Haryana

Sonipat

494/2013

DALIP SINGH S/O INDER SINGH - Complainant(s)

Versus

1. BIRLA SUN LIFE INSURANCE CO. LTD.,2. B.M. BIRLA SUNLIFE INSURANCE CO. LTD. - Opp.Party(s)

KULDEEP SHARMA

13 May 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.

               

 

                                Complaint No.494 of 2013

                                Instituted on:20.12.2013

                                Date of order:18.05.2015

 

Dalip Singh sonof Inder Singh, resident of village Bahrampur, tehsil Bapoli, district Panipat.

 

…Complainant.  

Versus

 

1.Birla Sun Life Insurance Company Limited, through its Branch Manager, SCO 1, Sector 14, Sonepat.

2.Branch Manager, Birla Sun Life Insurance Company Limited, B-8, Gujranwala Town, FF Model Town, Delhi.

3.Managing Director/Asstt. Manager (Claims) Birla Sun Life Insurance Company Limited, VIth Floor, Kasarvadvali Ghodbander road, Thane(W)-400601.

                                                     …Respondents.

 

 

COMPLAINT UNDER SECTION 12 OF       

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Sh. Kuldip Sharma Adv. for complainant.

           Sh. Vikas Bakshi Adv. for respondents. 

 

BEFORE     NAGENDER SINGH, PRESIDENT.

          PRABHA WATI, MEMBER.

          D.V. RATHI, MEMBER.

 

O R D E R

 

          Complainant has filed the present complaint against the respondents alleging therein that his son namely Satyaveer since deceased had got himself insured with the respondent no.1 and purchased the policy from Sonepat branch i.e. respondent no.1 for Rs.8 lacs vide policy no.005788879 dated 8.10.2012.  The complainant was appointed as nominee by the life assured.  The life assured Satyaveer since deceased had been regularly paying the installments, but unfortunately he had expired on 25.10.2012.  The information regarding his death and relevant documents were sent to the respondents which were received on 20.4.2013.    But the respondents did not make the payment of the sum assured despite repeated requests and reminders.  The complainant, however, received a letter dated 31.10.2013 from the respondent no.3 declining the claim by mentioning that the life assured is reported to have died on 25.10.2012.  The complainant had submitted a death certificate showing that Satyaveer had died on 25.10.2012.   They have also alleged that they have investigated and established that Satyaveer had died long before the application for insurance.  The respondents have wrongly repudiated the claim of the complainant and that amounts to a grave deficiency in service on the part of the respondents.  So, he has come to this Forum and has filed the present complaint.

2.        In reply, the respondents have submitted that the complainant has filed the false and frivolous complaint with the malafide intentional and this Hon’ble Forum has no jurisdiction to try and decide the present complaint.  The intricated question of law and facts are involved in the present complaint which requires voluminous documents and evidence for determination which is not possible in summary procedure .  The life assured i.e. Satyaveer died on 29.9.2012 and not on the date mentioned by the complainant. The death certificate of the deceased life assured is forged and fabricated.   The complainant is not entitled to any claim as the life assured had died much before the commencement of the policy.  The respondents have rightly repudiated the claim of the complainant vide letter dated 31.10.2013.  There is no deficiency in service of any kind on the part of the respondents and thus, prayed for the dismissal of the present complaint.

3.        We have heard the arguments advanced by the ld. Counsel for both the parties at length and we have also gone through the entire relevant material available on the case file carefully & minutely.

4.        Ld. Counsel for the complainant has submitted that the respondents have wrongly and illegally repudiated the legal and genuine claim of the complainant and that amounts to a grave deficiency in service on the part of the respondents.

 

          On the other hand, ld. Counsel for the respondents have argued that the complainant has filed the false and frivolous complaint with the malafide intentional and this Hon’ble Forum has no jurisdiction to try and decide the present complaint.  The intricated question of law and facts are involved in the present complaint which requires voluminous documents and evidence for determination which is not possible in summary procedure .  The life assured i.e. Satyaveer died on 29.9.2012 and not on the date mentioned by the complainant. The death certificate of the deceased life assured is forged and fabricated.   The complainant is not entitled to any claim as the life assured had died much before the commencement of the policy.  The respondents have rightly repudiated the claim of the complainant vide letter dated 31.10.2013.  There is no deficiency in service of any kind on the part of the respondents.

 

          The respondents in support of their case has placed on record the document Ex.O-8 i.e. photo copy of Anganwari register.  It has been mentioned at serial no.10 that Satyavir Singh son of Dalip Singh, Caste Odd, died on 29.9.2012.  The bare perusal of this document shows that prior to serial no.10, at serial no.9 the date of death of Ritik has been mentioned as 6.10.2012 and at serial no.13, the date of death of Tika Ram is mentioned as 14.1.2012.  So, the registration of the death as per this document has not been entered datewise.  Further this document is neither attested nor is proved by any of the witness and authenticity of this document also seems to be doubtful.  On the other hand, the complainant has placed on record the document C1 reference of policy no.005788879, C2 death claim intimation, C3 medical attendant’s certificate, C4 death certificate of Satyavir Singh issued by Registrar, Birth and Death, Block PHC, Bapoli, C5 statement of Suraj Bhan and Om Parkash, C6 Statement of Radha wife of the complainant attested by Sarpanch Mehak Singh of village Behrampur, C7 statement of Mehak Singh, C8 photo copy of saving bank account of Dalip Singh, C9 copy of Ration Card, C10 copy of election ID card.

 

          At the time of arguments, the complainant has also placed on record the photo copy of register attested by Registrar, Birth & Death cum Senior Medical Officer, Block PHC, Bapoli, and as per this document Annexure JN, the date of death of Satyavir Singh is mentioned as 25.10.2012. 

 

          After considering all the relevant documents placed on record by the complainant and the respondents, we are of the opinion that Satyavir Singh had died on 25.10.2012.  For issuance of policy to any person, there is a process.  The policy holder is required to be introduced by a agent of the insurance company and the medical of the insured is also conducted by some medical officer.  So, after due verification, policy can only be issued.  But the respondents have failed to produce any document to prove that any fraud was committed by the Agent or family members of the deceased or any other person for getting the policy of insurance.  Accordingly, it is held that the complainant is entitled to get the claim amount to the tune of Rs.8 Lacs from the respondents in respect of the policy no.005788879 dated 8.10.2012.  Accordingly, we hereby direct the respondents to make the payment of claim amount of Rs.8 lacs to the complainant within a period of one month from the date of passing of this order, failing which, the above said amount shall fetch interest at the rate of 09% per annum from the date of filing of the present complaint till realization.

          With these observations, findings and directions, the present complaint stands allowed.

          Certified copy of this order be provided to both the parties free of cost.

File be consigned to the record-room.

 

 

(Prabha Wati)        (DV Rathi)                 (Nagender Singh-President)

Member DCDRF        Member DCDRF                   DCDRF, Sonepat.

 

Announced: 18.05.2015