DISTRICT CONSUMER DISPUTES REDRESSAL FORUM: KALAHANDI
C.C. No.17of 2008
Smt.Abantee Kumari Sahu,
W/o Sri Debendra Sahu,
At/po Paramandapur(Near Gudakhu Factory)
P.S. Bhawanipatna,Dist.Kalahandi.
…..Complainant
Versus
1. The Bajaj Allianz Life Insurance aCompany Latd.,
4th and 5th Floor,Ashoka Plaza,Corporate Software Park,
Serve No.32/3,Nagar Road,Viman Nagar,Pune-411014,.
2. Area Manager,
The Bajaj Allianz Life Insurance Company Ltd.,
Opposite Andhra Bank, New Colony,Po/Ps /Dist.Rayagada-765001(Orissa)
3. The Branch Manager,
The Bajaj Allianz Life Insurance Company Ltd.,16&B,
Forest Park,Shishu Bhawan Square,Bhubaneswar-751009(Orissa)
…..Opp.Parties
ORDER
Shri A.K.Purohit,President: The case of the complainant is that she had taken a “Unit Gain” policy bearing No.0004555992 from the O.Ps. As per the terms and conditions of the policy a yearly premium @ Rs.15,000/- to be paid for a period of three years and accordingly the complainant had paid the premium in advance, i.e Rs.40,000/- on dt.16.4.04 and Rs.5,000/- on dt.12.7.05. The complainant received an account statement from the O.P wherein she had allocated 60008.8811 amounting to Rs.1,22,965.74 as on 31.5.07. Accordingly the complainant surrender her policy on dt.5.10.07. Again the complainant received a statement showing an amount of Rs.1,47,974.71 for the aforesaid allocated units. But an amount of Rs.88,404/- only was paid to the complainant. To this the complainant represented the authorities for payment of the differential amount but the same was not responded by the O.Ps . The complainant alleges that although she is entitled to an amount of Rs.1,47,974.71p, she was paid with a lesser amount which amounts to deficiency in service on the part of the O.Ps. Hence, the complaint.
2. The O.Ps have contested the case by way of filing their written version jointly. According to the O.Ps the complainant has not paid the regular premium plus two top up premium for which her policy was lapsed. By the time her claim was settled proportionate numbers of units had been deducted under a lapsed policy, as per the policy conditions. The O.Ps have admitted the premium paid by the complainant as described in the complaint petition. The O.Ps have claimed no deficiency in service on their part.
3. Heard both the parties. The learned advocate for the complainant submitted that since the complainant had paid the entire premium amount of Rs.45,000/- she is entitled to the amount as shown in the statement as on dt.6.10.07 and hence the stand taken by the O.Ps regarding the lapsed of policy can not be sustained. On the other hand the learned advocate for the O.Ps submitted that instead of making the payment as per the regular premium of Rs.15,000/- and 2 top up premiums of Rs,.30,000/- the complainant had paid 15,000/- 25,000/- hence the premium had not been paid as per policy conditions and hence the complainant is not entitled to any differential amount.
4. Perused the documentary evidence available on record. This is a case based on the terms and conditions of the Unit Gain policy which are binding on the parties. Therefore the policy conditions has to be seen strictly.
Perused the policy schedule. The complainant is the policy hold and the date of commencement of the policy is 28.4.2004. The frequency of payment is annual and the premium amount is Rs.15,000/- and the due date of premium is 28th April of every year. It is an admitted fact that, the complainant has paid the premium of Rs.40,000/- on dt.16.4.04 and Rs.5,000/- on dt.12.7.05. The complainant had neither paid the premium on annual due date nor paid the entire 3 years premium at a time. Perused; the policy document para-6 of the policy document provides the mode of payment of premiums which reads as follows :-6.1(a) Regular Premiums are payable in full on the dates and at the rate mentioned in the Policy Schedule. However a grace period of not more than 30 days where the mode of payment of premium is other than monthly, and not more than 15 days in the case of monthly mode is allowed. If a premium is not paid during the days of grace in the first three years, the policy shall lapse and no benefit shall be payable. Provided however, if the regular premium plus top up premiums paid at any time within the first three years exceeds the regular premium payable for three years, the policy will not lapse and the benefits payable under the policy shall be as indicated in (d)below. If a premium is not paid during the days of grace after three full years’ premiums have been paid and the policy has been in force for the full sum assured for those three policy years, the benefits payable under the policy shall be as indicated in (d) below.
According to this conditions premiums are payable in full as per the rate mentioned in the policy schedule,. A grace period of 30 days is allowed for payment of premium. If the regular premiums paid at any time within the first three years, then the policy will not lapsed ;and the same shall be kept in force by effecting a premium holiday. Premium Holiday has been defined in the policy document as , “Premium Holiday is a temporary period during which the policy holder can keep his policy in force without payment of regular premiums. This holiday can be availed by the policy holde4 after payment of three years full regular premiums”. The complainant had not paid the premium on the due date as per the policy schedule, but paid the full regular premiums of three years. Therefore the complainant’s policy has not been lapsed and she has availed premium Holiday. Accordingly the policy has been kept for utilization of the funds for payment of cost of insurance. The value of the units has been calculated as per the funds available in the premium Holiday and an amount of Rs.88,404/- has already been paid to the complainant. The complainant has not produced any other calculation relating to premium Holiday. The complainant is not entitled to any amount for the period which she has not paid the premium amount. Hence there is no deficiency in service on the part of the O.Ps.
5. It is argued on behalf of the complainant that by applying the principle of estoppels the O.Ps can not deny to pay the amount as per the statement send by them on dt.6.10.07. According to the O.Ps the statement has been sent by mistake as there was computer complication. The policy conditions are binding on the parties and payments has been made as per the said conditions, the case is not coming under the principle of estoppels. Sending the statement dt.6.10.07 by the O.Ps is a mistake which was essential to the agreement as provided U/s 20 of the Indian Contract Act.
6. Under the aforesaid facts, in our considered opinion, there is no deficiency in service on the part of the O.Ps.
Hence the case is dismissed.
Pronounced in open forum today on this 11th day of November,2009 under the seal and signature of this forum.
Dictated and corrected
By me.
President
Sri I.P.Singh,Member : I agree
Smt. A.K.Maras,Member: I agree