Page 31 - Life Insurance Today February 2018

LEGAL

Legal Case Studies on Miscellaneous
Claims

Office of the Insurance Ombudsman, the insured. The omissions on the part of the insurer are
not befitting a responsible insurer. In these circumstances,
Kochi I am satisfied that the complainant is entitled to get dis-
Complaint No. IO/KCH/LI/21-013-794/2011-12 bursement of the entire maturity value of Rs. 44136/-.

M T Thomas In the result, an award is passed directing the insurer to
Vs pay an amount of Rs 44136/- to the complainant within
the prescribed period failing which, the amount shall carry
Aviva Life Insurance Co. Ltd interest @ 9% per annum from the date of filing of the
complaint till payment is effected.
The complainant had taken a policy from the Respondent-
Insurer and it matured on 18.11.2011. It was informed that Office of the Insurance Ombudsman,
compulsory pension only will be given as the maturity of
the policy is over. The complainant submitted that he paid Kochi
3 annual premiums and policy matured in 2011. He was Complaint No. IO/KCH/LI/21-011-747/2011-12
never informed before that he will have to compulsorily
go for pension after maturity. He is entitled to maturity Maria Virginia
value with interest. Vs

The insurer submitted that as per Article 4 of the policy ING Vysya Life Insurance Co. Ltd
conditions, after maturity the insured can get only pension.
The maturity value available is Rs. 44136/-. In spite of re- The complainant had taken a policy in the name of her
daughter from the Respondent Insurer paying Rs. 40000/
peated reminders, the complainant had not exercised the
option and the amount is kept in suspense account. - believing it to be a single premium one maturing after 5
years. The policy was issued as annual premium mode.
Later she was defrauded into foreclosing the same and a
Decision:- The maturity intimation letter sent by the in-
surer contains a caption "Payment method - If no option new policy for Rs. 12000/- was issued.
is exercised then refund would be processed through The complainant submitted that she never wanted a regu-
cheque". A close reading of the caption would reveal that lar premium policy and she was defrauded in taking the
if the options are not exercised, then the insurer would 2nd policy. She is entitled to receive back the premium
process refund through cheque. paid by her. The insurer submitted that the policy was is-
sued as per the proposal submitted that the complainant
This would invariably indicate that even after maturity, the and due to non-payment of premium it was terminated.
benefit of refund is available. In the present case, the com- The amount was transferred to a new policy as per the
plainant has exercised no option. Then the course action proposal submitted by the complainant. She is not entitled
available to the insurer was to process refund. After the 2nd to return of premium paid.
letter dated 6.10.2011, no intimation was sent to the com-
plainant informing the status of the maturity fund. It can- Decision:- As per the policy schedule, the complainant is
not be said that the insurer had protected the interest of the proposer and her major daughter is the life assured.

Life Insurance Today February 2018 31

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