Delhi

East Delhi

CC/439/2014

MOHINDER SAIN JAIN - Complainant(s)

Versus

HDFC LIFE INS - Opp.Party(s)

05 Feb 2018

ORDER

DISTRICT CONSUMER DISPUTE REDRESSAL FORUM (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

 

C.C. NO. 439/14

 

Shri Mohinder Sain Jain(since deceased)

Through his legal heirs

 

1. Smt. Sandhya Jain,

Aged 54 year

w/o Late Sh. Manoj Jain

KH-80, Kavi Nagar,

Ghaziabad, U.P.-201002

 

2. Sh.Ajay Jain,

Aged 56 years

s/o Late Sh. M.S. Jain

House No. 479,

8^th Main Road,

Sadananda  Nagar,

Banglore-560038.

 

3. Sh. Sanjay Jain,

Aged 53 years

s/o Late Sh. M.S. Jain

E-7, kalindi colony,

New Delhi-110065.

 

4. Smt. Deepa Dalwani,

Aged 66 years

w/o Late Sh. M.S. Jain

BG-6, Ground Floor,

Munrika DDA Flats,

New Delhi-110067.                                         ….Complainant

 

Vs.

 

 

HDFC Standard Life Insurance Co. Ltd.

Through Branch Manager

HDFC SL Delhi-Mayur Vihar Branch

Plot No. 1A, First Floor, Star City Mall

Mayur Place, District Centre, Phase-I

Mayur Vihar, Delhi – 110 091                                                          ….Opponent

 

Date of Institution: 09.05.2014

Judgment Reserved on: 05.02.2018

Judgment Passed on: 21.02.2018

CORUM:

Sh. Sukhdev Singh (President)

Ms. Harpreet Kaur Charya (Member)

 

Order By : Ms. Harpreet Kaur Charya (Member)

 

JUDGEMENT

            The present complaint has been filed by Shri Mohinder Sain Jain against M/s. HDFC Standard Life Insurance Co. Ltd. (OP) under Section 12 of the Consumer Protection Act 1986 alleging deficiency in services.   

2.         Briefly stated the facts of the complaint are that Shri Dhruv Jain, S/o Shri Manoj Jain, R/o KH80, Kavi Nagar, Ghaziabad, UP, had purchased HDFC SL Sampooran Samridhi policy plan from OP on 14.01.2013 vide policy no. 15733707, with premium of Rs, 29,101/- payable half yearly.  On 31.07.2013, the insured, Shri Dhruv Jain expired and the complainant being the nominee filed a claim, which was rejected by OP vide letter dated 25.01.2014 on the ground that the policy attained lapse state w.e.f. 14.07.2013 and since the policy had lapsed without any paid up values as on the date of death, the claim could not be processed. It has been stated thats cheque no. 125931 dated 07.07.2013 for Rs. 30,281/- issued towards half yearly premium was encashed by OP on  14.08.2013, which was returned by OP vide letter dated 30.01.2014. 

            The complainant has stated that the refusal of OP to process the death claim was malafide, hence, the present complaint praying for directions to OP to pay Rs. 8,00,000/- in respect of policy no. 15733707 alongwith interest @ 18% p.a. from the date of death,  Rs. 50,000/-  as   litigation  expenses  and Rs 50,000/- as compensation for harassment and mental agony.

            Copy of the policy bond has been annexed as Annexure C-1 alongwith first premium receipt, Death Certificate as Annexure C-2, letter dated 25.01.2014 by OP to the complainant as Annexure C-3 and letter for confirmation of payment processed via NEFT with respect to policy no. 15733707 dated 30.01.2014 have been annexed with the complaint.

3.         OP filed their written statement upon service of the summons in the present complaint, wherein they stated that the deceased life assured (DLA) had paid first premium and had failed to pay the premium due on 14.07.2013, therefore, the policy in question had lapsed.  It was further submitted that the death of DLA was informed to OP on 15.01.2014.  It was stated that after the death of DLA, a predated cheque with date 07.07.2013 was issued and the same was encashed by OP on 14.08.2013.  Return of premium amount was also admitted.  Rest of the contents of the complaint have been denied.

4.         Rejoinder to the WS was filed by the complainant where the contents of the WS have been denied and has reaffirmed the averments of his complaint.

5.         Evidence by way of affidavit was filed by both the parties where the complainant got examined himself and has reiterated the contents of the complaint.  He got exhibited policy premium receipt as Ex.CW1/1, death certificate as Ex.CW1/2, claim rejection letter as Ex.CW1/3, letter by OP dated 30.01.2014 as Ex.CW1/4 and policy terms and conditions as Ex.CW1/5.

            OP got examined Shri Akash Singh, associate Manager – Legal who has also deposed the contents of their WS on oath and got the authorization letter exhibited as Ex.OP1/1, rejection letter as Ex.OP/2 and letter dated 30.01.2014 as Ex.OP/3.

6.         We have heard the arguments on behalf of the Ld. Counsel for the complainant and Ld. Counsel for OP.  We have also perused the record.  During pendency of complaint, the complainant expired and his LR’s were brought on record.  The claim of the complainant was rejected on the ground that the policy no. 15733707 had lapsed w.e.f. 14.07.2013 and since the policy had lapsed without any paid-up value as on the date of death, so claim could not be processed. 

            If we look to Ex.CW1/1 – policy plan details, wherein it has been mentioned.

“We provide a grace period after the premium due date during which the policy is considered to be in-force with the risk cover. This plan has a grace period of 30 days for yearly, half-year and quarterly frequencies from the premium due date. The grace period for monthly frequency of premium payment is 15 days from the premium due date.

Should valid claim arise under the policy during the grace period, but before the payment of due premium, we shall still honour the claim. In such case, the due but unpaid premium will be deducted from any benefit payable”.

Thus, from the plain reading of the above paragraph, it is clear that though the due date of premium was 14.07.2013, the insured expired on 31.07.2013 which was  within a grace period of 30 days which was till 14.08.2013.  Thus, there was a valid claim under the policy during the grace period.  Even otherwise, it is an admitted fact that premium was received by OP on 14.08.2013 which is in grace period and the same was returned to the complainant via NEFT  So, the policy continued to be in force.

            Hence, the complaint was entitled to settlement of claim, death of life insured in road accident is also not disputed by OP.  Hence, we allow the present complaint and direct the OP to settle the claim after deduction of the premium, which was due on 14.07.2013. 

            We also award compensation of Rs. 15,000/- on account of compensation for mental harassment inclusive of litigation expenses.  The order be complied within 30 days from the date of order.     

            Copy of the order be supplied to both the parties as per rules.

File be consigned to Record Room.

 

(HARPREET KAUR CHARYA)                                          (SUKHDEV SINGH)

       Member                                                                            President