Haryana

Karnal

CC/265/2018

Anjali Devi - Complainant(s)

Versus

DHFL Pramerica Life Insurance Company Limited - Opp.Party(s)

Deepak Tuteja

11 Jun 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

                                                     Complaint no.265 of 2018

                                                     Date of instt. 05.10.2018

                                                     Date of decision 11.06.2019

 

Anjali Devi wife of late Shri Vipin Kumar Aggarwal son of Shri Bal Kishan Aggarwal resident of Kundli, Sonepat.

                                                                         ……..Complainant.

                                                Vs.

1. DHFL Pramerica Life Insurance Company Ltd. through its authorized Officer, 2^nd floor, SCO no.227, Sector-12, Urban Estate, Karnal.

2. DHFL Pramerica Life Insurance Company Ltd. through its authorized officer, 4^th floor, Building no.9-B, Cyber City, DLF City, Phase-III, Gurugram, Haryana.

…… Opposite Parties

 

Complaint u/s 12  of the Consumer Protection Act.

Before:     Sh. Jaswant Singh………..President

                Sh.Vineet Kaushik ………..Member

               

 

 Present:  Shri Deepak Tuteja Advocate for complainant.

                  Shri Abhishek Chaudhary Advocate for opposite parties.

 

                   (Jaswant Singh President)

ORDER: 

 

                   This complaint has been filed by the complainant u/s 12 of the Consumer protection Act 1986, on the averments that the husband of the complainant namely Shri Vipin Kumar(since deceased) has taken a insurance policy naming Smart Income Plan and signed proposal form no.LV004672006 on 22.03.2018 with the OPs in which sum assured was Rs.6,84,211/- plus other benefits as per policy commencing from 22.03.2018 and in case of death due to accident, some assured is Rs.6,84,211/- plus other benefits as per policy and complainant’s husband has also paid Rs.6500/- as premium at Karnal Branch for the abovesaid policy which was accepted by the OPs.  After taking the policy and within the cover time the husband of the complainant met with a road accident on 29.03.2018 and due to this accident the husband of the complainant got expired on the same day. After this police was called and lodged an FIR no.133 dated 29.03.2018 under section 279/304-A IPC Police Station Kundli in this regard. On 29.03.2018 post mortem of husband of complainant has also been conducted at Civil Hospital Sonepat, in which it has clearly mentioned that the death of Shri Vipin Kumar is due to road accident after paying the premium of policy. After the death of her husband complainant being nominee lodged the claim with the OPs and completed all the formalities. OPs did not pay the claim of the complainant after repeated requests to the OPs. Then complainant sent a legal notice to the OPs in this regard but it also did not yield any result. In this way there was deficiency in service on the part of the OPs. Hence complainant filed the present complaint.

2.             Notice of the complaint was given to the OPs, who appeared and filed written version stating therein that Deceased Life Assured, Shri Vipin Kumar the husband of complainant has approached the OPs for insurance and as per requirement of husband of complainant, he had signed proposal form on 14.03.2018 and submitted the same alongwith KYC document, with the company. Later on while processing his application as per standard operating procedure the company raised additional requirements and sent the additional requirement letter to DLA vide letter dated 23.03.2018. The company again sent reminder letters dated 30.03.2018 and 09.04.2018 to DLA to submit Bank Statement of last six months, which were required to be submitted but never submitted by him and due to the same reason the policy was never issued to the deceased and proposal was cancelled. It is further stated that the deceased submitted his proposal form on 22.03.2018 and without even completing all the formalities died on 29.03.2018 and till the date of death of the deceased the insurance policy was never issued to the deceased. Further, as per the IRDA regulations even after the submission of the proposal form, the insurance company has a right to accept or reject the proposal form within a period of 30 days from the date of submission of the proposal form. Since in the present case the only an incomplete proposal form was submitted since all the documents were not attached by the deceased and the fact that the deceased died within a week of making a proposal form of the deceased was never accepted and therefore the deceased was neither insured nor was having any privity of contract with the OPs. Hence there is no deficiency in service on the part of the OPs and prayed for dismissal of the complaint.

3.             Complainant tendered into evidence her affidavit Ex.CW1/A and documents Ex.C1 to Ex.C9 and closed the evidence on 23.1.2019.

4.             On the other hand, OPs tendered into evidence affidavit of Parmal Singh Ex.RW1/A and documents Ex.R1 to Ex.R7 and closed the evidence on 6.5.2019.

5.             We have appraised the evidence on record, the material circumstances of the case and the arguments advanced by the learned counsel for the parties.

6.             The case of the complainant is that her husband had taken an insurance policy on 22.03.2018 from the OPs, for sum assured Rs.6,84,211/- and complainant paid Rs.6500/- as premium. On 29.03.2018, husband of the complainant met with an accident and expired on the same day. An FIR no.133 dated 29.03.2018 under section 279/304-A has been lodged in Police Station Kundli. Post Mortem of late Vipin Kumar has also been conducted at Civil Hospital, Sonepat. The complainant lodged the insurance claim of the deceased Vipin Kumar, being legally wedded wife and also being the nominee in the policy, but OPs have not paid the sum assured Rs.6,84,211/- plus other benefits as per policy. Thus, the acts f the OPs amounts to deficient in service.

7.             On the other hand, the case of the OPs no.1 and 2 are that husband of the complainant had signed proposal form on 14.03.2018 and submitted the same alongwith KYC document. Later, on while processing his application as per standard operating procedure the OP raised additional requirement and sent the additional requirement letter to DLA vide letters/reminders dated 23.03.2018, 30.3.2018 and 9.4.2018 to DLA to submit Bank statement of last six months, which were required to be submitted but never submitted by him and due to the same reason the policy was never issued to the deceased and proposal was cancelled. In the absence of the contract of insurance between the parties the present complaint is liable to be dismissed.

8.             Admittedly, DLA has approached the OPs for insurance and signed proposal form on 14.03.2018 and submitted the same alongwith KYC documents. OPs while processing his application raised additional requirements and sent the letters dated 23.03.2018 in this regard. OPs again sent reminders dated 30.3.2018 and 9.4.2018 to DLA to submit Bank statement of last six months, which was never submitted by DLA. Due to non-submission of documents as required by OPs, the policy was never issued to the deceased and proposal was cancelled. As per IRDA regulations even after the submission of the proposal form, the insurance company has a right to accept or reject the proposal form within a period of 30 days from the date of submission of the proposal form. DLA died within a week of making of proposal form. Without issuing the insurance policy, the deceased was neither insured nor was having and privity of contract with the OPs. Hence, we are the firm view that there is no force in the complaint.

 9.       Thus, as a sequel to abovesaid discussion, we do not find any merits in the complaint and the same is hereby dismissed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:11.06.2019                                                                       

                                                                   President,

                                                              District Consumer Disputes

                                                               Redressal Forum, Karnal.      

 

                        (Vineet Kaushik)         

                         Member