:COMMON ORDER:
Mr K B SANGANNANAVAR, JUDICIAL MEMBER
1. These Appeals are filed under Section 15 of Consumer Protection Act, 1986, aggrieved by the order dated 27.02.2016, passed by District Consumer Disputes Redressal Forum, Karwar (Uttara Kannada) District in Consumer Complaint Nos.144/2014, 48/2015, 49/2015 and 65/2015 (for short District Forum and parties as arrayed in Consumer Complaints).
2. The facts in brief to decide in this common order would be:
Though higher amount of maturity value mentioned in the policy, lesser amount is paid on maturity to the complainants. In respect of CC No.144/2014, maturity sum assured in the policy is Rs.1 lakh, whereas Rs.29,844/- is paid, Rs.5,969/- is paid towards loyalty addition, in
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respect of CC 48/2015 maturity sum assured in the policy is Rs.1,25,000/-, whereas Rs.66,215 is paid, Rs.15,280.50 is paid towards loyalty addition. In CC 64/2015, the maturity sum assured in the policy is Rs.1 lakh, while amount paid is Rs.41,393/-. These complainants having been received the amount offered by OP, raised consumer complaints before the DF, under section 12 of CP Act 1986 for payment of maturity amount in respect of Jeevan Saral policy.
3. According to complainants, in the order of complaints mentioned above, they are still to be paid Rs.1 lakh, Rs. 74,065, Rs.70,105/- Rs.1 lakhs respectively. These complaints were contested by the OPs and District Forum held enquiry, by receiving evidence of respective parties including documents. After conclusion of the enquiries directed the OPs to pay Rs.1 lakh in CC No.144/2014, Rs.74,065/- in respect of policy No.631532440 and another sum of Rs.74,065/- in respect of policy No.631532439 in CC No.48/2015, Rs.70,105/- in CC No.49/2015 and Rs.1 lakh in CC No.64/2015 with interest @ 7% per annum from date of complaint till date of deposits and till realisation within one month and these orders are now impugned by the OP on the grounds that impugned order passed by the District Forum is illegal, unlawful and opposed to the well established principles of law. The District Forum has erred in not considering the fact as the documents produced by the Ops are not been controverted by the complainants. The District Forum has not at all applied its mind about the policy terms and unique features of the Jeevan Saral Policy and has passed a blanket order without assigning any reasons for having arrived at the conclusion burdening the OP. When an educated man signed the proposal form it is deemed acceptance. The OP being a Private Sector never resort to such misrepresentation and moreover, the concerned plan has been recognized and awarded Golden Peacock Award for its unique features and brought laurels to the Corporation. The amount so collected from the policy holders are held in its capacity
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as trustees. The money held by OP is a public money, which will be returned to the family members of the insured in case of contingencies. The complainants are not layman and they are working in State Government Organisations. The complainants having been misguided raised consumer complaints after receipt of maturity value as per the terms and conditions of respective policies and impugned order passed is liable to be set aside in exercise of appeal powers vested in this Commission.
4. The Commission heard learned counsels on record for the parties to these Appeals and we have gone through the impugned order passed by District Forum along with LCRs.
5. Now, we have to examine whether impugned order passed by the District Forum in the respective complaints is contrary to the facts and law for the grounds set out in the Appeal ?
6. At the very outset, it would be appropriate to make mention as to the policy type, plan and term. The policy is named 'Jeevan Saral Plan- 165'. In the first complaint, term 10 years, the policy commenced from w.e.f 27.01.2004 death sum assured is Rs.1,27,000/-, maturity sum assured Rs.50,935/-, the date of maturity 27.09.2014 and the instalment premium is Rs.510/- per month, last premium paid in the month of August 2014/ The amount settled for Rs.66,215/- in this policy, whereas the complainant raised complaint for additional liability at Rs.74,065/-
7. In respect of second complaint, it was commenced on 28.02.2004, death sum assured Rs.1 lakh, maturity sum assured Rs.23,876/-, date of maturity on 28.02.2014, instalment premium Rs.408/- or Rs.2,226/- yearly, last premium paid in the month of August 2013 and the amount paid is Rs.29,845/-. The complainant still claims Rs.1 lakh.
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8. In third complaint policy commenced on 28.09.2004, death sum assured Rs.1,25,000/-, maturity sum assured Rs.54,895/-, the date of maturity on 28.09.2014, instalment premium Rs.23,033/- half yearly last premium paid in the month of 2014. The amount settled for Rs.71,364/- and he is still 6 additional premium to be paid and the liability fixed at Rs.70,105/-.
9. In fourth complaint policy commenced on 28.08.2004, death sum assured Rs.1 lakh, maturity sum assured Rs.42,210/-, the date of maturity date of maturity on 28.08.2014 instalment premium Rs.408 per month last premium paid in the month of May, 2014 and still 6 additional premium to be paid and the liability fixed at Rs.1 lakh.
10. In so far as all the 4 policies are concerned, policy, type, plan and terms are one and the same and they are styled 'Jeevan Saral Plan- 165', the term is for 10 years.
11. In the above circumstances, this Commission has to examine whether they are entitled for additional liability of Rs.74,065/-, Rs.1 lakh, Rs.75,105/- and Rs.1 lakh respectively as claimed and as ordered in the impugned orders. The District Forum recorded reasons fixing additional liability on OP and ordered in favour of complainants. The DF below ordered on the basis of death sum assured which is admittedly Rs.1,25,000/-, Rs.1 lakh, Rs.1,25,000/- and Rs.1 lakh respectively. In our view, this is the crux of the dispute between the parties to the complaints, the facts remain that the complainants are alive even as on the date of maturity and the OP settled their claim as stated above and could not settle pursuant to the amount mentioned in respect of death sum assured.
12. According to OP, in respect of CC No.144/2014 in consideration of the age of the policy holders the policy term is 10 years and Rs.100/- premium is paid, the maturity sum assured. The entry should be 56 years as per table is Rs.5,969/-, premium maturity sum 400/- X
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5,969/-/100 which would be worked at Rs.23,876/-. Further added loyalty at Rs.450/- per Rs.1000/-, multiple by maturity sum assured namely 250 X 23,876/- / 1000/-, which would be Rs.5,969/-. Therefore, total amount payable to Sri. Beeranna D Patagar, the policy holder would be Rs.29,845/- which is already settled.
13. In respect of CC No.48/2015, policy holder Sri Vishwanath Ishwar Hegde in so far as two policies, the premium would be Rs.500/- each and the maturity sum assured would be Rs.64,174/- and Rs.65,194/- respectively as he was 42 years at the entry, the terms policy is 10 years, as per chart the maturity sum assured Rs.100/- per monthly premium, Rs.10,187/- policy holder was paid Rs.500/- per month. Therefore, the maturity sum assured will be Rs.10,187/- X 500/100, which would be Rs.50,935/-. In this case, death benefit sum assured is Rs.500/- basic premium X 250 time, which would be Rs.1,25,000/- which was mentioned in the schedule of the policy bond along with this OP are refunding along with premium paid excluding first year and other extra premium paid, the amount of sum assured claimed by the complainant as printed in the schedule is the death sum assured payable on death during the term of the policy, if the policy is in force as on the date of death. In the policy, OP has clearly written that in the event of the life assured surviving the date of maturity a sum equal to the maturity sum assured in force after partial surrender if any along with the corresponding loyalty addition if any shall be payable. As per this, they have paid maturity sum assured at Rs.50,935/- + loyalty addition of Rs.15,280.50. Thus totally Rs.66,200/- was paid on each of the policies. According to OP, policy holder has mistaken the death sum assured for maturity sum assured has some considerable force and this was not considered by the District Forum which has to be held error committed in perceiving the facts placed on record by the parties.
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14. The OP has honoured the claim payment as per eligible benefits considering the term and premium paid applies to LIC Jeevan Saral Plan 125 with loyalty addition.
15. In respect of CC No.49/2015 the life assured namely Smt. Nirmala Vishnu Hegde. This case is almost similar to the case of Sri Vishwanath Ishwar Hegde stated above.
16. In respect of CC No.64/2015, the life assured Sri. Ananth Narasimha Kamath, as per policy condition maturity sum assured for policy term 10 and age of the life assured at entry 50 is Rs.8,442/- per monthly premium of Rs.100/-. Hence, monthly premium paid Rs.408/- and maturity sum assured is Rs.42,210/- is Rs.400 X 8442/100 which would be at Rs.33,768/-, to which loyalty addition thereon for Rs.250/- per Rs.1000/- sum assured is 33768/ X /250/1000 which would be at Rs.8,442/-, the total payable would be maturity sum assured + loyalty addition is equal to 33,768/- + Rs.8,442 equal to Rs.42,210/- out of this, unpaid premium of June 2014 and July 2014 and Re.1/- towards revenue stamp and totally Rs.870/- is recovered and Rs.41,393/- net amount payable would paid to the policy holder is paid.
17. In view of above particulars, found on record, if we could examine maturity benefit for the monthly premium paid in respect of LIC Jeevan Saral Plan-165 with loyalty addition scheme payment 10 years through monthly RD maturing benefit after 10 years calculated by OP/LIC could be said incorrect. In this regard, District Forum failed to examine the object of the scheme and its benefit, thereby arrived at a wrong conclusion, only on the basis of maturity sum assured death benefit sum assured under main plan accident benefit sum assured term rider sum assured Column wherein mentioned Rs.1,25,000/- in two policies, Rs.1 lakh each in remaining policies of these cases.
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18. It is found from the enquiry file of the District Forum, chart showing maturity sum assured per Rs.100/- monthly premium was not at all examined and in our view, the decision of Hon'ble NCDRC in Revision Petition No.3833/2011 in the case of Virupakxappa Vs LIC of India wherein it is held that A case of typographical error providing lesser policy term policy holder expecting annuity payments as per incorrect date of maturity-aggrieved by receipt of further premium demand invoice -deficiency of service alleged applied by District Forum could not be applied to the facts of these Appeals, since they are governed by plan No.165 with loyalty addition and as per the chart submitted by OP . It is in this view of the matter impugned order passed by the District Forum has to be held contrary to the facts and law are liable to be set aside.
19. Accordingly, all these Appeals filed under Section 15 of CP Act 1986 are hereby allowed. Consequently, impugned order dated 27.02.2016 passed in CC No.144/2014, CC Nos.48/2015, 49/2015 and 64/2015 respectively are hereby set aside and dismissed the compliant Nos.144/2014, 48/2015, 49/2015 and 64/2015 with no order as to costs.
20. Amount in deposit is directed to be transfer to the District Forum for needful.
21. Return the LCRs forthwith.
22. Keep the original of this Order in Appeal No.920/2016 and copy thereof in rest of the Appeals to complete the records.
23. Send a copy of this Order to the District Commission and the parties concerned, immediately.
Lady Member Judicial Member President *s