Haryana

StateCommission

CC/11/2015

NARESH MADAN - Complainant(s)

Versus

BHARTI AXA LIFE INSURANCE CO.LTD. - Opp.Party(s)

IN PERSON

24 May 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

Complaint No  :      11 of 2015

Date of Institution: 02.02.2015

Date of Decision :  24.05.2017

 

1.      Naresh Madan, C-1, HNG Colony, Hindustan National Glass & Industries Limited, Rohtak Road, Bahadurgarh, Haryana-124507.

 

2.      Deepak Madan s/o Sh. Naresh Madan, C-1, HNG Colony, Hindustan National Glass & Industries Limited, Rohtak Road, Bahadurgarh, Haryana-124507

                                     

Complainants

Versus

 

The Managing Director, Bharti Axa Life Insurance Company Limited, Unit 601 & 602, 6^th Floor, Raheja Titanium, Off Western Express Highway, Goregaon (East), Mumbai-400063.

                                      Opposite Party

 

CORAM:             Hon’ble Mr. Justice Nawab Singh, President.

                             Mr. Balbir Singh, Judicial Member.

                                                                                                         

Present:               Shri Vikrant Bamboo, Advocate for Complainants.

                             Shri Akhilesh Vyas, Advocate for Opposite Party.

 

                                                   O R D E R

 

BALBIR SINGH, JUDICIAL MEMBER

 

        As per version of the complainants, Smt.Narbada Madan (since deceased)-wife of complainant No.1 and mother of complainant No.2, was provided an Insurance Policy under Protect Term Plan on 19^th January, 2014 by Bharti Axa Life Insurance Company Limited-Opposite Party (for short ‘the Insurance Company’), for a period of 30 years mentioning Sum Assured as Rs.50,00,000/-. An amount of Rs.9944/- was deposited as annual premium on the same date along with proposal form and other documents. Later on she was got medically examined by the Insurance Company on 31^st January, 2014. Unfortunately on 10^th February, 2014 Smt. Narbada Madan (hereinafter referred to as ‘the proposer’) met with an accident and she died on the same date. Information was sent to the Police and First Information Report No.23 was lodged in the Police Station on the same date. On next day i.e. 11^th February, 2014 the complainants informed the opposite party regarding death of the proposer. An email message was also sent to the opposite party on 26^th February, 2014 regarding death of the proposer. In the meanwhile, on 12^th February, 2014, an email message was received from the opposite party regarding cancellation of the insurance policy.

2.                On 14^th February, 2014, a counter offer letter was received from the opposite party giving fresh proposal with revised terms of the proposal reducing the sum assured as Rs.30,00,000/-. The proposer- Narbada Madan was no more in this world to accept the fresh proposal. Vide letter dated 4^th March, 2014 received on 24^th March, 2014, the insurance policy/proposal was cancelled due to non-production of the required information and documents. The complainants being nominees of the proposer-Narbada Madan, submitted their claim vide letter dated 14^th April, 2014 alongwith documents. The opposite party failed to settle the claim amount of Rs.50.00 lacs. In this regard, the complainants submitted letter dated 01^st August, 2014 and few other letters so that the settlement of the claim may be possible.  A complaint was also filed by the complainants in the office of Insurance Ombudsman on 5^th December, 2014 which could not be entertained for want of pecuniary jurisdiction as the claim of the complainants was more than an amount of Rs.20.00 lacs. It is prayed that the complaint filed by the complainants be allowed holding that the complainants are entitled to receive an amount of Rs.50.00 lacs on account of loss caused due to death of the proposer-Narbada Madan; an amount of Rs.10.00 lacs on account of un-necessary harassment and mental agony and an amount of Rs.10,000/- as costs of litigation.

3.                The Insurance Company-Opposite Party in its written version has taken plea that the complaint is not maintainable under the provisions of Consumer Protection Act, 1986; that the complainants have concealed material facts from this Commission and that this Commission has no jurisdiction to decide this complaint.

4.                As per version of the opposite party, the contract regarding providing insurance policy in between Smt.Narbada Madan and the Insurance Company-opposite party was not complete before her sudden death on 10^th February, 2014 Smt. Narbada Madan only had submitted proposal form and other documents alongwith an amount of Rs.9944/- as premium giving offer to the Insurance Company for obtaining insurance policy for a period of 30 years mentioning sum assured as Rs.50.00 lacs. In fact, when Smt. Narbada Madan died, the process regarding this contract was going on. On 31^st January, 2014, the proposer was medically examined. Thereafter, a letter was addressed to the proposer on 12^th February, 2014 regarding cancellation of the insurance policy mentioning that the date of birth mentioned in the proposal form and Permanent Account Number Card was different. It is denied that the complainants informed the opposite party regarding death of the proposer on 11^th February, 2014. In fact, information regarding death of the proposer was received from the complainants through email message on 26^th February, 2014.

5.                Considering the annual income of the proposer and other factors, a fresh proposal was given to Smt.Narbada Madan vide counter offer letter dated 14^th February, 2014 for obtaining her consent mentioning sum assured as Rs.30.00 lacs instead of Rs.50.00 lacs. It was also offered that excess premium amount shall be refunded as and when proposal was accepted. It is also pleaded that on 25^th February, 2014 the complainant No.1 sent email message mentioning acceptance of the offer without disclosing death of his wife. The fresh proposal was not accepted. In these circumstances, as the proposer had died before acceptance of the proposal, the unconcluded contract was cancelled vide letter dated 4^th March, 2014. Earlier letter dated 11^th February, 2014 was sent to the proposer seeking clarification regarding her date of birth. A letter dated 13^th March, 2014 was received by the opposite party from the complainants for re-consideration of the decision taken by the opposite party. Regarding decision of cancellation of the un-concluded contract, the opposite party issued letters on 14^th April, 2014 and thereafter on 7^th August, 2014 as the agreement in between Smt. Narbada Madan-proposer and the Insurance Company-opposite party was not complete. The complainants are not entitled to receive any other amount as claimed in the complaint. It is prayed that the complaint filed by the complainants be dismissed with costs.

6.                It will be pertinent to mention here that the complainant-Naresh Madan and his son Deepak Madan, were nominees of the deceased Smt. Narbada Madan, as mentioned in the proposal form. After filing an application by Deepak Madan, he was allowed to be impleaded as complainant No.2 in this complaint. Amended title of the complaint was also filed on the same date on 22^nd March, 2016.

7.                Complainant-Naresh Madan appeared in the witness box as CW-1 and also adduced in evidence the following documents:-

                   Downloaded Print of the Insurance Policy      Exhibit C-1

                   Statement of account                                        Exhibit C-2

                   Death Certificate                                                          Exhibit C-3

                   Copy of F.I.R.                                                     Exhibit C-4

                   Copy of email                                                     Exhibit C-5

                   Copy of letter dated 14.02.2014                      Exhibit C-6

                   Copy of letter dated 04.03.2014                      Exhibit C-7

8.                The Insurance Company-Opposite Party has adduced in its evidence affidavit of Smt. Sunita Yadav, Associate Manager Legal as Exhibit OP-1 and documents Exhibits OP-1 to OP-33.

9.                We have closely perused entire pleadings and evidence on the file. In this order, we shall discuss only those documents in detail which are relevant for decision of this case.

10.              We have heard learned counsel for the parties and perused the case file.

11.              During the course of arguments, there was no controversy of any type that before acceptance of the proposal and issuance of the insurance policy documents, the proposer-Narbada Madan met with an accident on 10^th February, 2014 and she succumbed to the injuries suffered at the time of accident. The opposite party was informed through email message dated 26^th February, 2014 (Exhibit OP-8) by the complainants. Regarding death of the proposer, F.I.R. No.23 (Exhibit C-4) was lodged on the same day in Police Station, Bahadurgarh. Exhibit C-3 is the Death Certificate of deceased Narbada Madan.  

12.              It is an admitted fact that the proposal form (Exhibit OP-25) alongwith other documents was submitted by the proposer to the opposite party on 19^th January, 2014. It is also an admitted fact that the proposal form providing insurance policy mentioning sum assured as Rs.50.00 lacs was for a period of 30 years. As required, the proposer on the same date deposited the first annual premium amount of Rs.9944/-. It is also an admitted fact that the proposer was called again by the opposite party and her medical examination was conducted by a doctor on the panel of the opposite party on 31^st January, 2014. Before any further progress in the matter, the proposer died on 10^th February, 2014. In fact, the complainant Naresh Madan and his wife thought that all proceedings regarding providing insurance policy, were complete as and when the proposal form was submitted and the premium amount was paid.

13.              As per version of the opposite party, the contract was not complete as before 10^th February, 2014 neither the proposal form submitted by the proposer was accepted nor acceptance letter and other relevant documents regarding the insurance policy were issued to the proposer. The complainants could not adduce any evidence and even have not taken any plea that acceptance letter or any other document concerned with the insurance policy was sent to the proposer before her death. In these circumstances, legally and technically the contract in between the proposer and the opposite party was incomplete. What happened as and when the proposer breathed her last on 10^th February, 2014, the opposite party issued a letter dated 11^th February, 2014 (Exhibit OP-11) mentioning that there is a mismatch in between Pan Card and Proposal Form regarding date of birth of the proposer. No clarification regarding date of birth could be possible after death of the proposer. As per record, the opposite party was first time informed regarding death of the proposer vide email message dated 26^th February, 2014 (Exhibit OP-8). In the letter dated 12^th February, 2014 (Exhibit C-5) there is mention regarding cancellation of the proposal.

14.              In this way, the proposal submitted by the proposer-Narbada Madan was not accepted and a fresh counter offer letter for fresh proposal (Exhibit C-6) was issued on 14^th February, 2014 in the name of proposer-Smt.Narbada Madan offering that she could be provided life insurance policy for the same period in case she accepts the proposal to get the revised sum assured mentioned as Rs.30.00 lacs instead of Rs.50.00 lacs. In case the fresh proposal is accepted, the excess premium amount of Rs.1282.17 shall be refunded to the proposer. No acceptance letter could be received from Smt. Narbada Madan as she was no more in this world, so the counter offer for proposal as well as initial proposal was cancelled vide letter dated 4th March, 2014 (Exhibit C-7). Thereafter, the complainants submitted few other letters in the months of May, June and July, 2014 for re-consideration of the claim of the complainants. The letters of correspondence adduced in evidence show that prayer of the complainants in this regard time and again was declined. Much discussion is not needed of those letters of correspondence in this order. Now situation is quite clear. The complainants have failed to prove that the proposal of Smt. Narbada Madan was ever accepted by the opposite party. Unfortunately, the proposer-Narbada Madan died in a road side accident when process regarding providing the insurance policy was in progress. When the medical examination of the proposer was conducted on 31^st January, 2014 how findings can be given that the insurance policy was provided with effect from 19^th January, 2014 merely because premium amount was paid by the proposer. Moreover, apart from payment of premium amount, the opposite party is required to verify regarding health, economical condition etc of the proposer before acceptance of the proposal. There was mistake in the date of birth of the proposer in the proposal form and the opposite party thought it proper to issue counter letter for revised proposal considering the financial condition and source of income of the proposer. Unfortunately, when the counter offer of proposal was issued, the proposer was no more in this world to accept that offer. A contract can be considered as complete in case the proposal of one party is accepted by the other party without any change or amendment. The copy of the salary statement of the proposer is Exhibit OP-15.

15.              During the course of arguments, learned counsel for the opposite party also pointed out that at few places in the letters of correspondence like Exhibits OP-24 and OP-25, insurance policy number has been mentioned. Moreover, the cancellation letter should have been issued within 15 days from the date of submitting the proposal form. During the course of arguments, learned counsel for the complainants could not show any such terms and conditions or provisions of law that in case letter regarding cancellation of the proposal is not issued within 15 days, the proposal should be treated as accepted.  We feel merely because on few documents like Exhibits OP-24 and OP-25, insurance policy number has been mentioned. It cannot be considered that the proposal has been accepted. In fact, on these documents the policy number as well as proposal number are mentioned. Moreover, in such type of matters, findings cannot be based merely on technicalities.

16.              As a sequel as per discussions above in detail, we have no hesitation in holding that contract in between proposer-Narbada Madan and the opposite party-Insurance Company was not complete as her proposal was not accepted by the opposite party before the date of her death. Unfortunately due to her death revised proposal issued by the opposite party vide letter dated 14^th February, 2014 also could not be accepted as the proposer breathed her last on 10^th February, 2014. In this way, findings are given that the proposer was not provided life insurance policy. Insurance Company-opposite party is not liable to pay any amount on account of this incomplete act of transaction in between the proposer and the opposite party.

17.              It is an admitted fact that when claim submitted by the complainants was not settled and accepted by the opposite party, a petition was filed by the complainants before the Insurance Ombudsman, Chandigarh. The Insurance Ombudsman declined to interfere in the matter for want of pecuniary jurisdiction as claim of the complainants in this case is for an amount of more than Rs.20.00 lacs. Much discussion is not needed of the documents adduced in evidence by the complainants as well as the opposite party in connection with the proceedings regarding this controversy before the Insurance Ombudsman, Chandigarh. No other point was raised at the time of arguments.

18.              As a result as per discussions above in detail, findings are given that the complainants have failed to prove that Smt. Narbada Madan was provided insurance policy cover and that her proposal in this regard was accepted by the Insurance Company-Opposite party. Resultantly, the complainants are not entitled to receive any amount as claimed in this complaint. We find no merit in this complaint and the same stands dismissed. Parties are left to bear their own costs.

 

Announced: 24.05.2017

(Balbir Singh) Judicial Member

(Nawab Singh) President

 

CL