Sri Devakumar.M.C.

      Member

1.     The complainant has filed the complaint under section 12 of the C.P.Act, 1986, against the opposite parties, alleging negligence and unfair trade practice and seeking a direction to pay the balance amount of Rs.30,922/-, loyalty additions as per policy terms along with interest at 18% p.a. from the date of maturity of the policy till the date of release of the said amount and Rs.1,00,000/- towards mental agony and physical strain with other reliefs.
2.     The complainant purchased opposite parties “Jeevan Saral (with profits) policy on 19.02.2004.  A sum of Rs.255/- has been deducted every month from complainant’s salary and remitted to opposite party.  As per policy, the maturity sum assured was Rs.62,500/-.  The complainant paid Rs.30,600/- (i.e. 255 x 120 months = 30,660/-).  The policy got matured on 15.02.2014.  Claims made under the policy, by submitting all the relevant documents.  The opposite parties credited only Rs.31,578/- to complainant’s account through NEFT and intimated same vide letter No.679/- claim,s dated 19.02.2014. Aggrieved by the same complainant, made several requests to opposite parties, to settle the claims, but the opposite parties gave an untenable reply, hence the complaint, seeking reliefs.
3.     Opposite party Nos.1 and 2 filed common version and denies the allegation as false.  Issue of policy is admitted.  It submits the maturity sum assured was erroneously mentioned in policy bond as Rs.62,500/- instead of Rs.25,467/-.  The mistake crept in was due to typographical error, same was informed in its letter dated 26.04.2014 and 25.07.2014.  The ‘maturity benefit’ is payable on survival of the insured to the term of the policy. The profit is payable in the form of “Loyalty Addition” and the same is payable with maturity benefit on survival of the insured.  Further, since the policy holder survive for the term of the policy (i.e. 10 years), he is not entitled to receive the “Term Assurance”, as the same is payable only in the event of the death of the insured, during the policy terms.  The opposite parties admitted the payment of Rs.30,600/- towards the premium for the entire term of 10 years, at Rs.255/- premium per month.  The opposite parties paid Rs.31,578/- through NEFT on 19.02.2014 itself.  Hence, pleaded that there are no lapses on their part and prays for dismissal of the complaint.
4.     To establish the facts, the complainant filed his affidavit along with several documents.  The opposite parties also filed affidavit with documents.  Both parties filed written arguments and made oral submissions.  Perused the material on record and posted the matter for orders.
5.     The points arose for our consideration are:-

1. Whether the complainant establishes the negligence and unfair trade practice on the part of opposite parties in not settling the maturity sum assured with loyalty addition, on survival and thereby he is entitled for the relief sought?
2.  What order?

6.    Our findings on the aforesaid points are as follows:

Point No.1 :- Partly in the affirmative.

Point No.2 :- As per final order for the following

:: R E A S O N S ::

7.    Point No.1:- The complainant obtained the policy known as “Jeevan Saral” (with profits) from opposite parties on 19.02.2004, for a monthly payment of premium of Rs.255/- through salary, for a term of ten years.  The policy bond bearing No.721929694 was issued, wherein the maturity sum assured was mentioned as Rs.62,500/- with loyalty bonus. A total of Rs.30,600/- (i.e Rs.255 x 120 months = 30,600/-) has been paid towards the policy term.  The policy matured on 19.02.2014.
8.    The claim application was made by submitting the original policy bond with opposite party No.2.  A sum of Rs.31,578/- has been credited to the account of complainant through NEFT banking and intimated the same vide letter dated 19.02.2014.  Nothing credit of lesser amount to the account, requested the opposite party No.2, vide letter dated 05.03.2014 and demanded to release the balance amount with loyalty addition.  The opposite party No.2 tendered an untenable reply on 26.04.2014, stated the payment made was in order, due to typographical error the maturity benefit was wrongly mentioned in the policy.  Aggrieved by the reply, another letter was written to opposite party No.2, on 05.05.2014, same was replied on 04.08.2014, stated that the amount paid by the branch office was in order, the sum of Rs.62,500/- was payable only on death of the policy holder during the term and not the maturity sum assured as such, regretted for the same.  Hence, the aggrieved complainant filed the complaint and sought for the reliefs.
9.    The opposite party contended that the policy issued on to the complainant on 19.02.2004.  The policy provides on, insured surviving to the term of policy, a sum depends on the term chosen as well as age of the proposer.  Whereas the benefit payable on death depends on the quantum of basic premium offered to pay by the insured.  The benefits eligible on survival is completely different from the amount payable on premature death of the insured.  Further contended, that, the software was not ready at that point of time, to print the policy bond.  Hence, the contents have been manually typed and delivered to the complainant.  In this way, the mistake was crept in resulting in wrong mention of maturity sum assured benefits and the same was contended as unintentional.  Since, the complainant has enjoyed the insurance coverage of Rs.62,500/- and an additional insurance coverage of Rs.62,500/- for death due to accident, the double benefit is unsolicited and unethical.  So, the opposite party contended that, the payment made by the opposite party No.2, was in order and no deficiency in service and hence not liable to pay any compensation for the same.  As such, prays for dismissal of the complaint.
10. On perusal of the documents placed on record, the issue of Jeevan saral insurance policy is established.  The payment of premium amount for a duration of 120 months also established.  As per the original policy bond, the maturity sum assured was Rs.62,500/-.  The policy was for a period of 10 years.
11. The opposite party has paid Rs.31,578/- on 19.02.2014.  The opposite party issued the policy bond on 09.03.2004 to the complainant, whereas the maturity sum assured has been mentioned as Rs.62,500/-.  Now, on claiming the bond amount, the opposite parties opened their eyes and have come up with the defence of typographical error with many other explanations, which were not clearly explained to the complainant, either by the agents or by the opposite parties at the inception.  This is certainly an unfair trade practice adopted by opposite parties, the defence of the opposite parties are not justifiable and hence the opposite parties are jointly and severally liable to pay the maturity sum assured amount with loyalty additions to the complainant along with interest and also liable to pay compensation for the mental agony and financial hardship caused.   Accordingly, point No.1 is answered partly in the affirmative.   
12. Point No.2:- In view of the above observations, we proceed to pass the following

:: O R D E R ::

1. The complaint is allowed in part.
2. The opposite parties are jointly and severally be directed to pay the balance maturity sum assured of Rs.30,922/- with loyalty bonus along with interest at 12% p.a. on the total sum, form the date of maturity of the policy, to the complainant, within 60 days of this order.  Failing which, the opposite parties jointly and severally shall be liable to pay interest at 12% p.a. on the said sum, until compliance.
3. The opposite parties jointly and severally shall pay Rs.5,000/- compensation for the mental agony, hardship caused and Rs.2,000/- towards cost of the proceedings to the complainant within 60 days of this order.  In default to comply, the opposite parties shall pay interest at 12% p.a. on the said total sum, until payment made.
4. In case of default to comply this order, the opposite parties shall undergo imprisonment and also liable for fine under section 27 of the C.P.Act, 1986.
5. Give the copies of this order to the parties, as per Rules.

(Dictated to the Stenographer transcribed, typed by her, transcript corrected by us and then pronounced in open court on this the 16^th December 2016)

                          (H.M.SHIVAKUMARA SWAMY) 

                                      PRESIDENT     

(M.V.BHARATHI)                           (DEVAKUMAR.M.C.)

      MEMBER                                         MEMBER