Haryana

StateCommission

A/1329/2017

LIC OF INDIA - Complainant(s)

Versus

ASHA RANI AND OTHERS - Opp.Party(s)

VANDANA MALHOTRA

19 Dec 2022

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

 

                                                      First Appeal No.1329 of 2017

                                                 Date of Institution: 23.10.2017

                                                          Date of final hearing: 19.12.2022

Date of pronouncement: 18.01.2023

 

Senior Divisional Manager, Life Insurance Corporation of India, SCO No. 34, 5, Sector 1, HUDA, Rohtak Branch Office, Branch Office Life Insurance Corporation of India, Shyamji Complex, Delhi Rohtak Road,  Bahadurgarh, Distt. Jhajjar.

…..Appellant

Versus

1.      Asha Rani Wd/o Jitender Singh S/o Roop Chand

2.      Sanju minor S/o Jitender Singh S/o Roop Chand

3.      Jyoti minor D/o Jitender Singh S/o Roop Chand

4.      Ajay minor S/o Jitender Singh S/o Roop Chand All minor through their mother Smt. Asha Rani being their natural guardian and next friend R/o 265, Rajindra Park, Ex. Nangloi, Delhi.

…..Respondents

CORAM:    S.P. Sood, Judicial  Member

                    Suresh Chander Kaushik, Member

 

Present:-    Mr. Rajneesh Malhotra, Advocate for the appellant.

                   Mr. Sant Lal Barwala, Advocate for the respondents.

 

                                                 ORDER

S P SOOD, JUDICIAL MEMBER:

          Delay of 16 days in filing the present appeal has been condoned for the reasons stated in the application for condonation of delay.

2.      The present appeal No.1329 of 2017 has been filed against the order dated 04.09.2017 of the District Consumer Disputes Redressal Forum, Jhajjar (In short Now “District Commission”) in complaint case No.299 of 2016, which was allowed.

3.       The brief facts of the case are that complainant’s husband  was insured with opposite party(OP), who expired on 28.01.2015.  Being a nominee, complainant filed death claim with OP and same was repudiated by OP on 19.03.2016. Complainant filed appeal before Central Office Claims Review Committee, which was rejected. Thus, there being deficiency in service on the part of the O.P, hence this complaint.

4.      In its written version, OP raised preliminary objections with regard to locus standi, cause of action, complainant having suppressed the true and material facts, want of jurisdiction, complaint being vague, bogus and frivolous. On merits, it was submitted that claim of the complainant was rightly repudiated as policy was lapsed due to non deposit of premium on February 2013 and same was got revived on 14.10.2013 for the full sum assured on the strength of personal statement regarding health made by insured but he concealed the true and material facts from OP as he remained ill and suffering from KOCH (FUC of abcess of lever) and T.B. of chest at the time of revival. The policy was under loan and Rs.68,000/- with due interest was recoverable from him. Thus, there being no deficiency in service on the part of the OP, complaint deserves dismissal.

5.      After hearing both the parties, the learned District Commission, Jhajjar has allowed the complaint vide order dated 04.09.2017, which is as under:-

“In view of aforesaid discussion and findings, it is observed that the respondent shall pay a sum of Rs.7,50,000/- i.e. sum assured as per insurance policy placed on record as Ex.R-2 along with other due benefits, if any, with an interest @ 9% p.a. from the date of death of life assured i.e. 28.01.2015 as is proved from document Ex.C-1 till its actual realizations to the complainant. The complainant is also entitled for a sum of Rs. 5500/- on account of litigation expenses for the present unwanted and unwarranted litigation only due to the deficiency in service on the part of the respondent. However, it made clear that the respondent will be at liberty to recover the loan amount, if any, from the complainant if permissible under policy terms and conditions.”

6.      Feeling aggrieved therefrom, OP-appellant have preferred this appeal.

7.      This arguments have been advanced by Sh. Rajneesh Malhotra, learned counsel for the appellant as well as Sh. Sant Lal Barwala, learned counsel for respondents. With their kind assistance the entire record of the appeal as well as record of District Commission including whatever evidence has been led on behalf of  both the parties has also been properly perused and examined.

8.      Learned counsel for the appellant argued that deceased got Life Jeewan Saral (with profits) policy and had to pay the premium of Rs.3062/- monthly but deceased did not pay the premium due in February, 2013 and due to which the policy in question got lapsed. However the policy was revived on 14.10.2013 on deposit of due premium and insured made a declaration regarding his good health and that he was not suffering from any disease whereas the life assured was employed with Delhi Jal Board and remained on leave due to medical grounds for 175 days. He did not disclose the material facts regarding his health that he was suffering from KOCH (FUC of abscess of lever) and T.B. of chest at the time of revival of policy. The policy in question was under loan and an amount of Rs.68000/- with due interest was recoverable from insured. So for all these reasons the appellant have rightly repudiated the claim of the respondent on 19.03.2016. The complainant was not entitled for the claim amount as prayed for.

9.      Learned counsel for the respondent argued that complainant’s husband was duly insured with appellant for a sum of Rs.7,50,000/-. The life assured expired during the subsistence of the policy. Being a nominee, the complainant has filed the claim, which was wrongly repudiated. Learned District Commission has rightly allowed the complaint of the complainant and prayed for dismissal of the appeal.

10.    It is admitted that during the continuation of the policy, the life assured has died.   At the time of revival of the policy, the appellant should have got conducted medical tests of the insured, but in this case, the appellant did not insist for the medical tests etc. of the life insured. The insurance company wrongly repudiated the claim of the complainant. When the policy in question was revived by the authorities after fulfilling all type of formalities and the learned District Commission rightly allowed the claim of the complainant. The learned District Commission had committed no illegality while passing the order dated 04.09.2017.  The appeal is also devoid of merits and stands dismissed.

11.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the respondents-complainants against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

12.    Application(s) pending, if any, stand disposed of in terms of the aforesaid order.

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

14.    File be consigned to record room.

 

 

18th  January, 2023           Suresh Chander Kaushik            S. P. Sood                                                                Member                                             Judicial Member    

 

S.K

(Pvt. Secy.)