State Consumer Disputes Redressal Commission
Sbi Life. Ins. Com. Ltd vs Chhotu Lal on 19 November, 2025
FA/104/2021
SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
BEFORE THE RAJASTHAN STATE CONSUMER
DISPUTES REDRESSAL COMMISSION, CIRCUIT
BENCH AT BIKANER
FIRST APPEAL NO: 104/2021
1. SBI Life Insurance Co. Ltd.
1st floor, Rani Bazaar, Near Rani Bazar Pool, Bikaner
2. Manager, SBI Life Insurance Co. Ltd.
Registered Corporate Office, SBI Life Insurance Co. Ltd.,
Natraj, MV Road, & Western Express Highway Junction,
Andheri (E), Mumbai-400069, Maharashtra.
...Appellants
-VERSUS-
1. Shri. Chhotulal
S/o Shri Harji Ram R/o Badi Jasolai, Near Outer Signal,
Bikaner- 33400
...Complainant / Respondent
2. Manager, State Bank of India (Earlier SBBJ)
KEM Road Branch Bikaner, Rajasthan
...Respondent No. 2
Before
HON'BLE MR. A.K. AGARWAL - MEMBER (JUDICIAL)
HON'BLE MR. R.N. SARSWAT - MEMBER (NON-JUDICIAL)
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FA/104/2021
SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
Present:
For Appellants: Mr. Gautam Giri, Advocate
For Complainant/ R. No. 1: Mr. Poonam Chand Kansara, Advocate
For Respondent No. 2: None Present
Dated: 19/11/2025
Judgment
Authored by: Hon'ble Mr. R. N. Sarswat - Member
Complainant's version Mr. Chhotulal (hereinafter referred to as "the Complainant") maintains a savings bank account bearing No. 51092728512 with the State Bank of India. He asserts that, on the persuasion and inducement of the Branch Manager of SBI (hereinafter referred to as "Respondent No. 2"), he purchased an SBI Life Flexi Smart Insurance Policy bearing No. IM002312303 from SBI Life Insurance Co. Ltd. (hereinafter referred to as "the Appellants"). The Complainant deposited Rs.60,000 as the annual premium, and the policy commenced on 31.03.2014. According to him, Respondent No. 2 assured him that he would receive double the deposited amount on completion of the policy term, along with applicable interest and bonus. Acting upon these assurances, the Complainant deposited a total of Rs.300,000 over a period of five years.
On 18.03.2019, the Complainant submitted the discharge form for the release of Rs.6,00,000/- and furnished copies of the insurance policy, his bank account details, and Aadhaar card. However, to his surprise, the Appellants credited only Rs.268,077/- to his account on 31.03.2019, which was Rs.31,923/- less than the amount he had actually deposited. Despite approaching the Appellants repeatedly, he did not receive any satisfactory explanation or details regarding the deductions made. According to the Complainant, the conduct of both the Appellants and Respondent No. 2 amounts to a deficiency in service.
Aggrieved by the conduct of the Appellants and Respondent No. 2, the Complainant filed Consumer Complaint No. 139/2019 before the District Consumer Disputes Redressal Commission, Bikaner (hereinafter referred to as "DCDRC") on 27.08.2019, seeking the following reliefs:
1. Payment of double the amount deposited in the policy (Rs.600,000/-
). Or, repayment of the total amount originally deposited Page 2 of 16 ALLOWED FA/104/2021 SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
(Rs.300,000/-) along with interest at the rate of 18% per annum, bonus, and the illegally deducted amount (Rs.31,923/-).
2. Compensation of Rs.50,000/- for mental agony.
3. Reimbursement of Rs.15,000/- for litigation expenses.
Proceedings before the DCDRC The complaint was duly registered by the District Consumer Disputes Redressal Commission, Bikaner ("DCDRC"), and notices were duly issued to all the opposite parties. Upon service of notice, all opposite parties entered an appearance and filed their respective written statements.
(a) Written Statements All the opposite parties filed separate written statements as follows:
OP Nos. 1 and 2 - Insurance Company (Appellants herein):
The Appellants, SBI Life Insurance Co. Ltd. (Opposite Party Nos. 1 and 2), filed a detailed written statement denying all allegations levelled by the Complainant. Their submissions, in essence, were as follows:
1. No Inducement or Misrepresentation: The Appellants categorically denied that any assurance was ever given to the Complainant regarding doubling of the maturity amount or payment of any guaranteed bonus. The policy purchased was a unit-linked, non-participating life insurance plan, where returns depend solely on market-linked Net Asset Value (NAV).
2. Territorial Jurisdiction: It was contended that the complaint was not maintainable before the DCDRC, Bikaner, since Opposite Party No. 2 is based in Mumbai. Therefore, the Commission lacked territorial jurisdiction to entertain the complaint.
3. Bar of Limitation under Section 24-A of the Consumer Protection Act, 1986: The policy was issued on 31.03.2014, whereas the complaint was filed only on 27.08.2019, well beyond the statutory limitation period of two years. No application for condonation of delay was filed. The complaint, therefore, deserved dismissal on this ground alone.
4. Acceptance of Policy Terms by the Complainant: The Appellants submitted that all policy documents, including the Policy Bond, Benefit Illustration, and Welcome Letter, were duly provided to the Complainant. He was also granted a free-look Page 3 of 16 ALLOWED FA/104/2021 SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
period (15/30 days), during which he never raised any objections. His continued payment of premiums for five consecutive years indicated full acceptance of the policy terms.
5. No Clause for Refund of Premiums: The Appellants clarified that the policy did not provide for the refund of premiums. The Complainant had availed of life insurance coverage during the entire tenure, and any refund of premiums would amount to unjust enrichment.
6. Correct Maturity Amount Paid as per Policy Terms: Since this was a ULIP policy, the maturity amount was payable strictly based on the prevailing NAV and number of units. The amount of Rs.268,077/- credited to the Complainant was the correct maturity value calculated in accordance with the terms and conditions of the policy, leaving no scope for alleging deficiency in service.
7. Distinction Between SBI and SBI Life: The Appellants emphasized that State Bank of India (SBI) and SBI Life Insurance Co. Ltd. are separate legal entities. Therefore, the insurer cannot be held liable for any alleged statements made by employees of the bank.
8. Complaint Based on Misconception: The Appellants alleged that the complaint was based on a fundamental misunderstanding of the nature of a unit-linked insurance policy. The Complainant was seeking benefits to which he was never entitled under the contract.
In support of the written statement on behalf of OP Nos. 1 and 2 (SBI Life Insurance Co. Ltd.), an affidavit was filed by Ms. Neelam Singh, AVP Legal, SBI Life Insurance Co. Ltd.
Opposite Party 3 - SBI (Respondent Nos. 2 herein):
Respondent No. 2, the Branch Manager of SBI, also denied having given any assurance that the deposited amount would be doubled. He contended that the Complainant willingly opted for the policy after being explained its salient features, and that no false promise or inducement was made.
In support of its written statement, the Bank filed an affidavit by Ms. Aarti Kumari, Branch Manager, KEM Road Branch, Bikaner.Page 4 of 16
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Both the Appellants and Respondent No. 2 alleged that the consumer complaint was based on a misconception of the nature of the policy and was filed with the intention of claiming benefits to which the Complainant was not entitled.
(b) Evidence and Hearing In support of his complaint, the Complainant filed an evidence affidavit and produced the following documents to substantiate his claim that the insurance premiums had indeed been deducted from his account, though the amount was not paid per the policy:
1. Copy of the First Premium Receipt.
2. Copy of the Policy Document.
3. Copy of the Letter dated 18.09.2018, 18.10.2018, 17.11.2018, and 5.12.2018 sent by the Appellants to the Complainant.
4. Copy of the Bank Statement.
5. Copy of the Maturity Form and Advance Discharge Voucher.
6. Copy of the Letter by the Complainant to the Appellants.
7. Copy of the Welcome Letter dated 31.03.2014.
8. Copy of the Transaction cum Unit Statement.
9. Copy of the Letter by the Appellants to the Complainant, dated 04.06.2019.
10. Copy of the RTI Letter cum Application.
The Appellant produced the following documents to substantiate his claim:
1. Copy of the Proposal Form.
2. Copy of the Policy Document.
3. Copy of the Benefit Illustrations.
4. Copy of the Guidelines on Non-Linked Insurance Products Regulations, 2013.
5. Copy of the Maturity Intimation Letter with Reminder Letters.
6. Copy of the Maturity Documents Acknowledgement Letter.
7. Copy of the Transaction cum Unit Statement.
8. Copy of the Reply date 16.07.2019.
9. Copy of the RTI Letter and its reply.Page 5 of 16
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The Appellants also filed an evidence affidavit sworn by Ms. Neelam Singh, AVP (Legal), SBI Life Insurance Co. Ltd., affirming the correctness of the facts and documents relied upon.
Order of the DCDRC After hearing the parties and examining the material placed on record, the DCDRC recorded the following findings:
The Commission noted that the Complainant had paid a total premium of Rs.300,000/- over five years and had been under the impression--based on the representation allegedly made by the Branch Manager of SBI--that he would receive double the deposited amount upon maturity. The DCDRC observed that the Complainant was a layperson and appeared to have been influenced by the assurance purportedly given by Respondent No. 2 at the time of purchasing the policy.
Concerning the objections raised by the Appellants, the DCDRC rejected the contention regarding territorial jurisdiction. It held that the policy was purchased at Bikaner, the premiums were deposited through the Complainant's bank account in Bikaner, and the deficiency alleged by the Complainant pertained to the maturity proceeds credited to that same account. Hence, part of the cause of action arose within the territorial limits of the Commission.
On the question of limitation, the DCDRC held that the cause of action continued until the date the maturity amount was credited, i.e., 31.03.2019. Since the complaint was filed on 27.08.2019, it was found to be within the period prescribed under Section 24-A of the Consumer Protection Act, 1986.
The DCDRC further observed that although the Appellants relied on the nature of the policy as a unit-linked insurance plan, they had failed to produce any cogent material to rebut the allegation that Respondent No. 2 had induced the Complainant by promising that the amount invested would double. The Commission noted that the Complainant had repeatedly written to the Appellants seeking clarification regarding the deductions made from the maturity amount, but did not receive a satisfactory explanation. The documentary record reflected that the Appellants had credited an amount lower than the total premium deposited, which the Commission held to be prima facie indicative of unfair treatment toward the Complainant.
The Commission held that the Appellants and Respondent No. 2 failed to exercise due diligence and transparency while selling the policy, particularly Page 6 of 16 ALLOWED FA/104/2021 SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
in explaining the nature, risks, and return structure of a ULIP. It concluded that the service was deficient as well as an element of unfair trade practice, as the Complainant was made to believe that he would receive higher returns than those actually payable under the policy terms.
For its reasoning, the DCDRC placed reliance on the principles laid down by the Hon'ble Allahabad High Court in Dr. Virendra Pal Kapoor vs Union of India & Ors.
Relief Granted:
In view of the above findings, vide order dated 09.02.2021, the DCDRC allowed the complaint against Opposite Party Nos. 1 and 2 (the Insurance Company and its functionaries- Appellants herein) and dismissed against Opposite Party No. 3 (SBI Bank -Respondent No.2 herein).
The operative directions issued were:
The Appellants were directed to pay Rs.331,923/-, being the amount deducted from the assured amount of Rs.600,000/-, after having paid only Rs.268,077/-. This amount was to carry interest @ 9% per annum from 27.08.2019 until realization.
To pay Rs.25,000/- to the Complainant towards compensation for mental agony.
To further pay Rs.10,000/- towards litigation expenses.
The Compliance was to be made within one month of the order, failing which the entire amount would carry interest @9% per annum from the date of the order.
Dismissal as against Respondent No. 2 (SBI Bank).
Appeal The Appellant, being aggrieved by and dissatisfied with the impugned order dated 09.02.2021 passed by the Learned District Consumer Disputes Redressal Commission, Bikaner ("Ld. District Commission") in Complaint No. 139/2019, prefers the present appeal dated 01.03.2021, on the following, amongst other grounds:
1. Error in directing payment of the "Sum Assured" at maturity:
The policy expressly distinguishes between the Death Benefit and the Maturity Benefit. Under Clause 4.3, the Sum Assured is payable only Page 7 of 16 ALLOWED FA/104/2021 SBI Life Ins. & Anr. Vs. Chhotulal & Anr.
in the event of the policyholder's death during the currency of the policy, while Clause 4.4 stipulates that, upon maturity, only the Policy Account Value is payable. As the complainant survived the entire policy term, he was entitled only to the Policy Account Value.
The DCDRC gravely erred in directing the Appellant to pay the Sum Assured at maturity by proceeding on the incorrect assumption that such benefit becomes payable upon the survival of the policyholder. Such is contrary to the explicit contractual provisions and violates settled principles of insurance law, rendering the impugned order legally unsustainable.
2. The complainant accepted the policy; free-look not exercised:
The complainant duly received the policy documents but did not invoke the statutory free-look option provided under Clause 14.1. He continued to pay premiums regularly for five consecutive years, which constitutes unequivocal acceptance of the policy terms.
The DCDRC erred in holding that the complainant was not bound by the standard-form contract, despite his conscious acceptance and continued conduct under the policy.
3. Policy charges were properly disclosed and contractually permitted:
All applicable charges--including premium allocation charges, policy administration charges, mortality charges, and fund management charges--were transparently disclosed through the proposal form, policy bond, and benefit illustration.
The finding of the DCDRC that charges were not adequately explained is contrary to the record. In particular, Clause 18 of the proposal form contains the complainant's express acknowledgement confirming understanding of all policy features and associated charges.
4. Incorrect finding regarding risk cover and maturity value:
The complainant enjoyed a risk cover of Rs.6,00,000/- up to the age of 65 years, notwithstanding that he entered the policy at the age of 60 years, thereby attracting higher mortality charges.
The DCDRC overlooked this material aspect. The maturity value of Rs.268,077/- was correctly computed as the Policy Account Value plus bonus additions, after permissible fund management charge deductions. The complainant himself admitted having received this amount.
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5. Alleged oral assurance of "double return" unsupported by evidence:
The finding that a bank facilitator orally assured double returns is wholly unsustainable. No documentary evidence supports this allegation, and the policy terms themselves negate any such promise. Insurance agents and bank facilitators do not have the authority to offer guaranteed returns on variable insurance products.
The burden of proof lay upon the complainant, which he failed to discharge. The adverse inference drawn from the non-filing of the facilitator's affidavit is misplaced, given that the insurer produced the entire contract.
6. Reliance on an irrelevant High Court judgment:
The DCDRC relied upon an order of the Hon'ble High Court, Lucknow, which has no relevance to the present case and, in any event, stands stayed by the Hon'ble Supreme Court. Such reliance is legally untenable and vitiates the reasoning of the impugned order.
7. Complaint barred by limitation:
The complaint challenges policy terms and representations allegedly made in March 2014. However, the complaint was filed only in August 2019, after more than five years. Even assuming any cause of action, it arose in 2014 when the policy was issued. The complaint is thus clearly barred under Section 24-A of the Consumer Protection Act, 1986, and the DCDRC erred in entertaining a time-barred claim.
8. Maturity value computation undisputed but ignored:
The insurer placed the complete computation of the maturity value on record. The complainant did not dispute the calculation. Nevertheless, the DCDRC ignored the computation and incorrectly assumed that the Sum Assured is payable at maturity, resulting in a patently erroneous finding.
9. Policy approved by IRDAI; insurer complied with all regulations:
The policy complies with the IRDAI (Non-Linked Insurance Products) Regulations, 2013, and IRDAI (Linked Insurance Products) Regulations, 2013, applicable to variable insurance products. The insurer is bound by the IRDAI-approved contractual terms and cannot deviate from them by granting benefits not contemplated under the policy. The DCDRC failed to appreciate this statutory and regulatory mandate.Page 9 of 16
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10. Contract must be interpreted strictly - settled law ignored:
The impugned order violates settled law that insurance contracts must be construed strictly and courts cannot rewrite policy terms. The Hon'ble Supreme Court in General Assurance Society Ltd. v. Chandumull Jain, United India Insurance v. Harchand Rai, Vikram Greentech, and Sony Cheriyan has reaffirmed this principle. The impugned order disregards these binding precedents and substitutes contractual obligations with equitable considerations, which is impermissible.
11. Erroneous observation regarding non-delivery of policy statements:
The Complainant did not plead non-receipt of policy statements at any stage. The DCDRC, nonetheless, suo motu raised this issue during arguments and relied upon it while passing adverse findings. Such an approach is contrary to settled procedural norms. All statements were regularly dispatched by ordinary post.
12. No deficiency in service; compensation unwarranted:
Since the insurer acted strictly in accordance with the contractual terms and IRDAI regulations. There was no deficiency in service. The direction to pay the additional amount, interest @ 9% per annum, Rs.25,000/- for alleged mental agony, and Rs.10,000/- as litigation costs, is wholly unwarranted and liable to be set aside.
An affidavit in support of the appeal has been filed by Ms. Dhanya K.P., AVP (Legal), SBI Life Insurance Co. Ltd., affirming the correctness of the facts.
Points for Determination Upon perusal of the record, the pleadings of the parties, and the impugned order dated 09.02.2021 passed by the DCDRC, the following points arise for determination before this Hon'ble Commission:
1. Whether the DCDRC erred in law and on facts in directing the Appellant to pay the "Sum Assured" as the maturity benefit, contrary to the express terms of the insurance contract?
2. Whether the complainant, having accepted the policy, failed to exercise the free-look option, and continued paying premiums for five years, is estopped from disputing the policy terms at a belated stage?Page 10 of 16
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3. Whether all policy charges, deductions, and features--including mortality charges, allocation charges, fund management charges, and policy administration charges--were duly disclosed and accepted by the complainant?
4. Whether the DCDRC failed to appreciate the existence of risk cover and the impact of mortality charges on the policy value?
5. Whether the alleged oral assurance of "double the invested amount"
was proved by the complainant through any admissible or cogent evidence?
6. Whether the DCDRC was justified in relying upon an unrelated High Court judgment that is stayed by the Hon'ble Supreme Court?
7. Whether the consumer complaint filed in 2019, challenging a policy issued in 2014, was barred by limitation under Section 24-A of the Consumer Protection Act, 1986?
8. Whether the maturity value of Rs.268,077/- was correctly calculated and paid strictly in accordance with the policy terms and IRDAI regulations?
9. Whether the DCDRC failed to appreciate that the insurer is bound by IRDAI-approved terms and cannot pay benefits not contemplated under the contract?
10. Whether the DCDRC failed to apply the settled legal principle that insurance contracts must be interpreted strictly?
11. Whether the findings of the DCDRC regarding non-delivery of policy statements were erroneous, especially in the absence of any such plea by the complainant?
12. Whether any deficiency in service or unfair trade practice was made out against the Appellant when the policy benefits were paid strictly in line with the governing contract?
13. Whether the award of interest, compensation for mental agony, and litigation costs was justified in the absence of any proven deficiency in service?
Findings of the Commission After hearing the learned counsel for the parties, perusing the record, examining the impugned order, and the legal position settled by the Hon'ble Supreme Court and the National Commission, this Commission records its findings on the points for determination as follows:
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1. On Maturity Benefit vs. Sum Assured The DCDRC erred in concluding that the "Sum Assured" was payable at maturity. The policy expressly stipulates that the Sum Assured is the death benefit payable only in the event of death during the policy term, whereas the maturity benefit comprises the Policy Account Value. Since the complainant survived the term, only the account value was payable.
Consistent judicial precedent mandates strict interpretation of insurance contracts. In Oriental Insurance Co. Ltd. v. Sony Cheriyan (1999) 6 SCC 451, the Hon'ble Supreme Court held that courts cannot rewrite or enlarge policy terms. Similarly, in LIC v. Hira Lal (2011) 14 SCC 45 and United India Insurance Co. Ltd. v. Harchand Rai (2004) 8 SCC 644, it was held that no benefit outside the contract can be granted.
Thus, the direction to pay the Sum Assured at maturity is contrary to the policy and settled law.
2. On Free-Look Period and Acceptance of Contract The complainant received the policy in 2014, did not invoke the free-look option, and paid premiums for five years. Such conduct constitutes unequivocal acceptance of the contractual terms.
In Bharat Watch Company v. National Insurance Co. Ltd. (2019) 6 SCC 212, the Hon'ble Supreme Court held that once a policy is accepted and acted upon, its terms bind the insured. The Hon'ble NCDRC in Reliance Life Insurance Co. Ltd. v. Rekhaben Nareshbhai Rathod (2019) affirmed that non-exercise of free-look rights amounts to full acceptance.
Hence, the finding that the complainant was "not bound" by the terms is patently erroneous.
3. On Non-disclosure of Charges All applicable charges -- premium allocation, administration, mortality, and fund management charges -- were disclosed in the proposal form, benefit illustration, and policy document. The complainant acknowledged understanding these details in writing.
In LIC v. Consumer Education & Research Centre (1995) 5 SCC 482, the Hon'ble Supreme Court held that written disclosures bind the insured. Likewise, in SBI Life Insurance Co. Ltd. v. Jyotsna Saha (2018), the Hon'ble NCDRC held that disclosure of charges through the standard documents satisfies legal requirements.
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Thus, the finding of non-disclosure is contrary to documentary evidence.
4. On risk cover and mortality charges The complainant enjoyed risk cover of Rs.600,000/- throughout the term. Having entered the policy at the age of 60 years, the policy attracted higher mortality charges--an inherent and IRDAI-approved component of ULIP products.
The DCDRC failed to appreciate that such deductions are essential elements of a variable insurance product. The Hon'ble Supreme Court in HDFC Standard Life Insurance Co. Ltd. v. Raghvendra Rao, (2018) 7 SCC 664, and the Hon'ble NCDRC in Reliance Life Insurance Co. Ltd. v. Rekha Rani (2019), have held that deduction of mortality and fund charges cannot be treated as a deficiency in service.
5. On Alleged Oral Assurance of "Double Return"
The allegation that a bank official orally assured "double return"
is unsupported by any documentary evidence or witness testimony. The policy documents expressly negate any such guarantee.
The Hon'ble Supreme Court in National Insurance Co. Ltd. v. Laxmi Narain Dhut (2007) 3 SCC 700 held that oral statements cannot override written policy terms. The Hon'ble NCDRC in ICICI Prudential Life Insurance Co. Ltd. v. Dilip Kumar (2019) held that claims of verbal promises are untenable unless substantiated.
Therefore, the adverse inference for non-production of the facilitator's affidavit is misplaced, and the burden of proof -- which lay on the complainant -- was not discharged.
6. On Reliance upon a Stayed High Court Judgment The DCDRC relied on a judgment of the Hon'ble Allahabad High Court (Lucknow Bench), which stands stayed by the Hon'ble Supreme Court. Reliance on a stayed judgment is impermissible and renders the reasoning of the DCDRC legally unsustainable.
7. On Limitation The policy was issued in 2014, and any grievance regarding its terms or alleged mis-selling arose then. Filing of the complaint in 2019 rendered it barred by limitation under Section 24-A of the Consumer Protection Act.
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The Hon'ble Supreme Court in State Bank of India v. B.S. Agricultural Industries (2009) 5 SCC 121 held that consumer fora must dismiss time-barred complaints. In Kandimalla Raghavaiah & Co. v. National Insurance Co. Ltd. (2009) 7 SCC 768, limitation was held to be mandatory and jurisdictional.
The finding of a "continuing cause of action" is thus contrary to binding precedent.
8. On Computation of Maturity Value The insurer produced the complete maturity computation, unit statements, and NAV-based details, all of which remained unchallenged by the complainant. The District Commission failed to examine these documents.
In LIC v. Asha Goel (2001) 2 SCC 160, the Hon'ble Supreme Court held that where contractual terms and undisputed records support computations, fora cannot substitute their own calculations.
Hence, the finding that the amount paid was "less than premium paid" is without basis and ignores the nature of variable/ULIP products.
9. On Compliance with IRDAI Regulations The policy in question conforms to IRDAI (Non-Linked Insurance Products) Regulations, 2013, and IRDAI (Linked Insurance Products) Regulations, 2013, applicable to variable insurance products. The insurer is bound by IRDAI-approved terms and cannot disburse benefits contrary to regulatory frameworks.
The DCDRC failed to appreciate this statutory mandate, rendering its conclusions unsustainable.
10. On Interpretation of Insurance Contracts The impugned order disregards settled principles governing the interpretation of insurance contracts. The Hon'ble Supreme Court in Vikram Greentech (Supra), Chandumull Jain (Supra), Sony Cheriyan (Supra), and in Harchand Rai (Supra) has held that insurance contracts must be construed strictly and courts cannot imply benefits not expressly provided.
By granting a benefit never contemplated under the contract, the DCDRC effectively rewrote the policy, an approach repeatedly deprecated by the Hon'ble Supreme Court. Thus, the impugned order is legally unsustainable.
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11. On Non-Delivery of Policy Statements The complainant did not plead non-receipt of policy statements. The DCDRC raised this issue suo motu at the argument stage. Such a ground, not forming part of the pleadings and unsupported by evidence, cannot sustain an adverse finding.
12. On Alleged Deficiency in Service There is no evidence of deficiency, as the policy was issued per IRDAI-approved terms and all the documents were provided accordingly. Also, the maturity amount was calculated per contract, and no guaranteed return was promised in writing.
The Hon'ble Supreme Court has held in the case of SBI Life Insurance Co. Ltd. v. Asha Surana, (2019) 16 SCC 509, that no deficiency arises when an insurer acts strictly as per policy terms.
Thus, the finding of deficiency and unfair trade practice is unsustainable.
13. On Award of Compensation Since no deficiency is established, the award of additional maturity payment, interest @ 9% p.a., Rs.25,000/- for mental agony, and Rs.10,000/- litigation cost is unjustified.
In Ghaziabad Development Authority v. Balbir Singh (2004) 5 SCC 65, the Hon'ble Supreme Court held that compensation must correlate with proven wrongdoing, not conjecture.
The compensation awarded in this case is therefore liable to be set aside.
Conclusion In view of the foregoing findings, it is evident that the impugned order suffers from multiple factual and legal infirmities.
The DCDRC misapplied the contractual terms governing maturity benefits, disregarded binding precedents mandating strict interpretation of insurance contracts, overlooked clear disclosures and acknowledgements by the complainant, and erroneously invoked principles of limitation, deficiency in service, and compensation without any evidentiary foundation.
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The insurer acted strictly in accordance with the IRDAI-approved policy terms, and no promise or assurance beyond the written contract has been established.
The complainant, having accepted the policy and its terms without objection for five years, cannot now seek benefits contrary to the contract.
Accordingly, the impugned order cannot be sustained in law.
Order In view of the above:
The appeal is allowed.
The order dated 09.02.2021 passed by the DCDRC, Bikaner, in Complaint No. 139/2019, is set aside.
The consumer complaint filed by the Respondent/Complainant is dismissed.
The original record, along with the copy of this order, shall be transmitted back to the DCDRC, Bikaner, forthwith.
No order as to costs.
(Arun Kumar Agarwal) (Ram Niwas Sarswat)
Member (Judicial) Member (Non-Judicial)
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