Haryana

Karnal

CC/88/2019

Smt. Ankita Taneja - Complainant(s)

Versus

Aviva Life Insurance Company India Limited - Opp.Party(s)

Gurmeet Singh Khillan

01 Oct 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                          Complaint No. 88 of 2019

                                                          Date of instt.18.02.2019

                                                          Date of Decision 01.10.2019

Smt. Ankita Taneja d/o Shri Ashok Taneja resident of House no.163, sector-8, Part-2, Urban Estate, Karnal.

                                                …….Complainant.

                                        Versus

Aviva Life Insurance Company India Ltd. 2^nd floor, Parkash Deep Building 7, Tolstoy Marg, New Delhi.

                                                                         …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

      Sh.Vineet Kaushik ………..Member

                Dr. Rekha Chaudhary…….Member

 

 Present:  Shri G.S.Khillan Advocate for complainant.

                   Shri Vineet Rathore Advocate for opposite party.

 

                   (Jaswant Singh President)

ORDER:                    

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that complainant namely Neru Taneja was insured with the OP under the Aviva Little Master Policy bearing no.00272301/ALM2058312 and the complainant was nominee of the abovesaid policy. The complainant is the real daughter of the policy holder. As per policy, the complainant was entitled for a sum of Rs.1,00,000/- in case of death of the policy holder. The complainant’s mother had been suffering from Dengue and the condition of the mother of the complainant worsened due to the disease as such she was admitted in Fortis Hospital, Mohali on 17.09.2008 and remained admitted till 24.09.2008. After that, she was shifted to Sir Ganga Ram Hospital, New Delhi where she died on 30.09.2008. The complainant was minor at the time of death of the mother as per date of birth is 8.11.1995 and as such the present claim was filed after attaining the age of majority. The complainant moved a complaint bearing no.012151137 to the OP for claiming the amount of Rs.1,00,000/- under the policy. However, the said claim was rejected by the OP, vide letter dated 29.10.2018 on the ground that there is concealment of the fact. The OP further alleged that the mother of the complainant was having history of chronic diarrhea and Anemia as such, she has concealed this fact in the proposal form and the complainant is not entitled to sum assured under the policy. The complainant also submitted all the relevant documents including treatment record and Death Certificate of the mother of the complainant to the OP. The OP has illegally rejected the claim of the complainant as there was no concealment on the part of the policy holder and death was not directly related to the alleged medical history. The condition of the mother of the complainant deteriorated due to the suffering from Dengue fever and not from the alleged earlier disease. In this way there was deficiency in service on the part of the OP. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OP, who appeared and filed an application under section 24-A & 26 of the Consumer Protection Act as amended upto date for dismissal of the complaint for want of limitation and vexatious. It is alleged in the application that the complaint filed by the complainant is beyond the period of limitation as prescribed under the Consumer Protection Act. The complainant is not allowed to file the complaint under to thrash the period of limitation of two years as provided under section 24-A of the C.P.Act. It is further alleged in the application that the complainant has filed the complaint after delay of around ten years. The mother of the complainant i.e. Neeru Taneja has purchased the policy on 17.06.2008 and had expired on 30.09.2008 and the limitation of claim was imparted to the OP by the father of the complainant on 5.12.2008 and after processing the claim, same was repudiated and informed to the father of the complainant vide, repudiation letter dated 17.12.2008 and 24.02.2009 as the discharge summary dated 24.09.2008 issued by Fortis Hospital clearly submitted at claims stage, stated that the deceased life assured had a history of anaemia but these material facts were not disclosed in the proposal form dated 17.06.2008 by the deceased life assured who was an educated lady. Keeping in view the facts and circumstances of the complaint in hand, it is very much clear that the claim under policy has rightly been repudiated around 10 years back. The complainant in a calculated design, has filed the present non-est complaint once again without disclosing these facts.

3.             Complainant filed the reply to the application of the OP stating therein that the complaint is well within the period of limitation. In this case the cause of action has accrued in favour of the complainant on 29.10.2018 when the claim was rejected on the ground of concealment of fact. The complainant was minor at the time of death of her mother and after attaining majority, she submitted her claim to insurance company. In the repudiation letter dated 29.10.2018, the OP has nowhere mentioned above repudiation letter dated 24.02.2009 and now the insurance company has come with a fictitious ground to defect the claim of the complainant. The complainant has not received any alleged letter from the insurance company.

4.             According to the complainant her mother Neeru Taneja has purchased the policy an insurance policy on 17.06.2008 and she had expired on 30.09.2008. It is further alleged that the complainant was minor at the time of death of the mother as per date of birth is 8.11.1995 and as such the present claim was filed after attaining the age of majority. On the other hand, OP alleged that the limitation of claim was imparted to the OP by the father of the complainant on 5.12.2008 and after processing the claim, same was repudiated and informed to the father of the complainant vide, repudiation letter dated 17.12.2008 and 24.02.2009 as the discharge summary dated 24.09.2008 issued by Fortis Hospital clearly submitted at claims stage, stated that the deceased life assured had a history of anaemia but these material facts were not disclosed in the proposal form dated 17.06.2008 by the deceased life assured who was an educated lady. Keeping in view the facts and circumstances of the complaint in hand, it is very much clear that the claim under policy has rightly been repudiated around 10 years back.

5.             In the present case cause of action to file the present complaint accrued to the complainant on 24.02.2009 after repudiation of the claim. Present complaint is filed by complainant on 18.02.2019 1 i.e. after 10 years of accrual of cause of action. As per 24A of Consumer Protection Act:-  

“ The District Forum, the State Commission or the National Commission shall not admit a complaint unless it is filed within 2 years from the date on which the cause of action has arisen. Present complaint is filed beyond the period of limitation of 2 years.  Complainant has not filed any application for condonation of delay.  No sufficient cause for not filing the complaint within time has been shown or explained by the complainant. Hence as per the provision of Section 24A of Consumer Protection Act the present complaint is beyond the limitation.  Hence the present complaint is not maintainable.

6.              Complainant alleged that at the time death of her mother she was minor and her date of birth is 8.11.1995 and she filed the complaint after attaining the date of majority. This plea of complainant is also not tenable as per her date of birth complainant attaining the majority date on 8.11.2013 but she filed the present complaint in the year 2019, therefore, the present complaint is barred by the provision of section 24(A) of the Consumer Protection Act, 1986. So, the application of the OP is allowed and the present complaint is dismissed being time barred Parties be informed accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:01.10.2019                                             President,

                                                              District Consumer Disputes

                                                               Redressal Forum, Karnal.      

        (Vineet Kaushik)          (Dr. Rekha Chaudhary)

            Member                           Member