ORDER

BY SRI.H.R.SRINIVAS, PRESIDENT.

This is the Complaint filed by the Complainant U/S Section 12 of Consumer Protection Act 1986, against the Opposite Parties (herein referred in short as O.Ps) alleging the deficiency in service in not refunding the premium paid in respect of the insurance policy obtained by him from OPs and for refund of the said premium along with interest @ 10% p.a from 27.10.2018 till the payment of the entire amount along with compensation of Rs.25,000/- for causing mental shock, agony and harassment and  for other reliefs as the Commission deems fit.

2.     The brief facts of the complaint are that; the complainant obtained “Met Money Back” Insurance Policy for a sum of Rs.2,50,000/- on 27.04.2014 to mature on 27.04.2024 on an half yearly/annual premium of Rs.12,785.60/- and insurance policy issued by OP bearing No.21311095. He paid insurance premium without default till 27.10.2018 and the total sum paid was Rs.1,27,856/-. At the time of obtaining the insurance, he was employed, earning money and able to pay the premium. At present his health deteriorated and there is loss of vision, also lost his job and he is not having re-employment and has become unemployed and his medical expenditure is increasing every day and is not in a position to pay premium. Hence he requested OP 2 to refund the premium paid by him along with interest at 10% p.a. OP are unnecessarily creating hassles for the said amount and not refunded the same. He is not in a position to pay the further insurance amount and hence had to issue a legal notice on 10.05.0219 demanding OP to refund the amount. The notice sent to OP 1 returned unserved whereas though OP 2 received the notice, remained silent without replying and refunding the amount. This amounts to deficiency in service on the part of the OP and hence prayed to allow the complaint.

3.     Upon the service of notice, Sri I. Gopal Krishna advocate appeared on behalf of OP 1 & 2 and filed version along with documents, denying each and every allegation made in the complaint. OP has admitted that the complainant has obtained insurance from them and paid the premium as mentioned therein, whereas, they cannot refund the premium against the terms and conditions of the insurance policy, since the same is given to cover the risk for a particular period. Since the risk is covered, he has to pay the premium. The complaint on that ground is liable to be dismissed. The risk is covered as long as the policy is in active status. The contract of insurance is the contract of indemnity wherein, the insurer assumes the risk of the policy holder, in case of non-occurrence of the event, insurer is not liable to refund the amount paid as premium. They have taken the decision in conformity of insurance of terms and condition of the policy issued. They cannot act beyond the same. There is no deficiency on their part. Complainant could have used the Free Look Period and could have returned or cancelled the policy. Without any grievance, the complainant paid the insurance premium upto 2018. Complainant has to read the terms and condition of the policy. Complainant has not produced any documents regarding his health condition, losing the job, and incapacity of paying the insurance policy premium. They have not at all given assurance to refund the premium with or without interest at any point of time. Since it is a money back policy, they have returned the amount for which the complainant was entitled to, after completion of 5 years policy. Afterwards, complainant failed to pay the renewal premium. Thereby the subject policy has attained paid-up status. The prayer of the complaint is afterthought one. Complainant cannot claim any damages. There is no deficiency in service and hence prayed to dismiss the same.

4.     In order to prove the case, both the parties filed their affidavit evidence and produced documents. Arguments Heard. The following points arise for our consideration:-

1) Whether the complainant has proved deficiency in service on the part of the Opposite Party?

2) Whether the complainant is entitled to the relief prayed for in the complaint?

5.     Our answers to the above points are:-

POINT NO.1 & 2:             In the negative

 For the following

REASONS

6.     POINT No.1:-

   Perused the complaint, version, affidavit evidence and the documents produced by respective parties.  It is not in dispute that the complainant obtained insurance policy from OP for a period of 10 years by paying half yearly installment at a premium of Rs.12,786/- and paid the same till October 27.10.2018. It is his case that, since he lost the job, no income and due to his falling health he cannot pay the premium and wants the premium amount paid by him i.e., Rs.1,27,856/- to be returned along with interest at 10% p.a. On perusing the insurance documents filed, it is a Money Back Policy and as per the terms and conditions of the policy issued, the premium paid cannot be refunded that to with the interest. Hence denial of the refund of the premium amount paid by the complainant to OP cannot be held as deficiency in service. Further the OP is bound by the condition 3.2 that is regarding premium discontinuation and 3.4 policy surrender. As per the said clause of surrender of the policy, the amount payable as per clause 3.4.2(1) is applicable and since already 4 years is over in respect of the regular premium, complainant is entitled for 50% of the regular premium less the benefit already paid from the 4^th policy year to 7^th policy year. When such being the case the contention raised by the OP in the version deserves to be accepted. Hence we are of the opinion that not paying the premium amount by OP does not constitute deficiency in service. Hence we answer point no 1 in the negative. Hence complainant is not entitled for any of the relief prayed and answers point 2 also in the negative. However it is made clear that in case, the complainant wants to surrender the policy; OP has to take a decision of repayment of the amount under clause 3.4.2(1) of the insurance policy issued to the complainant less already paid. With above observation we pass the following order;

ORDER

1. Complaint is dismissed. Parties to    bare their own cost.
2. Send a copy of this order to both parties free of cost.

Note:You are hereby directed to take back the extra copies of the Complaints/version, documents and records filed by you within one month from the date of receipt of this order.

(Dictated to the Stenographer over the computer, typed by him, corrected and then pronounced by us in the Open Commission on this 27^th day of NOVEMBER 2020)

MEMBER                        PRESIDENT

ANNEXURES

1. Witness examined on behalf of the Complainant/s by way of affidavit:

Copies of Documents produced on behalf of Complainant/s:

Ex P1: Copy of the Insurance certificate along with terms and conditions.

Ex P2: Copy of the Bank statement.

Ex. P3: Copy of the receipt for having paid insurance premiums.

Ex P4: Copy of the brochure issued by OP regarding the insurance policy.

Ex P5: Copy of the medical reports.

Ex P6: Copy of the notice issued by 2^nd Addl. Labour Court Bangalore.

Ex P7: Copy of the Government order dated 12.04.2018.

Ex P8: Copy of the letter issued by Commission of labour to the secretary Labour Department.

Ex P9: Copy of the Report by the Labour Officer.

Ex P10: Copy of the claim filed by me before the Labour Court.

Ex P11: Copy of the legal notice.

Ex P12: Copies of the postal acknowledgments.

2. Witness examined on behalf of the Opposite party/s by way of affidavit:

-NIL-

Copies of Documents produced on behalf of Opposite Party/s

-NIL-

MEMBER                        PRESIDENT