Punjab

Sangrur

CC/382/2018

Poonam Rani - Complainant(s)

Versus

DHFL Pramerica Life Insurance Co. Ltd. - Opp.Party(s)

Sh.Nem Kumar

27 Oct 2022

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

                                                                        Complaint No. 382

 Instituted on:   18.09.2018

                                                                         Decided on:     27.10.2022

 

Poonam Rani aged 42 years Wd/o Sh. Ravinder Kumar, R/O 74/1, W No.4B, Karkhana No.2, Near Mangla Ashram, Dhuri and District Sangrur.

                                                          …. Complainant.     

                                                 Versus

1.     DHFL Pramerica Life Insurance Company Ltd. through its Manager, 4^th Floor, Building No.9, Tower-B, Cyber City, DLF Phase III, Gurgaon 122002.

2.     DHFL Housing Finance Corporation Ltd. through its M.D. Warden House, 2^nd Floor, Sir PM Road Fort, Mumbai 400 001.

3.     DHFL Housing Finance Corporation Ltd. through its Manager, A-301 and 302, 3^rd Floor, Elante Office Complex, Industrial Area, Phase 1, Chandigarh 160019 .

4.     DHFL Housing Finance Corporation Ltd. through its Manager, SCO 94-95, New Market, Leela Bhawan, Bank Colony, Patiala.

5.     DHFL Housing Finance Corporation Ltd. through its Manager, SCF 14, 1^st Floor, Kaula Park, Sangrur 148001.

             ….Opposite parties. 

 

For the complainant    : Shri Nem Kumar, Adv.

For the OP No.1            : Shri Sanjeev Goyal , Adv.

For OP No.2 to 5            : Shri Karanveer Singh, Adv.

 

Quorum                                           

JOT NARANJAN SINGH GILL     : PRESIDENT

SARITA GARG                               : MEMBER

 

          ORDER BY

          SARITA GARG, MEMBER

               

1.             Complainant has approached this Forum/Commission alleging inter-alia that her husband Shri Ravinder Kumar  took a house loan from the OPs number 2 to 5 vide loan account number 00002660 to the tune of Rs.14,62,990/- and the complainant was having a joint saving bank account with her husband Shri Ravinder Kumar bearing number 0140000103163111 with the PNB Main Brnch, Dhuri for repayment of loan amount through ECS.  It is further averred that to secure the said loan, OPs number 2 to 5 got the same insured from OP number 1 for the period of 10 years and the husband of the complainant was provided DHFL Home Shield insurance policy vide COI No.GC000006K130800 by charging single premium of Rs.37,434.26 for coverage period of ten years from 6.12.2016 to 5.12.2026 and the premium amount was included in the loan account so raised by the husband of the  complainant.  Further case of complainant is that her husband was paying the loan instalments regularly till his death. It is further averred in the complaint that no terms and conditions of the policy were ever supplied to the complainant or her husband.

2.             Further case of complainant is that husband of the complainant Shri Ravinder Kumar suffered death on 02.01.2018 and accordingly the OPs were intimated and requested to waive off the loan amount, but OP number 1 repudiated the claim of the complainant on 4.5.2018 on illegal grounds, which is said to be wrong and illegal. The OPs number 2 to 5 were required to get the insurance amount from OP number 1 alongwith interest, but all in vain.  It is worth mentioning here that OP number 1 is the sister concern of OPs number 2 to 5.   It is further averred that OPs number 2 to 5 have got deposited the total amount of Rs.1,07,440/- by putting pressure from the complainant on various dates i.e. Rs.65,000/- on 5.7.2018 and Rs.21,220/- on 10.8.2018 and Rs.21,220/- on 10.09.2018 even after the death of Shri Ravinder Kumar, which is also said to be illegal deposit from the complainant.  Though the complainant requested the OPs to settle the loan account by recovering the amount from the insurance company i.e. OP number 1, but all in vain.  Thus, alleging deficiency in service on the part of the OPs the complainant has prayed that the OPs be directed to provide insurance benefit by repayment of balance loan amount, to refund the so deposited amount of Rs.1,07,440/- alongwith interest and further to pay to the complainant an amount of  for Rs.1,00,000/- on account of compensation for mental agony, harassment and further Rs.22,000/- as litigation expenses.

3.             Upon being served,  OP number 1 appeared and filed written reply, wherein preliminary objections are taken up on the grounds that the complaint is false and frivolous one, that the complainant has not come to the Commission with clean hands and has suppressed true and correct facts  about his ailment. The non- disclosure of the disease for which he was getting the treatment was a significant material fact which affects the decision of the OP in accepting a proposal for the insurance.  That the complainant has filed the complaint with malafide intention.  On merits, it is submitted that the husband of the complainant submitted proposal form dated 6.12.2016 for the grant of life insurance cover under DHFL Home Shield Plan and all the medical questionnaires were given in the negative by the life assured and issuance of policy in question to Shri Ravinder Kumar has been admitted for the period from 6.12.2016 to 5.12.2026.  It is further submitted that after inquiry report dated 16.4.2018, the OP repudiated the claim of the complainant vide letter dated 4.5.2018 and refunded the premium amount of Rs.32,551/-.

4.             In reply filed by OPs number 2 to 5, preliminary objections are taken up on the grounds that the complainant has concealed material facts from this Commission, that the complainant has got no cause of action and no relief can be granted to the complainant and prayed for dismissal of the complaint.  In the main reply to complaint, it has been stated that OPs number 2 to 5 granted loan to the complainant which was repayable in the monthly instalment of 10 years. It is further admitted that the house loan to the tune of Rs.14,62,990/- was granted to the complainant. It is submitted that insurance policy was got signed by the complainant and her husband after admitting the contents. It is admitted that the loan amount of Rs.14,62,990/- was covered by way of insurance availed by the husband of complainant from OP number 1.  It is admitted further that husband of the complainant died and after that the claim of the complainant was rejected and further the OP number 1 refunded a sum of Rs.32,551/- to the loan account of the complainant. It is admitted that an amount of Rs.65,000/- and further sum of Rs.42,440/- was recovered from the complainant on account of loan account.  The other allegations leveled in the complaint have been denied.

5.             The complainant has also produced rejoinder to the written reply of the OPs number 1 and 2 to 5 denying the allegations therein and reiterated the contents of the complaint.

6.             The learned counsel for the parties produced their respective evidence before this Commission in the shape of documents and affidavits. The complainant has produced Ex.C-2 to Ex.C-22 copies of documents and Ex.C-1 is the affidavit of complainant. On the other hand, the learned counsel for OP number 1 has produced Ex.OP-1/1 to Ex.OP-1/6 copies of documents and Ex.OP1/7 affidavit of Parmal Singh and closed evidence. The learned counsel for OP number 2 to 5 has produced Ex.OP2to5/2 to Ex.OP2to5/6 copies of documents and Ex.OP2to5/1 affidavit of Shri Jeewan Garg and closed evidence.

7.             We have gone through the pleadings put in by the parties along with their supporting documents with their valuable assistance.

8.             Learned counsel for the complainant has vehemently argued that the husband of complainant, namely, Ravinder Kumar  took a house loan from the OPs number 2 to 5 vide loan account number 00002660 to the extent of Rs.14,62,990/-and the complainant was having a joint saving bank account with her husband Shri Ravinder Kumar bearing number 0140000103163111 with the PNB Main Branch, Dhuri for repayment of loan through ECS.  It is further contended by the learned counsel for the complainant that to secure the said loan taken by the husband of the complainant,  OPs number 2 to 5 got the same insured from OP number 1 for the period of 10 years and the husband of the complainant was provided DHFL Home Shield vide COI No.GC000006K130800 by charging single premium of Rs.37,434.26 for coverage period of ten years from 6.12.2016 to 5.12.2026 as is evident from the copy of the insurance policy Ex.C-3. The grievance of the complainant is that OP number 1 has wrongly repudiated the rightful claim of the complainant vide letter dated 4.5.2018 Ex.C-6 on the ground that the insured Shri Ravinder Kumar was having history of Chronic Pancreatitis prior to the date of application and as such premium amount of Rs.32,551/- was refunded to Dewan Housing Finance Corporation Limited Group towards the full and final settlement of the complaint. Ex.C-12 is the copy of legal notice served upon the OPs for discharging the loan liability raised against the complainant after the death of her husband Shri Ravinder Kumar and Ex.C-13 to Ex.C-17 are copies of postal receipts. Ex.C-21 is the sworn affidavit of Smt. Poonam Rani complainant to support her allegations leveled in the complaint against the OPs. Moreover, in the rejoinders filed by the complainant, it is stated that the written reply filed by the OPs is wrong and the allegations leveled in the complaint have been reiterated.  Further learned counsel for complainant has contended that Shri Ravinder Kumar was paying the loan instalments regularly till his death. It is further contended that no terms and conditions of the policy were ever supplied to the complainant or her husband.  Further it is contended by learned counsel for the complainant that husband of the complainant Shri Ravinder Kumar died on 2.1.2018 and accordingly the OPs were intimated to waive off/clear the loan amount, but OP number 1 repudiated the claim of the complainant on 4.5.2018 on illegal grounds, which is said to be wrong and illegal. Further the learned counsel for complainant has  contended that OPs number 2 to 5  are required to get the insurance amount from OP number 1 alongwith interest, but since the OPs number 2 to 5 have connived with the OP number 1 being its sister concern, repudiated the claim of the complainant.  It is worth mentioning here that OP number 1 is the sister concern of OPs number 2 to 5.   It is further contended that OPs number 2 to 5 have got deposited the total amount of Rs.1,07,440/- by putting pressure from the complainant on various dates i.e. Rs.65,000/- on 5.7.2018 and Rs.21,220/- on 10.8.2018 and Rs.21,220/- on 10.09.2018, which is also said to be illegal deposit from the complainant. Learned counsel for the complainant has contended further that though complainant requested the OPs to settle the loan account by recovering the amount from the insurance company i.e. OP number 1 as the husband of the complainant, Shri Ravinder Kumar was insured for the full dues of the loan amount, but nothing was done by OPs number 2 to 5. As such, the learned counsel for complainant has prayed that the complaint be accepted with heavy costs.

9.             On the other hand, learned counsel for  OP number 1 has though admitted the insurance of the husband of complainant, Shri Ravinder Kumar for the loan amount taken by him from the Ops number 2 to 5 and the issuance of the policy is also admitted.  The death of Shri Ravinder Kumar has also been admitted by the OPs, but it is stated that the claim has been repudiated as he was suffering from pre-existing disease of chronic pancreatitis.  It is also admitted by the learned counsel for OP number 1 that Shri Ravinder Kumar was insured under DHFL Home Shield Plan and all the medical questionnaires were given in the negative by the life assured and issuance of policy in question to Shri Ravinder Kumar has been admitted for the period from 6.12.2016 to 5.12.2026.  It is further contended that after receiving the inquiry report dated 16.4.2018, the OP repudiated the claim of the complainant vide letter dated 4.5.2018 and refunded the premium amount of Rs.32,551/- so recovered from the complainant. On the other hand, the learned counsel for OPs number 2 to 5 has contended vehemently that loan amounting to Rs.14,62,990/- was granted to the complainant which was repayable in instalments and the said loan was got insured from OP number 1 in case of death of the insured. It is further contended by the learned counsel for OPs number 2 to 5 that husband of the complainant died on 2.1.2018  and after that the claim of the complainant was rejected and further the OP number 1 refunded a sum of Rs.32,551/- (being the insurance premium) to the loan account of the complainant. It is admitted that an amount of Rs.65,000/- and further sum of Rs.42,440/- in two installment was recovered from the complainant on account of loan account. It is further contended by the learned counsel for Ops number 2 to 5 that the claim of the complainant has rightly been repudiated.

10.            After perusal of the whole case file and hearing the arguments of the learned counsel for the parties, we find that husband of the complainant took a house loan of Rs.14,62,990/- from OPs number 2 to 5 which was got insured from OP number 1 by paying the requisite premium.  It is also admitted that husband of the complainant was insured with OP number 1 for the whole of the loan amount for the period from 6.12.2016 to 5.12.2026 by paying the requisite premium amount of Rs.37,434/- as is evident from the copy of the insurance policy on record, Ex.C-4. It is also admitted fact that Shri Ravinder Kumar insured died on 02.01.2018. In the present case, the grievance of the complainant is that though after the death of Shri Ravinder Kumar, his wife Poonam Rani, complainant approached OPs for waiving off the due loan amount being Shri Ravinder Kumar was insured with the OPs, but in the present case grievance of complainant is that OP number 1 has wrongly repudiated the rightful claim of the complainant on the ground that the insured Shri Ravinder Kumar was having pre-existing disease of chronic pancreatitis, but we are unable to accept such a contention of the learned counsel for OP number 1 that the claim has rightly been repudiated.  It is worth mentioning here that husband of the complainant, Shri Ravinder Kumar took house loan from Ops number 2 to 5 and they (OPs number 2 to 5) got the house loan insured from OP number 1, who is also sister concern of the OPs number 2 to 5.  It is further worth mentioning here that OP number 1 repudiated the claim and refunded the premium amount of Rs.32,551/- on 1.5.2018 after the death of Shri Ravinder Kumar to OPs number 2 to 5 to Dewan Housing Finance Corporation Limited Group towards the full and final settlement for COI No. GC000006K130800, as is evident from the copy of repudiation letter dated 4.5.2018 which is on record as Ex.C-6, which is not fair on the part of the OP number 1.  Moreover, it is not open for OP number 1 insured to refund the premium amount of Rs.32,551/- after the death of insured Shri Ravinder Kumar on the ground that he was having pre-existing disease.  There is no explanation from the side of the OP number 1 that why they did not got medically checked the insured Shri Ravinder Kumar from the medical team before issuing the insurance policy and it is only OP number 1 collecting the premium and at the time of paying the insurance claim, OP number 1 refunded the proportionate premium amount of Rs.32,551/- to OPs number 2 to 5. It is further worth mentioning here that no such insurance policy having terms and conditions qua health has been provided to the complainant, whereas as per Ex.C-4,  the master policy holder is DHFL i.e. Juristic person not having physical existence and as such there is no likelihood of terms and conditions of health in the insurance policy, thus the question of any concealment of fact on behalf of the insured Shri Ravinder Kumar does not arise at all. Moreover, it is admitted case of the complainant that no such terms and conditions of the policy were ever supplied to the complainant.

11.            To support such a contention, the learned counsel for complainant has cited M/s. Modern Insulators Ltd. versus Oriental Insurance Co. Ltd. 2000(1) CLT 615 (Supreme Court of India), wherein it has been held : “Plea of the complainant that only the cover note and the schedule of insurance policy were supplied and other terms and conditions including the exclusion clause were not communicated. Plea of the respondent rejected and claim allowed by the State Commission as assessed by the surveyor with 18% interest. New plea taken by the respondents before the National Commission and the judgment of the State Commission set aside.  Held that as the terms and conditions of the standard policy wherein exclusion clause was included, were neither a part of the contract of insurance nor disclosed to the appellant, respondent cannot claim the benefit of the said exclusion clause. The finding of the National Commission that it is equally responsibility of the respondent to call for these term and conditions even if they were not sent by the appellant as alleged held untenable in law.”  As stated above, in the present case, the insurance was got done by OPs number 2 to 5 from OP number 1 (who is sister concern of OPs number 2 to 5) and even after rejecting the claim of the complainant, OP number 1 refunded the premium amount of Rs.32,551/- to Ops number 2 to 5.  On the other hand, the learned counsel for OP number 1 has cited Life Insurance Corporation of India versus Manish Gupta, Civil Appeal No.3944 of 2019 decided on 15.4.2019 (Supreme Court), wherein it has been held that the claim was rightly repudiated as the documentary material indicates there was clear failure on part of claimant to disclose that he had suffered from rheumatic heart disease since childhood.  But, we may mention that in the present case, the insurance of the deceased Ravinder Kumar was taken by OPs number 2 to 5 for insuring the loan amount from their sister concern, OP number 1 and Shri Ravinder Kumar was never made known to about the insurance policy and the OP number 2 to 4 only debited the premium to the loan account of the deceased Shri Ravinder Kumar, which clearly shows that OP number 1 repudiated the rightful claim of the complainant wrongly by conniving with the OPs number 2 to 4 and even the premium amount of Rs.32,551/- was refunded by OP number 1 to OPs number 2 to 5 to avoid the insurance claim liability, which we find it to be a clear cut case of deficiency in service on the part of OP number 1.

12.            Further we have also perused the copy of the insurance policy Ex.OP1/2, wherein  in the Abstract of Terms and Conditions and Benefit under Exclusions nowhere it is mentioned that the claim is not payable if there is any pre-existing disease and it is mentioned in the same if there is a suicide within a period of one year of taking the insurance policy, then 80% of the premium shall be refundable, but in the present case the death has occurred even after more than one year of taking the insurance policy as the policy was effective from 6.12.2016 and the death of Ravinder Kumar took place on 02.01.2018, as such, we may mention that there is nothing mentioned in the exclusion clause to repudiate the claim of the complainant in the present circumstances of the case. Further we may mention that OPs number 2 to  5 have wrongly got deposited under threat an amount of Rs.65,000/- on 5.7.2018, an amount of Rs.21,220/- on 10.8.2018  and further an amount of Rs.21,220/- on 10.9.2018 i.e. total Rs.1,07,440/- from the complainant, which is also required to be refunded to the complainant as discussed above.

 

13.            In view of our above discussion, we find it to be a clear cut case of deficiency in service on the part of the OPs and accordingly, we order OP number 1 to pay to OPs number 2 to 5 the whole of the due loan amount as on 2.1.2018 (i.e. date of death of the insured Shri Ravinder Kumar)  and after clearing the loan account without charging any amount from the complainant, no due certificate be issued to the complainant by Ops number 2 to 5. We further direct OPs number 2 to 5 to refund to the complainant the so deposited amount of Rs.1,07,440/- as detailed above alongwith interest @ 7% per annum from the date of deposit till realization.  We further direct OP number 1 to pay to the complainant an amount of Rs.25,000/- as compensation for mental tension, agony and harassment and further an amount of Rs.11,000/- as litigation expenses.  This order be complied with by the opposite parties within 60 days from the date of receipt of certified copy of this order.

 

14.            The complaint could not be decided within the statutory time period due to heavy pendency of cases.

15.            Copy of this order be supplied to the parties free of cost. File be consigned to the records.

                                Pronounced.

 

                                October 27, 2022.

 

            (Sarita Garg)                           (Jot Naranjan Singh Gill)

                 Member                                          President

                                               

 

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, SANGRUR .

                                                                         Misc. No.       4

 Instituted on:   17.11.2022

                                                                         Decided on:     18.11.2022

 

Poonam Rani aged 42 years Wd/o Sh. Ravinder Kumar, R/O 74/1, W No.4B, Karkhana No.2, Near Mangla Ashram, Dhuri and District Sangrur.

                                                          …. Complainant.    

                                                 Versus

1.     DHFL Pramerica Life Insurance Company Ltd. through its Manager, 4^th Floor, Building No.9, Tower-B, Cyber City, DLF Phase III, Gurgaon 122002.

2.     DHFL Housing Finance Corporation Ltd. through its M.D. Warden House, 2^nd Floor, Sir PM Road Fort, Mumbai 400 001.

3.     DHFL Housing Finance Corporation Ltd. through its Manager, A-301 and 302, 3^rd Floor, Elante Office Complex, Industrial Area, Phase 1, Chandigarh 160019 .

4.     DHFL Housing Finance Corporation Ltd. through its Manager, SCO 94-95, New Market, Leela Bhawan, Bank Colony, Patiala.

5.     DHFL Housing Finance Corporation Ltd. through its Manager, SCF 14, 1^st Floor, Kaula Park, Sangrur 148001.

 

                                                     ….Opposite parties. 

 

Present: Shri Mohinder Ahuja, Adv. For Ops No.2 to 5.

 

18.11.2022.

 

                File taken up today on the application of the counsel for OPs number 2 to 5.

                The above said complaint number 382 which was instituted on 18.09.2018 has already been decided by this Commission on 27.10.2022.  The learned counsel for the OPs number 2 to 5, namely, Shri Mohinder Ahuja, Advocate has filed an application for correction of the Advocate name as inadvertently the name of Shri Karanveer Singh, Advocate has been written instead of Shri Mohinder Ahuja, Advocate. A perusal of the file reveals that the power of attorney has also been signed by Shri Karanveer Singh, Advocate and Shri Mohinder Ahuja, Advocate for OPs number 2 to 5.  Accordingly, we order that in the final order dated 27.10.2022 of the above said case, the name of Shri Mohinder Ahuja, Advocate be also read alongwith Shri Karanveer Singh, Advocate.  This order will be the part of our earlier order dated 27.10.2022 and the same be tagged with the original order dated 27.10.2022 in the above said complaint case.  A copy of this order be also placed in this file.

                A copy of this order be also issued to the parties free of cost. Compliance be made and file be consigned to records.