P.SUBRAMANIAN Vs. INSURANCE OMBUDSMAN

JUDGEMENT

(1.) Heard Mr. Sunder Mohan, Learned Counsel for the Petitioner and Mr. M.B.Raghavan of M/s. M.B.Gopalan Associates, Learned Counsel appearing for the Second and Third Respondents and perused the materials placed on record, apart from the pleadings of the parties.

(2.) The Petitioner had been issued with 'Jeevan Saral' policy bearing No. 705158949 by the Third Respondent on 28.03.2010 and it is accepted that he had been paying the premium at the rate of Rs.31,153/- every month from the time of its commencement on the due dates till July 2018. While so, the Third Respondent by letter dated 12.07.2018 informed the Petitioner that it had been noticed in the policy document issued that there had been inadvertent typographical error in the 'Maturity Sum Assured', which has been shown as blank and that as per the plan condition, the correct amount of 'Maturity Sum Assured' is Rs.14,92,250/- and that all other terms and conditions remain unaltered, and the Petitioner was requested to send the original policy document to make endorsement with the corrected maturity value and in the event of his failure to submit the same, the correct amount of 'Maturity Sum Assured' of Rs.14,92,250/- will only be payable at the time of maturity. In response to that letter dated 12.07.2018 received from the Third Respondent, the Petitioner by e-mail dated 29.08.2018 objected to the proposal of correcting the originally agreed 'Maturity Sum Assured' value from Rs.62,50,000/- to Rs.14,92,250/- and contended that having paid the total premium of Rs.31,77,606/- from 28.03.2010 till then on monthly basis, it was totally illogical and unfair to unilaterally propose to reduce the same by citing the flimsy ground of typographical error, which was unacceptable and the Third Respondent was required to withdraw the said letter dated 12.07.2018 and confirm the original maturity value of Rs.62,50,000/- as per the original policy document. Thereafter, the Third Respondent by letter dated 10.09.2018 claimed that Rs.62,50,000/- is the 'Death Benefit Sum Assured' and not the 'Maturity Sum Assured' which column has been left blank in the policy document. The Petitioner by another letter dated 06.12.2018 restated his objection for the change of the amount in the 'Maturity Sum Assured' and further contended that in terms of Section 45 of the Insurance Act, 1938, any change in the policy condition ought to have been informed to him within three years from the date of the policy, in which event he would have stopped paying the premium and opted for better insurance and investment options and called upon the Third Respondent to pay the 'Maturity Sum Assured' as per the policy, failing which he would have to resort to legal proceedings. The Third Respondent by letter dated 21.12.2018 repeated that the 'Maturity Sum Assured' of Rs.14,92,250/- conveyed earlier was correct and that the sum of Rs.62,50,000/- claimed by the Petitioner was the 'Death Benefit Sum Assured' as per the plan conditions.

(3.) Aggrieved by the aforesaid action of the Third Respondent, the Petitioner complained to the First Respondent on 25.01.2019 invoking the Insurance Ombudsman Rules, 2017, to declare and hold that the 'Maturity Sum Assured' is Rs.62,50,000/- in respect of the aforesaid policy and to direct the Second and Third Respondents to pay the said maturity benefits along with loyalty addition and Rs.20,00,000/- as compensation for mental agony and trauma caused to him.