Order by:
Smt.Aparana Kundi, Member
1. The complainant has filed the instant complaint under section 35 of the Consumer Protection Act, 2019 stating that Mohinder Singh son of Kundan Singh(now deceased) was insured with Opposite Parties vide policy no.008849057 for a sum of Rs.4,40,000/-. The said policy was purchased on 25.08.2022, through agent of Opposite Parties namely Guntaj Singh resident of Ferozepur and 1st installment was paid to Opposite Parties on 29.08.2022 of Rs.21,631/-. Unfortunately, the said Mohinder Singh had died on 04.09.2022. Due information was given to Opposite Parties. Thereafter complainants being legal heirs of the Mohinder Singh have completed all the formalities and lodged the claim with Opposite Parties, but the Opposite Parties have not paid any amount to the complainants. Due to act and conduct of the Opposite Parties, the complainants have suffered mental tension and harassment. Hence, this complaint. Vide instant complaint, the complainants have sought the following reliefs:-
a) Opposite parties may be directed to pay an amount of Rs.4,40,000/- on account of death claim of Mohinder Singh alongwith interest @ 12% per annum from the date of claim till its realization.
b) To pay an amount of Rs.20,000/- as compensation for causing mental tension, harassment and agony.
c) To pay an amount of Rs.25,000/- as litigation expenses.
d) And any other relief which this Commission may deem fit and proper be granted to the complainants in the interest of justice and equity.
2. Opposite Parties appeared through counsel and contested the complaint by filing written reply taking preliminary objections therein inter alia that the complaint under the reply is not maintainable and is liable to be dismissed as the Life assured has attempted to misguide and mislead the Commission; no cause of action ever arose in favour of the Life assured and against the Opposite Parties to file the present complaint and hence, the complaint under reply is an abuse of the process of law; the Life assured has created a false story in his complaint to mislead this Commission by concocting and distorting the facts and circumstances of the present case. the complainants while filing a joint complaint have not filed any application U/s 35(1)(c) of the Consumer Protection Act, 2019 for seeking permission to file a joint complaint. The lacuna cannot be allowed to be filled at this juncture and the complaint is liable to be dismissed; the complainants have arrayed office of Aditya Birla Sun Life Insurance Company Ltd. at Moga but there is no office of opposite party at Moga from last 4-5 years, hence the present complaint is liable to be rejected for mis-joinder of necessary parties. Averred that the complainant no.1 has alleged that his father Sh.Mohinder Singh (since deceased) had purchased one life insurance policy (ABSLI Assured Savings Plan) bearing No.008849057 on 25.08.2022 through insurance advisor of opposite parties namely Sh.Guntaj Singh and his father had deposited Rs.21,631/- towards first installment of premium with the opposite parties. The insured had to deposit four installments of Rs.40,000/- per annum for twelve years and in case policy holder dies within the period of policy, the nominee was to get the sum assured of Rs.4,40,000/-. Averred further that in pursuance to the submission of the proposal form, the deceased i.e. Sh.Mohinder Singh was asked to get himself medically examined as he was 65 years old and medical examination was necessary. Mohinder Singh got himself medically examined on 30.08.2022 at Pankaj Lab Clinical Laboratory at Ferozepur Cantt. by Dr.Kamal Kant. After receiving the medical examination report, blood report findings, Opposite Parties had raised certain requirements on 02.09.2022 wherein the deceased Mohinder Singh was asked to pay extra premium to the tune of Rs.11.82/- for every sum assured of Rs.1,000/- i.e. Rs. 5,434.84/- for sum assured of Rs.4,40,000/- including 4.5% towards GST. The said premium was yet to be deposited by Mohinder Singh. The documents qua the issuance of policy basis proposal and other medical documents were pending, when the answering opposite parties received an intimation from its Senior Associate Partner, Aditya Birla Capital, Bathinda on 06.09.2022 that Mohinder Singh had expired. Since, the deceased life assured expired even before issuance of the policy, therefore, the premium which was received by the opposite parties was returned back vide Cheque No.001395 dated 09.09.2022 for amount of Rs.21,631.50/-. After this email, the answering opposite parties tried to contact the legal representative of the deceased Mohinder Singh, but since none could be found, therefore the answering opposite parties sent an email at the email id of complainant no.1 (which was in the record of the Opposite Parties) wherein the cancellation of application/proposal was intimated to the complainant. Averred further that whenever an application/proposal for insurance is received by the opposite parties then, as & when the same is processed, a policy number is automatically generated in the system of the insurance company but this does not mean that insurance policy is issued. Mere generation of a policy number does not constitute issuance of policy. Averred further that it is a settled law that mere receipt and retention of premium until after the death of the applicant or the mere preparation of the policy documents is not acceptance. Acceptance must be signified by some act or acts agreed on by the parties or from which the law raises a presumption of acceptance. In the present case, since the deceased Mohinder Singh had already expired on 04.09.2022 i.e. before the issuance of the policy, therefore, there was no contract executed between the parties. Once, the initial deposit of premium was refunded by the opposite parties and the policy was not in existence on the date of death of Sh. Mohinder Singh, hence it could be safely concluded that there was no privity of contact between the parties. Averred further that opposite parties has the right to either accept the proposal or reject the same. In the present case, admittedly, the opposite parties did not accept the proposal and not issued the policy. However, the premium was duly returned. The present complaint has not disclosed true & correct facts and that it is merely a concocted story which has been manipulated with the intention to defame the Opposite parties, to take undue advantage of the Life assureds’ own wrong and just to frustrate the process of law. On merits, it is submitted that Sh.Mohinder Singh (since deceased) had submitted to the opposite parties, a proposal/application dated 29.08.2022 for the purchase of ABSLI Assured Savings Plan, wherein the annual premium was to the tune of Rs.40,000/- was to be paid for 12 years and policy term was 20 years. The sum assured in the said policy was Rs.4,40,000/-. It is wrongly mentioned in the complaint that policy bearing No.008849057 was issued by the opposite parties. All other allegations made in the complaint are denied and a prayer for dismissal of the complaint is made.
3. In order to prove the case, complainants have tendered into evidence their affidavits Ex.C1 to Ex.C4, alongwith copies of documents Ex.C5 to Ex.C10.
4. To rebut the evidence of complainant, ld. counsel for the Opposite Parties has tendered into evidence affidavit of Ms.Aakriti Manocha, Deputy Chief Manager-Legal Ex.OPs/1 alongwith copies of documents Ex.OPs/2 to Ex.OPs/4.
5. We have heard the ld. counsel for both the parties, perused the written arguments submitted on behalf of Opposite Parties and also gone through the record.
6. The matter relates to insurance claim to the tune of Rs.4,40,000/- against Opposite Parties on account of demise of Mohinder Singh on 04.09.2022 by the complainant being his legal heirs/representatives. But in support thereof the very basis of the claim i.e. insurance policy has not been produced on record, though in para no.2 of the complaint, complainants mentioned a policy no.008849057 averring that Mohinder Singh (since deceased) was insured by Opposite Party No.2 vide this policy having been purchased on 25.08.2022, but in the same para in last line, the complainants have mentioned, first installment of premium of Rs.21,631/- was paid to Opposite Party No.2 on 29.08.2022. Further there is no evidence on record to establish that legally, enforceable contract of insurance was ever executed between the parties. Mere fact of payment of first installment does not automatically result in binding of legal, enforceable contract between the parties. Neither there are specific averments in the complaint in this regard whether payment to the tune of Rs.21,631/- was accepted by Opposite Parties to make contract of insurance binding legally and enforceable by the Opposite Parties nor there is no such evidence on record to establish this fact.
7. On the other hand, the Opposite Parties has come with specific plea that upon submission of proposal form Mohinder Singh (since deceased) was asked to get himself medically examined and upon receipt of medical examination report dated 30.08.2022, the Opposite Parties raised certain requirements on 02.09.2022, categorically asking Mohinder Singh (since deceased) to pay additional premium to the tune of Rs.5434.84 paisa including 4.5 % GST, which was yet to be deposited by Mohinder Singh (since deceased). To falsify the pleas taken by Opposite Parties, the complainants have not produced any evidence on record.
8. As already been discussed, the complainants have not produced any substantiating evidence on record to establish that any legal, enforceable and valid contract of insurance had ever been executed between the parties. The mere fact of automatic generation of policy number in the system of the insurance company on submission of application or proposal form with payment of installment before final acceptance by the insurance company cannot automatically construe to mean issuance of insurance policy. Rather there is nothing mentioned about any such medical examination of Mohinder Singh (since deceased) and payment of additional amount of premium in the body of the complaint by the complainants and this amounts to concealment of fact by the complainants resulting in serious damage to the case of the complainants.
9. In view of the entire discussion made above, on failure of the complainants to prove that there is any legal, enforceable and valid insurance policy been issued in the name of Mohinder Singh (since deceased), any such claim for an amount to the tune of Rs.4,40,000/- of insurance on account of unfortunate demise of Mohinder Singh alongwith interest falls flat to the ground.
10. So, from the above discussion, the present complaint is hereby dismissed. Keeping in view the peculiar circumstances of the case parties are left to bear their own costs. The pending application(s), if any also stands disposed of. Copy of the order be supplied to the parties free of cost. File be consigned to record room.
Announced in Open Commission
