CONSUMER DISPUTES REDRESSAL FORUM,PALAKKAD

Dated this the 22^nd May, 2015

PRESENT :  SMT. SHINY.P.R, PRESIDENT

               :  SMT. SUMA. K.P, MEMBER                      Date  of filing : 21/10/2014

CC /160/2014

M.C.Ushadevi,

W/o.C.Prabhakaran,

“Sreekrishna”, Sneha Nagar,

Angavalparambu,

Akathethara, Palakkad.                                             :        Complainant

(Party in person)    

                                                          Vs

1. Vanaja (Code No.3289773),                                  :        Opposite parties

    LIC Agent, Branch No:II,

    TSM Complex, 2^nd Floor,

    P.B.No.13, Palakkad – 678 001

    (By Adv.M.P.Rajesh)     

2. Branch Manager,

    LIC of India, Branch No:II,

    TSM Complex, 2^nd Floor,

    P.B.No.13, Palakkad – 678 001

   (By Adv.T.P.George)

O R D E R

By Smt. Suma. K.P, Member,

The complainant has taken an LIC Policy Jeevan Saral Plan Table 165 bearing No.774543887 with date of commencement on 13/11/2004 as per the proposal form through 1^st opposite party  and the premium paying term was 10 years.  The yearly premium under the policy was Rs.4,804/- and she has remitted the premium for the whole term.  The death benefits sum assured under the plan was Rs.1 lakh and the maturity sum assured was Rs.32,512/- as shown in the policy bond.  Complainant submits that she is a chronic patient suffering from asthma and BP and had crossed 60 years.  At the time of the issuance of the policy the 1^st opposite party made her believe that the premium term was only for 5 years.  Only after the issuance of the bonds, he realized that premium paying term was 10 years.  When she enquired about it with 1^st opposite party she told her that she will be able to surrender the policy after 5 years.  After the lapse of 5 years she demanded the 1^st opposite party to surrender the policy.  At that time 1^st opposite party replied that if  she continues with the policy for another period of 5 years she will be able to receive an amount of Rs.1.25 lakhs.  Moreover the 1^st opposite party misrepresented and availed a loan for the complainant from the said policy and issued another policy for that amount.  The complainant had incurred a loss of Rs.2,000/- for the above acts.  The policy was matured for payment on 13/11/2014 and the OP has credited an amount of Rs. 40,640/- towards the complainant’s account on the maturity date.  Complainant submits that she was very much depressed by receiving such a lesser amount.  She had paid an amount of          Rs.48,040/- towards premium of the said policy.  She further submits that she ought not have accepted the policy if the 1^st opposite party had convinced her about the real facts. The complainant had suffered such a heavy loss due to the  misrepresentation of the 1^st opposite party.  Hence she had approached before this Forum directing the opposite parties to pay the paid up value of Rs.48,040/- along with bonus and cost of this proceedings to the tune of Rs.1 lakh.   

The notice was served to the opposite parties for appearance.  Both the Opposite parties filed the respective version denying the allegations in the complaint. The opposite parties admit that the complainant had taken  an LIC policy Jeevan Saral Plan Table 165 bearing No.774543887 as per the proposal form submitted by her through the 1^st opposite party.  The death benefit sum assured under the plan was Rs.1 lakh and the maturity sum assured was Rs.32,512/- as shown in the schedule of the policy bond.  The amount payable on maturity was the maturity sum assured and loyalty additions.  The policy was matured for payment on 13/11/2014.  The loyalty additions payable on the date of maturity was Rs.8,128/-.  The total amount payable was Rs.32,512/- + Rs.8128/- = Rs. 40,640/-.  The amount was paid to the complainant on 13/11/2014 through NEFT after obtaining the duly signed and witnessed discharge form, policy bond and NEFT details.  The amount was credited to her account on 13/11/2014 itself. 

Under Jeevan Saral Plan, the proposer has to first decide the amount of premium he/she wants to pay per annum.  Once the premium is chosen, the sum assured payable on death gets automatically determined, which is 250 times of the monthly premiums, whatever be the age of the policy holder and the term of the policy.  This is called the death sum assured under the policy.  Inshort, death cover will be the same, irrespective of age at entry and the term of the policy, but the sum payable on maturity will be different for each age at entry and the term of the policy.  Maturity sum assured is determined taking in to account age at entry and term of policy.  In case of death claim under in force policy along with death sum assured and loyalty additions, amount of premiums paid excluding first year premium and extra premiums will be refunded as death claim. This is a plan with high risk coverage on lesser premium.  Hence the death sum assured is more and the maturity sum assured will be comparatively low. 

As per the plan conditions, death sum assured under the policy is fixed at 250 times of the basic monthly premiums payable and thus under this policy it is fixed at Rs.1 lakh.  As per the terms of the policy, the maturity sum assured, for the age at entry, term of the policy and the premiums payable opted by the life assured, under this policy was calculated as Rs.32,512/-.  This was also printed in the policy schedule issued to the policy holder on 29/11/2004.  The complainant had also availed a loan of Rs.12,000/- from the above said policy on 27/11/2008.  It was repaid along with interest of  Rs.1179/- @ 9% interest on 30/12/2009.  Complainant had also taken another policy under plan number 191/5/1, LIC’s Market Plus One, with a single premium of Rs.12,000/- with policy No-776738090.  The term of the policy was 5 years and the date of maturity was 2/12/2013.  The complainant had surrendered the above policy on 4/7/2012 and received a sum of Rs.15,853/-.  The 1^st opposite party denies all the allegations in the complaint.  The complainant was a govt. employee, at the time of taking the policy.  She had signed the proposal form only after fully convinced about the terms and conditions of the policy.  She had never misrepresented and compelled her to take a loan from the policy amount and also compelled to continue the policy for 10 years till its maturity, or mislead her that she would get Rs.1,25,000/- after 10 years etc.   All those allegations in the complaint are absolutely false without any truth or bonafides.   The maturity sum assured and death benefit sum assured are shown in the policy schedule itself. 

2^nd opposite party submitted that they are governed by rules and regulations framed by LIC of India from time to time.  As such in this case, as per rules, the complainant is eligible only for maturity sum assured and loyalty additions if any, and not for any bonus or interest as claimed in the complaint.  The amount due under the policy has been settled in full to the complainant and there is no deficiency of service.  The complainant had also received the amount in full and final satisfaction of all her claims, without any protest.  Hence the complainant is estopped from claiming any further amount from the 2^nd opposite party.  There was no unfair trade practice or deficiency of service on the part of the opposite parties and the complainant is not entitled to get any of the relief claimed in the complaint.  Hence the complaint has to be dismissed.

Both complainant as well as opposite parties filed their respective chief affidavits. Ext.A1-A5 was marked from the part of the complainant and Ext.B1-B5 was marked from the part of the opposite parties.   

Matter was heard.

The following issues are to be considered.

1. Whether there is any deficiency of service on the part of the opposite parties?
2.   If so, what are the reliefs and cost? 

 ISSUES 1 & 2

          We had perused the documents as well as affidavits produced from both sides.    It is obvious from Ext.A2 as well as from Exct.B1 document that as per the terms of policy the maturity sum assured under this policy was calculated as Rs.32,512/- and the loyalty addition payable under this policy is Rs.8,128/-.  The complainant has stated in the proof affidavit that she was suffering from BP, Asthma and other ailments at the time of taking the policy.  The proposal form submitted by the complainant which was marked as Ext.B2 shows otherwise.  She had no ailments at the time of taking the policy.  Admittedly the complainant was a govt. employee at the time of taking the policy in 2004.  She had signed the proposal form (Ext.B2) after understanding about the terms and conditions of the policy.  The allegations stated in the complaint that the 1^st opposite party has misrepresented about the terms and conditions of the said policy and compelled her to take a loan from the policy amount, and also to continue the policy for 10 years till its maturity and mislead her that she would get Rs.1,25,000/- after 10 years are not proved by the complainant before this Forum.  The maturity sum assured and the death benefit sum assured is shown in the policy bond itself.  From Ext.A5 it is evident that the amount due under the policy has been settled in full and final to the complainant on 13/11/2014.  If the complainant had any disagreement with the policy terms and conditions, the complainant could have asked for cancellation of the policy within 15 days of receipt of the policy bond as per the Insurance Regulatory Development Authorities (Protection of Policy holders rules).  Without doing so implies that she had accepted the policy conditions.  Our  Hon’ble Supreme Court of India in Vikram Greentech(I) Ltd. & Anr. Vs New India Assurance Co. Ltd reported on 1^st April, 2009  has laid down that the Endeavour of the court must always be to interpret the words in which the contract is expressed by the parties.  The court while construing the terms of policy is not expected to venture into extra liberalism that may result in re-writing the contract or substituting the terms which were not indented by the parties.   In this case also the terms and conditions mentioned in the policy has been strictly complied upon.   Hence we cannot attribute any deficiency of service on the part of the opposite parties.  In the result complaint is dismissed without any cost.

Pronounced in the open court on this the 22^nd  day of May 2015.

                                                                         Sd/-

                                                                   Smt. Shiny.P.R

                                                                     President

                                                                        Sd/-                                                                                                                   Smt. Suma. K.P

                                                                       Member

                                                A P P E N D I X

Exhibits marked on the side of complainant

Ext.A1- Letter dtd.27/08/2014 (Photocopy)

Ext.A2 – Bond of LIC(Photocopy)

Ext.A3- Loan Paper (Photocopy)

Ext.A4series-Receipts 10 nos.

Ext.A5- Complaint letter against agent

Exhibits marked on the side of Opposite party

Ext.B1-Attested  true copy of policy 774 543 887 dtd.13/11/2014

Ext.B2-Proposal form submitted by the policy holder dtd.13/11/2014 (Photocopy)

Ext.B3- Attested true copy of policy 776  738 090 dtd.02/12/2008

Ext.B4- Proposal form submitted by the policy holder dtd.02/12/2008 (Photocopy)

Ext.B5- Maturity claim discharge form signed by the complainant dtd. 07/11/2014

Witness marked on the side of complainant

Nil

Witness examined on the side of opposite party

Nil

Cost Allowed

No  cost allowed