Insurance companies only show interest in premium which may reach to company timely but insurance claim

Mahesh Pratap Singh Yogi M P Singh <yogimpsingh@gmail.com>
Erring L.I.C.may refund my premium paid on 10-Jul-2013 i.e. Rs.24999.37 with interest as concerned staffs told that company arbitrarily closed my policy plan.
Mahesh Pratap Singh Yogi M P Singh <yogimpsingh@gmail.com> 11 September 2018 at 18:53
To: bimalokpal.lucknow@ecoi.co.in, pmosb <pmosb@pmo.nic.in>, presidentofindia@rb.nic.in, supremecourt <supremecourt@nic.in>, inscoun <inscoun@gbic.co.in>, urgent-action <urgent-action@ohchr.org>, v.jayanthkumar@irda.gov.in, suresh@irda.gov.in, Somesh Busi <somesh@irda.gov.in>

Please take this communication as a reminder of earlier representations.
Respected Sir, 
                                     Concerned staffs of the department had assured that just after the appointment of the insurance ombudsman, my case will be put up before the ombudsman table in order to provide a reprieve to the applicant and applicant had submitted the documents as sought by the personnel concerned but it is unfortunate that the concerned body still not reached on any conclusion so in order to awake the concerned staffs, this reminder is being served. 
11/09/2018                                                                      Yours sincerely
                                                                                     Surendra Kumar Maurya          

On Mon, 5 Feb 2018 at 00:52, Mahesh Pratap Singh Yogi M P Singh <yogimpsingh@gmail.com> wrote:
To
                                               LUCKNOW -Shri/Smt……..
                                                                                                 
                                           Office of the Insurance Ombudsman,
                                                                                                   
                                              6th Floor, Jeevan Bhawan, Phase-II,
                                                                                                     
                                                Nawal Kishore Road, Hazratganj, 
                                                                                                               
                                                  Lucknow – 226 001. 
                                                                                                         
                                           Tel.: 0522 – 2231330 / 2231331
                                                                                                       
                                            Fax: 0522 – 2231310
                                         Email: bimalokpal.lucknow@ecoi.co.in
Subject -Concerned matter is subjected to tyrannical treatments and fraudulent practice of an insurance company named  Max Life Insurance Company Limited, Max House ,Third floor ,1 Dr. Jha Marg , Okhla New Delhi 110020, India which is depriving your justice seeker of her genuine and legitimate rights by taking recourse of false, fake and flimsy grounds and facts arbitrarily subsequently applicant takes shelter in the court of You Hon‘ble Sir as you Hon’ble Sir have the jurisdiction to deal with such matters in accordance with the rule of law.
 Jurisdiction of Office 
 (Union Territory, District) Districts of Uttar Pradesh :
Lalitpur, Jhansi, Mahoba, Hamirpur, Banda, Chitrakoot, Allahabad, Mirzapur, Sonbhabdra, Fatehpur, Pratapgarh, Jaunpur,Varanasi, Gazipur, Jalaun, Kanpur, Lucknow, Unnao, Sitapur, Lakhimpur, Bahraich, Barabanki, Raebareli, Sravasti, Gonda, Faizabad, Amethi, Kaushambi, Balrampur, Basti, Ambedkarnagar, Sultanpur, Maharajgang, Santkabirnagar, Azamgarh, Kushinagar, Gorakhpur, Deoria, Mau, Ghazipur, Chandauli, Ballia, Sidharth Nagar.
Petitioner/Applicant- Surendra Kumar Maurya S/O Jeera Lal Maurya MOBILE NUMBER-7388397486, Mohalla-Shivala Mahanth, PostPutali Ghar, District-Mirzapur,Pincode-231001, Uttar Pradesh.
                                Versus 
Respondent- Chairman, Max Life Insurance Company Limited, Max House, Third floor, 1 Dr Jha Marg, Okhla New Delhi 110020, India.
With great respect to revered Sir, your applicant invites the kind attention of the Hon’ble Sir to the following submissions as follows. 
1-It is submitted before the Hon’ble Sir that Undoubtedly your applicant had to pay the next premium by 10-July-2014 but because of fatal illness of my wife and me your applicant couldn’t do so but delay in payment of the premium could be condoned. Most important point is without refunding my paid premium in accordance with the rule, how the policy can lapse? 
2-It is to be submitted before the Hon’ble Sir that your petitioner submitted a representation before the chairman   Chairman, Max Life Insurance Company Limited, Max House, Third floor, 1 Dr Jha Marg, Okhla New Delhi 110020, India on 08-Oct-2017 which is attached with this representation. Your petitioner also submitted representation before the accountable staffs of the government of India i.e. on public grievance portal of government of India which is registered as bearing Registration number-  DEAID/ E/2017/03404. Hon’ble Sir may be pleased to take the perusal of attached PDF document with this representation. 
3-It is to be submitted before the Hon’ble Sir that on 02-Nov-2017 staffs of aforementioned Life Insurance Company replied as – We advise as above, having forwarded your grievance to the concerned Insurer for addressing the issue. The resolution posted by the Insurer is as below. : Resolution attached in PDF format. You can take up the grievance through Integrated Grievance Management available with the link http://igms.irda.gov.in/.In case if you are not satisfied with the resolution provided by the insurer, he/she may file a complaint with the concerned Insurance Ombudsman (for settlements up to 30 lacs ) for examination and disposal under the provisions of Insurance Ombudsman Rules, 2017. For any further information, he may visit www.gbic.co.in. Further, the Insurance Ombudsman Scheme is an Alternate Dispute Resolution mechanism with summary proceedings. In case if you are not satisfied with the decision of the Insurance Ombudsman or the amount is Our Mission (Insurance regulatory and development authority of India) “To Protect the interests of the policyholders, to regulate, promote and ensure orderly growth of the insurance industry and for matters connected therewith or incidental thereto.” LUCKNOW -Shri/Smt…….. Office of the Insurance Ombudsman, 6th Floor, Jeevan Bhawan, Phase-II, Nawal Kishore Road, Hazratganj, Lucknow – 226 001. Tel.: 0522 – 2231330 / 2231331 Fax: 0522 – 2231310 Email: bimalokpal.lucknow@ecoi.co.in more than 30 lacs, you are free to approach other appropriate judicial or grievance redresses forums. Hon’ble Sir may be pleased to take the perusal of attached PDF document with this representation. 
   4-It is to be submitted before the Hon’ble Sir that your petitioner also sought information as 
An application under subsection 1 of section 6 of Right to Information Act 2005 to seek following point-wise information with CPIO Insurance regulatory and development authority of India within the stipulated time as prescribed under subsection 1 of section 7 of Right to Information Act 2005.
 1-Please made available the regulations set up by the authority in order to secure the interest of insurance policyholders from insurers.
 2-Before penalizing any insurance policyholder what are the setup norms? Please make available those provisions to your applicant. 
3-Before forfeiting the premium of insurance policyholders whether to serve legal notice is not mandatory as being done by the insurance company in the context. The principle of natural justice can be overlooked before forfeiting paid premium of insurance policyholders. Please make available the provision which allows such arbitrary action on insurance policyholders by insurers.
 4-According to insurance company staffs, the policy will acquire cash value if it has been in force for at least three years and provided all premiums that have fallen due have been received. The guaranteed cash value in this policy will be 30% of premiums (excluding the first year’s premium) received. Please provide the provision under which consumer’s right of your applicant is secured if Rs. 25000.00 paid as the premium is forfeited by the insurance company as policy is lapsed according to company policy. 
5-Being a regulatory body, how such arbitrary rules of an insurance company is being allowed to propagate in the society consequently innocent citizens is being cheated. Please make available the provisions of the constitution which prohibit regulatory body to curb such economic offences committed by wrongdoer insurance companies mushrooming in our society like frogs in the rainy seasons. 
Please help your information seeker in public interest so that justice may be sought. For this, your applicant shall ever pray you, Hon’ble Sir. Yours sincerely Surendra Kumar Maurya S/O Jeera Lal Maurya MOBILE NUMBER-7388397486, Mohalla-Shivala Mahanth, Post-Putali Ghar, DistrictMirzapur, Pincode-231001, Uttar Pradesh. 
5-It is to be submitted before the Hon’ble Sir that CPIO V Jayanth Kumar of Insurance Regulatory and Development Authority of India replied which is attached to this representation. 
Enter Registration Number IRDAI/R/2017/50547
Name Surendra Kumar Maurya
Date of filing 12/11/2017
Public Authority Insurance Regulatory and Development Authority of India
Status REQUEST DISPOSED OF
Date of action 08/12/2017
Reply :- The scanned copy of the reply is attached herewith
View Document
CPIO Details :- Shri V. Jayanth Kumar (Life)
Phone: 
v.jayanthkumar@irda.gov.in
First Appellate Authority Details :- Shri Suresh Mathur
Phone: 
suresh@irda.gov.in
Nodal Officer Details :-
Telephone Number
Email Id somesh@irda.gov.in

Enter Registration Number IRDAI/R/2017/50547
Name Surendra Kumar Maurya
Date of filing 12/11/2017
Public Authority Insurance Regulatory and Development Authority of India
Status REQUEST DISPOSED OF
Date of action 08/12/2017
Reply :- The scanned copy of the reply is attached herewith
View Document
CPIO Details :- Shri V. Jayanth Kumar (Life)
Phone: 
v.jayanthkumar@irda.gov.in
First Appellate Authority Details :- Shri Suresh Mathur
Phone: 
suresh@irda.gov.in
Nodal Officer Details :-
Telephone Number
Email Id somesh@irda.gov.in

99. For section 113 of the Insurance Act, the following section shall be substituted, namely:— “113. (1) A policy of life insurance shall acquire surrender value as per the norms specified by the regulations. (2) Every policy of life insurance shall contain the formula as approved by the Authority for calculation of guaranteed surrender value of the policy. (3) Notwithstanding any contract to the contrary, a policy of life insurance under a non-linked plan which has acquired a surrender value shall not lapse by reason of non-payment of further premiums but shall be kept in force to the extent of paid-up sum insured, calculated by means of a formula as approved by the Authority and contained in the policy and the reversionary bonuses that have already been attached to the policy: Provided that a policy of life insurance under a linked plan shall be kept in force in the manner as may be specified by the regulations. (4) The provisions of sub-section (3) shall not apply— (i) where the paid-up sum insured by a policy, inclusive of attached bonuses, is less than the amount specified by the Authority or takes the form of annuity amount less than the amount specified by the Authority; or (ii) when the parties, after the default has occurred in payment of the premium, agree in writing to other arrangements.”.

113.(1) A policy of lifeinsurance under which the whole of the benefits become payable either on the occurrence, or at a fixed interval or fixed intervals after the occurrence, of a contingency which is bound to happen, shall, if all premiums have been paid for at least three consecutive years in the case of a policy issued by an insurer, or five years in the case of a policy issued by a provident society defined in Part III, acquire a guaranteed surrender value, to which shall be added thesurrender value of any subsisting bonus already attached to the policy, and every such policy issued by insurer shall show the guaranteed surrender value of the policy at the close of each year after the second year of its currency or at the close of each period of three years throughout the currency of the policy:
 
 Provided that the requirements of this subsection as to the addition of the surrender value of the bonus attaching to the policy at surrender shall be deemed to have been complied with where the method of calculation of the guaranteed surrender value of the policy makes provision for the surrender value of the bonus attaching to the policy:
 
Provided further that the requirements of this subsection as to the showing of the guaranteed surrender value on a policy shall be deemed to have been complied with where the insurer shows on the policy the guaranteed surrender value of the policy by means of a formula accepted in this behalf by the Authority as satisfying the said requirements:
 
Provided further that the provisions of this subsection as to the showing of the guaranteed surrender value on a policy shall not take effect until after the expiry of six months from such date as the Authority may, by notification in the official Gazette, appoint in this behalf
 
(2) Notwithstanding any contract to the contrary, a policy which has acquired a surrender value shall not lapse by reason of the non-payment of further premiums but shall be kept alive to the extent of the paid-up sum insured, and the paid-up sum insured shall for the proposes of this sub-section include in full all subsisting reversionary bonuses that have already attached to the policy, and shall, where the policy is one on which the maximum number of annual premiums payable is fixed and the premiums are of uniform amount, be before the inclusion of such bonuses not less than the amount bearing to the total sum insured  by the policy exclusive of bonuses the same proportion as the total periodfor which premiums have already been paid bears to the maximum period for which premiums were originally payable.
 
(3) A policy kept alive to the extent of the paid-up sum insured under subsection (2) shall not be entitled by virtue of that sub-section to participate in any profits declared distributable after the conversion of the policy into a paid-up policy.
 
(4) Sub-section (2) and sub-section (3) shall not apply – 
 
(a)               where the paid-up sum insured by a policy being a policy issued by an insurer, is less than one hundred rupees inclusive of any attached bonus or takes the form of an annuity of less than twenty-five rupees, or where the paid-up sum insured by a policy, being a policy issued by a provident society as defined in Part III, is less than fifty rupees inclusive of any attached bonus or take the form of an annuity of less than twenty-five rupees, or
 
(b)               where the parties after the default has occurred in the payment of the premium agree in writing to some other arrangement, or
 
(c)                to policies in which the surrender value is automatically applied under the terms of the contract to maintaining the policy in force after its lapse through non-payment of premium.

This is a humble request of your applicant to you Hon’ble Sir that how can it be justified to withhold public services arbitrarily and promote anarchy, lawlessness and chaos in an arbitrary manner by making the mockery of law of land? This is need of the hour to take harsh steps against the wrongdoer in order to win the confidence of citizenry and strengthen the democratic values for healthy and prosperous democracy. For this, your applicant shall ever pray you, Hon’ble Sir. 
     Dated-05/02/2018                                                                                       Yours sincerely 
                                                                                                       Surendra Kumar Maurya S/O Jeera Lal Maurya 
                                                                                                                                 Through 
                                                                                                                  Yogi M. P. Singh, Mobile number-7379105911, Mohalla- Surekapuram, Jabalpur Road, District-Mirzapur, Uttar Pradesh, Pin code-231001.

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Mahesh Pratap Singh Yogi M P Singh

Concerned staffs of the department had assured that just after the appointment of the insurance ombudsman, my case will be put up before the ombudsman table in order to provide a reprieve to the applicant and applicant had submitted the documents as sought by the personnel concerned but it is unfortunate that the concerned body still not reached on any conclusion so in order to awake the concerned staffs, this reminder is being served.

Preeti Singh
2 years ago

A policy of lifeinsurance under which the whole of the benefits become payable either on the occurrence, or at a fixed interval or fixed intervals after the occurrence, of a contingency which is bound to happen, shall, if all premiums have been paid for at least three consecutive years in the case of a policy issued by an insurer, or five years in the case of a policy issued by a provident society defined in Part III, acquire a guaranteed surrender value, to which shall be added thesurrender value of any subsisting bonus already attached to the policy, and every such policy issued by insurer shall show the guaranteed surrender value of the policy at the close of each year after the second year of its currency or at the close of each period of three years throughout the currency of the policy:

Arun Pratap Singh
2 years ago

In this country, insurance companies only lures the common citizenry, then loot them without compassion.Undoubtedly action must be taken against erring insurance companies but who will do so as the individual appointed on these posts are very corrupt who are busy in filling their pockets.

Beerbhadra Singh
1 year ago

Nou a days wrongdoer insurance companies through its agents are cheating innocent gullible citizenry by colluding with the corrupt staffs of the government and insurance ombudsman is either not appointed by the government if appointed they remain mute spectators in the matter. Whether it is reflection of good governance in which innocent and gullible surgery is being looted by the corrupt insurance companies which is quite obvious from the dealings of such companies. Only to say that we are providing good governance to the citizenry is not sufficient as it must be asked from the citizenry whether the governance is good or bad because the electorates will respond properly. A poor is itself vulnerable if it is looted then what is the credibility of those who are seated at the highest rank.