West Bengal

Nadia

CC/296/2019

PRABIR KUMAR DAS - Complainant(s)

Versus

THE BRANCH MANAGER , LICI - Opp.Party(s)

SUBHASHIS RAY

25 Apr 2024

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION
NADIA
170,DON BOSCO ROAD, AUSTIN MEMORIAL BUILDING.
NADIA, KRISHNAGAR
 
Complaint Case No. CC/296/2019
( Date of Filing : 25 Sep 2019 )
 
1. PRABIR KUMAR DAS
S/O- RAMESH CHANDRA DAS RANA PRATAP ROAD, ANANGANAPARA, P.O.- SHAKTINAGAR, P.S.- KOTWALI PIN- 741102,
Nadia
West Bengal
...........Complainant(s)
Versus
1. THE BRANCH MANAGER , LICI
SALT LAKE BRANCH, CF- 163, SECTOR- I, SALT LAKE, KOL- 700 064
Kolkata
West Bengal
2. THE BRANCH MANAGER, LICI,
KRISHNAGAR MAIN BRANCH, D.L.ROY ROAD, P.O.- KRISHNAGAR, P.S.- KOTWALI, PIN- 741101
Nadia
West Bengal
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. HARADHAN MUKHOPADHYAY PRESIDENT
 HON'BLE MR. NIROD BARAN ROY CHOWDHURY MEMBER
 
PRESENT:SUBHASHIS RAY, Advocate for the Complainant 1
 SWAPAN GHOSH, Advocate for the Opp. Party 1
Dated : 25 Apr 2024
Final Order / Judgement

Ld. Advocate(s)

                                    For Complainant: Makbul Rahaman

                                    For OP/OPs :Swapan Ghosh

 

            Date of filing of the case                      :25.09.2019

            Date of Disposal  of the case              :25.04.2024

 

Final Order / Judgment dtd.25.04.2024

The concise fact of the case of the complaint  is that the  complainant insured  LIC policy for Rs.3,39,780/- with a maturity  value  of Rs.11,21,920/- and death benefit  of sum assured  of Rs.10,00,000/- and accidental benefit  is Rs.10,00,000/-. The premium was Rs.48,540/-. The complainant  started  depositing  the said premium. After  depositing   the  first  premium   on  13.07.2011  the  OP  No.2 Branch Manager, LICI issued one  certificate  to the complainant  on 27.10.2011. The complainant continued  that policy  for 7 years  and deposited  total premium of Rs.3,39,780/-. Suddenly,  the complainant  fell ill and lost his vision. On 03.10.2018 the complainant  filed an application  to the Branch Manager, LICI, Krishnagar with prayer for surrendering  the policy before its maturity on 03.10.2018. The LICI refunded  Rs.2,64,000/- without arising  any reason although  the complainant  deposited  Rs.3,39,000/-. Due to his sudden, illness the complainant  was compelled  to surrender  the policy.  The complainant  thus suffered  loss of Rs.75,000/- due to premature  surrendering  of the policy.  Due to getting  less amount  the complainant  sustained mental pain and harassment  for which  is entitled  to get compensation. The cause of action arose  on 27.10.2011 and thereafter,  on 03.10.2018 when the  complainant  surrendered  the policy.  The complainant prayed  for  an award  to get return  of Rs.75,000/- from the OPs and Rs.1,00,000/- towards mental pain and agony and harassment .

          The Opposite parties  contested the case  by filing  W/V wherein  they denied  the major allegations . The OPs challenged  the case as not maintainable. The complainant  is not a consumer under the C.P Act. The positive defence  case of the OPs  is that the complainant surrendered  the policy before  its maturity  and to that effect he violated  the policy terms and conditions . After being satisfied  he received  Rs.2,64,000/- in full and final settlement  of the policy . So, question of loss of Rs.75,000/- does not arise. The OPs claimed  that the case of the  complainant is liable  to be dismissed.

          The conflicting pleadings of the parties and the different  point raised  by the parties  in course of argument  led this Commission  to ascertain  the  following points for proper adjudication  of the case.

 

Points for Determination

Point No.1.

Whether the  case is maintainable in law and its present form.

Point No.2.

Whether the case is barred by any provisions  of law.

Point No.3.

          Whether the complainant is entitled to get the relief  prayed for.

Point No.4.

          To what other relief if any the complainant is entitled to get.

 

Decision with Reasons

Point No.1&2.

Both the points are  involved  with  maintainability  of the case and as such these are taken up together  for the sake of brevity and convenience of discussion.

The  OPs challenged  the case as not maintainable  and barred by limitation. After perusing the  pleadings  of the parties  and the evidence in the case record  it is found  that the complainant surrendered  the insurance  policy before  maturity  on 03.10.2018 and the present case is filed  on 25.09.2019. So, the present case  is filed  within the  statutory period  of limitation , so there is no ground  to hold that the case is barred by limitation . Both the parties reside within the territorial jurisdiction of this Commission.  The amount of relief  claim  also falls  within the  pecuniary jurisdiction  of this Commission, so the present case is not barred by any provisions  of law.

Accordingly,  point 1&2 are answered in favour of the complainant positively.

 

Point No.3&4.

Both the points are   closely  interlinked with each other and as such  these are taken up together for proper adjudication  of the case.

It is the admitted  position  that the complainant surrendered  the policy  before maturity  due to loss  his vision following cerebral attack . The OP  insurance company  refunded  a sum of Rs.2,64,000/- instead of Rs.3,39,000/-, so the complainant alleged  that a sum of Rs.75,000/- has been  paid less to him by the OP company.

The complainant in order to substantiate the case adduced  both  oral evidence in the form of affidavit in chief and documentary evidence. The complainant proved the following  documents:-

Annexure-1 is the LICI Jeevan Saral Policy.

Annexure-2 is the LICI premium receipt in the name of complainant  Prabir Kumar Das.

Annexure-3 is the  disability  certificate  of the complainant  issued by Nadia District  Hospital , Krishnagar.

Annexure-4 is the  complaint lodge by the complainant to the CAB, Nadia dated 27.02.2019.

There is no denial  of the fact that the  complainant  is a policy holder  under the OPs and he submitted the said policy before its  maturity under the  constrained  circumstances of  his felling ill due to cerebral attack in which he lost his vision.

It is also  admitted  fact that the  policy was in force at that time.

Ld. Defence Counsel  argued  that in case of premature surrender  of  a policy that is partial  surrender  the proportionate  amount shall be  deducted. He drew  the attention of this Commission as regards  clause 8 of the said policy . As per clause  8 “partial surrender. On completion  of three or the more years  from the date of commencement  and payment  of premium for at least three  full years  partial surrender  shall be permitted. This will be effected by reducing  the only premium under the policy  and corresponding to  the amount by which the annual premium is  reduced shall  become payable  on a partial  surrender.

Ld. Senior Defence Counsel further argued  that , so there is no illegality  or irregularity  in the less payment  to the complainant. The complainant is a highly educated person. He signed  the policy bond  after knowing  the terms and conditions  of the policy. So, he got the  actual amount what he is entitled  to, that is Rs.2,64,000/-. He also argued that before lock period penal amount was deducted.

The case record shows that the date of proposal of the policy  is 24.10.2011 and date of commencement  is 13.07.2011. The policy  is guided  by table 165 for 25 years . The date of maturity  is 13.07.2036. The date of surrender  is 03.10.2018. The complainant continued  the policy for 7 years, so  due to premature  surrender  the OPs  did not pay  the entire maturity  value of the policy by  deducting  Rs.75,000/-.

It is fact that the complainant  deposited  the total premium  of Rs.3,39,780/-. The OPs could not deny the said fact .

The OPs categorically  stated in cross-examination against the question of the complainant  that the complainant  was paid surrender value  vide voucher no. 422161 dated 25.10.2018 as per calculation table 165 so monthly premium  without rebate  was paid to him. So, it is crystal  clear that there is  no deficiency in service .

Ld. Senior Advocate  for the OPs argued that  the complainant  is estopped  from denying  the terms and conditions  of the policy  as per the rule of estoppels.

Ld. Advocate for the  complainant  counter argued that there is no document  that the reduced calculation  was served  to the complainant and as such he was kept in dark regarding  the calculation  made by the  OPs.

The argument  has reasonable force . There is nothing  within four-corners of the case  record  that  the OPs  ever informed  the complainant about  the actual calculation  of payment of the said sum of Rs.2,64,000/-.

Ld. Defence Counsel  further argued  that the complainant  deliberately  avoided to answer the cross-examination  motivatedly.

The answer given by the complainant  against  the question  put by the OPs  in cross-examination disclose  that  the complainant  answered  all the questions  in stereotype  manner  that he did not read out  properly the question of OPs , so he could not understand  the said questions .

The complainant  could have approached  this Commission  to direct the OPs to file petition in printed  form  instead of hand written  application  of interrogatories  but without doing so , taking  that plea of not understanding  it  cannot  save  him against the specific  allegation of the OPs that the complainant  suppressed  some facts  by no answering  the said question properly.

Ld. Advocate for  the complainant referred  to a decision reported  in WP (C) complaint  No. 14885 of 2018 and 25559 of 2019 of Hon’ble Kerala High Court wherein it was held  that the LIC is bound by the facts and figures of the documents .

The said case law  does not  apply  since in the reported case there was  no premature  surrender  of the policy. That apart the settlement of the dispute in Lok Adalat was upheld by the Hon’ble High Court, Kerala. So, the said case law does not help the complainant.

Thus after assessing  the entire evidence  in the case record  the Commission  is of the view the OPs  failed to inform the  complainant about the method  of calculation  for payment  of Rs.2,64,000/- instead of  his actual claim  of Rs.3,39,000/-. Had the complainant  knew about the  said calculation  then he might have not filed this case. This has caused harassment  for which he is entitled to get compensation.

In the result  the complaint case succeeds  on contest  in part with cost.

Point no.3&4 are answered  in affirmative in favour of the complainant.     

Hence,

                              It is

Ordered

that the complaint case no.CC/296/2019 be and the same is allowed on contest with cost of Rs.5,000/- (Rupees five thousand) against OPs. The complainant  do get an award  for a sum of Rs.30,000/- (Rupees thirty thousand) towards harassment  for mental pain and agony. The Ops are directed to pay Rs.35,000/- (Rupees thirty five thousand) to the complainant  within 30 days  from the date of passing the final order  failing which the entire award money shall carry an interest @ 8% p.a till the date of its realisation.

All Interim Applications  (I.A) stand disposed of  accordingly.

D.A to note in the trial register.

The case is accordingly disposed of.

Let a copy of this final order be supplied to both the parties at free of costs.    

          

Dictated & corrected by me

 

 ............................................

                PRESIDENT

(Shri   HARADHAN MUKHOPADHYAY,)                                 ................ ..........................................

                                                                                                                          PRESIDENT

                                                                                            (Shri   HARADHAN MUKHOPADHYAY,)

 

I  concur,

 ........................................                                                 

          MEMBER                                                                

(NIROD  BARAN   ROY  CHOWDHURY)             

 
 
[HON'BLE MR. HARADHAN MUKHOPADHYAY]
PRESIDENT
 
 
[HON'BLE MR. NIROD BARAN ROY CHOWDHURY]
MEMBER
 

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