Page 32 - Life Insurance Today February 2018

As per the insurer, as there was no payment of further by the policy conditions. Here the policy was lapsed due
premiums, the policy was terminated as per Clause 4.3. If to non-payment. Clause 5 of the policy conditions deals
at all surrender value was available, the insurer ought to with non-forfeiture provisions and Clause 4 deals with
have paid the same to the life assured and not to the Guaranteed surrender value. It is specifically provided that
proposer. Now it is revealed that the surrender value in at least 3 years premium has to be paid for applying both
the 1st policy had been utilized for issuing the 2nd policy. the above provisions. Here the complainant had not paid
3 full years premiums.
This is said to be at the request of the proposer. In the
request though the amount to be transferred is noted as So, Non- forfeiture and Guaranteed Cash Surrender Value
Rs. 13000/-, the policy was issued for Rs. 12000/-. All these provisions are not applicable in this case. So, the stand
are in violation of the basic principles of insurance. When taken by the insurer in this regard is in consonance with
the life assured in the 1st policy was entitled to receive the policy conditions. But here a situation has arisen where
the fund value in the policy, the very inception of the 2nd no amount is payable to the complainant though he had
policy in the name of the complainant utilizing the fund paid nearly Rs. 180000/- .
value of the 1st policy is irregular and illegal and the very
inception of the second policy is vitiated. It is to deal with such situations, Rule 18 of RPG Rules em-
power the Insurance Ombudsman to provide ex-gratia pay-
In the result, an award is passed directing the insurer to ment to the insured in appropriate cases. In the result, to
pay Rs. 13000/- with 9% interest from 03.02.2011 till the meet the ends of justice, the complaint is disposed of with
date of award with cost of Rs. 2000/- to Smt. Remya Jo- a direction to the Respondent-Insurer to pay Rs. 90000/- as
seph, the life assured in the 1st policy within the pre- ex-gratia to the complainant within the prescribed period,
scribed period failing which Rs. 13000/- shall carry further failing which the amount shall carry interest @ 9% per an-
interest at 9% per annum from the date of award till the num from the date of award till payment is effected.
payment is effected.
Office of the Insurance Ombudsman,
Office of the Insurance Ombudsman,
Kochi
Kochi
Complaint No. IO/KCH/LI/21-001-864/2012-13
Complaint No. IO/KCH/LI/21-011-287/2012-13
V Vijayakumar
Santosh Kuruvila
Vs
Vs
LIC of India
ING Vysya Life Insurance Co. Ltd
The complainant had taken a Jeevan Aadhar policy from
The complainant had taken a policy from the Respondent- the Respondent-Insurer for the benefit of his handicapped
Insurer and paid 5 half yearly premiums and discontinued son. When the policy matured, he was informed that the
payment due to financial constraints. When he approached benefits will be available to the beneficiary, only after the
the insurer for refund of premium, it was told that nothing complainant's death. After having several correspondence
was payable. The complainant submitted that he was never with the insurer, he had again written a letter to the in-
informed that to get surrender value, he has to pay premi- surer on 18.02.2011 explaining his condition and request-
ums for 3 years. He is entitled to refund of premium paid ing for maturity value. There was no communication be-
by him. The insurer submitted that the policy was issued as tween the complainant and the insurer thereafter. He had
per the proposal submitted. There was no free look cancel- preferred the present complaint before this Forum on
lation request from the complainant. Due to non- payment 07.02.2013.
of premiums, the policy lapsed and no surrender value is
available as 3 full years premium was not paid. Decision:- As per Rule 13 (3) (a) & (b) of RPG Rules, as the
present complaint had been filed beyond one year from
Decision:- It is seen that the policy was issued as per the 18.02.2011, the complaint is barred by limitation. The
proposal form submitted by the complainant. The rights complaint is therefore, not maintainable. In the result, the
and liabilities of the parties to the contract are controlled complaint is dismissed as barred by limitation. T

32 February 2018 Life Insurance Today

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