IN THE CONSUMER DISPUTES REDRESSAL COMMISSION, ALAPPUZHA
Thursday the 28th day of October, 2021.
Filed on 08-09-2020
Present
- Sri.S.Santhosh Kumar BSc.,LL.B (President )
- Smt. C.K.Lekhamma.B.A.L,LLB (Member)
In
CC/No.209/2020
between
Complainant:- Opposite parties:-
Smt. Revamma(Geetha) The Manager,
Kattunkalveli Life Insurance Corporation
Aryad Panchayath of India, Branch Code-78PWard-13, Avalookkunnu.P.O Cherthala Branch,
Alappuzha Municipal Shopping Complex
(Party in peson) Cherthala-688524
(Adv. S.Devlal)
O R D E R
SRI. S.SANTHOSH KUMAR (PRESIDENT)
Complaint filed u/s 35 of the Consumer Protection Act, 2019.
Complainant’s case in brief is as follows:-
Complainant’s husband Sri. Krishnankutty had joined a Jeevan Anand Policy on 9/9/2004 and the sum assured was Rs. 5,00,000/-. He was remitting the premium correctly and had availed a loan as loan no. 7103 on the security of the policy. While so on 23/9/2019 Sri. Krishnankutty died due to heart attack and the complainant being the nominee is entitled to receive an amount of Rs. 15,00,000/-. On 4/11/2019 complainant filed an application before the opposite party and on 8/11/2009 they paid an amount of Rs.1,14,200/-. Contrary to policy conditions entire amount was not paid. On 28/11/2019 complainant sent a lawyers notice demanding Rs.15,00,000/-. However by mistake the amount was shown as 1,50,000/- instead of Rs.15,00,000/-. After receiving the notice on 11/12/2019 opposite party deposited an amount of Rs.51,521/- in the account of the complainant. Sri.Krishnankutty had remitted the premium for more than 15 years and so complainant is entitled to Rs.15,00,000/-. Opposite party deducted an amount of Rs.7,93,856.61/- as default in insatlment and loan and paid Rs. 1,14,200/- on 8/11/2019. Complainant is entitled to realize an amount of Rs. 6,00,000/- along with interest and also entitled to realize an amount of Rs.54,000/- along with interest for which the complaint.
2. Opposite party filed a version mainly contenting as follows:-
The Jeevan Anand(Plan No.149) policy was issued to Krishnankutty which commenced on 9/9/2004. The premium payment term of the policy was 16 years. As per policy under plan 149 is that it provides for sum assured and accrued bonus at the end of the stipulated premium paying term on survival of the life assured. In addition to the same, an additional amount equal to the sum assured is payable on death of life assured after premium paying term, provided policy was kept in force as on date of survival benefit payment ie,, premiums for premium paying term must be paid in full. The policy is a combination of endowment and deferred whole life assurance.
3. In case of death during premium paying term, death claim will be settled for sum assured/ paid up value + vested bonus. The terms and conditions of the policy contract in this regard are clear, and the benefit payable on death before the end of the stipulated premium payment term, is clearly mentioned in the schedule of the policy document.
4. The life assured expired on 23/09/2019, and the Gross Death Claim amount that would have to be paid as per policy conditions is Rs.8,32,744/-, as follows:-
Basic Sum assured | Rs.5,00,000/- |
Bonus for 16 years for Rs.1000 sum assured (621 + 45+20) ( Final Additional Bonus) | Rs.686/- |
Bonus for Rs.5,00,000/-Sum assured 500 X 686 | Rs.3,43,000/- |
Sum assured plus bonus | Rs.8,43,000/- |
Less: unpaid Premia instalment (Policy year 18-19) | Rs.10,256/- |
Balance Gross amount | Rs.8,32,744/- |
5. The life assured had, on 10/8/2018, availed a gross loan of Rs.6,70,800/- on the policy and the said loan along with interest up to the date of death is to be recovered from above amount of Rs.8,32,744/-.
6. Though the liability of the opposite party in full conformity with the policy conditions and declared bonus rates is as above, the Corporation has, by circular Ref: Actl/2009/4 dated.2/4/2005, made a liberal provision for settlement of Special Surrender value under Jeevan Anand Policy, in case it is higher than the Death Claim amount under the policy conditions.
7. The calculation of the Special Surrender value is as follows:-
Date of death - 23/09/2019
Date of commencement - 09/09/2004
First un paid Qly instalment premium - 09/06/2019
Premuim paid for 14.75 years.
8. The Special Surrender value under the policy is the sum total of the Special surrender value for the endowment assurance component plus the special surrender value for deferred whole life component, as the plan is a combination of endowment and deferred whole life assurances.
9. STEP 1- CALCULATION OF SPECIAL SURRENDER VALUE FOR ENDOWMENT ASSURANCE COMPONENT
Premia paid for 14.75 years and premium payment term is 16 years. | |
Paid up Sum Assured (PUSA) 14,75/16 X 5,00,000/- | 4,60,937/- |
Bonus for 1000 sum assured (621 +45X 0.75) | 654/75 ie, bonus for 14.75 years |
Bonus for Rs.5,00,000/- sum assured = 500 X 654/75 | 3,27,375/- |
Paid up value = PUSA + vested Bonus = Rs.4,60,937 +3,27,375 | 7,88,312/- |
Special Surrender Value for Endowment Assurance component = PUV X factor = 7,88,312 X 0.9578 | 7,55,046/- |
10. STEP 2 – CALCULATION OF SPECIAL SURRENDER VALUE FOR DEFERRED WHOLE LIFE COMPONENT.
= PUSA x v n-d x SV factor
= 4,60,937 x v n-d x sv factor
n is the premium payment term and d is the duration(to the nearest half year)
n is 16 years and d is 15 years and as such, n-d =1, and consequently v factor is 1/1.08 – as per circular dated 2/4/2005.
Special Surrender Value = 4,60,937 x 1/1.08 x 0.3587
= 1,53,091/-
Total Special Surrender Value = Rs.7,55,046 + 1,53,091/- = 9,08,137/-
From the said total Special Surrender Value, loan and interest upto the date of death are to be recovered.
11. The gross amount of Special Surrender Value for the policy as on the date of death worked out to Rs.9,08,137/- as above, which is more than the Gross death claim amount under the policy terms and conditions. Consequently, a net amount of Rs.1,14,280/- ie, after deduction of outstanding loan of Rs. 6,70,800/- along with loan interest of Rs.71,337/-, miscellaneous deductions to the tune of Rs.199/-, and unpaid instalments of premia with interest amounting to Rs.51,521/- was paid to the complainant on 8/11/2019. However , when it was later found that the amount of Rs.51,521/- was not to be recovered there from, the same was refunded on 10/12/2019. Thus a net amount of Rs. 1,65,801/-(Rs. 1,14,280 + Rs.51,521/-) was paid to the complainant in full conformity with the rates and terms applicable. After the death of the insured on 23/9/2019 the opposite party settled the claim within time as early as on 8/11/2019. Thereafter the complainant issued a lawyers notice dated 28/11/2019 claiming that an amount of Rs.6,00,000/- still remains due towards the policy amount. Prompt reply was given on 6/12/2019. An amount of Rs.51,521/- was also paid immediately when a bonafide mistake was found out. Complainant is not entitled for getting any more amount and hence the complaint may be dismissed with compensatory cost.
12. On the above pleadings following points were raised for consideration:-
1. Whether there is deficiency in service?
2.Whether the complainant is entitled to realize an amount of Rs.6,00,000/- along with future interest as prayed for?
3. Whether the complainant is entitled to realize an amount of Rs.54,000/- as prayed for?
4.Reliefs and costs.?
13. Evidence in this case consists of the oral evidence of PW1 and Ext.A1 to A5 from the side of the complainant. Ex B1 and B2 were marked during her cross examination. Opposite party has not adduced any oral evidence. Ext.B3 was marked.
14. Point No. 1 to 3:-
PW1 is the complainant in this case. She filed an affidavit in tune with the complaint and marked Ext.A1 to A5. During cross examination Ext.B1 and B2 were marked.
PW1, the complainant in this case is the widow of late Sri. Krishnankutty who had a Jeevan Anand Policy taken on 9/9/2004 from the opposite party M/s Life Insurance Corporation of India and the sum assured was Rs.5,00,000/-. Krishnankutty was regularly remitting the premium and while so on 23/9/2019 he died due to heart attack. According to PW1 who is the nominee of Krishnankutty she is entitled for an amount of Rs.15,00,000/-. On 4/11/2019 she filed an application before the opposite party and on 8/11/2019 she received an amount of Rs. 1,14, 280/-. However since the whole amount was not received on 28/11/2019 she sent a lawyers notice demanding the remaining amount and thereafter on 11/12/2019 Rs. 51,521/- was transferred to her account. According to her as per the policy she is entitled for Rs. 6,00,000/- and Rs. 54,000/- being the interest up to 28/11/2019. Hence the total claim is Rs. 6,54,000/- along with future interest. Opposite party filed a version admitting the policy. The policy commenced on 9/9/2004 and as per plan No.149 the term of the policy was 16 years. The assured expired on 23/9/2019 and as per the policy conditions the death claim amount is Rs. 8,32,744/-. On 10/8/2018 Krishnankutty had availed a gross loan of Rs.6,70,800/- and it is to be deducted from the gross amount. However the case was considered under Special Surrender Value and the total amount payable to the nominee was Rs. 9,08,137/-. Out of the same the loan amount of Rs. 6,70,800/- was deducted and the remaining amount of Rs. 1,14,280/- was paid to PW1. Later it was found that an amount of Rs. 51,521/- is also due to the complainant and it was paid. Hence according to them no amount is due to the complainant and the complaint was filed on a wrong notion that she is entitled for Rs.15,00,000/-. Complainant got examined as PW1 and Ext.A1 to A5 were marked. Ext.B1 and B2 were marked during cross examination of PW1 and Ext.B3 was marked from the side of opposite party.
15. The case advanced by PW1 is that as per the policy she is entitled for an amount of Rs.15,00,000/-. But from Ext.B1 it is seen that the sum assured is only Rs.5,00,000/-. The policy commenced on 9/9/2004 and table and term was 149-16. Admittedly Krishnankutty had availed gross loan of Rs.6,70,800/- as on 10/8/2018. So opposite party is entitled to recover the said amount from the amount due to the nominee. In the version filed by the opposite party the entire calculation is given. As per the 1st step the balance gross amount is Rs. 8,32,744/- from the same opposite party is entitled to deduct the loan amount. As per Step 1 the surrender value is Rs. 7,55,046/- and as per step.2 the Surrender Value Rs.9,08,137/-. Since the calculation of Step.2 was beneficial to the nominee it was considered by the opposite party and after deducting the loan amount of Rs. 6,70,800/- and the loan interest is Rs. 71,337/- the balance amount is Rs. 1,14,280/- was paid to PW1. But it was noticed that there was some mistake in calculation and additional amount of Rs. 51,521/- was also credited to the account of complainant ( total amount is Rs. 1,65,801/-)
16. When examined as Pw1 complainant stated that after the death of the husband she received more than Rs. 9,00,000/-, that is including the loan amount. After deducting the loan amount she received an amount of Rs.1,14,280/- and later she received Rs. 51,521/-. She also admitted that the claim was settled within 2 months after the death of her husband. So from the evidence adduced from the opposite party it can be seen that the opposite party had settled the claim that also within 2 months from the date of death of the husband of PW1. It appears that PW1 was under a wrong impression that she is entitled to get Rs. 15,00,000/-. However she could not produce any documents to prove the same. Admittedly from Ext.B1 policy it is seen that the sum assured is only Rs. 5,00,000/-. Other than the sum assured as per the conditions of the policy the policy holder was entitled for bonus also. The said total amount came more than Rs. 9,00,000/- from which opposite party had recovered the loan along with interest and the remaining amount was paid to PW1 who is the nominee. Admittedly the amount was paid within 2 months from the date of death of the assured and so there is no deficiency of service from the part of opposite party. Without any basis the complaint was filed on a wrong notion that she is entitled for Rs.15,00,000/-. Since the opposite party had calculated the amount more advantageous to the nominee and paid the entire amount, PW1 is not entitled to claim any more amount. Hence the points are found against the complainant.
17. Point No.4:-
In the result complaint is dismissed. Parties are directed to bear their respective cost.
Dictated to the Confidential Assistant, transcribed by her corrected by me and pronounced in open Commission on this the 28th day of October, 2021.
Sd/-Sri.S.Santhosh Kumar (President)
Sd/-Smt.Sholy.P.R (Member)
Appendix:-Evidence of the complainant:-
PW1 - Revamma (Complainant)
Ext.A1 - Letter dtd. 11/11/2019
Ext.A2 - Letter dtd.8/11/2019
Ext.A3 - Copy of Lawyers Notice dtd.28/11/2019
Ext.A4 - Postal Receipt
Ext.A5 - AD Card.
Evidence of the opposite parties:-
Ext.B1 - Jeevan Anand Policy
Ext.B2 - Copy of letter dtd. 6/12/2019
Ext.B3 - Delegation of Powers Regulation No.41 of LIC
///True Copy ///
To
Complainant/Oppo. party/S.F.
By Order
Senior Superintendent
Typed by:- Br/-
Compared by:-