Date of filing : 29-10-2010
Date of order : 30-05-2012
IN THE CONSUMER DISPUTES REDRESSAL FORUM, KASARAGOD
CC.223/2010
Dated this, the 30th day of May 2012
PRESENT
SRI.K.T.SIDHIQ : PRESIDENT
SMT.P.RAMADEVI : MEMBER
SMT. K.G.BEENA : MEMBER
Dr.Shrinidhi Saralaya, } Complainant
S/o. Seetharama Saralaya,
Vasyam, Baradka, Po.Perdala,
Kasaragod Dt. 671 551.
(Adv.Shrikanta Shetty,
Prakash Ammannaya,P.R, Kasaragod)
Bajaj Allianz Life Insurance Co.Ltd, } Opposite party
1st Floor, Thumbe Arcade, Falnir,
Mangalore. 575 001.
(Adv. K.V.Jayaraj, Hosdurg)
O R D E R
SMT.K.G.BEENA, MEMBER
The nutshell of the case is that Late Dr.Malini Saralaya was a policy holder of Bajaj Allianz Life Insurance Policy commencing from 28-03-2008. She paid the first premium of `50,000/-. The 2nd premium was not paid in time and the policy was lapsed on 22-07-2009. Dr. Malini requested opposite party to receive the policy through a letter and has given `25,000/- as 2nd instalment but opposite party refused to receive the 2nd premium but advised her to pay the amount along with request letter to accept the same. Dr. Malini met with an accident and died on 26-07-2009 till her death opposite party was not taken steps to receive the policy and thereby caused heavy loss and mental agony to the complainant.
2. According to opposite party, complainant’s wife was a policy holder of Unit Gain Regular Premium Century Plus Plan insurance for an assured sum of `2,50,000/-. The complainant’s wife had paid `50,000/- as her first premium. The premium frequently was annual. The complainant’s wife had to pay the 2nd premium amount of `50,000/- on or before 31-03-2009 but she failed to do so. The opposite party is functioning under the provision of Insurance Act by abiding all concerned statutes. The clauses in policy document is binding the insurer and insured. The proposal of the complainant was accepted by the opposite party. The complainant is premature. There is a grievance redressal committee under the Bajaj Allianz Life Insurance Company Ltd. Besides the central government has established an office of Insurance Ombudsman to attend the grievance of policy holders. Moreover, the complaint is bad for non-joinder of necessary parties. The insurance consultant mentioned in para 2 of the complaint ought to have been a party to this complaint.
3. Complainant filed chief affidavit in support of his case. Exts A1 to A9 marked through him operation Manager, Bajaj Allianz Life Insurance Co.Ltd filed affidavit and cross examined on affidavit. Ext.B1 marked. Both sides heard and documents scrutinized.
4. Here the question raised for consideration:
1. Whether there is deficiency of service on the part of opposite party?
2. If so, what is the relief?
5. Complainant deposed before the Forum that opposite party issued a policy document to his deceased wife. He has surrendered the policy before the opposite party for settlement of the claim. As per policy document the policy holder has to pay `50,000/- as yearly premium. She has joined in “Century Plus’ policy and the term is 10 years. The 2nd premium was not paid in time, she has gone for delivery and was an unaware of the due date. The agent told that the subsequent premium need to be paid at the rate of `25,000/- each from the 2nd premium onwards. Deceased Dr. Malini Saralaya give a request to receive the policy. But due to undue delay on the part of opposite parties to process the application, the policy was not revived till the death of Dr. Malini. The policy holder Dr. Malini met with an accident and died on 26-07-2009. The complainant who is the nominee of the policy made the claim on18-02-2010 which is marked as Ext.A5. On 13-03-2010 opposite party informed the complainant through Ext.A6. As the policy was in lapsed condition on date of death the claim has been approved for refund of fund value only under policy conditions. Eventhough the complainant sent lawyer notice on 17-06-2010 claiming the sum assured as per IInd policy is. ` 1,25,000/- as the opposite parties failed to process the application of the policy holder in a speedy manner is the deficiency of service on their part and the complainant is entitled to get `1,25,000/-.
6. PW2 deposed before the Forum that he was the insurance consultant, through him Dr. Malini availed the policy. Ist premium was paid through him and 2nd premium company did not accepted because there is an option to decrease the regular premium. He submitted Ext.A4 before opposite party on 22-07-2009. Company received the letter but not accepted the premium of `25,000/-.
7. PW2 again deposed that the company did not accepted `25,000/- because for want of an application for the reduction of annual premium from the insured. Had the insured paid `50,000/- then the company would have received the amount”. Here it is the duty of the insurance consultant to inform the party that for reduction of annual premium an application is highly necessary and collect the same on the same moment. Ext. A4 might have given in accordance with his suggestion. It is clear from the deposition of PW2 that Dr. Malini had given `25,000/- to him as 2nd instalment at the time of giving Ext.A4. The insurance consultant could have inform her that an application for reduction of premium is necessary for acceptance of the amount. The insurance consultant behaved in a very negligent manner. Ext. A4 submitted by the deceased Malini for the revival of the policy with reduced premium before 5 days of her unexpected death itself revels that she was genuinely interested in reviving the policy with a reduced premium amount only because of the lethargic attitude of the opposite parties employees they did not promptly acted upon the willingness of the deceased to revive the policy. PW2 had given the policy to Dr. Malini he very well know that the policy is already lapsed and an application is required for reduction of premium. But opposite parties bothered about their benefits only. DW3 deposed before the Forum that there office is well equipped with electronic medias. They will get communications from the Head office from the system. Since they accepted update the system. If it is true application for revival has been approved within two or three days. But they were negligent in providing service to the customers and there by caused one week delay in getting approval from the head office of an insurance company. This shows their improper service and negligence. In a policy of Life Insurance every seconds service of opposite party is vital as far as the life of insured is concerned. No doubt there is deficiency of service on the part of opposite party. Opposite party is liable to compensate the loss and mental agony of the complainant. Had the second policy is processed in time the nominee would have get `1,25,000/- on the death of the assured. Complainant suffered huge loss due to undue delay on the part of opposite party.
In the result, complaint is allowed and opposite party is directed to pay compensation of the ¼ th of the assured amount i.e. `30,000/- within 30 days from the date of receipt of this order. Failing which necessary steps will be taken considering the request of the complainant.
MEMBER MEMBER PRESIDENT
Exts.
A1.19-3-2008 letter sent by OP to complainant.
A2.Photocopy of FIR
A3. Post Mortem Report.
A4. Photo copy of letter Sent by complainant to Opposite party.
A5. letter sent by complainant to Death Claim Department Bajaj Allianz Life Insurance
Co.Ltd, Mangalore Branch.
A6.13-4-10 letter sent by OP to complainant.
A7.17-6-10 copy of lawyer notice.
A8. Acknowledgement card.
A9. Photocopy of Death Certificate.
B1. Policy Document.
X1 series Product circular
X2. Claim Summary sheet.
PW1. Dr.Shreenidhi Saralaya.A.
PW2. Balachandran.R.
PW3. Supreetha P.Pakkala
DW1. Shinoj P.T.K.
MEMBER MEMBER PRESIDENT
Pj/
