Haryana

Sonipat

CC/162/2015

JEET PATI W/O LATE SHRI SHISH PAL - Complainant(s)

Versus

BAJAJ ALLIANZ LIFE INSURANCE COM. LTD. - Opp.Party(s)

B.S. CHAHEL

05 May 2016

ORDER

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

SONEPAT.

 

 

                             Complaint No.162 of 2015

                             Instituted on:15.05.2015

                             Date of order:05.05.2016

 

Jeet Pati wife of late Sh. Shish Pal son of Sh. Chandgi Ram, resident of village Garhi Sarai Namdar Khan, tehsil Gohana, distt. Sonepat.

                                      ...Complainant.

 

                      Versus

 

1.Bajaj Allianz Life Insurance Co. Ltd., Subhash Chowk, Sonepat through its Branch Manager.

2.Serve Haryana Gramin Bank Branch Gohana through its Branch Manager.

 

 

                                      ...Respondents.

 

COMPLAINT UNDER SECTION 12 OF

THE CONSUMER PROTECTION ACT,1986

 

Argued by: Shri BS Chahal, Adv. for complainant.

           Shri Jai Kanwar Adv. for respondent no.1.

           Shri Rohtash Sabharwal for respondent no.2.

         

BEFORE-  NAGENDER SINGH, PRESIDENT.

        SMT.PRABHA WATI, MEMBER.

       

O R D E R

 

         Complainant has filed the present complaint against the respondents alleging therein that her husband Shri Shish Pal was working as Sweeper in MC Gohana and he has obtained LIC policy during his life time from the respondent under the scheme of Tatkal Bima Group Insurance for Rs.1,25,000/- in the year 2011 by paying the premium of Rs.5000/- vide policy no.123752028 and till date, Shish Pal had been regularly depositing the installments with the respondents.  Unfortunately the said Shish Pal had expired on 21.9.2014 and thereafter, the complainant has lodged the claim with the respondents and has submitted all the required documents for the release of the claim amount, but the respondents have refused to pay the claim amount to the complainant due to the reason that 4^th installment has not been deposited and in this way, there is lapse in depositing the installment and the said excuse is a lame excuse on the part of the respondents because all the above installments have been deposited by the deceased and the last installment was deposited on 13.2.2014 vide receipt dated 13.2.2014 itself. So, there is a grave deficiency in service on the part of the respondent and thus, the complainant has come to this Forum and has filed the present complaint.

2.       The respondents no.1 and 2 have appeared and they filed their separate written statement.

         The respondent no.1 in its written statement has submitted that no cause of action has accrued to the complainant for filing the present complaint since the respondent no.1 has already settled the claim for permissible fund value amounting to Rs.13571/- vide cheque no.110435 dated 17.12.2014 towards full and final settlement of all the claims under the membership no.5500538463 on the life of Shish Pal strictly in accordance with the terms and conditions of Group Master Policy no.0123752028 administered by Gurgaon Gramin Bank and the said cheque has been duly received by the complainant. Further the deceased did not pay premium due on 11.2.20124 even within the grace period though he was required to pay yearly premium at the rate of Rs.5000/- without any obligation to the respondent.  The complainant was knowing well that she is not entitled to any death coverage claim under the membership since the risk on the life of his husband had ceased to exist due to non payment of premium due on 11.2.2014 and the policy was lying lapsed on the date of death of the said insured member.  The deduction of the premium by the master policy holder cannot in any way be deemed to be payment of premium to the respondent no.1. The respondent no.1 has rejected the claim of the complainant by invoking the terms and conditions of Master policy as well as certificate of insurance.  The claim lodged by the complainant is not tenable and is inadmissible as per terms and conditions of the policy.  There is also no deficiency in service of any kind on the part of the respondent no.1.  The deceased member himself has failed to discharge his contractual obligation and did not pay the premium due on 11.2.2014 even within the period of grace and thus, his membership has elapsed and the life insurance cover on the life of insured member ceased to exist due to non payment of regularly premium.  The complainant is not entitled for any relief and compensation and thus, prayed for the dismissal of the present complaint.

         The respondent no.2 in its amended written statement has submitted that Sh. Shish Pal son of Chandgi Ram was having a saving account on.2102502473, new no.77481900024733 with the respondent no.2.    It is admitted that as per account statement an amount of Rs.5000/- has been paid by the bank to Bajaj Allianz Life Ins. Co. on 13.2.2014. 

3.       We have heard the arguments advanced by ld. Counsel for both the parties at length and have also gone through the entire relevant records available on the case file very carefully.

4.       Ld. Counsel for the respondent no.1 has submitted that statement has submitted that no cause of action has accrued to the complainant for filing the present complaint since the respondent no.1 has already settled the claim for permissible fund value amounting to Rs.13571/- vide cheque no.110435 dated 17.12.2014 towards full and final settlement of all the claims under the membership no.5500538463 on the life of Shish Pal strictly in accordance with the terms and conditions of Group Master Policy no.0123752028 administered by Gurgaon Gramin Bank and the said cheque has been duly received by the complainant. Further the deceased did not pay premium due on 11.2.20124 even within the grace period though he was required to pay yearly premium at the rate of Rs.5000/- without any obligation to the respondent.  The complainant was knowing well that she is not entitled to any death coverage claim under the membership since the risk on the life of his husband had ceased to exist due to non payment of premium due on 11.2.2014 and the policy was lying lapsed on the date of death of the said insured member.  The deduction of the premium by the master policy holder cannot in any way be deemed to be payment of premium to the respondent no.1. The respondent no.1 has rejected the claim of the complainant by invoking the terms and conditions of Master policy as well as certificate of insurance.  The claim lodged by the complainant is not tenable and is inadmissible as per terms and conditions of the policy.  There is also no deficiency in service of any kind on the part of the respondent no.1.  The deceased member himself has failed to discharge his contractual obligation and did not pay the premium due on 11.2.2014 even within the period of grace and thus, his membership has elapsed and the life insurance cover on the life of insured member ceased to exist due to non payment of regularly premium.  The complainant is not entitled for any relief and compensation.

         In the present case, the respondent no.2 in its amended written statement has submitted that Sh. Shish Pal son of Chandgi Ram was having a saving account on.2102502473, new no.77481900024733 with the respondent no.2.    It is admitted that as per account statement an amount of Rs.5000/- has been paid by the bank to Bajaj Allianz Life Ins. Co. on 13.2.2014. 

         He has placed on record some documents i.e. Statement of account Ex.RW2/A.  The bare perusal of the statement of account Ex.RW2/A and other documents Ex.C6, C7, C8 andC11 itself shows that an amount of Rs.5000/- was debited each time on different dates i.e. 11.2.2011, 4.2.2012, 4.2.2013 and 13.2.1014.  So after considering these documents, we are of the view that the premium amount has been paid by the deceased in due time and this time is fully admitted by Serv Haryana Gurgaon Gramin Bank/respondent no.2 in its written statement in para no.3 on merits.

         So, we find force in the present complaint and the complainant is entitled to get some sort of relief from the respondent no.1.  Accordingly, we hereby direct the respondent no.1 to deduct the amount of Rs.13571/- from the amount of Rs.125000/- and then to pay the balance amount to the complainant within a period of 60 days from the date of passing of this order, failing which, the above said amount shall fetch interest at the rate of 09% per annum from the date of passing of this order till its realization. The respondent no.1 is also directed to compensate the complainant to the tune of Rs.5000/- (Rs.five thousand) for rendering deficient services, harassment and mental agony.

                      With these observations, findings and directions, the present complaint stands allowed qua respondent no.1.

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

File be consigned to the record-room.

 

 

(Prabha Wati Member)            (Nagender Singh-President)

DCDRF, Sonepat.                       DCDRF, Sonepat.

 

Announced:05.05.2016