SRI JIBAN KRUSHNA BEHERA, MEMBER (I/C)
The complainant has filed this complaint petition, U/s 35 of the Consumer Protection Act, 2019, (here-in-after called as the “Act”) alleging deficiency-in-service against the Ops with a prayer to return the amount of Rs.1,03,652/- which has been drawn by the Ops from his Savings Account with interest, to declare the said drawal by the Ops as wrong & illegal along with compensation and cost of the litigation.
2. The case of the complainant, in short, is that he is a customer under SBI Life Insurance who had purchased one policy from the Ops vide policy No.35012269405 on 12.7.2011 with payment mode for 10 years for a sum assured Rs.2,00,000/- and that the instalment was last due on 26.7.2020. The Ops have deducted Rs.3,03,652/- illegally and unauthorizedly instead of sum assured of Rs.2,00,000/- from his S.B. Account No.11157582624 without any just cause which casts a deficiency in service on their part and for the above acts of the Ops, the complainant, being a senior citizen, suffered mental agony. Since the date of maturity, the complainant approaching from pillar to post, but the Ops did not pay any heed to it. For the above latches of the Ops, the complainant served legal notice on 20.12.2022 against the Ops with a request to refund the excess amount of Rs.1,03,652/- with interest, but till today, they did not pay any amount. Hence, finding no other way out, the complainant was constrained to file the case with the reliefs stated in the complaint petition.
That to substantiate his case, the complainant relied upon the following documents, which are placed in the record-
- Photocopy of policy bond.
- Photocopy of message of Ops.
- Photocopy of letter sent to Insurance Ombudsman, Bhubaneswar.
- Photocopy of reply of Ombudsman, Bhubaneswar.
- Photocopy of letter sent to OP No.2.
- Photocopy of reply of OP No.2.
- Photocopy of maturity payment letter issued by Ops in favour of complainant.
- Photocopy of SB Account in the name of the complainant.
- Photocopy of legal notice.
3. That in the present case, on receipt of notice, Ops have made their appearance and filed their respective written versions.
4. In their written version, OP No.1 & 2 have stated, inter alia, that OP No.3 is not their employee, rather, he is an employee of State Bank of India through whom the policy in question was sourced. These Ops have stated that they have paid maturity amount of Rs.2,88,020/- to the account of the complainant on 27.7.2021 which was also intimated to him vide letter dated 28.7.2017. That apart, the complainant is entitled to get basic sum assured on his attaining age of 100 years from the maturity value paid. It is clear that the insurance cover continues till he attains 100 years of age and the present maturity amount paid alone cannot be viewed as the benefit under the policy. In case the complainant had disagreed with the terms and conditions of the policy, he had option to cancel the policy, but he had continued with the policy and paid all the annual premiums for four years and now raised allegations regarding terms and conditions of the policy after maturity of the policy in question. In the above premises, these OP No.1 & 2 have prayed to dismiss the case. In support of their case, not a single document has been filed on behalf of OP No.1 & 2.
5. OP No.3, in his written version, has stated that the complainant has involved him in the present case with mollified intention with a view to harass him as because he has no role in the transaction between him and OP No.1 & 2. Further, the complainant has not raised any specific allegation against him. Hence, it is prayed by OP No.3 that the case may be dismissed.
6. In view of the above averments of parties, the points for determination in this case are as follows:-
(i) Whether the complainant is a consumer or not?
(ii) Whether the complainant has cause of action to file this case?
(iii) Whether this consumer case is maintainable?
(iv) Whether there is any deficiency in service on the part of the OPs?
(v) Whether the complainant is entitled to get the relief, as sought for?
(vi) To what other relief(s), the complainant is entitled to?
F I N D I N G S
7. To arrive at a definite conclusion, it is to be decided as to whether the complainant is a consumer or not, he has a cause of action to file the case and whether the case is maintainable. In this connection, Annexure-1, the policy bond in question dated 28.7.2011, Annexure-2, the first premium deposit slip dated 26.7.2011, go to show that the complainant had purchased the above policy bond from the Ops. From Annexure-6, it is found that the Ops will pay the basic sum assured along with vested reversionary bonus and terminal bonus at the endowment maturity date along with an additional amount equal to the basic sum assured on endowment assurance with whose life maturity date. With the above terms and conditions, the Ops paid Rs.2,88,020/- in the account of the complainant on 28.7.2022. It is also found in the said document that if the death occurs before the completion of endowment term then the Ops will pay basic sum assured plus vested simple reversionary bonus along with terminal bonus and if the death occurs after the completion of endowment term but prior to endowment assurance with whole life maturity date then the Ops will pay basic sum assured. Annexure-7 shows that the Ops paid the gross maturity amount of Rs.2,00,000/-, vested bonus of Rs.65,200/- and terminal bonus of Rs.22,820/-, in total Rs.2,88,020/- in the SB Account of the complainant. The complainant has not filed the details of the policy bond to show about the date of maturity of the policy in question. On the other hand, it is the version of the Ops that the date of maturity of the policy was 26.7.2021 and they paid the maturity value on 27.7.2021. Further, the complainant has not filed any document to show with regard to the fact that he had deposited the premium of the policy till its maturity. On the other hand, the Ops have claimed that the alleged policy was issued in favour of the complainant with yearly premium payment for a term of 10 years and the complainant had paid 10 yearly premiums in favour of his policy. So, the question of deducting more premium than the sum assured does not arise. It is further stated that apart from the maturity value already paid, the complainant will be entitled for the basic sum assured of Rs.2,00,000/- till the complainant-life assured completes 100 years of age. From the above, it is clear that the insurance in question continues till the complainant attains his 100 years of age. As per the terms and condition of the policy, the complainant had opted for whole life option under the policy. So, the complainant is entitled to get basic sum assured on attaining his 100 years age. In case the complainant would not have agreed with the terms and conditions of the policy, he should have cancelled the policy with the terms and conditions of the policy under the free look option, but he did not do so, rather, he continued with the policy and paid all the premiums for ten years. From the Annexure-1, in the caption “Free Look Option”, it has been clearly mentioned that in case the complainant is not satisfied with the terms and conditions as mentioned in the policy document, he has the option to return the policy to the Ops and cancel the cover within 15 days of receipt of the policy document. To clarify the terms and conditions of the policy, if the death occur before the completion of endowment term then the Ops will pay basic sum assured, reversionary bonus and terminal bonus and further if the death occurs after the completion of endowment term but prior to endowment assurance with whole life maturity date then the Ops will pay basic sum assured. According to Ops, endowment term means attaining of 100 years age by the life assured. But, here in the present case, the complainant is not yet attained his age of 100 years nor does his death occurs before or after the completion of endowment term. He is still alive till date. Therefore, in view of the terms and conditions of the policy in question, the complainant-life assured is only entitled to basic sum assured, vested bonus and terminal bonus, which the complainant has already received from the Ops. Moreover, the complainant has not produced any paper to show that the Ops have drawn excess amount of Rs.1,03,652/- from his SB Account. Therefore, no deficiency in service is found to have been committed by the Ops in rendering their service towards the complainant. Consequently, this Commission is of the considered opinion that the complainant is not a consumer, he has no cause of action to file the present case and the case is not maintainable. Hence, the complainant is not entitled to get any relief what-so-ever in this case.
Hence, it is ordered –
O R D E R
The case of the complainant be and the same is dismissed on contest against the Ops. In the peculiar facts and circumstances of the case, no order as to costs.
Pronounced in the open court of this Commission, this the 10th day of June, 2024 under signature & seal of the Commission.
