Punjab

Sangrur

CC/3/2015

Sukhwant Kaur - Complainant(s)

Versus

Canara HSBC OBC Life Ins. - Opp.Party(s)

Shri Sanjeev Goyal

08 May 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

                                                               

 

                                                Complaint No.    003  

                                                Instituted on:      01.01.2015

                                                Decided on:       08.05.2015

 

Sukhwant Kaur wife of Late Shri Satnam Singh, resident of H.No.139, Village Nadampur, Sub Tehsil Bhawanigarh, Tehsil and Distt. Sangrur.

                                                        ..Complainant

                                        Versus

1.             Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited, Unitech Trade Centre, 2^nd Floor, C-Block, Sushant Lok, Phase-I, Sector 43, Gurgaon-122 009 through its authorised signatory.

2.             Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited, C-31 & C-32, 1^st Floor, Connaught Circus, New Delhi-110 001 through its Managing Director.

                                                        ..Opposite parties

 

For the complainant    :       Shri G.S.Shergill, Adv.

For OPs                    :       Shri G.P.Sharma, Advocate.

 

Quorum:    Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

 

 

Order by : Sukhpal Singh Gill, President.

 

1.             Smt. Sukhwant Kaur,  complainant (referred to as complainant in short) has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that the husband of the complainant, namely, Shri Satwant Singh (referred to as DLA in short) obtained the services of the OPs by getting himself insured vide policy number 0039452019 through their agent Oriental Bank of Commerce, Bhawanigarh  and under the policy the husband of the complainant was insured for Rs.2,50,000/- and in case of unfortunate death an amount of Rs.5,00,000/- was payable to the beneficiary. It is further stated that the DLA died on 13.9.2013 due to heart attack.   It is further stated that after passing of five months of the death of the insured, the complainant came to know about the insurance policy and lodged the claim with the OPs through Oriental Bank of Commerce Branch Bhawanigarh and submitted all the documents to the OPs, but the OPs did not release the claim.  Lastly, the complainant got served a legal notice on 20.8.2014 upon the OPs and after receiving the legal notice, the OPs released an amount of Rs.2,50,000/- on 29.09.2014, but withheld the remaining amount of Rs.2,50,000/-.  Thus, alleging deficiency in service on the part of the OPs, the complainant has prayed that the Ops be directed to release the remaining amount of Rs.2,50,000/- along with interest @ 18% per annum from the date of death till realisation, that the OPs be directed to pay interest @ 18% per annum on the delayed amount of Rs.2,50,000/- from the date of death till 29.9.2014 and further claimed compensation and litigation expenses.

 

2.             In reply, preliminary objections are taken up on the grounds that the complaint is false, malicious, incorrect and is nothing but an abuse of process of law, that the claim of the complainant has been rightly paid and that the Ops have paid the claim strictly as per the policy conditions.  On merits, it is admitted that the DLA was insured under the policy in question for an assured sum of Rs.2,50,000/-. It is further stated that the after the death of the DLA, the OPs received the death claim intimation on 28.3.2014, whereas the insured had died on 13.9.2013. It is further stated that after receiving the claim intimation, the OPs requested the complainant on various occasion and sought documents vide letters dated 17.4.2014, 21.5.2014, 24.6.2014 and 9.7.2014, but she did not submit the documents. It is further averred that the claim being an early claim as the DLA died within a period of six months of the date of issue of the policy, the OPs carried an investigation to settle the claim and after completion of investigation, the OPs accepted the claim and paid the amount.  It is stated further that the fund value of the invested premium under the said policy as per NAV on the date of claim intimation was Rs.18,294.62. However, as per the terms and conditions of the said policy, the death benefit is the higher of fund value or the sum assured and accordingly the complainant was paid an amount of Rs.2,50,000/- under the policy. It is further averred that the claim amount has rightly been paid to the complainant and nothing is due towards the OPs. As such, the OPs have prayed for dismissal of the complaint.

 

3.             The learned counsel for the complainant has produced Ex.C-1 affidavit, Ex.C-2 copy of letter, Ex.C-3 copy of legal notice, Ex.C-4 to Ex.C-5 copy of receipt, Ex.C-6 copy of death certificate and closed evidence. On the other hand, the learned counsel for OPs has produced Ex.OP-1 copy of proposal form and policy document, Ex.OP-2 copy of death claim intimation, Ex.OP-3 to Ex.OP-4 copies of letters, Ex.OP-5 affidavit, Ex.OP-6 to Ex.OP-8 copies of letters and closed evidence.

 

4.             We have very carefully perused the pleadings of the parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits dismissal, for these reasons.

 

5.             It is an admitted case of the parties that the DLA took a policy bearing number 0039452019 from the Ops under which he was insured for Rs.2,50,000/-.   It is also an admitted fact that the claim amount of Rs.2,50,000/- under the policy in question has already been paid to the complainant. 

 

6.             Now, the complainant has filed the present complaint to recover further  amount of Rs.2,50,000/- from the OPs as according to the complainant the Ops are liable to pay Rs.2,50,000/- in case of natural death and Rs.2,50,000/- on account of the sum assured.  Under the circumstances, the question for determination before us is only whether the OPs are liable to pay further sum of Rs.2,50,000/- or not as an amount of Rs.2,50,000/- has already been paid to the complainant.

 

7.             We have very carefully perused the whole case file as well as the policy document Ex.OP-1, but we are unable to find anything in the policy document entitling the complainant to get the total amount of Rs.5,00,000/- under the policy in question.  Further the complainant has not produced any documentary evidence to show that how the Ops are liable to pay further an amount of Rs.2,50,000/- to the complainant.  Clause 2.1 ‘Death Benefit’ of the policy Ex.OP-1 is reproduced below:-

“a) If the death of the life assured occurs on or after the risk commencement date during the policy term and the claim is admitted, we will pay you higher of the following as death claim:

(i)     Sum Assured less partial withdrawals, if any made during the last two years preceding death of the Life assured.  In case Life Assured is aged 60 years or more at the time of death, then all the partial withdrawals made after the Life Assured reached 58 years of age would be deducted.

(ii)    Fund value as on the date of the registration of death claim by us.

(iii)   Hundred and Five percent of all premiums paid less partial withdrawals, if any, made during the two years preceding death of the life assured. In case life assured is aged 60 years or more at the time of death, then all the partial withdrawals made after life assured reached 58 years of age would be deducted.”

 

8.             We may mention here that in the clause ‘death benefit’ under the policy document Ex.OP-1, it is no where mentioned that in case of natural death, the double of the insured amount shall be paid to the beneficiary/nominee.  As such, we find that the Ops have already paid the claim amount of Rs.2,50,000/- to the complainant and nothing more is payable to the complainant and further find no deficiency in service on the part of the OPs.

9.             It is worth mentioning here that the complainant is also not entitled to the interest on the delayed payment of Rs.2,50,000/- from the date of death till 29.09.2014.  It is admitted case of the complainant herself that she lodged the claim after five months of the death of the DLA and thereafter the OPs took some time to investigate the claim and after completion of the investigation, the Ops immediately paid the claim amount of Rs.2,50,000/- on 29.9.2014, as such, we are of the considered opinion that the Ops are not liable to pay any interest to the complainant on the delayed payment.

10.            In view of our discussion, we dismiss the complaint of the complainant. However, the parties are left to bear their own costs. A copy of this order be supplied to the parties free of cost. File be consigned to records.

                Pronounced.

                May 8, 2015.

                                                        (Sukhpal Singh Gill)

                                                           President

 

 

                                                              (K.C.Sharma)

                                                                Member

 

 

                                                                (Sarita Garg)

                                                                   Member