SMT.MOLYKUTTY MATHEW : MEMBER

        This is a complaint filed by the complainant U/S 35 of the Consumer Protection Act 2019  for an order directing  the OP’s to pay Rs.2,50,000/- with dividend  to the complainant as premium  amount  paid by the complainant along with Rs.5,00,000/- as compensation  for mental agony and hardship suffered by the complainant and cost of litigation  for the deficiency of service and unfair trade practice  on  the  part of OPs.

The brief of the complaint :

    The  complainant  has taken a policy bearing No.778927517 from 1^st OP.  The 3^rd OP’s agent E.T.Bharathi approached the complainant and introduced as Peerless agent and believed the words of this OP the complainant taken the policy , will get the maximum benefit.  The complainant has taken the policy with payment  of Annual target premium of Rs.25,000/- for a period of 10 years.  The policy is effective from 30/4/2010.  The maturity of the said policy falls due  on 30-/4/2020 and the sum assured is Rs.2,50,000/-.  After taking the policy the complainant had remitted a sum of  Rs.2,25,000/- for the period of 9 years with annual  premium payment of Rs.25,000/- per year.  After remitting  Rs.2,25,000/- for a period of 9 years the complainant could not continue the payment  due to some financial problem and therefore the complainant approach the OP for refund  the amount paid by  the complainant, but the OP has refused to make full payment and instead offered an amount of Rs.1,55,348/- being surrender value  as  on  17/6/2019.  The complainant had already remitted a sum of Rs.2,25,000/- towards the premium of policy for a period of 9 years but the OP is offering only Rs.1,55,348/- as against the payment of Rs.2,25,000/-.  The OP is withholding an amount of Rs.69652/- without assigning any valid reason  and no such terms are prescribed in the  policy document.  The OP has determined the surrender value as on 17/6/2019 by applying the unit price of which the complainant has no knowledge nor the  OP has explained this in the policy document.  The price of the unit is not explained  or shown anywhere in the policy document.  The complainant has approached the OP on several occasions in their office at Kannur but the OP has not turned up.  Then the OP was directed to pay one more instalment of Rs.25,000/-.  Then the complainant remitted Rs.25,000/- on 7/8/2019.  But the OP insisting the complainant to pay Rs.25,000/- per year further  10 years also.  There is no surrender charge to be  levied the 6^th policy year on wards as indicated in the policy document.  So the OP’s cannot withhold a sum of Rs.69,652/- from the premium paid of  Rs.25,000/- and the  complainant paid Rs.25,000/- on 7/8/2019also.  The OP is  liable  to pay the premium amount of Rs.2,50,000/- paid by the complainant with dividend.  But the OP is not paid the amount and cheated the complainant.  The act of  OP’s,  the complainant caused much mental agony and financial loss.  So there is deficiency of service and unfair trade practice on the part of OP’s.  Hence the complaint.

       After receiving the notice  OPs 1&2 appeared before the commission  and filed their written version. They contended that the policy issued to the complainant is a unit linked policy and is a speculative investment and the complainant is not a consumer and the complaint is not maintainable.  Moreover, they stated that  the effective date of  the policy is 30/4/2010 and the maturity date is  30/4/2030, the policy term is 20 years and the last instalment of the ATP is payable on 30/4/2029.  The policy was issued to the complainant as required by him in the  proposal form.  The policy of the complainant incepted on 30/4/2010 and the complainant  had accepted the terms and condition of the policy by a declaration.  According to the condition of the policy the policy holder has a period of 15 days from the date of receipt of the policy to  review the terms and condition  of the policy and where the policy holder  disagrees to  any of those terms or conditions the policy holder has the option  to return the policy stating that the reason  for his objection.  The surrender value of the policy of the complainant as on 8^th August 2022 is Rs.1,93,583.96/- .The complainant is  thus a motivated attempt to obtain unfair advantage and OPs 1&2 have no deficiency in service and unfair trade practice.  Hence the complaint is liable to be dismissed.

      On the basis  of the rival contentions by the pleadings the  following  issues  were framed for consideration.

1. Whether there is  any deficiency of service   on the part of the opposite parties?
2. Whether the complainant is entitled for any relief?
3. Relief and cost.

     The evidence consists of the oral testimony of PWs1 to 3  and  Exts. A1 ,A2 and Ext.X1 were marked . On OP’s side Ext.B1 marked. OPs 1&2 filed argument note and complainant argued the mater.

Issue No.1: 

          The  Complainant  adduced evidence before the commission by submitting  his chief affidavit in lieu of  his chief examination to the tune of the pleadings in the complaint and denying the  contentions in the version.  He was cross examined as PW1 by OPs 1&2.  The documents  Exts.A1 & A2 were marked on his  part  and  PWs 2&3 were also examined  and Ext.X1 marked through PW2 the Bank manager.  In Ext.A1 is the policy and Ext.A2 is the award of insurance Ombudsman.  In Ext.X1 is the bank account statement of PW3.  According to the complainant he is he  policy holder of 1^st OP and he paid annual target premium of Rs.25,000/- per year for a period of 10 years.  The maturity date of the policy due on 30/4/2020.  The complainant had remitted Rs.2,25,000/- for a period of 9 years and the  complainant could  not continue the payment due to  some financial problem and the complainant approached the OP for refund of the amount paid by the complainant, but the OP has refused to make full payment and instead offered an amount of Rs.1,55,348/- being the  surrender value  as on  17/6/2019.  In order to prove the  case of complainant he produced 2 witness and examined as PWs2&3.  In the evidence of PW1 he deposed that  “ policy എടുക്കുന്ന സമയത്ത് proposal form  ൽ ഒപ്പിട്ടു കൊടുത്തോ?  ഒപ്പിട്ടു കൊടുത്തിരുന്നു. വായിച്ചിട്ടില്ല. policy യുടെ  terms and conditions മനസ്സിലാക്കിയിട്ടാണ്  ഒപ്പിട്ട് കൊടുത്തത് ? അല്ല. ഞാൻ വായിച്ചു മനസ്സിലാക്കിയിട്ടില്ല. ഞാൻ 10കൊല്ലം policy തുക അടച്ചിരുന്നു. 9 കൊല്ലം എന്നു പറഞ്ഞാൽ ശരിയല്ല. ഞാൻ 21/2ലക്ഷം രൂപ അടച്ചു.  നിങ്ങളുടെ policy life coverage ഉള്ള policy ആണ് എന്ന് പറഞ്ഞാൽ? ശരിയല്ല. company യുടെ terms and conditions    പ്രകാരം 155348/- രൂപ നിങ്ങൾക്ക് അനുവദിച്ചിട്ടുണ്ട് എന്നു പറയുന്നു ശരിയാണ്. ഞാൻ വാങ്ങിയിട്ടില്ല. In re-examination PW1 also stated that    എനിക്ക് policy യെ പറ്റി ഒരു ധാരണയും ഇല്ല. എനിക്ക് ഇതിനെപ്പറ്റി പറഞ്ഞു തന്നത് OPയുടെ ആളുകൾ ആണ്. In the evidence of PW3 he deposed that “ നിങ്ങളും പരാതിക്കാരനും എടുത്ത policy വെവ്വേറെയാണ് എന്നും നിങ്ങൾക്ക് അനുവദിച്ചു കിട്ടാനുള്ള തുകയാണ് company അനുവദിച്ചതെന്ന് പറയുന്നു? ശരിയല്ല. പരാതിക്കാരന്ർറെ policy വേറെ type policy ആണ് എന്നും നിങ്ങൾ  എടുത്ത policy അല്ല എന്നും പറയുന്നു? ശരിയല്ല. In re-examination “ നിങ്ങൾക്ക് policy പ്രകാരം പണം ലഭിക്കുന്നതിന് അതുമായി ബന്ധപ്പെട്ട മുഴുവൻ രേഖകളും companyയിൽ surrender  ചെയ്തോ? company യിൽ മുഴുവൻ രേഖകളുംനൽകിയിരുന്നു. The OP is contending that the complainant’s and PW3’s policies were different in nature and then the OP’s bounden duty is to produce the PW 3’s policy before the commission and  to prove the same.  But OP’s not produce PW3’s policy before the commission failed to prove that the policy given to PW3 is a different policy also. Moreover in the  evidence  of PW2 who produced the bank statement of PW3 dtd.28/12/2018 issued by 1^st OP to PW2’s account for an amount of Rs.2,63,879.73 and marked as Ext.X1 also.  The 1^st OP vehemently stated that there is  no deficiency  of service on their part.  They relied up on Ext.B1 to  substantiate   their defence.  On perusal of the pleadings, documents and evidence , we the commission hold that the complainant is the policy holder of the insurance  scheme and he paid Rs.2,50,000/- for 10 years premium.  The complainant stated that he and PW3 taken the same policy and to filed application for  return the amount before 1^st OP’s office.  But PW3’s amount is credited as Rs.2,63,879.73/- on his bank account .  But the OP contended that the policy of the complainant and PW3’s are different.  Hence at the time of evidence 1^st OP is liable to produce the PW3’s policy before the  commission.  But he fails to do so and no amount was credited to complainant’s account by  the OP.  So we hold that there is deficiency of service  and unfair trade practice on the part of  opposite parties .  Hence the issue No.1 found in favour of the complainant and  answered accordingly.

Issue Nos.2&3:

        As discussed above the, the complainant is the policy holder of 1^st OP.  The complainant had remitted a sum of Rs.2,25,000/- for the period of 9  years with annual premium payment of Rs.25,000/- per year.  PW3 also taken the same policy and he got  an amount of Rs.2,63,879.73/- from 1^st OP. Thereafter the complainant paid additional amount of Rs.25,000/- also.  The total payment remitted by the complainant for the insurance policy before 1^st OP as Rs.2,50,000/- . So  we hold that the OP’s are directly bound to redressal the grievance caused to the complainant.  So the complainant is entitled to get the remitted policy amount.  Therefore we hold that the opposite parties are liable to pay the remitted  policy amount of Rs.2,50,000/- and Rs.50,000 as dividend to the complainant along with  compensation for  mental agony of the complainant for Rs.50,000/- and Rs.10,000/- as litigation cost.  Thus  the issue No.2&3 are also accordingly answered. 

          In the result the complaint is allowed in part  directing the   opposite parties  jointly and severally liable to pay the remitted  policy amount of Rs.2,50,000/- and Rs.50,000 as dividend to the complainant along with  compensation for  mental agony of the complainant for Rs.50,000/- and Rs.10,000/- as litigation cost   within  30 days of  receipt  of this order. In default the amount of Rs.2,50,000/- and  Rs.50,000/- as dividend  carries 12% interest per annum from the date of order till realization.  Failing which the  complainant is at liberty to  execute  the  order as  per the  provisions  of Consumer Protection Act 2019.

Exts:

A1- Policy schedule

A2-Ombudman award

X1-certified copy of bank account statement

B1- Policy

PW1-N.Radhakrishnan- complainant

PW2- Jithesh Jose-witness of PW1

PW3-Jithesh Jayendran-witness of PW1

Sd/                                                         Sd/                                                     Sd/

PRESIDENT                                     MEMBER                                         MEMBER

Ravi Susha                                       Molykutty Mathew                            Sajeesh K.P

eva           

                                                                       /Forwarded by Order/

                                                                   ASSISTANT REGISTRAR