with free consent chose the Jeevan Viswas Plan No.136 bearing policy No.391353501 which commenced on 19.12.2001 with sum assured of Rs.50,000/- covering a period of 10 years. This plan of insurance is designed in response to the General need and also for the benefit of handicapped dependents. The Complainant had taken this policy for pension for her mentally retarded child. It is clearly mentioned column No.2 A of the proposal form under object of insurance. In Jeevan Viswas policy, there is a special declaration mentioning name of the dependent child. The maturity amount will be payable as under @ 20% for the capital sum to the proposer, on maturity or on death (b) 80% of the capital sum to be compulsory utilized to purchase annuity. The total sum will be SA Rs.50,000.00.
Guaranteed addition - Rs.30,000/-
Total Capital Sum - Rs.80,000/-
20% of Capital sum - Rs.16,000/-
Purchase annuity - Rs.64,000/-
20% of the capital sum is paid to the Complainant as per cheque No.153004 dated 19.12.2011. The Complainant opted voluntarily annuity on half yearly and paid 4307/- towards annuity due on 6/12 and 12/12. Hence Complaint is not maintainable.
4. On perusal of complaint, version and documents, the Forum raised the following points for considerations.
1. Whether there is deficiency of service from the part of Opposite Party?
2. Relief and cost.
5. Point No.1:- The complainant filed proof affidavit and is examined as PW1 and documents are marked as Exts.A1 to A3. The Opposite Party also filed proof affidavit and Opposite Party is examined as OPW1 and Ext.B1 is marked. Opposite Party's witness is examined as OPW2 and Exts.B2 to B9 and Ext.B9(a) are marked.
6. On going through the Ext.A3 policy, the name and address of the life assured proposer is Smt. Reeta Cleetus. No where in the policy, the name of handicapped dependent is shown. Ext.B2 is the proposal form. According to the Complainant, Ext.B2 is not filled up by her and it is filled up by the agent K.M Murali and the Complainant do not know the contents. In the 2nd page of Ext.A3 documents, there is a space which requires the name of handicapped dependent, relationship to life assured, age of handicapped dependent. But these spaces are blank and nothing is written in it. Ext.A3 is the original insurance contract between the life assured and the insurance company. In the main contract, there is no clear and specific mention regarding handicapped dependent and payment in annuity. The Forum is of the view that even if Jeevan Viswas policy is meant for the handicapped dependent it should be stated in the policy and the proper should be convinced regarding the actual purpose of the policy. An ordinary man cannot understand these things when joining the policy. The Complainant would not have filed this complaint if she was aware of the real purpose of the policy. The Complainant was under the impression that she had joined in an ordinary policy wherein she will get the policy amount on maturity. More over, according to the Complainant, she did not get any notice prior to the change of maturity amount to another scheme. The Opposite Party should be more vigilant while a person is joining in to a policy. Here the non-convincing of the actual purpose of policy and the policy lacks the details of handicapped dependent and also no notice is send before change of maturity amount to another scheme are deficiency of service from the part of Opposite party. Point No.1 is found accordingly.
7. Point No.2:- Since point No.1 is found in favour of Complainant, the Complainant is entitled to get cost and compensation.
In the result, the complaint is partly allowed and Opposite Party is directed to pay Rs.64,000/- (Rupees Sixty Four thousand) only to the Complainant being the balance maturity amount with accrued interest along with Rs.2,000/- (Rupees Two thousand) only as compensation and Rs.1,000/- (Rupees One thousand) only as cost of the proceedings. The Opposite party shall comply the order within 30 days from the date of Receipt of this order.
Dictated to the Confidential Assistant, transcribed by him and corrected by me and Pronounced in the Open Forum on this the 10th day of February 2015.
Date of Filing:10.12.2014
PRESIDENT: Sd/-
MEMBER : Sd/-
/True copy/
Sd/-
PRESIDENT, CDRF, WAYANAD.
APPENDIX.
Witness for the complainant:
PW1. Reetha Complainant.
Witness for the Opposite Party:
OPW1. Narayana Naik. Manager, Divisional Office, Kozhikode.
OPW2. Pradeep kumar. Branch Manager, LIC, Sulthan Bathery.
Exhibits for the complainant:
A1. Income Certificate. dt:03.01.2014
A2. Medical Certificate. dt:14.03.2014.
A3. Copy of Policy Schedule.
Exhibits for the opposite Party.
B1. Copy of Letter. dt:02.05.2013
B2. Copy of Proposal Form
B3. Copy of Letter. dt:12.10.2011.
B4. Copy of Letter. dt:27.10.2011.
B5. Receipt of Policy Payment. dt:26.12.2012.
B6. Discharge Voucher. dt:29.10.2011.
B7. Copy of Letter. dt:05.07.2013.
B8. Copy of Letter. dt:02.05.2013.
B9. Copy of Letter. dt:06.12.2013
