Haryana

Sonipat

CC/341/2014

POONAM W/O RAJBIR SINGH - Complainant(s)

Versus

1. FUTURE GENERAL LIFE INSURANCE CO. ,2. FUTURE GENERAL LIFE INSURANCE CO. LTD. - Opp.Party(s)

MANAN SINGH

01 Jul 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.       

 

                                Complaint No.341 of 2014

                                Instituted on:11.12.2014                                              Date of order:28.07.2015

 

Poonam wife of late Rajbir son of Harphool, resident of village Garhi Khera Kalan, Delhi State at present c/o Shri Chiran Son of Shri Kanwar Singh, resident of village Nahri, distt. Sonepat.

..Complainant

                            Versus

 

1.Future Generali Life Insurance Co. Ltd., having its Branch Office at 98-101, First Floor Shehnai Banquet Hall, Civil road, Rohtak through its Branch Manager.

2.Future Generali Life Insurance Co. Ltd. having its corporate office at India Bulls Finance Centre, Tower3, 6^th Floor, Senapati Bapat Marg, Elphin Stone (W) Mumbai-400013 through its Managing Director/Authorized signatory.

3.Shereema Insurance Consultancy Ltd., 209-R, Model Town Atlas road, Sonepat Corporate Agent of Future Generali Ins. Co. Ltd. through its Branch Manager, Sonepat.

..Respondents.

 

COMPLAINT UNDER SECTION 12 OF       

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Sh. Maman Singh, Advocate for complainant.

           Ms. Kamlesh Khatri, Adv. for respondents no.1 and 2.

           Respondent no.3 ex-parte on 21.1.2015.

 

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 she is the legally wedded wife of late Rajbir son of Harphool and nominee in policy as well, who had purchased a policy bearing no.00527644 on 14.6.2010 for Rs.5 lacs  from respondent no.3 who is corporate agent of the respondent no.2.  Unfortunately, the husband of the complainant had expired on 20.3.2011 in an accidental death due to fall from height.  Intimation regarding untimely death of Rajbir Singh was given to the respondents  and DD no.117B dated 20.3.2011 was lodged with PS Badli, Delhi and DD no.121 BC dated 20.3.2011 was also lodged with PS Samaypur Badli, Delhi on the ruqa sent by the doctor.  Post mortem  of the dead body of Rajbir was conducted in BJR Memorial hospital at Jahangir Puri, Delhi.  The complainant being the nominee has lodged her claim with the respondents and has completed all the required formalities.  As per terms and conditions of the policy, in case of accidental death, the nominee is legally entitled to get three times amount of the assured amount  plus fund value plus guaranteed loyalty addition.   The respondents offered a very meager amount to the complainant i.e. Rs.50,000/- only.   The complainant has made the requests to the respondents several times to pay the amount as per terms and conditions of the policy, but of no use and that amounts to a grave deficiency in service on the part of the respondents.  So, she has come to this Forum and has filed the present complaint.

2.        In reply, the respondents no.1 and 2 have submitted that  as per the terms and conditions of the policy, if the policy is not suitable, the policy holder may get his/her policy cancelled by returning the policy and policy documents within 15 days (free look period) from the day the policy holder received the policy.  It is further submitted that with respect to policy no.00527644 the company vide letter dated 31.8.2012 has informed the complainant that the maximum sum assured allowable to the insured, which in the present instance, was Rs.5 lacs under all policies with the company and the said limit had been exhausted under policy no.00524550.  As a consequence, the respondent company was willing to refund a sum of Rs.50,000/- being a total premium paid under the concerned policy subject to returning to the company the Advance Discharge Voucher duly signed and stamped by the complainant.   The complainant is not legally entitled to receive three times the insured amount alongwith all other benefits and interest.  The complainant has filed the present complaint with ulterior motive.  It is also submitted that the respondents no.1 and 2 had investigated the claim and as per the report of investigating agency, on the date of death the life assured was drunk.  It is further evident from the postmortem report that the blood samples of the life assured were preserved for further investigation as to intoxication and content of alcohol.  The complainant had deliberately not provided the respondents no.1 and 2 the final report which conclusively proves that the death of life assured falls within the four corners of the terms and conditions governing accidental death benefit under the policy.  Hence only the claim  of Rs.5 lacs under the other policy was accepted by the respondent company.  It is further submitted that since the maximum sum assured allowable to the life assured was Rs.5 lacs which limit was exhausted under policy no.00524550, the refund of total premium paid of Rs.50,000/-, on policy no.00527644 was an appropriate recourse resorted to by the respondent no.1 and 2. Certified copy of final police report had not yet been submitted by the complainant with the respondents no.1 and 2 for the other policy. The complainant instead of submitting the final police report sent a legal notice dated 14.3.2014 to the respondent company which was duly replied vide letter dated 25.4.2014.  There is no deficiency in service on the part of the respondents no.1 and 2 and the complainant is also not entitled for any relief and compensation and thus, prayed for the dismissal of the present complaint.

          The respondent no.3 was proceeded against ex-parte vide order dated 21.1.2015.

3.        We have heard the arguments advanced by 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 respondent has submitted that the post mortem report of the husband of the complainant clearly indicates that the blood samples of the life assured have been preserved for investigation as to whether there was any alcohol content in the blood of the life assured.  Further the respondent vide letter dated 31.8.2012 had demanded final police report in order to conclusively determine if death of life assured was accidental.  But this report was never received by the respondent.

          The bare perusal of the documents submitted by the complainant also shows that there is nothing on the file to prove that the complainant has ever submitted the blood sample report and police final report with the respondent. 

          Thus, this Forum is unable to conclude whether the injured got injuries in the road side accident or the cause of injury could not be find out. 

          At the time of arguments ld. Counsel for the complainant has submitted while relying on the pleadings of complaint as pleaded in para no.3 that Rajvir son of Harphool died on 20.3.2011 in an accidental death due to fall from height. 

          But it is very sorry state of affairs that in the entire complaint or affidavit, it has not been mentioned anywhere that as to from which place i.e. house, office, building or mall, Rajvir fall.  No location or site or any particular name and number of the place has been mentioned from which Rajvir fall.  So, in our view, from the pleadings, affidavit and evidence led by the complainant, it is no where established that the death of Rajvir was due to accidental injuries.  The deceased was also having the policy no.00524550 which was obtained by him from the respondents on 17.6.2010.  But the deceased without disclosed the above said fact of having policy no.00524450 dated 17.6.2010, got issued another policy in his favour bearing no.00527644.  Had the deceased brought this very fact in the knowledge of the respondents, in that event, the respondents must have verified the fact and purpose why the deceased is obtaining the policy one after the another.  So, in our view the ends of justice would be fully met if directions are given to the respondent to refund the premium amount to the complainant (which was deposited by the deceased) within a period of one month from the date of passing of this order, failing which, the said amount shall fetch interest at the rate of 9% per annum from the date of passing of this order till realization.

 

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

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

File be consigned to the record-room.

 

 

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

Member DCDRF        Member DCDRF                   DCDRF, Sonepat.

 

Announced:28.07.2015