( Passed on dated 22nd April, 2016 )
Per Ms. Varsha O. Patil – Hon’ble Member.
The complainant filed this complaint u/s 12 & 14 of Consumer Protection Act, 1986.
The brief facts of the case are as follows:-
2. The complainant had purchased the LIC’s New Bima Gold policy under the plan and term 179/20 of Sum assured Rs.50,000/- in the name of his decease son Sagar bearing policy No. 975678126. The date of commencement of the said policy was 28/03/2007. The complainant is the nominee under the said policy the policy was issued terms and conditions.
3. On dated 12/01/2014, life assured Sagar was died in road accident near village Motkuli, Dist. Hoshangabad (M.P.) that as per contract complainant received death claim of Rs.50,000/- as full sum assured but the O. P. No. 1 & 2 refused to pay the DAB claim to the complainant.
4. The policy was issued by the O. P. to the deceased with assurance to pay full sum assured on the date of incidence to the complainant under the said policy.
5. The O. P. No. 1 issued a letter of repudiation of DAB claim on 09/09/2014 to the complainant, the husband of the complainant submitted the application on 13/09/2014 requesting to pay DAB claim but the O.P.No.1 did not replied said application. After some days he went to the office of O. P. No.2 and requested to pay the DAB Claim. The concerned authority told him that under the said policy life assured did not paid DAB premium and hence no claim shall be payable.
6. The O.P. has appointed their L.I.C. agent to collect the business and therefore the proposal form is to be filled up by their appointed LIC agent. The complainant is a layman. She did not know about the policy terms and conditions as it was duty of O. P. No. 1 & 2 to inform to the complainant to pay the DAB premium by writing a letter or by any other electronics means but the O.P. did not do so. It is physically, mentally and financially harassment to the complainant of non payment of DAB claim.
7. Therefore, the complainant has issued legal notice on dated 19/08/2015 through Adv. Shri. S. V. Sukhdeve, but the O. P. neither replied to the said notice nor make the payment. Hence the complainant has filed complaint for deficiency in service with claim Rs.50,000/- along with interest 12% from the date of repudiation of DAB Claim.
8. The complaint is admitted and issued notice to the O. P. No. 1 & 2. After receipt of notice issued by Forum, O. P. No. 1 & 2 was appeared through their counsel and filed their reply.
9. In the written statement O. P. No. 1 & 2 denied the contents of complainant’s complaint. In their reply they stated that the father of life assured, Shri. Pradeep Ujwane had submitted proposal dated 15/03/2007 for policy on life of his minor son for LIC’s New Bima Gold policy Table No. 179 for 20 years terms for Rs.50,000/- sum assured and policy No. 975678126 was issued, on life of his son Sagar whose date of birth was 07/06/1989. His son is 17 years, 9 months and 8 days old and was thus minor having not completed the age of 18 years at time of submission of proposal. Thus, his completed the age of 17 years and therefore not being competent to contract, the proposal was submitted by his father. Although policy can be taken on the life of minors, as per LIC’s rules, minors are not eligible to Accidental Benefit due to this reason; the proposal form also does not contain a question relating to Accidental Benefit in policy. The proposal also does not contain a question about nomination, as the minor life assured can not make nomination in policy as per permission of Sec. 39 of Insurance Act, 1938, as such; policy issued by opposite party does not have the name of nominee in it. However, life assured can make a nomination after attaining age of majority i.e. 18 years during his life time. The opposite party gave the calculation of premium in the policy and the conditions. Therefore, the present claim of the complainant is required to be dismissed.
10. The complaint has filed documents nos. 1 to 18 on record.
11. The counsel for complainant Mr. Sukhdeve argued that the complainant nominee under the policy No. 975678126 at the time of taking policy. The decease was minor and therefore, the mother of decease became the nominee. As per the policy contract the complainant is the nominee. She has received death claim of Rs.50,000/- as full sum assured. But refused to pay the DAB claim to the complainant which is equal to the amount of sum assured as per the terms and conditions laid down in the policy bond.
On 12/01/2014, life assured was died in road accident near village Matkuli, Dist. Hoshangabad (M.P.). As per the contract complainant received death claim of Rs.50,000/- as full sum assured but O.P. refused to pay the double accident benefit to the complainant.
The husband of the complainant submitted the application on dated 13/09/2014, requesting to pay DAB claim but the O.P.No.1 did not replied to the said application.
After some days he went to the office of O.P.No.2 and requested to pay DAB claim. The concerned authority told him that under the said policy life assured did not paid DAB additional premium and hence no claim shall be payable. The O.P. malafidly shown their deficiency of service to repudiate the DAB claim for which they require to punish according to law hence complaint may be allowed.
12. The counsel for O. P. No. 1 & 2 Mr. Dixit argued that the father of life assured submitted proposal dated 15/03/2007 for policy on life of his minor son for LIC’s New Bima Gold policy table No. 179 for 20 years terms for Rs.50,000/- sum assured and policy No. 975678126 was issued his son’s date of birth is 07/06/1989, his son was 17 years, 9 months and 8 days old and was thus minor having not completed the age of 18 years at the time of submission of proposal. Thus, he completed age was 17 years and therefore not being competent to contract.
He further argued that the policy document shows that the name of life assured as Sagar and Pradeep Ujwane as proposer. As policy was on life of minor son, and minor life assured can not be given accident benefit the premium payable in the policy was without additional premium for accident benefit. Thus, policy remained without accident benefit till the death of life assured. Accident benefit was not payable under the policy. Therefore, the case is liable to be dismissed.
13. As per complaint and arguments and documents filed on record following points came for consideration.
Sr. No. | Points | Findings |
1. | Whether the complaint is deserves to be allowed? | NO |
2. | What Order? | As per final order. |
REASONING & FINDINGS
14. The complainant’s son Sagar whose date of birth was 07/06/1989. His son was 17 years 9 months and 8 days old and was thus minor having not completed the age of 18 years at the time of submission of proposal. Thus, his completed age was 17 years and therefore not being competent to contract. Although policy can be taken on the life of minors as per LIC’s rules, minors are not eligible to accident benefit. The proposal also does not contain a question about nomination as the minor life assured can not make nomination in policy as per permission of Sec. 39 of Insurance Act, 1938. After attaining majority the minor who became major had to file application for accidental benefit and ready to pay additional premium then in that case the insurance company is liable to pay the benefit of double accident benefit to the insured. Admittedly, there is no such application in respect of present policy.
15. The counsel for O. P. No. 1 & 2 argued and shows the documents that Sagar and Pradeep Ujwane as proposer and as per policy rule minor life assured can not be given accident benefit, the premium payable in the policy was without additional premium for accident benefit. After attaining majority age life assured can opt for accident benefit by paying additional premium to avail this benefit. Thus policy remained without Accident Benefit till the death of life assured and therefore not payable under the policy.
Hence, the following order is passed:-
-: ORDER :-
1. The complaint is dismissed.
2. No order as to costs.
