State Consumer Disputes Redressal Commission
Mohinder Singh vs The Branch Manager, Lic & Others on 19 November, 2024
ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB, CHANDIGARH.
First Appeal No.612 of 2023
Date of institution : 12.09.2023
Reserved on : 25.10.2024
Date of decision : 19.11.2024
Mohinder Singh aged about 69 years son of Shri Bawa Singh, resident
of village Sakrali, P.O. Bhadson, Tehsil Nabha, Patiala.
......Appellant/complainant
Versus
1. The Branch Manager, Life Insurance Corporation of India, Branch
Nabha, District Patiala through its Branch Manager.
2. The Divisional Manager, Life Insurance Corporation of India, having
its Divisional Office at Sector 17, Chandigarh, through its Divisional
Manager.
3. Life Insurance Corporation of India, having its Northern Zonal Office
at Jeevan Bharti, P.B. No.630, Connaught Circus, New Delhi-
110001, through its Zonal Manager/Administrative Officer.
4. Life Insurance Corporation of India, having its Head Office at
Central Office, Yogakshema, Jeevan Bima Marg, Nariman Point,
Mumbai-400021.
5. The Branch Manager, Satellite Office, Life Insurance Corporation of
India, Amloh, District Fatehgarh Sahib.
.....Respondents/Opposite parites
First Appeal under Section 41 of the
Consumer Protection Act,2019 against
the order dated 19.06.2023 passed by
District Consumer Disputes Redressal
Commission, Fatehgarh Sahib.
Quorum:-
Mr. H.P.S. Mahal, Presiding Judicial Member
Mrs. Kiran Sibal, Member 2 FA No.612 of 2023 Present:-
For the appellant : Sh. Deepak Aggarwal, Advocate
For respondents : Sh. Rajneesh Malhotra, Advocate
KIRAN SIBAL, MEMBER
The instant appeal has been filed by the
appellant/complainant against the impugned order dated 19.06.2023 passed by the District Consumer Disputes Redressal Commission, Fatehgarh Sahib( in short, "the District Commission"), whereby the complaint filed by the complainant against opposite parties ( in short 'OPs'), under Section 35 of the Consumer Protection Act, 2019, has been dismissed.
2. It would be apposite to mention that hereinafter the parties will be referred, as have been arrayed before the District Commission.
3. Brief facts of the case for disposal of the appeal are that the complainant has alleged that he being allured by the official/agent of OP No.5, purchased a policy bearing No.165201141 dated 31.01.2012 under LIC's Jeevan Saral (with Profits) plan for the sum assured of Rs.10,00,000/-. It was assured by the official/agent of OP No.5 that the complainant would get the total sum assured of Rs.10,00,000/- on the date of maturity of the policy. The complainant had paid a total sum of Rs.4,78,340/- till the date of maturity i.e. 27.01.2022 and after maturity of the policy, he requested the OPs to pay the sum assured of Rs.10,00,000/- along with interest and other benefits, but they had disbursed a total sum of Rs.2,70,408/- only in the saving bank account of the complainant. The complainant alleged that the OPs are escaping from their liability as per agreed terms and conditions at the time of 3 FA No.612 of 2023 purchase of the policy. The complainant visited the office of the OPs many times and requested them to pay the total sum assured but they failed to make the said payment. The complainant also served legal notice upon the OPs to pay the total sum assured but all in vain. Alleging deficiency in service on the part of the OPs, the complainant filed consumer complaint before the District Commission and sought directions against the OPs to pay total sum assured of Rs.10,00,000/- along with interest and other benefits and further to pay Rs.1,00,000/- as compensation on account of mental agony and harassment suffered by the complainant as well as litigation expenses.
4. Upon notice, OPs appeared through counsel and filed written reply, wherein they raised certain preliminary objection, which are not required to be reproduced here for the sake of brevity. On merits, the OPs stated that the complainant had approached them for the purchase of the policy and it was told to him that in case of accidental death during the period of policy, his nominee/legal hairs would get Rs.10,00,000/- or otherwise he would get maturity amount of Rs.1,89,760/- plus bonus. The complainant, after understanding the terms and conditions had agreed to purchase the policy in question and paid premium to the tune of Rs.24,256/-, payable as half yearly under the policy. The OPs further stated that under the Term Life Insurance policy, the policy holder pays the premium for entire term of policy and at the end of the term, if the policy holder survives, nothing is payable to the policy holder as the entire premium amount is applied towards mortality charges. However, under the Jeevan Saral Plan in question, in the event of death of policy 4 FA No.612 of 2023 holder during the term of the policy, the death benefit is huge i.e. including 250 times of monthly premium amount plus loyalty additions for the completed years and also the refund of premium. Further if the policy holder survives the term of policy, he would get the maturity value and also the loyalty additions for the completed term. As such, the policy holder is getting lots of benefits in return of the premium, he has paid. In the present case, the maturity sum assured to the tune of Rs.1,89,760/- was duly mentioned in the policy and after providing loyalty additions an amount of Rs.2,70,408/- was rightly paid to the complainant on 07.02.2022 i.e. after attaining the maturity.
5. The parties led their evidence in support of their respective contentions before the District Commission. The District Commission after going through the record and hearing learned counsel for the parties, dismissed the complaint of the complainant, vide impugned order. Aggrieved with the same this appeal has been filed by the appellant/complainant.
6. We have heard the Ld.counsel for the parties and have carefully gone through the record on the file and written submission filed by the parties.
7. Learned counsel for the appellant/complainant has vehemently contended that the alleged table No.1 & 2 relied upon by the Insurance company, was never supplied to the complainant at the time of issuance of the policy. Further the District Commission did not consider the fact that on the receipts of premium paid by the complainant, the amount i.e. Rs.10,00,000/- is clearly mentioned as the 5 FA No.612 of 2023 sum assured. The appellant was depositing the premium regularly in time, under the bona fide belief that the sum assured is Rs.10,00,000/-, which he would get on attaining the maturity of the insurance policy in question. The Learned counsel has further argued that the District Commission has failed to appreciate the fact that the appellant/complainant has paid a total premium of Rs.4,78,340/- to the OPs and therefore he may get about 10,00,000/- on maturity that too after paying such a huge amount as premium he gets only Rs.2,70,408/- as maturity amount along with some loyalty addition, which is less than the premium paid during the tenure of the policy. In support of his contentions, the learned counsel relied upon the judgment of Hon'ble National Commission in the case of 'Life Insurance Corporation of India Vs. Consumer Welfare Association & Anr.', passed on 21.06.2018 in First Appeal No.1531 of 2018. The learned counsel further argued on the similar lines as stated in the complaint and prayed for acceptance of the present appeal by setting aside the impugned order.
8. On the other hand, the learned counsel for the respondents/OPs has contended that the District Commission has rightly dismissed the complaint of the complainant and there is no illegality or perversity in the same. The learned counsel further argued that since the main purpose of the plan is to provide risk coverage and high returns are available under death benefit and the appellant was also aware about the benefits available on the maturity of the policy, the insurance company had rightly paid the amount of Rs.2,70,408/- to the appellant as maturity benefits. The learned counsel further argued on the similar 6 FA No.612 of 2023 lines as stated in the written reply and prayed for dismissal of the present appeal.
9. We have given thoughtful consideration to the contentions raised by the parties.
10. Admitted facts of the case are that the respondent/complainant was insured with appellant/OP, vide insurance policy bearing No.165201141, Ex. C-1, commencing from 31.01.2012 till 27.01.2022. It is also not in dispute that the respondent/complainant regularly paid the insurance premium i.e. Rs.24,260/- half yearly, totaling to a sum of Rs.4,75,340/- till the date of maturity. The case of the appellant/complainant is that he was assured by the OPs that the sum assured of the said policy at the time of maturity is Rs.10,00,000/-, but the respondents/OPs had disbursed a total sum of Rs.2,70,408/- only in the saving bank account of the complainant after the maturity of the policy. Alleging deficiency in service on the part of the respondents/OPs, the appellant/complainant filed consumer complaint before the District Commission, which was dismissed, vide impugned order. Aggrieved with the same present appeal has been filed by the appellant/complainant.
11. The foremost contention raised by the appellant/complainant is that the alleged table No.1 & 2 of the terms and conditions of the insurance policy were never supplied to him at the time of issuance of the policy and District Commission has wrongly relied upon the same while passing the impugned order. To determine the said issue, we have perused the evidence, pleadings of the parties as well as impugned 7 FA No.612 of 2023 order. Exhibit C-1, which is the policy bond, placed on record by the complainant himself along with the terms and conditions. Exhibit C-2 to C-14 are various renewal premium receipts of the same policy, again placed on record by the complainant himself. Even Ex.C-15 clearly spells out the benefits of the LIC scheme, the premium paid, maturity calculated, age, coverage etc. The appellant/complainant has never agitated his concern with insurance company with regard to non-receipt of terms and conditions of the policy along with alleged table, rather has himself placed on record the policy bond and other documents as stated above. Had he been aggrieved with this alleged deficiency, he would have opted to get his policy bond cancelled under the free look period also, which he failed to do so. In the light of the said facts, we have no hesitation to conclude that the allegation regarding non receipt of the policy terms and conditions, is on a vague footing and therefore rejected.
12. Now, we proceed to decide the main grievance of the appellant/complainant, as stated in the appeal, that the District Commission did not consider the fact the appellant was to get Rs.10,00,000/- on maturity, whereas the insurance company only paid Rs.2,70,408/- as maturity value alongwith some loyalty addition, which is even less than the amount of premium i.e. Rs.4,78,340/- paid by the appellant/complainant. The contents of the policy bond are very relevant to iron out the said controversy and a bare perusal of same i.e. Ex.C-1, clearly shows that under the heading 'Maturity Sum Assured' it is clearly mentioned as Rs.1,89,760/- and under heading 'Death Benefit 8 FA No.612 of 2023 Sum Assured' it has been mentioned as Rs.10,00,000/-. Further under heading Accident Benefit Sum Assured it has been mentioned as Rs.10,00,000/-. It has been specifically mentioned in the said policy bond under the heading 'Maturity Benefit' that 'in the event of the Life Assured surviving the date of maturity a sum equal to maturity sum assured in force after partial surrender, if any, along with the corresponding loyalty addition, if any, shall be payable.' As per the said terms mentioned in the policy, the entitlement of a policy holder, on surviving the date of maturity, is the maturity sum assured i.e. Rs.1,89,760/- along with corresponding loyalty addition. Moreover, the OP have vehemently denied any deficiency in service on their part and have also deposed in the affidavit filed by Harvinder Puri, Manager (Legal) that policy holder was well aware of the benefits of the insurance policy. Under the term life insurance policy, the policy holder pays the premium for entire term of policy and at the end of the term, if the policy holder survives, nothing is payable to the policy holder as the entire premium amount is applied towards mortality charges. However, under the Jeevan Saral Plan, in the event of death of policy holder during the term of the policy, the death benefit is huge, i.e. including 250 times of monthly premium amount, plus loyalty additions for the completed years and also the refund of the premium. Further if, the policy holder survives the term of policy, he will get the maturity value and also the loyalty additions for the completed term. The main purpose of LIC's 'Jeevan Saral Plan' is to provide death risk coverage and high returns are available under the policy. The death benefit i.e. Rs.10,00,000/- was available only if the insured did not survive during the policy period. 9 FA No.612 of 2023 However, benefit available on the maturity of the policy are clearly stated as Rs.1,89,760/- along with corresponding loyalty addition i.e. totaling to Rs.2,70,408/-. The insurance company has duly fulfilled its obligation and paid the said amount on maturity to the complainant on 07.02.2022. We have also gone through the reply of the OPs dated 23.02.2022 to the legal notice issued by the complainant and find that the appellant/complainant was duly made aware about the amount paid by the insurance company to him under the terms and conditions of the policy, which were duly printed on the policy bond. As such, we are of the opinion that there is no deficiency in service on the part of the respondents/OPs and the appellant/complainant has grossly erred in reading the contents of the policy bond. The Judgment of Hon'ble National Commission, in the case of Life Insurance Corporation of India Vs. Consumer Welfare Association & Anr,(Supra), relied upon by the appellant/complainant is not applicable to the facts and circumstances of the present case as in the cited judgment there was typographical error in mentioning the amount of maturity sum assured and death sum assured as the same were interchanged in the policy document, but in the present case in hand, it has been specifically mentioned the amount of Rs.1,89,760/- under the heading "Maturity Sum Assured" in the policy bond. Hence, the we do not find any merit in the contentions raised by the appellant/complaint and the same are hereby declined.
13. Sequel to our above discussion, we do not find any material infirmity and irregularity in the impugned order passed by the District 10 FA No.612 of 2023 Commission and the same is hereby upheld. Finding no merit in the appeal the same is hereby dismissed.
14. The appeal could not be decided within the stipulated period due to heavy pendency of Court cases.
(H.P.S. MAHAL) PRESIDING JUDICIAL MEMBER (KIRAN SIBAL) MEMBER November 19, 2024.
(Dv)