BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MYSORE-570023

CONSUMER COMPLAINT NO.7/2019

DATED ON THIS THE 5^th September, 2019

      Present:   1) Sri. C.V.Maragoor

B.Com., L.L.M., - PRESIDENT   

                     2) Sri. Devakumar.M.C.           

                                        B.E., LLB., PGDCLP   - MEMBER

Sri C.V.MARAGOOR,

President

1.       This complaint is filed by S.Prakash S/o late K.S.Mani resident of Mysuru to direct the opposite party No.1 the Branch Manager, LIC of India, Mysuru to pay a sum of Rs.2,50,000/- with interest at 18% p.a. from the date of maturity i.e. 13.10.2018 till payment of assured insurance amount, to pay Rs.2,00,000/- towards mental and physical torture suffered by the complainant at the hands of opposite parties and issue mandatory order against opposite party No.2 agent not to give false assurance at the time of introducing policy conditions to the public in future.
2.      It is the case of complainant that he had taken new Bheema Gold Insurance Policy bond bearing No.721968350 and its date of commencement was on 13.10.2006 and maturity date as on 13.10.2018. After maturity period, the complainant has approached the opposite party No.1 to disburse the maturity amount of Rs.2,50,000/- but the opposite party No.1 and its staff have behaved arrogantly and forced the complainant to sign for the statement of claim for a sum of Rs.1,85,464/- instead of Rs.2,50,000/-. Then the complainant has written a grievance letter to the insurance Ombudsman, Hyderabad on 18.07.2018 and in turn they informed the complainant to approach Mysuru branch.  The opposite party No.1 has failed to settle the insurance claim hence, this complaint for deficiency in service.
3.       The opposite party No.1 appeared through its learned counsel and filed written version admitting the fact that the complainant had taken new Bheema Gold Insurance Policy bond for a sum assured Rs.2,50,000/- commenced from 13.10.2006 and the date of maturity was on 13.10.2018. It is the case of opposite party No.1 that before the date of maturity this opposite party has sent letter to the complainant on 11.07.2018 by speed post and remainder letter dated 24.09.2018 to submit voucher for payment of the policy amount.  As per the policy terms sum assured Rs.2,50,000/- payable only in case of death of the life assured provided the policy is in force.  The complainant has received survival benefits in the year 2010 and 2014 a sum of Rs.37,500/- in each year and after deducting total survival benefits of Rs.75,000/- + loyalty addition maturity value payable on maturity to the complainant is Rs.1,85,464/-.  The opposite party No.1 denied that the Branch Manager and their staff have mis-behaved with the complainant when he asked for claim amount of Rs.2,50,000/-.  The complainant has not highlighted with regard to receipt of survival benefits of Rs.75,000/-.  Though the opposite party No.1 was ready and willing to pay the maturity amount well in advance by sending letter, the complainant has refused to receive it by submitting voucher as such there is no deficiency in service on the part of opposite party No.1.  On the above grounds, the opposite party No.1 asked to dismiss the complaint with exemplary cost.
4.      The opposite party No.2 agent filed separate version supporting the contentions of opposite party No.1.
5.      The complainant filed his affidavit in lieu of evidence and produced nine documents in support of his case.  That one P.Rajashekara, Administrative Officer working in Divisional Office, Mysuru filed affidavit evidence and produced four documents. 
6.       We have heard the oral arguments advanced by the learned counsel for the complainant and opposite parties in addition to written brief submitted by them and points that would arise for determination are as under:-  

1. Whether the complainant proves that the act of opposite party to submit voucher for Rs.1,85,464/- amounts to deficiency in service?
2.  Is complainant entitled to the reliefs sought for?

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

Point No.1 :- In the negative;

Point No.2 :- In the negative for the below;

:: R E A S O N S ::

8.         Point Nos.1 and 2:- The learned counsel for the complainant submits that the terms and conditions of policy are not legible as such furnishing inlegible terms and conditions of policy amounts to unfair trade practice.  The learned counsel further submitted that the complainant has paid regular premium and the opposite party No.1 has to pay a sum of Rs.2,50,000/- on the date of maturity i.e. on 13.10.2018, but it came forward to pay Rs.1,85,464/- as such the act of opposite party amounts to deficiency in service.  As against this, the learned counsel for the opposite party No.1 submits that the complainant has taken twice survival benefits of Rs.37,500/- each and receiving survival benefits by the complainant is not highlighted in the complaint.  The assured – complainant shall bound by the terms and conditions of the policy.  The complainant has produced the copy of policy bond intimation sent by the opposite party No.1 on 07.02.2018 to submit voucher to receive Rs.1,85,464/- since the maturity period as on 13.10.2018.  The complainant has produced letters issued to the opposite party No.1 and Ombudsman.
9.         The opposite party No.1 has not disputed the complainant taken new Bheema Gold Insurance Policy for Rs.2,50,000/- in the year 2006 for a period of 12 years.  It is not further disputed by the opposite party No.1 that the complainant has paid regular premiums for a period of 12 years.  The opposite party No.1 has produced proposal form along with blank format and original policy bond and discharge voucher sent to the complainant.  According to the terms and conditions of LIC’s New Bheema Gold Insurance expiry of policy term, total amount of premium paid + loyalty addition if any less the amount of survival benefits paid earlier payable after the expiry of the policy term.  It is further stated under death benefit that payable in case of death of the life assured during the policy term provided the life cover is in force for the full sum assured.  On perusal of the terms and conditions of Bheema Gold Insurance Policy only in case of death of assured the sum assured is Rs.2,50,000/- is payable to the survivors or legal heirs of the assured.
10.       The learned counsel for the opposite party No.1 relied upon the case of Ekgot Singh S/o Sh Thrilok Singh V/s E.Meditek Solution Limited and LIC of India, Chandigarh Revision Petition NO.4779/2012 dated 26.02.2016 rendered by the Hon’ble National Commission, New Delhi.  In the above case, it is held that the parties were bound by the terms and conditions of the policy.  It is further held that the complainant got all the documents and policy including conditions and privileges, parties were bound by the terms and conditions of the policy.  Further, the opposite party No.1 brought to the Forum Notice the case of Oriental Insurance Company Limited Vs Sony Cheriyan AIR 1999 Supreme Court 3252.  Wherein Apex Court held that the insurance policy between insurer and the insured represents a contract between the parties since the insurer undertook to complete the loss suffered by the insured on account of risks covered by the insurance policy, the terms of the agreement have to be strictly construed the determine and extent of liability of the insurers.  The insured cannot claim anything more than what is covered by insurance policy. That being so, the insured has also to act strictly in accordance with the statutory limitations or terms of the policy expressively set out therein.
11.       The complainant himself produced Sr.No.1 LIC New Bheema Gold Policy issued to him in the year 2006. It is mentioned with regard to payment of survival benefits once in four years from the date of commencement of policy.  The complainant has not denied payment of survival benefits of Rs.37,500/- for the first time in 2010 and second time in 2014.  The opposite party No.1 after deducting the survival benefits already received by the complainant has asked the complainant to submit voucher for Rs.1,85,464/-.  The complainant is not entitled for sum assured amount of Rs.2,50,000/- i.e. payable only on the death of insured as per the terms and conditions of the policy.  That apart already the complainant has received Rs.75,000/- survival benefits twice in terms of the policy conditions.  Therefore, the complainant is not entitled for Rs.2,50,000/- as such there is no deficiency in service on the part of opposite party No.1 as it has agreed to comply with the terms and conditions of new Bheema Gold Insurance Policy taken by the complainant.
12.       The learned counsel for the complainant during the course of arguments has come up with a new allegation that the terms and conditions printed on the policy bond are not legible as such it amounts to unfair trade practice on the part of opposite party No.1.  Firstly the complainant has not taken such a stand in the complaint, secondly if the terms and conditions were not legible the complainant would have asked the opposite party to deliver legible copy.  Therefore, there is no force in the contention of learned counsel for the complainant that the terms and conditions of policy bond are not legible amounts to unfair trade practice.  In view of the above discussion, the complaint deserves to be dismissed.  Accordingly,  we proceed to pass the following

:: ORDER ::

1. The complaint filed by S.Prakash is dismissed without cost.

2. Furnish the copy of order to the complainant and opposite parties at free of cost.

(Dictated to the Stenographer transcribed, typed by her, transcript corrected by us and then pronounced in open court on this the 5^th September, 2019)