By: Smt. R.K.Madanavally, Member
Facts in brief:-
The complainant had availed a policy under the opposite parties through an agent. The policy was for a period of ten years ie, 28. 3.04 to 28.3.14. The total sum insured for the above policy was Rs.5000000/-. There was an additional bonus also. According to the complainant after the maturity period, he is entitled for Rs.500000/- along with bonus.
After the maturity, the complainant got a letter from the opposite parties by intimating him that he is entitled to a maturity amount of Rs. 200016/- out of which, Rs.51856/- will be paid as bonus and basic amount of Rs.148160/-. The complainant had already paid 2,45000/- towards the policy. As per the policy certificate issued by the opposite parties, the maturity amount is shown as Rs.500000/-. By denying the entire amount and bonus, opposite party has committed deficiency in service. Hence this complaint.
The opposite parties filed version where in they denied the entire averements of the complainant. The quarterly installment of the policy was Rs. 6125/-. In the said policy, the death sum assured was Rs.500000/- and maturity sum assured was Rs.148160/-. The date of maturity was 28.3.14.
The policy was matured for payment on 28.3.14. Before the three months of the maturity itself, the maturity claim intimation was sent to the complainant, intimating him that the amount of maturity will be Rs.2000016.
After receiving the intimation, the complainant had submitted the duly executed discharge form, original policy bond and his NEFT details. The opposite party submitted that' Jeevan Saral' policy is a unit linked plan. This plan contains higher death cover, a smooth return liquidity and a lot of flexibility like partial surrender auto cover, loan facility etc. Death cover will be treated as sum assured and it will be 250 times of basic monthly premium. The maturity amount paid is as per the policy conditions and is correct. All the conditions are pointed overleaf of the original policy bond. In the complaint, there is no mental agony or hardships or pecuniary loss sustained to the complainant. There is no deficiency in service on the part of the opposite party and the complaint has to be dismissed with cost.
The main issues arises for our consideration here in are;
1) Whether the complainant is entitled for Rs.500000/- as prayed for ?
2) Whether there is any deficiency in service on the part of opposite party?
If so relief and cost?
Point No.1 and 2
There was no oral evidence on the side of the complainant. Ext. A1 to A3 documents were marked on the side of the complainant. Opposite party was examined as Dw1. The documents pertaining to opposite party was marked as Ext B1 to B3. Ext. A1 is the photo copy of the Ext. B1 ie the policy issued infavour of the complainant.
According to the complainant he is entitled for Rs.500000/-. It is interested to note that the complainant and opposite party are relying on the same document. The terms and conditions and and other clauses are noted in tiny letters. A lay man cannot read and under stand the contents in a bare reading. The sum assured on death in in the policy was Rs.500000/-. The complainant's belief is that he will get the sum assured after the maturity of the policy. But according to opposite party, if insured person dies during the existence of the said policy, his heirs will get Rs.500000/-. Other wise he will get the maturity benefit only. In the above case the complainant had paid 245000/- towards opposite party as the total premium, But opposite party intimated him that he would get only a sum of Rs.200016/- as maturity amount.
During the policy period of 10 years the complainant might have paid the premium by believing that he would get Rs.500000/- from opposite party after the completion of the policy period. There may be some conditions in the relying documents. That should have been in properly conveyed to the complainant. Other wise it will amount to clearly a misleading. Misleading the consumers with writing in tiny letters is deficiency in service. Hence opposite party is liable to compensate the complainant. But if at all there is deficiency it is not proper to direct the opposite party for remitting the entire amount of Rs.500000/-. Opposite party shall remit a reasonable amount towards the complainant. Hence we are allowing the complaint in part and point No.1 and 2 are answered accordingly.
Point No.3
In view of the above discussions we order that .
Opposite party shall remit Rs.245000/- to the complainant along with a compensation of Rs.10,000/- and a cost of Rs.7500/-. Opposite party is directed to pay 6% interest up on the above amount from the date of pronouncement of this order. This order shall be complied within one month from the date of receipt of the copy of this order.
Dated this 31st day of March, 2016
A.A.VIJAYAN, PRESIDENT
R.K.MADANAVALLY , MEMBER
MINI MATHEW, MEMBER
APPENDIX
Witness examined on the side of the complainant : Nil
Documents marked on the side of the complainant : Ext.A1to A3
Ext.A1 : Photo copy of the policy certificate
Ext.A2 : Discharge form of the policy maturity issued by opposite party
Ext A3 : Premium payment intimation letter
Witness examined on the side of the opposite party : DW1
DW1 : Opposite party
Documents marked on the side of the opposite party : Ext. B1 to B3
Ext.B1 : Original policy certificate issue opposite party to the complainant.
Ext.B2 : Discharge form of the policy maturity issued by opposite party.
Ext.B3 : Proposal form for the policy.
A.A.VIJAYAN, PRESIDENT
R.K.MADANAVALLY , MEMBER
MINI MATHEW, MEMBER
