By Sri. MOHANDASAN.K, PRESIDENT

The case of complainant in brief is as follows: -

1.            The complainant subscribed one LIC policy infavor of his son and the policy number was 788835549.  The policy assured amount was Rs.1,00,000/- (Rupees One lakh  only) and the installment of half yearly premium was Rs.4,710/-(Rupees four thousand seven hundred and ten only).He remitted premium up to 5 years without any interruption. He remitted total amount of Rs.56,280/-(Rupees fifty six thousand two hundred and eighty only).Complainant decided to surrender the policy for the education purpose of his son and filed an application for the same.  The LIC refunded an amount of Rs.41,241/- (Rupees forty one thousand two hundred and forty one only) on 31/05/2018.There was a short of   Rs.15,040/- (Rupees fifteen thousand and forty only) from the total amount he remitted. The subscription of complainant was endowment policy T 14(with profit). Usually after 5 years of completion of remittance the policy holder entitled for the refund of entire amount with 10.5% interest. The insurance company assured the same to the complainant while he subscribes the policy. The complainant approached opposite party after five and half years to surrender the policy for the education purpose of his son. There was short of 15,040/-(Fifteen thousand and forty rupees only) rupees out of the paid amount. The complainant approached opposite party as per Information Act but there was no satisfactory answer. It was told that he is not entitled for surrender value. Complainant approached this Commission for the remitted amount with interest and cost and also compensation. 

2.         On admission of the complaint notice was issued to the opposite party and the opposite party filed version denying the entire averments and allegations in the complaint.    It is submitted that the opposite party had issued an endowment assurance policy bearing No. 788835549 dated 15/01/2013 on the life of complainant son Sri. Fahad Ummer. The complainant signed and filed the proposal form and submitted to the opposite party. Opposite party also admitted that the installment of premium under the policy was Rs.4,710/-/-(Rupees four thousand seven hundred and ten only)   and the complainant remitted the premium amount up to July 2018. The policy holder had given request for surrender of policy on 25/05/2018 and an amount of Rs.41,241/- (Rupees forty one thousand two hundred and forty one only) was given to the complainant as surrender value on 31/05/2018.

3.         The opposite party denied that they had under taken to refund the premium amount remitted along with interest at the rate of 10.5% to the policy holder.  The opposite party denied that they had cheated the policy holder, that the company did not issue true information under RTI request. 

4.         The opposite party submitted that they had issued an endowment assurance policy bearing NO.788835549. Dated 15/01/2013 on the life of complainant son and on the basis of proposal form filed and signed and submitted by the complainant. The assured amount under the policy was Rs.1,00,000/- (Rupees one lakh only) and the term of the policy was 11 years. The installment premium under the policy was Rs.4,710/- (Half yearly) and the complainant remitted the premium up to July 2018.  The complainant requested for a surrender value of policy on 25/05/2018 and an amount of Rs.41,241/-(Rupees forty one thousand two hundred and forty one only)  was issued as surrender value on 31/05/2018. The opposite party submitted that they calculated the paid-up value of policy as Rs.50,000/- (Rupees Fifty thousand only) since the premium is paid for half of the term. Bonus accrued was Rs.21,400/- (Rupees twenty-one thousand and four hundred only) and so the total sum was Rs.71,400/-(Rupees Seventy one thousand four hundred only). The said amount of Rs. 71,400/- (Rupees Seventy-one thousand and four hundred only) is the value of the above policy amount as on the date of maturity that is on 15/01/2024.  Since the policy holder submitted request for termination of policy is entitled to 57.76 % of the above amount that is Rs.41,241/-(Rupees forty-one thousand two hundred and forty one only -. The opposite party paid the same as the eligible amount of surrender value as in full and final settlement of the policy.

5.         The opposite party contended that the privileges and conditions governing the policy is printed on the back of the policy document and the life insurance is an alienated contract on the principles utmost good faith and performance of the contract is as per the conditions and privileges embodied in the policy documents which is evidence of contract and binding to the parties. There is no provision for refunding premium amount. The premium paid by the insured is to cover on his life for the given period.    The complaint here in taken the policy for a period of 11 years and the same is discontinued before the expiry of the term stipulated in the policy. The prayer of the complaint is baseless and there is no deficiency of service or cause of action alleged.  There is no question of mental agony, hardship or financial loss to the complainant   and so the complaint be dismissed with cost of the opposite party.

6.         The complainant and opposite party filed affidavit and documents.  The documents on the side of complainant marked as Ext. A1 to A11.  Ext. A1 is insurance policy dated 15/01/2013. Ext. A2 is application for the surrender value. Ext. A3 is surrender application submitted by complainant to the LIC. Ext. A4 is first premium receipt dated 15/01/2013. Ext. A5 is letter of surrender issued by the opposite party to the complainant dated 31/05/2018. Ext. A6 is copy of application under Right to Information Act Ext. A7 is reply from LIC to the complainant on RTI application dated 30/07/2018. Ext. A8 is copy of appeal under section 19 of RTI Act. Ext. A9 is reply from LIC to complainant dated 01/09/2018. Ext. A10 copy of power of attorney. Ext. A11 is details of endowment policy T 14. Opposite party filed document and they are marked as Ext. B1 to B5. Ext. B1 is copy of policy Ext. B2 is surrender request, Ext, B3 is surrender letter.  Ext. B4 is surrender value quotation. Ext. B5 is surrender value payment voucher.

7.         Heard both sides, perused the documents and notes of argument of the opposite party.

The following points arises for consideration: -

1. Whether the complainant is entitled for the entire remitted amount towards   
13031.  

           2) Whether there is deficiency in service on the part of opposite party?

3. Relief and cost?

8.         Point NO.1

The grievance of the complainant is that he remitted an amount of Rs.56,280/- (Rupees fifty-six thousand two hundred and eighty only) towards the premium for the period of 5 years without any default.  The premium amount for half yearly installment was Rs.4,710/- (Rupees four thousand seven hundred and ten only). He claimed the surrender value after five and half years but insurance company allowed only 41,241/- (Forty-one thousand two hundred and forty-one rupees only) rupees. According to complainant there is a short of Rs.15,040/- (Rupees fifteen-thousand and forty only) in total amount of remittance. The contention of the complainant is that he is entitled for refund of entire remitted amount along with interest.  

9.         The opposite party contended that they had issued surrender value of the policy which the complainant is entitled as per terms of policy.  According to them the sum assured under the policy was Rs.1,00,000/- (rupees one lakh only) and the policy issued for a term of 11 years, the installment premium under the policy was Rs.4,710/- (half yearly) and the complainant remitted the premium up to July 2018. The complainant requested for premature surrender value of policy on 25/05/208 and an amount of Rs.41,241/-(Forty-one thousand two hundred and forty-one rupees only) was paid as surrender value on 31-05-2018 to the complainant. The opposite party calculated the paid value under the policy as Rs.50,000/- (Rupees Fifty thousand only) since the premium is paid for half of the term. The total sum assured under the policy is admittedly 1,00,000/- (One lakh rupees only) rupees. It is submitted by opposite party that bonus acquired on the above sum of Rs.50,000/- is 21,400/- and the total value of the policy as on the date of maturity that is on 15/01/2024 is Rs.71,400/- (50,000 +21400). It is also submitted that policy holder has given request for termination of policy and then the entitlement of the complainant will be 57.76% of the above amount and that is Rs.41,241/-(Forty-one thousand two hundred and forty-one rupees only). The opposite party, according to them assessed surrender value as Rs.41,241/-(Forty-one thousand two hundred and forty-one rupees only)  and it was paid to the complainant as full and final settlement of the policy.

10        The contention of the opposite party is that the prayer of the policy holder seeking refund of premium paid with interest and compensation is baseless and against the insurance law. It is submitted that the premium paid by the insured was to cover risk on his life for the given period and as per the policy there is no provision to refund premium paid. The policy in this complaint was taken for 11 years and the same discontinued before the expiry of term stipulated in the policy.  It is to be noted that the risk stood covered for the period for which premium was paid.  The opposite party quoted the wordings of the National Commission that “the insurer cannot be asked to refund the premium for the period when risk was covered and the insured cannot be given advantage of the risk coverage and also of refund of premium”.

11.       The complainant submitted that he joined in endowment policy T-14 of the LIC. Usually according to him on completion of remittance of premium for a period of 5 years without interruption the policy holder is entitled for the remitted amount along with 10.5% interest.  Complainant submitted that he remitted the amount for the 5 years without interruption and on demand of money he approached the insurance company. But the company paid only after deducting 15,040/- (Fifteen thousand and forty rupees only) rupees from the remitted amount.

12.       The contention of the opposite party is that there was no obligation to refund the premium amounts remitted along with interest at the rate of 10.5% to the policy holder and there was no offer to refund the premium amount with interest to the policy holder. According to them there is no such rule or provision of law revealing the insurance law. It is also submitted that the document Ext. A11 produced by the complainant revealing the ‘dating back interest – 10.5%’ is not correct. Dating back is a facility given to the insured person using which policy holder can ask the insurer to start the policy from an earlier date than the one on which he actually signs the policy.  Hence the contention of the complainant on the basis of document Ext.A11 is baseless. It is also pointed out by the opposite party that the conditions specified in a policy which is contract of insurance statutory in nature as to be strictly construed and in this complaint the opposite party acted as per the terms and conditions of the policy.

13.       In the above fact and circumstances there is no dispute that the opposite party issued an amount to the complainant after deducting sum amount from the total amount paid as premium towards the policy by the complainant. The reason for the same has properly explained by the opposite party that the complainant surrendered the policy as pre mature one. It can also be noted that the premium paid by the insured complainant was to cover risk on his life for the given period. We find that there is merit in the contention of the opposite party. It is not proper to content that a policy holder is entitled for the entire benefit while he surrendering his policy in an earlier period. In this complaint the policy term was 11 years and the complainant surrendered the policy after completing five and half years. The complainant approached opposite party for the surrender value on 25/05/2018 and an admitted amount of 41,241/- (Forty-one thousand two hundred and forty-one rupees only)   rupees was allowed to the complainant on 31/05/2018 itself. So, in this complaint Commission hold that the complainant is not entitled for the entire amount of premium remitted by him and interest thereon.  It is to be noted that the complainant was under the impression that the amount remitted towards the policy will be refunded after completion of five years in toto and interest also will be given to him. It is also to be noted that while subscribing to the policy of the opposite party it is the duty of the opposite party to make understand the complainant about all the terms and conditions of the surrender value as per the policy. Lapse of enlightening the policy holders on consequences of and terms and conditions is an issue to be resolved at the initiative of opposite party at the earliest opportunity. It will cause considerable reduction of complaints on the insurance claims. The complainant in person effectively and properly represented his complaint but at the same time Commission cannot find that complainant is entitled for the benefit as prayed in the complaint.

In the light of above fact and circumstances points 2 and 3 does not arises and we dismiss the complaint.

Dated this 27^th day of December, 2021.