Chandigarh

StateCommission

A/102/2022

Reliance Nippon Life Insurance Company Ltd. - Complainant(s)

Versus

Hakam Singh - Opp.Party(s)

Sanjeev Goyal & Gaurav Bhardwaj Adv.

21 Jul 2022

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

 

 

Appeal No.	:	102 of 2022
Date of Institution	:	24.06.2022
Date of Decision	:	21.07.2022

 

 

 

 

 

 

1]      Reliance Nippon Life Insurance Company Limited, Corporate Office at 5^th Floor, South Wing, Reliance Centre, Off. Western Express Highway, Santacruz East, Mumbai – 400055.

2]      Reliance Nippon Life Insurance Company Limited, SCO No.123-124, 2^nd Floor, Sector 17-C, Chandigarh.

Both through their authorized signatory Amit Rana, Branch Manager, Reliance Nippon Life Insurance, available at SCO No.123-124, Third Floor, Above Reliance Jewels, Sector 17C, Chandigarh – 160017.

……Appellants/Opposite Parties.

Versus

Hakam Singh, aged about 74 years S/o Sh. Dalip Singh, resident of H.No.271, Sector 44-A, Chandigarh.

…..Respondent/Complainant.

 

 

BEFORE:  JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                MRS. PADMA PANDEY, MEMBER

              MR. RAJESH K. ARYA, MEMBER

 

 

ARGUED BY:-    

 

Sh. Gaurav Bhardwaj, Advocate for the appellants.

 

PER  RAJESH  K. ARYA, MEMBER

                   This appeal has been filed by the opposite parties, namely, Reliance Nippon Life Insurance Company Limited (appellants herein), against order dated 21.04.2022 passed by the District Consumer Disputes Redressal Commission-II, U.T., Chandigarh (in short ‘District Commission’), vide which, Consumer Complaint bearing No.1138 of 2019 filed by the complainant, namely, Hakam Singh (respondent herein) has been allowed in the following manner:-

“7]       From the above discussion and findings, we are of the opinion that the deficiency in service has been proved on the part of OPs. Therefore, the present complaint is allowed with direction to the Opposite Parties to pay the balance amount of Rs.1,18,139/- (i.e. Rs.1,48,264 – Rs.30,125/-) to the complainant along with interest @10% p.a. w.e.f. 13.8.2019 (date of death of life assured) till its payment.  The OPs are also directed to pay an amount of Rs.15,000/- to the complainant towards compensation for causing him mental agony and harassment, along with litigation cost of Rs.10,000/-.

         This order shall be complied with by the OPs within a period of 30 days from the date of receipt of copy of this order, failing which they shall also be liable to pay additional cost of Rs.10000/-.”

2.             The facts in brief, as culled from the impugned order passed by the District Commission, were as under: -

        “The complainant being the legal heir and nominee of deceased insured Mrs. Rupinder Kaur filed the present complaint. It is stated that the deceased insured Mrs.Rupinder Kaur obtained one Policy No.11886727 (Cash Flow Plan) from OP  Company effective from 12.4.2008 (Ann.C-1) covering the death benefits with Guaranteed Sum Assured and Non-Guaranteed Accumulate Reversionary Bonus.  It is also stated that the deceased insured Mrs.Rupinder Kaur paid regular premium of said policy since the year 2008 till her death on 13.8.2019 (Ann.C-2).  Thereafter, the complainant being the nominee under the said policy, lodged claim of death benefits, whereupon the OP Company approved & paid an amount of Rs.30,124.84 and transferred the same through NEFT in the account of complainant, whereas per policy they were bound to pay a sum of Rs.86,200/- towards Guaranteed Sum Assured and Rs.62,064/- towards Non Guaranteed Accumulate Reversionary Bonus to the complainant.  The complainant raised the issue with OP Company for payment of balance amount, but to no avail. Hence, this complaint.

          2]       The OPs have filed joint reply and while admitting the factual matrix of the case, stated that the life assured opted the 19 years premium paying term   (Ann.C-1) and paid 11 premiums under the policy, therefore, the sum assured come to Rs.49,905.26.  It is stated that as per terms & conditions of the policy, in case the policy is paid up, then the survival benefits which were already paid are liable to be deducted from the calculated sum assured and in the present case, a total sum of Rs.43,908/- was already paid to the life assured as survival benefits during her life time i.e. Rs.14,366.60 in April, 2012, Rs.14,367/- in April, 2015 and Rs.14,367/- in April, 2018.  It is submitted that after deducting the survival benefit from the sum assured i.e. Rs.49,905.26-43,908 = Rs.6807.26 (Death Benefit) and further by adding the vested bonus of Rs.23,317/- into the death benefits, the total amount comes to Rs.30,124.26 and accordingly, an amount of Rs.30,125/- was transferred into the account of complainant-nominee.  It is submitted that nothing is due against the opposite parties as per terms & conditions of the policy.  Pleading no deficiency in service, the OPs have prayed for dismissal of the complaint.”

3.             The impugned order dated 21.04.2022 has been assailed by the appellants on the ground that the Ld. District Commission while calculating the amount wrongly relied upon the illustration benefit table and calculated the sum assured as Rs.86,200/ and further calculated non-guaranteed accumulated reversionary bonus of Rs.62,064/-. It has further been stated that as per Note appended on Page 9 of Annexure C-1, some benefits were guaranteed and some benefits are variable but the Ld. District Commission wrongly picked the figures. It has further been stated that as per the record, the vested bonus comes to Rs.23,317/-, which was duly paid to the respondent. It has further been stated that the Ld. District Commission did not consider the payment of Rs.43,908/-, which had already been paid to the respondent on account of survival benefits, which was to be subtracted. Reliance has been placed on Export Credit Guarantee Corporation of India Vs. M/s Garg Sons International, 2013 (1) CPC 192, wherein the Hon’ble Supreme Court has held that the courts are expected to give paramount importance to the terms of insurance contract into between the parties and terms of insurance policy must be strictly construed in order to determine the extent of liability of the insurer. Further reliance has been placed on Vikram Greentech (I) Ltd.  and another Vs. New India Assurance Co. Ltd., 2009 (4) CLT 313 and Deokar Exports Pvt. Ltd. Vs. New India Assurance Co. Ltd., 2009 (2) CLT 15, wherein it has been held that in a contract of insurance, rights and obligations are strictly governed by the policies of insurance and no exception or relaxation can be made on the ground of equity.  Further reliance is placed on the judgment of Hon’ble National Consumer Disputes Redressal Commission, New Delhi in LIC of India and others vs. Mahendra Singh, 2011 (4) CLT 39 wherein it has been held that the terms of policy are in the nature of a contract and their interpretation has to be made in accordance with the strict construction of the contract. Lastly, prayer for dismissal of complaint has been made.

4.                After hearing the Ld. Counsel for the appellants and going through the material available on record very carefully, we are of the considered opinion that the appeal is liable to be dismissed at the preliminary stage for the reasons to be recorded hereinafter. The contentions raised by the appellants that Ld. District Commission did not consider the payment of Rs.43,908/-, which had already been paid to the respondent on account of survival benefits and remaining Rs.6807.26 only was payable as Death Benefit has no force inasmuch as the Ld. District Commission has rightly observed in its order that the total amount of Rs.1,48,264/- (Rs.86,200 + Rs.62,064) was due towards death benefit of the life assured under the policy as this observation of the Ld. District Commission is corroborated from Reliance – Cash Flow Plan (Policy Schedule), Annexure C-1, wherein under the heading “Benefit Payable”, it was clearly mentioned that on death of the life assured at any time prior to 11^th April 2027, an amount of Rs.86,200/- plus the vested bonuses would be payable and this was the sum assured under the said Policy Schedule. As regards the next contention that Survival Benefit payments made earlier were to be deducted from paid up value as stipulated in “Benefit Illustration for – Cash Flow Plan with Out Profits”, it may be stated here that this contention is also not sustainable as the Ld. District Commission, under the said Benefit Illustration, rightly arrived at a figure of Rs.1,18,139/-, after deducting an amount of Rs.30,125/- which had already been paid to the complainant/nominee. Thus, in our concerted view, the Ld. District Commission rightly directed the appellants to pay the balance amount of Rs.1,18,139/- to the respondent along-with interest w.e.f. 13.08.2019 i.e. the date of death of the life assured till its payment.  We do not find any infirmity, illegality or material irregularity in the well reasoned order passed by the Ld. District Commission. As regards the judgments cited by the appellants, no doubt, these judgments lays down law with regard to terms and conditions of insurance but in view of aforesaid facts and circumstances of the case, the appellants have failed to derive any benefit out of the cited case laws.

5.                 For the reasons recorded above, the appeal being devoid of any merit is dismissed, at the preliminary stage, with no orders as to costs.

6.                Certified copies of this order be sent to the parties free of charge.

7.                File be consigned to Record Room after completion.

Pronounced

21.07.2022.

 

[RAJ SHEKHAR ATTRI]

PRESIDENT

 

 

(PADMA PANDEY)

MEMBER

 

 

(RAJESH K. ARYA)

MEMBER

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