State Consumer Disputes Redressal Commission
Dandu Krihsna Murthy Raju,Erragadda, ... vs The Branch Manager Of Sriram Life ... on 7 February, 2013
BEFORE THE A BEFORE THE A.P.STATE CONSUMER DISPUTES REDRESSAL COMMISSION : HYDERABAD. F.A.No. 635/2012 against C.C.No.64/2012, Dist. Forum, Rangareddy . Between: Dandu Krihsna Murthy Raju, S/o.D.Venkataraju, R/o.H.No.8-3-167/30 Flat No,201, Erragadda, Hyderabad- 18. Appellant/ Complainant And The Branch Manager of Sriram Life Insurance Company Ltd., Alluri Trade Center, K.P.H.B., Hyderabad-72. Respondent/ Opp.party Counsel for the Appellant : Party in person Counsel for the Respondent : M/s.K.R.R.Associates QUORUM: SMT.M.SHREESHA, HONBLE INCHARGE PRESIDENT, And SRI S.BHUJANGA RAO, HONBLE MEMBER.
THURSDAY, THE SEVENTH DAY OF FEBRUARY, TWO THOUSAND THIRTEEN.
Oral Order : (Per Sri S.Bhujanga Rao, Honble Member).
*** This appeal is directed against the order dt.27.7.2012 of the District Forum, Rangareddy, made in C.C.No.64/2012. The appellant is the complainant and the respondent is the opposite party in C.C.No.64/2012 filed by the appellant/complainant seeking direction to the opposite party as follows:
1.
to refund the premium paid as Rs.3 lakhs with 12% interest,
2. to pay the risk component Rs.6 lakhs with 12% interest
3. to pay Rs.25,000/-
towards medical and clinical fee
4. to pay extra collected Rs.1316/- , Rs.201 and Rs.398/-
5. to pay Rs.10,000/- towards compensation for deficiency of service and unfair trade practice,
6. to pay Rs.5000/- towards costs of the complaint.
For the sake of convenience, the parties are described as arrayed in the complaint.
The brief case of the complainant as set out in the complaint is as follows:
The complainant obtained a policy (SHRIVISHRAM) bearing no.LN 070900002767 dt.28.1.2009 as investment plan for three payments, from opposite party. In the first year he paid Rs.1 lakh and for the second and third payments, he paid together Rs.2 lakhs on 20.1.2012 to update the policy within two years at Divisional Office of opposite party. The opposite party failed to invest the fund in the market, by keeping the fund in abeyance, which is unlawful and failed in reviving the policy, within two years. Due to the negligence of the opposite party, the policy was rescinded and cannot be revived at all. Rs.2 lakhs kept in abeyance belongs to the complainant and the said amount must be given back to the complainant as the policy was taken by the opposite party.
The complainant sent a registered letter to the opposite party expressing his grievance, but the opposite party did not respond to the said letter.
The opposite party also liable for the compensation due to the foreclosure of the policy. Further case of the complainant is that the complainant as an insurance agent with code no.2557 of the opposite party branch at Kukatpally in 2006, booked 14 policies within a year with medical and clinical examination expenditure around Rs.25,000/-. This amount has been claimed but not paid. The opposite parties are liable to pay the amount of Rs.25,000/- to the complainant.
As the opposite party made mistake to collect extra amounts of Rs.1316/-, Rs.201/- and Rs.398/-
due to non functioning of computer system, during the first and second weeks of April, 2011, by doing wrong calculations, the opposite parties are liable to pay those amounts to the complainant. Hence the complaint.
The opposite party did not appear and contest the complaint before the District Forum, though he was served with notice. Hence the District Forum set him exparte.
During the course of enquiry of the complaint, by the District Forum, in order to prove his case, the complainant filed evidence affidavit and got marked Exs.A1 to A11.
After hearing the complai nant as party in person and on consideration of the material placed on record, the District Forum allowed the complaint, in part, directing the opposite party to pay Rs.3 lakhs with interest at 12% p.a. from 21.1.2012 till the date of payment and also directed to pay Rs.50,000/- as compensation and Rs.3000/- towards costs.
Not satisfied with the said order, the complainant preferred the above appeal contending that the order passed by the District Forum is unjust in law. That the District Forum allowed the complaint partially without considering the coverage option (General) as fund value invested, Rs.1 lakh or sum assured Rs.6 lakhs, whichever is higher in all ULIP. That the District Forum passed an order suggesting amicable settlement of the claim of Rs.25,000/- as medical examination claim as an agent for 12 policies under Code no.2557 and also two more policies totaling to 14 policies without any order for the claim. That the District Forum passed a suggestive order to look into excess amounts collected Rs.1316/-, Rs.201/- and Rs.398/- paid by the appellant/complainant collected from the appellant/complainant either to be refunded or adjusted to the customer, as a fair play, by the organization, without passing any order against the opposite party. The impugned order therefore liable to be set aside and the remaining claims made in the complaint may be allowed.
We heard the appellant/complainant party in person and counsel for the respondent/opposite party and perused the material placed on record including the written arguments filed by the appellant and the respondents counsel.
Now the point for consideration is whether the impugned order of the District Forum Rangareddy is vitiated for misappreciation of fact or law?
The impugned order regarding the direction to the opposite party to pay Rs.3 lakhs with interest at 12% p.a. from 21.1.2012 till the date of payment and to pay Rs.50,000/- as compensation and Rs.3000/- as costs, is not challenged by the appellant/complainant in this appeal. Therefore the order of the District Forum to that extent has become final.
The appellant/complainant has not placed any cogent material on record to show that how he is entitled to claim the risk component of Rs.6 lakhs, as sum assured, as high value, especially when there was no policy in existence, as it was lapsed due to non payment of premium for two years.
In the Policy Schedule and Policy Conditions and the Privileges at point no.7, the premium allocation charges are specifically explained for the UNIT LINKED POLICIES. It is mentioned that in the first year 60% of the premium paid by the policy holder will be deducted for policy allocation charges and with remaining amount, the units will be allotted and risk will be covered. From second year onwards till the end of policy term, 5% of the premium will be deducted towards the charges and with the remaining amount, units will be allocated and risk will be covered. The policy holder is provided with an option of surrendering the policy, only after completion of three years, provided atleast three years premia is paid. If the policy lapses by not paying all the due premia for atleast three years, from the date of commencement of the policy, the insurance cover under this policy will cease immediately.
However, the policy can be revived within two years from the date of lapse, subject to continued insurability to the satisfaction of the insurance company together with arrears of premia. During this period of revival, the insurance cover to the extent of the sum assured will be continued after deducting mortality charges, services tax on mortality charges and also policy administration charges by cancelling units. If the policy is not revived, during this revival period, the contract shall be terminated by paying the surrender value. It is an admitted fact that the complainant has not paid the renewal premium within two years period to keep his policy in force. It is the contention of the respondent insurance company that since the complainant has not revived the above policies and as a result, the policy was terminated and the company has withdrawn the fund for investment, therefore the complainant is entitled to only the fund value. It is true, that the complainant deposited Rs.2 lakhs, but the same was done after the policy was lapsed. In our considered view, the insurance company cannot suo motto revive the policy by adjusting the amount paid by the complainant after nearly two years, towards the premium for lapsed 2 years and requested to revive the policy without the consent or knowledge of the complainant, especially when the policy was lapsed for non payment of premium. The complainant is not entitled to claim the risk component of Rs.6 lakhs the sum assured, especially in the absence of any casualty, contemplated under the terms and conditions of the policy.
The appellant/complainant claimed a sum of Rs.25,000/- towards medical and clinical examination, as an agent of the opposite party for 12 policies under Code no.2557. The District Forum did not allow the claim on the ground that no documentary evidence was adduced by the complainant, in proof of the same. Even in the appeal also, the complainant did not adduce any cogent evidence in proof of the said claim.
Further, the dispute regarding the payment of medical examination and clinical fee by the opposite party does not come within the meaning of the Consumer Protection Act and the complainant does not fall within the definition of Consumer within the meaning of Consumer Protection Act.
The complainant has not explained either in the complaint or in his evidence affidavit as to how he arrived at the excess amounts said to have been collected from him by opposite party. In the absence of such explanation , basing on Exs.A6, A7 and A8 receipts, it is not possible to direct the opposite party to pay the said amounts to the complainant.
Having regard to the facts and circumstances, we do not find any grounds much less valid grounds to interfere with the impugned order of the District Forum.
In the result, the appeal is dismissed confirming the order of the District Forum, but in the circumstance of the case without costs.
INCHARGE PRESIDENT MEMBER Pm* Dt.
30.1.2013