MS. NIPUR CHANDNA, MEMBER
ORDER
14.11.2024
1. A complaint under Section 12 of Consumer Protection Act filed. In brief the facts are that being induced by the representation made by the OP complainant purchased the Life Ins. Policy in which complainant was the owner of the policy and his deceased son as the insured person and the policy named as “BSLI Vision Plan” having annual premium of Rs. 49,361.13 vide policy bearing no. 004988388 dated 13.07.2011 for the period of five years term commencing from the date of issuance of the policy.
2. It is further alleged by the complainant that as per the terms and conditions of the said policy, the said policy was having sum assured of rs. 1,84,500/- as well as guaranteed survival benefit of Rs. 1,84,500/-.
3. It is alleged by the complainant the complainant is regularly paying the premium (half yearly) but unfortunately his son got expired on 22.10.2013. Complainant approached OP for processing the death claim against the policy in question. As per the policy complainant is entitled for sum assured of rs. 1,84,500/- as well as guaranteed survival benefit of Rs. 1,84,500/- along with monthly addition accrued interest till date of death and other benefits but the OP Ins. Co. only paid a sum of Rs. 1,84,500/- along with bonus addition of Rs. 16,863/- totaling to Rs. 2,1,363/- vide cheque bearing no. 000120 dated 31.01.2014 despite the fact that complainant is entitled for guaranteed survival benefit of Rs. 1,84,500/- also. Being aggrieved by the arbitrary settlement of the claim in question complainant served legal notice dated 11.11.2014 thereby calling upon the OP to release the balance sum of Rs. 1,84,500/- against guaranteed survival benefit . The OP Ins. Co. vide its letter dated 09.12.2014 duly replied to the legal notice and denied the demand of the complainant. Being aggrieved by the decision of OP Co. of rejecting the balance claim, complainant approached this Commission for redressal of his grievance.
4. Notice of the complaint was sent to OP. OP filed its written statement wherein it denied any deficiency in service on its part. It is further stated that as per regulation 4 (1) and 6 (2) of the IRDA, the company sent a copy of proposal form along with the policy documents to the policy holder through Blue Dart which was duly received by the complainant at his registered mailing address. The policy holder had amply opportunity to go through the documents and notify the discrepancies, if any, within free look period of 15 days. In the instant case complainant had never approached OP with any discrepancies and as such the complainant is not entitled for raising any dispute in respect to the terms and conditions incorporated in the policy in question. As per the aforesaid policy the complainant is entitled for survival benefit as well as death benefit.
5. As per the policy the guarantee survival benefit is applicable at the end of GSB terms and the death benefits would be applicable in the event the life insured dies during the GSB terms. It is further stated that the guaranteed survival benefit is payable to the policy holder, if the life assured survive, after completion of the policy terms whereas the guaranteed death benefit shall be payable to the nominee when the life assured dies before completion of GSB terms. Since, in the instant case the life assured dies prior to the completion of GSB terms, the opposite party has rightfully paid the death benefit of Rs. 1,84,500/- along with bonus of Rs. 16,863/- as per the policy terms and conditions. It is further stated that the claim of the complainant as rightly dealt within the four corners of the policy terms and conditions as such the OP was justified in not giving the guaranteed survival benefit as alleged in the complaint. It is further requested that the present complaint is nothing but an abuse of the process of law and is without any cause of action, hence, dismissed with cost.
6. Rejoinder to the written statement of OP filed thereby denying the averments made in the written statement. Complainant filed his evidence by way of affidavit wherein he has corroborated the contents of his complaint. Complainant has also placed on record the copy of the policy documents, application form as well as letter dated 09.12.2014 in support of his contention.
7. Ms. Akriti Manocha Dy. Manager, Legal of OP Ins. Co. filed her evidence by way of affidavit wherein she has corroborated the contents of the WS. OP has also placed on record copy of the policy documents, application form as well as letter dated 31.01.2014, discharge receipt issued by complainant in support of its contention.
8. Both the parties filed their written arguments. We have heard the arguments advance at the bar by Sh. Rajender Kumar counsel for complainant and Sh. S.K. Bhati counsel for OP.
9. Before adverting to the disposal of the present complaint case let us peruse the relevant provision of CP Act 1986 which are reproduced as under:-
Section 11 Jurisdiction of the District Forum
(1) Subject to the other provisions of this Act, the District Forum shall have jurisdiction to entertain complaints where the value of the goods or services and the compensation, if any, claimed 1[does not exceed rupees five lakhs].
(2) A complaint shall be instituted in a District Forum within the local limits of whose jurisdiction- (a) the opposite party or each of the opposite parties, where there are more than one, at the time of the institution of the complaint, actually and voluntarily resides or 1[carries on business, or has a branch office or] personally works for gain; or (b) any of the opposite parties, where there are more than one, at the time of the institution of the complaint, actually and voluntarily resides, or 1[carries on business or has a branch office, or personally works for gain: PROVIDED that in such case either the permission of the District Forum is given, or the opposite parties who do not reside, or 1[carry on business or have a branch office, or personally work for gain, as the case may be, acquiesce in such institution; or (c) the cause of action, wholly or in part, arises.
- Admittedly, in the present complaint case the complainant is the resident of Mukharji Nagar, Delhi –09.The complainant has purchased the policy of OP and has mentioned two addresses of the OP in the arrays of parties. The first address is of Mumbai and second is of Gujranwala Town, New Delhi.
- Admittedly, the first address of the office of OP is of Mumbai, hence, does not fall within the territorial jurisdiction of this Commission. The complainant has mentioned the second address of OP at Gujranwala Town, New Delhi but failed to place on record any documentary evidence in respect to the any cause of action arose from the Gujranwala Town, New Delhi office of OP.
- Perusal of the record shows that neither the offices of OP nor any cause of action arose within the territorial jurisdiction of this Commission, hence, we are of the considered opinion that this Commission has no territorial jurisdiction to entertain and adjudicate the present complaint case.
- We have also gone through the entire record and found that as per the policy the guarantee survival benefit is applicable at the end of GSB terms and the death benefits would be applicable in the event the life insured dies during the GSB terms. The guaranteed survival benefit is payable to the policy holder, if the life assured survive, after completion of the policy terms whereas the guaranteed death benefit shall be payable to the nominee when the life assured dies before completion of GSB terms. Since, in the instant complaint case the life assured dies prior to the completion of GSB terms, the opposite party had rightfully paid the death benefit of Rs. 1,84,500/- along with bonus of Rs. 16,863/- as per the policy terms and conditions. In our considered opinion the claim of the complainant was rightly dealt within the four corners of the policy terms and conditions by OP Ins. Co. as such the OP was justified in not giving the guaranteed survival benefit as alleged in the complaint.
- In view of the above discussion we are of the considered opinion that the present complaint is not maintainable before this commission due to lack of territorial jurisdiction, moreover the complainant failed to establish the case of deficiency in service against OP, we therefore find no merits in the present complaint, same is hereby dismissed being devoid of merit.
- Copy of the order be given to the parties free of cost as per order dated 04.04.2022 of Hon’ble State Commission after receiving the application from the parties in the registry. Order be uploaded on www.confonet.nic.in.
Announced in open Commission on 14.11.2024.
Sanjay Kumar Nipur Chandna Rajesh
President Member Member
