AI Structured Summary
Not yet generated for this judgment
Judgment
V.K.Jain, J.
Notice of the revision petition has been served upon the respondent/complainant. No one however, is present for him despite service having effected on 15.06.18. I have therefore, heard the learned counsel for the petitioner. I have also considered the written arguments which the complainant/respondent has sent to this Commission by post.
The respondent/complainant had obtained an insurance policy from the petitioner corporation under its 15 year Jeevan Sanchay Plan. In terms of the said policy, the life of the complainant was assured to the extent of Rs.1,00,000/-. The term of the policy was 15 years and an yearly premium of Rs.10,007/- was payable by the complainant. During the duration of the policy, two payments of Rs.25,000/- each were made to the complaint. On maturity of the policy on 13.07.2016, a total sum of Rs.1,58,000/- was paid to him comprising Rs.1,08,000/- towards bonus/benefit and Rs.50,000/- towards the remaining sum assured, 50% of the sum assured having already been paid to him in two installments, one after 5 years and the other after 10 years of the policy. The complainant thereafter, approached the concerned District Forum by way of a consumer complaint claiming that he was entitled to a sum assured of Rs.1,00,000/- in addition to two installments of Rs.25,000/- each which had already been paid to him and bonus amount of Rs.1,08,000/-. Thus, according to him, he was entitled to a total sum of Rs.2,58,000/- whereas he had been paid only Rs.2,08,000/-. This was also his grievance that despite the sum assured being only Rs.1,00,000/-, the petitioner had taken Rs.1,50,000/- as the premium from him.
The complaint was resisted by the petitioner Corporation which inter-alia stated in its reply that the amount payable to the complainant had been duly paid to him and the premium paid by him was as per the terms of the policy.
The District Forum having dismissed the complaint, the complainant/respondent approached the concerned State Commission by way of an appeal. Vide impugned order dated 03.10.2017, the State Commission allowed the appeal and directed the petitioner Corporation to pay a sum of Rs.50,000/- to the complainant alongwith interest and compensation quantified at Rs.10,000/-. Being aggrieved from the order passed by the State Commission, the petitioner Corporation is before this Commission by way of this revision petition.
The insurance policy which the complainant had taken from the petitioner Corporation, to the extent it is relevant, reads as under:
Policy No. and Date of Commencement
Table and Term
Sum Assured Rs.
Due Date and Mode of Payment
Installment Premium Payable Rs.
470913415
13.07.2001
124-15
1,00,000
13th YRLY
10007.00
Payments to be made and the events on the happening of which it is to be made
BENEFITS
(a) Death Benefits
(i) On death of the Life Assured during the term of the policy, the basic sum assured is payable irrespective of survival already paid.
(ii) In addition to the basic sum assured Guaranteed and Loyalty additions, if any, as per provisions overleaf are also payable.
(b) Survival Benefits payable are given below for Rs.1,000/- Sum Assured
Duration Policy Terms & Table Nos.
12 15 20 25
(T-123) (T-124) (T-125) (T-126)
4 200 - - -
5 - 250 200 150
8 200 - - -
10 - 250 200 150
12 300 - - -
15 - 500 200 150
Special Provisions :
Guaranteed Additions: Provided the policy is in full force, a guaranteed addition of Rs.70 per thousand Sum Assured will be made to the sum assured at the end of each policy Anniversary and will be payable either on the stipulated date or Maturity or on earlier death of the Life Insured.
Loyalty addition: If after at least 5 full years premiums have been paid in respect of this policy on the Life assured surviving the stipulated date of maturity or on his earlier death and provided the policy is in full force on the date of maturity or on the date of death, then depending upon the Corporation's experience with regard to mortality, interest rate and expenses in respect of its Life Insurance business and based on such factor as the Sum assured and number of premiums paid under the Policy, the age of the Life Assured and such other considerations as may be relevant for the purpose, this policy may be eligible for payment of loyalty addition on such rate and such terms as declared by the Corporation.
Provided that different rates of Loyalty addition may be declared varying with the number of years' premiums paid, age at Entry of Sum Assured.
Provide further that no Loyalty addition will be payable in the event of policy being surrendered or discontinued or being paid-up before the date of maturity or date of death of Life Assured.
It is evident from the above referred terms of the insurance policy taken by the complainant that though the sum assured was Rs.1,00,000/-, he was required to pay annual premium of Rs.10,007/-. The premium paid by him, being in consonance of the terms of the policy, it cannot be said that any excess amount was recovered from him by the Corporation.
The next question which arises for consideration is as to whether the complainant was entitled to the sum assured of Rs.1,00,000/- over and above the first installment of Rs.25,000/- payable to him after 5 years and the second installment of Rs.25,000/- payable to him after 10 years. On a perusal of the terms of the policy, I find that the entire sum assured was payable to him in three installments, the first installment being payable after 5 years, the second installment being payable after 10 years and the third installment being payable after 15 years on maturity of the policy. Admittedly, the first two installments were paid to him before the policy matured. It is also not in dispute that the third installment of Rs.50,000/- was paid to him when the policy matured after 15 years. It is also not in dispute that bonus comprising of loyalty additions amounting to Rs.1,08,000/- was also paid to him on maturity of the policy.
Therefore, the entire amount payable to him under the terms of the policy was duly paid. The terms of the policy did not envisage payment of the entire sum assured i.e. Rs.1,00,000/- at the time of maturity of the policy. The amount payable to him on maturity of the policy was only Rs.50,000/-, the balance sum assured having already been paid to him in two installments, one at the end of 5 years and the other at the end of 10 years. The view taken by the State Commission is therefore, is not in consonance of the terms of the insurance policy and therefore, cannot be sustained.
For the reasons stated hereinabove, the impugned order is set aside and the complaint is consequently dismissed with no order as to costs.