APPEARED AT THE TIME OF ARGUMENTS

Pronounced on:  13^th February,  2020

ORDER

1.   The present Revision Petition has been filed under Section 21(b) of the Consumer Protection Act, 1986 against the impugned order dated 12.09.2019 of the State Consumer Disputes Redressal Commission, West Bengal (for short “State Commission”) whereby the appeal was allowed and the order of the District Consumer Disputes Redressal Forum, Kolkata (for short “the District Forum”) was set aisde.

2.      Brief facts relevant for disposal of the case are that the complainant had taken a life insurance policy named ‘Jeevan Saral’ which was effective from 28.04.2005 from the OP. The complainant had paid an annual premium of Rs. 14,412/- for 11 years. Later, vide letter 28.11.2015, the OP informed the complainant that the maturity sum assured was incorrectly typed as Rs. 3,00,000/- instead of Rs. 59,064/- due to typographical error. The OP asked the complainant to provide all the documents so that the corrected maturity sum assured could be provided to the complainant. To this, the complainant protested for getting the sum assured of Rs. 3,00,000/-. But the OP did not heed to the request of the complainant. Hence, the complainant filed a complaint before the District Forum.

3.      The complaint was resisted by the OP by filing a written version.  It was contended that for availing ‘Jeevan Saral’ plan, the policy holder has to decide the yearly premium. Once, it is chosen, the sum assured is automatically determined. This policy had unique feature having different sum assured and the maturity sum assured. The death sum assured was Rs. 3,00,000/- (250 times of monthly premium) and the maturity sum assured was Rs. 59,064/- together with loyalty addition payable after the date of maturity of the policy. The LIC – OP informed the complainant that there was an inadvertent typographical error in maturity sum assured which had been shown as Rs. 3,00,000/- instead of Rs. 59,064/-. The complainant filled the proposal form mentioning the death sum assured as Rs.3,00,000/- without any specific mention about maturity sum assured. The discharge voucher was rightly given of Rs. 59,064/- with loyalty addition of Rs. 22,149/- as per policy condition. For corresponding age of 58 years and the term of 11 years, the policy holder had to pay a yearly premium of Rs. 73,140/-. But the complainant paid only Rs. 14,412/- as yearly premium. So, maturity sum assured of Rs. 3,00,000/- of the complainant does not stand at all.

4.      The District Forum, vide order dated 19.02.2018, dismissed the complaint with the following observation:

It appears from the materials on record that on the maturity of the policy the o.p. duly issued discharge voucher and the same was sent to the complainant. The complainant was also informed regarding the typographical error appeared in the policy bond. The maturity sum assured was explained explicitly and the MSA was rightly printed as RS. 59,064/-. The o.p. further added the loyalty addition of Rs. 22,149/- as per policy condition. The calculation made by the LIC as per the terms and conditions of the policy and there was no hidden agenda on the part of the o.p. to deny the claim of the complainant. Considering the materials on record we hold that the insurance company rightly calculated the amount which the complainant will be entitled to get and communicated the same to that effect to him thereby we hold that there was no deficiency in service or unfair trade practice on the part of the o.p. having regard to the facts and circumstances we hold that the case filed by the complainant has got no merit and the complainant will not be entitled to get any relief as prayed for.

5.      Being aggrieved by the order of the District Forum, the complainant appealed to the State Commission. The State Commission vide order dated 12.09.2019, allowed the appeal with the following observation:

          In fact, no such tangible proof is furnished before us to establish that the beneficiary was duly apprised of such important aspect of the policy condition. Each and every governing terms and conditions of the insurance policy are required to be mandatorily mentioned in unequivocal terms in the policy bond so as to enable the policyholder take a judicious decision regarding continuing / discontinuing the policy within the free-look period.

          As the terms and conditions mentioned in the policy bond is binding on both sides, it is our considered opinion that the Respondent cannot get away paying paltry sum to the Appellant simply by attributing the mistake as typographical error. It was incumbent on its part to prove beyond all reasonable doubt that the Appellant was taken into confidence about such important feature of the policy. It is anybody’s guess, whether any person of reasonable prudence would agree to invest Rs. 1,58,532/- for getting a meagre sum of Rs. 59,064/- in return.

          As the policy bond did not exhibit true picture, there was no room for the Appellant to foresee the iniquitous design of the Respondent. Surely, this is not the way how policyholders should be treated by the Insurance Companies. Act of neglecting to perform an action which one has an obligation to do cannot be called as a typographical error. On facts, there is a clear lack of ‘due diligence’ and the mistake committed does not come within the preview of a simple typographical error. There are reasons to believe that it was purposely done to suppress the reality from the Appellant.

          As the bona fide of Respondent’s claim of inadvertent typographical error remains highly doubtful, it cannot be accorded benefit of doubt.

          In view of this, we direct the Respondent to pay the stated MSA of Rs. 3,00,000/- to the Appellant together with simple interest @ 9% p.a. from the date of filing of the complaint case till full and final payment is made. The aforesaid amount is payable within 40 days hence along with litigation cost amounting to Rs. 25,000/-.

6.      Being aggrieved by the order of the State Commission, the OP filed the instant revision petition.

7.      Heard the learned counsel for the petitioner. Perused the material on record. The complainant is a doctor by profession. The proposal form is hand- written. It is seen that there was no consensus ad idem when the policy was issued. No prudent person will invest Rs. 1,58,532/- to get Rs. 59,064/- in return. The Hon’ble Supreme Court in the case of Life Insurance v. Asha Goel, III (2008) CPJ 78 (SC) observed the following:

The contracts of insurance including the contract of life assurance are contracts uberrima fides and every fact of material must be disclosed, otherwise, there is good ground for rescission of the contract. The duty to disclose material facts continues right up to the conclusion of the contract and also implies any material alteration in the character of the risk which may take place between the proposal and its acceptance.

The date of commencement of the policy was 28.04.2005. The yearly premium payable was Rs. 14,412/- and the period of insurance was for 11 years. So, the complainant paid a total premium of Rs. 1,58,532/-. It is displeasing to note that inspite of paying so much, the OP said that the actual maturity sum assured was Rs. 59,064/-. The District Forum has erred in not holding the OP liable. It is unacceptable to any insured to receive lesser amount on maturity or term. Beforehand, if the insurer (LIC) had explained such factum to the proposer, he would never have opted to get any insurance policy. This prima facie shows that there was no ‘consensus ad idem’ which the policy was taken.

8.      In the instant case, it appears that the complainant was just allured by the insurance agent with rosy picture of policy returns. The complainant was paying regular annual premium of Rs. 14,412/- under presumption that he will receive certain good returns on maturity, but he was put into vacua and in the spineless condition. It is just unfair.

9.      On the basis of the forgoing discussion, I hold the OP liable for deficiency in service under section 2 (1) (g) as well as committing unfair trade practice as defined in section 2 (1) (r) of the Consumer Protection Act, 1986. Within the meaning and scope of section 21(b) of the Act, I find no grave error in the Order passed by the State Commission. The order of the State Commission is affirmed.  

10.    The revision petition, being misconceived and devoid of merit, is dismissed with cost of Rs. 50,000/- to be paid by the OP to the complainant. The entire amount shall be paid within six weeks from today, failing which it will carry interest @ 9% per annum till its realisation.