IN THE CONSUMER DISPUTES REDRESSAL FORUM, ALAPPUZHA
Wednesday the 31st day of August, 2016
Filed on 10.06.2015
Present
- Smt. Elizabeth George (President)
- Sri. Antony Xavier (Member)
- Smt.Jasmine.D. (Member)
in
CC/No. 173/2015
between
Complainant:- Opposite Parties:-
Sri. Jolly Abraham 1. The Branch Manager
Holy Nest LIC of India, Chengannur Branch
Pandanadu P.O. Chengannur P.O.
Chengannur
(By Adv. K.R. Rajeshkumar) 2. The Divisional Manager
LIC of India, Regional Office
Kottayam
3. The Chief Manager, LIC of India
Kerala Zone, Thiruvananthapuram
(By Adv. P.K. Mathew – for
opposite parties)
O R D E R
SMT. ELIZABETH GEORGE (PRESIDENT)
The case of the complainant is as follows:-
The complainant had taken a policy No.390905117 from the opposite party and paid an amount of Rs.10,234/- towards premium per year. The policy is taken on the life of his daughter Soly Jolly who was a handicapped. The policy became matured in the year 2009, but the first opposite party repudiated the claim stating that the policy amount will be paid on the death of the handicapped person. On 2.4.2015 his daughter died and the complainant approached the opposite party for the claim amount along with the death certificate. The opposite party issued a cheque for Rs. 1,01,140/- only on 14.5.2015. The assured amount of the policy is Rs.1,20,000/-. Even though he remitted Rs.1,23,400/- towards premium amount, he received only Rs.1,01,140/-. Alleging deficiency in service on the part of the opposite parties, the complaint is filed.
2. The version of the opposite parties is as follows:-
The policy is taken on the life of his daughter is wrong and hence denied. The Jeevan Adhar policy is specifically designed by the Corporation for the benefit of the handicapped dependant. The policy is issued not on the life of handicapped dependant, but it is in fact taken out on the life of a person who has a handicapped dependant. The policy provides for payment of 20% of the corpus and utilization of 80% of corpus for annuity only in the case of death of the life assured and not on the death of the handicapped dependant. On receiving the death intimation dated 18.4.2015 from the complainant, the amount was settled as per special provisions as follows:-
Annual Premium paid under the policy = Rs. 10,234/-
(Inclusive of premium for accident benefit)
Less: Annual premium for accident benefit = Rs. 120/-
Net Annual Premium Rs.10,234 – Rs.120 = Rs. 10,114/-
Total No. of years’ premium paid under the policy - 10 years
Total premium refundable Rs.10,114 x 10 = Rs. 1,01,140/-
The complainant cannot make any claim beyond the scope of the terms and conditions of the policy contract, when the terms and conditions of the policy conditions are crystal clear and when no right arises out of the contract or otherwise. The plan is designed in such a way that the policy proceeds will be given only for the benefit of the handicapped dependant and for nothing else. So there is no provision for loan, surrender, assignment, for Jeevan Adhar policy. The complainant is not entitled to get any relief as prayed for.
3. The complainant was examined as PW1. The documents produced which marked as Exts.A1 to A4. Opposite party produced one document which marked as Ext.B1.
4. The points came up for considerations are:-
1) Whether there is any deficiency in service on the part of the opposite parties?
2) If so the reliefs and costs?
5. It is an admitted fact that the opposite party has issued a policy No.390905117 with the date of commencement is 28.3.1999 in favor of the complainant. The policy certificate produced by the opposite party is marked as Ext.B1. On verifying the policy certificate, it is seen that the term of the policy for 10 years and the last date of premium payment is 28.3.2008. The complainant remitted the premium amount of Rs.10,234/- per year ad it became matured o 2009. According to the complainant after the policy became matured he claimed the policy amount and it was repudiated by stating that he can claim the amount only after the death of the handicapped. The handicapped person died on 2.4.2015. Thereafter the complainant approached the opposite party for getting the policy amount, but only on 14.5.2015, he has received a cheque for an amount of Rs.1,01,140/-. The allegation of the complainant is that even though the policy matured in the year 2009 he has received only the amount remitted without interest or any additions. The contention of the opposite party is that the plan provides for annuity for the benefit with the handicapped dependant on the death of the life assured. According to the opposite party, as per the special provisions of the policy, “In case the handicapped dependant predeceases the life assured during the term of the policy, the contract ceases and the life assured will have the option either to keep the policy in force for reduced sum assured or to receive refund of premiums paid excluding extra premium and accident premium if any.” They further stated that on receiving the intimation dated 18.4.2015 ad the amount was settled as per the special provisions of the policy, the amount so arrived is Rs.1,01,140/-. In this case it is an admitted fact that complainant remitted the premium for a period of 10 years and as per the policy certificate issued to the complainant it became matured in the year 2009. The handicapped dependant died in the year 2015. As per the policy, if the handicapped dependant predeceases the life assured during the term of the policy. The contract ceases and the life assured can receive refund of the premium paid excluding extra premium and accident premium if any. In the instant case, the complainant approached the opposite party not during the term of the policy, but 6 years after the period of maturity of the policy. On verifying the key features of LIC Jeevan Adhar Plan it is stated that, “There are guaranteed additions if at least 10 years premium have been paid.” In this case, opposite party refund the premium amount only after deducting the annual premium for accident benefit without any guaranteed additions. The failure on the part of the opposite party in refunding the amount without guaranteed additions amounts to deficiency in service.
In the result complaint is allowed partly. The opposite parties are directed to pay the interest rate of 8% for the amount of Rs.1,01,140/- from 28.3.2009 to 18.4.2015 to the complainant. The opposite parties are further directed to pay Rs.1000/- (Rupees one thousand only) towards costs of this proceedings to the complainant. The order shall be complied within one month from the date of receipt of this order.
Dictated to the Confidential Assistant transcribed by her corrected by me and pronounced in the Open Forum in this the 31st day of August, 2016.
Sd/- Smt. Elizabeth George (President):
Sd/- Sri. Antony Xavier (Member):
Sd/- Smt. Jasmine D (Member):
Appendix:
Evidence of the complainant:-
PW1 - Jolly Abraham (Witness)
Ext. A1 - Copy of the policy
Ext.A2 - Copy of the death certificate
Ext.A3 - Copy of the certificate of Medical Board
Ext.A4 - Copy of the identity card
Evidence of the opposite parties:-
Ext.B1 - Original Policy
// True Copy //
By Order
Senior Superintendent
To
Complainant/Opposite party/S.F.
Typed by:- pr/-
Compared by:-
