Haryana

StateCommission

A/410/2019

SHRIRAM LIFE INSURANCE COMPANY LTD. - Complainant(s)

Versus

ANITA AND ANOTHER - Opp.Party(s)

PRADEEP SHARMA

11 Sep 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

HARYANA, PANCHKULA

 

First Appeal No.410 of 2019

                   Date of Institution:25.04.2019

Date of Decision:11.09.2024

 

1.      The Manager, Shriram Life Insurance Company Ltd., Lot No.31-32, 5^th Floor, Ramky Selenium, Financial District, GachibowliHyderabad,  Telangana through its MD/Chairman.

 

2.      Branch Manager, Shriram Life Insurance Company Ltd., 3^rd Floor, SCO 10, Sector 3, Karnal.

 

          IIndAddress:SCO 241, 2^nd Floor, Sector-12, Karnal, Haryana.

 

…..Opposite Parties No.1 and 2/Appellants

 

Versus

 

 

1.      Smt.Anita, Wd/o Ved Pal, R/o Village Karamgarh,TehsilNarwana, District Jind.

…..Complainant/Respondent No.1

 

2.      Bipin Kumar Shriram Life Insurance Co. Ltd. through its Branch Manager, Shriram Life Insurance, 3^rd Floor, SCO-10, Sector-3, Karnal.

 

…..Opposite Party No.3/Respondent No.2

 

CORAM:   Hon’ble Mr. Justice T.P.S Mann, President.

                   Mr.S.P.Sood, Judicial Member

 

Present:-    Shri  Sukhvir Vohra proxy counsel for Sh. Pradeep Sharma, counselfor the appellants.

                   Respondent No.1 already proceeded against ex-parte.

                   Respondent No.2 already dispensed with.

 

O R D E R

T.P.S. MANN J.

 

          Delay of 53 days in filing the appeal is condoned for the reasons stated in the application for condonation of delay.

2.      Appellants-The Manager, Shriram Life Insurance Company Ltd.&Anr., have filed the instant appeal under Section 15 of the Consumer Protection Act, 1986 for challenging the order dated 09.01.2019 passed by learned District Consumer Disputes Redressal Commission, Jind whereby complaint filed by complainant-Smt.Anitawasdisposed of with following directions:

“In view of the aforesaid discussion, we dismiss the complaint against OP No.3 and allow the same against OPs No.1 & 2. The OPs No.1 and 2 are directed in the following manner:-

(i)      To pay sum assured of Rs.7,10,000/- (Rs.Seven Lacs ten thousand) to the complainant alongwith interest @ 7% per annum from the date of filing of complaint i.e. 07.06.2017 till its realization.

(ii)      To pay Rs.5,000/- as compensation for the mental agony & physical harassment, suffered by the complainant.

(iii)     To pay a sum of Rs.3,000/- as litigation expenses.

The OPs No.1 & 2 are further directed to comply with the aforesaid directions within a period of thirty days from the date of receipt of certified copy of this order, failing which the awarded amount, minus litigation costs, shall carry interest @ 9% per annum for the period of default.”

3.      The brief facts of the case as set out in the complaint are that the complainant’s husband Mr.Ved Pal (now deceased) S/o Ram Chander had insured his life with the O.P.No.1 through O.P.No.3 under policy No.NN131400040923 dated 28.03.2014 of Rs.7,10,000/-.  Complainant was nominee in the Policy. The complainant’s husband Ved Pal had deposited installment against the said policy.  The proposal form was filled at Jind on 25.03.2014 by OP No.3 i.e. authorized agent of OP No.1 in the presence of witness and same was recommended by OP No.3 at Jind.  Prior to issuing the above-said policy to the complainant’s husband, the agent of OPs got fulfilled all the formalities and after due verification OPs issued the said policy. The complainant’s husband had expired on 09.05.2014. Being a nominee, the complainant applied for claim from the authorized office.  She requested the authorities to pay the claim amount, but OPs have not paid the claim amount. Faced with this situation, she sent legal notice dated 26.11.2015 to the OP Nos.1 and 2 through counsel but they did not care and gave false reply of notice. Earlier the complaint was filed before District Consumer Commission, Karnal on 03.06.2016, which was dismissed as withdrawn due to want of jurisdiction. Second complaint was filed before District Consumer Commission, Jind, which was also dismissed on 13.10.2016 for want of jurisdiction and thereafter again, complaint was filed before the District Consumer Commission, Karnal on 17.11.2016, which was also dismissed on 02.05.2017 for want of jurisdiction with liberty to approach the competent forum.  Thereafter the complainant filed the present complaint at District Consumer Commission, Jind.  The complainant prayed that OPs be directed to pay claim amount of Rs.7,10,000/- along with interest & other benefits of policy to the complainant and also pay Rs.1,00,000/- as compensation alongwith interest @ 18% p.a. on account of mental tension, pain, agony, harassment and deficiency in services of OPs and complaint may kindly be accepted with costs.

4.      Notice being issued, OP Nos.1 and 2 appeared and filed written statement.  Preliminary objections about complaint being false, frivolous, malicious and vexatious, maintainability of complaint, territorial jurisdiction , concealment of true and material facts etc. were also raised and requested to dismiss the complaint.  On merits, it was pleaded that the complainant did not submit the requisite documents, which was necessary for disposal of the claim. It was submitted that OPs conducted its regular investigation and on perusal of enquiry, the OPs found that signature of deceased life assured on the proposal form with that of KVC documents submitted at proposal were not matching. Therefore, OPs sent a letter dated 18.03.2012 to the complainant to submit any copy of old documents containing signatures of life assured like pan card, passport, driving licence, property documents etc. The complainant did not respond to the two reminders sent on 08.04.2015  and 27.04.2015 respectively, but, complainant did not respond. Hence having no other option, the OPs legally repudiated the claim of the complainant vide repudiation letter dated 30.05.2015 in which an opportunity to the complainant was given to submit the required documents for reopening the case and process the claim accordingly. Thereafter, in the month of June, 2015 the complainant has submitted copy of pan card bearing No.AUWPV7783R containingthe picture and signature of the deceased life assured Vedpal, it sems to be morphed and not genuine. Hence the OPs sent a letter dated 14.08.2015 to complainant to submit original PAN card of life assured and details of other insurance policies held by life assured, however till date OPs have not received any reply.  In view of the above facts, the complainant was not entitled to any claim from the answering OPs.  OPs received legal notice dated 26.11.2015, which was duly replied on 25.01.2016.  The complainant earlier filed complaints on the same cause of action before the District Consumer Commission, Karnal, Jind, the present complaint was not maintainable. Thus there was no deficiency in service on the part of the OPs and prayed for dismissal of the complaint.

5.      OP No.3 was already proceeded against ex parte.

6.      After hearing both the parties, learned District Consumer Disputes Redressal Forum, Jind, (In short “District Consumer Commission”) partly allowed the complaint vide impugned order dated 09.01.2019 and relevant portion of the order is mentioned in para No.2 of the order.

7.      Feeling aggrieved therefrom, OPs-appellants have preferred this appeal for setting aside the impugned order.

8.      We have heard learned counsel for the appellants. With hiskind assistance the entire record of appeal and that of complaint alongwith Ex.C-1 to C-11 and Ex. OP1/1 to OP 1/9 werethoroughly perused andexamined.

9.      Learned counsel for the OPs/appellants vehemently argued that during the subsistence of the life insurance policy, the deceased expired and being a nominee, the complainant filed claim with the insurance company, but, they legally repudiated the claim of the complainant vide repudiation letter dated 30.05.2015 in which an opportunity to the complainant was given to submit the required documents for reopening the case and process the claim accordingly. Further argued that in the month of June, 2015 the complainant submitted copy of pan card bearing No.AUWPV7783R containing the picture and signature of the deceased life assured Vedpal, it sems that it was morphed and not genuine and hence the OPs sent a letter dated 14.08.2015 to complainant to submit original PAN card of life assured and details of other insurance policies held by life assured.However till date OPs did not receive any reply.  The complainant was not entitled to any claim from the answering OPs.

10.    It is not disputed that during the subsistence of the life insurance policy, the life insured had died.  It is also not disputed that after the death of the life assured, the complainant lodged the claim with the OPs-appellants. Perusal of the file shows that the OPs sent two reminders dated 08.04.2015, 27.04.2015 to submit the required documents by the complainant, but OPs repudiated the claim vide letter dated 30.05.2015, which was illegal and wrong.  As per letter dated 18.03.2015 (Ex. OP-1/4) issued by the OPs to complainant, it is mentioned that “claim is under process, the proposal form in which the deceased life assured has signed at the time of applying for insurance is not legible and therefore, they need any copy of the old documents bearing signatures of the life assured i.e.like Pan card, passport, driving license & property documents etc.   It is also admitted that the complainant submitted the copy of PAN card bearing No.AUWPV7783R of life assured to the OPs in the month of June 2015, which was admitted by the OPs in their reply. As per proposal form (Ex.C-2), it was found that signatures of the life assured were legible. The counsel for the complainant has already producedoriginal pan card of DLA Ved Parkash before the District Consumer Commission. The signatures in the proposal form and pan card were the same.  OPs are intentionally and deliberately not paying the genuine claim amount to the complainant. The OPs are held liable to pay the claim amount to the complainant.  Since, the complainant hadalready submitted the PAN card to the insurance company, the complainant is entitled for the claim amount. The learned District Consumer Commission has rightly partly allowed the complaint of the complainant. The State Consumer Commission finds no reason or ground to interfere with the order of learned District Consumer Commission. Hence the appeal being devoid of merit stands dismissed.

11. Statutory amount of Rs.25,000/- was deposited by appellants at the time of filing of this appeal. This amount is now ordered to be refunded to complainant-Anita against proper receipt, identification and verification as per rules and registry of this Commission is accordingly directed.

12.  

13.    A copy of this judgment be provided to all the parties free of cost as mandated by the Consumer Protection Act,2019. The judgment be uploaded forthwith on the website of the Commission for  perusal of the parties.

14.    File be consigned to record room.

 

11^th September, 2024         S.P.Sood                                                      T.P. S. Mann

                                                Judicial Member                                         President

 

S.K

(Pvt. Secy.)