Punjab

Sangrur

CC/547/2015

Bant Kaur - Complainant(s)

Versus

HDFC Standard LIC - Opp.Party(s)

16 Mar 2016

ORDER

 

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR

                                                                   

                                                                   Complaint no. 547                                                                                              

                                                                   Instituted on:  02.07.2015                                                                            

                                                                   Decided on:    16.03.2016

 

Bant Kaur wife of Late Sh. Ram Singh resident of  village Khokhar Tehsil Sunam, District Sangrur.   

…. Complainant.      

                                           Versus

 

1.     HDFC Standard Life Insurance company Limited, Malika Street, Near Sub Divisional Magistrate Office, Lehragaga, Tehsil Lehra, District Sangrur through its Branch Manager.  

 

2.     Manish Kumar agent of HDFC Standard Life insurance Company Limited Malika Street, near Sub Divisional Magistrate Office, Branch Lehragaga District Sangrur.

 

3.     HDFC  Standard Life Insurance Company Limited. Ramon House, H.T. Parekh Marg, 169, Backbay Reclamation, Church Gate, Mumbai, through its M.D. / authorized  signatory.   

             ….Opposite parties.

 

 

FOR THE COMPLAINANT:     Shri Vikramjit Garg Advocate                          

 

FOR OPP. PARTIES NO.1&3: Shri Sumir Fatta, Advocate.                    

 

FOR OPP. PARTY NO.  2:      Given up.                     

 

 

Quorum

         

                    Sukhpal Singh Gill, President

K.C.Sharma, Member

Sarita Garg, Member

           

ORDER:  

 

Sukhpal Singh Gill, President

 

1.             Bant Kaur complainant has preferred the present complaint against the opposite parties (referred to as OPs in short) on the ground that her husband  obtained the services of the OPs by getting himself insured w.e.f. 28.05.2012 to 24.05.2022 for an amount of sum assured of Rs.1,46,754/-.  The complainant was nominee of the said policy. The OPs charged Rs.25000/- from the husband of the complainant as first annual premium installment of the said policy. The husband of the complainant  paid three premiums with the OP No.1 in time as Manish Kumar agent of OP no.1 collected the premium in the presence of the complainant and Naib Singh. The Ops did not issue any receipts of premium to the husband of the complainant. The husband of the complainant died due to brain hemmorrhage on 05.03.2015. After the death of her husband, the complainant submitted all the relevant documents for releasing the claim amount with the OP No.1 but OPs failed to release the claim amount of the policy along with death benefits and other benefits i.e. about Rs.3,00,000/-.  Thus, alleging deficiency in service on the part of OPs, the complainant has sought following reliefs:- 

i)      OPs be directed to pay Rs.3,00,000/- along with  other benefits and interest @18% per annum till realization,

ii)     OPs be directed to pay to the complainant a sum of Rs.50000/- as compensation   on account of mental agony, harassment and to pay Rs.11000/- as litigation expenses.

2.             In reply filed by OPs No.1&3, preliminary objections on the grounds of maintainability , cause of action, locus standi and suppression of material facts. On merits, it has been admitted that Ram Singh paid Rs.25000/- as first premium. The annual premium of the said policy was Rs.25000/- per year. It has been denied that husband of the complainant regularly paid three annual premium to OP No.1 within time.  It has been denied that Manish Kumar was the authorized agent  of OPs and he collected the premium. The terms and conditions were read over to him in simple Punjabi and  after admitting and understanding the same  he signed the proposal form. Ram Singh failed to deposit  the annual  premium for the second year onwards due to which the policy of Ram Singh was lapsed and as per standard policy provisions  clause  5 (1) If any premium remains unpaid 15 days after the due date during the first 3 years of the policy, the policy will be altered to lapsed status and no benefits would be payable". No claim can be paid in case of lapsed policy. Accordingly the claim of the complainant was not entertained.

3.             During the proceedings of the case, learned counsel for complainant had made a statement on 03.09.2015 for giving up the OP No.2.  

4.             The complainant has tendered in his evidence documents Ex.C-1 to Ex.C-7 and closed evidence. On the other hand, OPs have tendered documents Ex.OPs1&3/1 and  Ex.OPs1&3/2 and closed evidence.

5.             In the present complaint, the husband of the complainant  Ram Singh purchased a policy bearing number 15191909 and the same  was effective from 28.05.2012 to 24.05.2022. The DLA had  paid a sum of Rs.25000/- being the amount of first installment of premium of the policy and same is Ex.C-3 on record. Since then the DLA has been paying  the premium every year and  after the death of policy holder the OPs are not paying the death benefit as per the policy to the nominee of the policy holder.

6.             In reply filed by the Ops No.1&3, they have submitted that the DLA had not paid  the subsequent premium and hence the claim was not paid as the policy has lapsed due to non-payment of the premiums.

7.             After having heard the arguments of the learned counsel for the parties and on going through the documents placed on record, we find that the DLA  was a customer  of the HDFC Bank Lehragaga and has been maintaining  the deposit account with them as per document Ex.C-6. The bank employee  Manish  Kumar  has signed the proposal form of the policy of the OPs as  financial consultant and same is Ex.OPs 1&3/2 on record. This shows that at the instance of  the employee Manish Kumar of the HDFC bank Lehragaga the policy was purchased by the insured and now the question before us is that whether the DLA had not paid  subsequent premium  or not ?

8.             The complainant in support of her version that the subsequent premium for the year 2013 had been paid has placed on record document Ex.C-6. In this document  an amount of Rs.25416/-  has  been paid to the HDFC standard Life i.e. OPs on 08.08.2013 by cheque number 016171 as the same has been debited from the account of the DLA. Further, the complainant  has submitted  that the third premium  had been paid in cash through Manish Kumar in the presence of Naib Singh and an affidavit  of Naib Singh had been placed on record  in support of her version which is Ex.C-1on record. The Ops No.1 and 3 have denied that the said  Manish Kumar was not their agent and so depositing of the third premium through him does not arise. In this way, we find that the question with regard to the payment of the third premium has not been corroborated by any cogent and reliance  evidence by the complainant whereas the payment of second premium is supported by the copies of back pass book which is Ex.C-6 on record.

9.             So in this case we find that only two installments have tangible, cogent  and reliable evidence of the complainant with regard to the payment of premium of the policy in question but the Ops have denied the payment of second premium as well which cannot be relied upon.

10.           Now  a days  with the fast growing business competition among the insurance  companies unhealthy practices develop to get  maximum benefits and profits. It is not a case of a businessman, trader or an educated employed person but that of a common poor man. He puts  his hard earned small savings in such schemes with a hope and aspiration that in case of accident or death he or his family shall get some immediate financial  assistance but in most of the cases he is left cheated when his claim is rejected with just a stroke of pen that he concealed some material facts at the time of signing proposal form or the claim was not properly submitted before the insurance company. That apart the agent of the company is required to explain all the details and conditions of the insurance policy sought by the customer. A common man is not  supposed to know all the niceties and technicalities of law. Once accepting the premium and having entered into an agreement without verifying the facts, the insurance company cannot wriggle out  of the liability merely by saying that the contract was made by misrepresentation and concealment. The insurance policies should not be issued and repudiated in such casual  mechanical manner. The policy entails the liability on both sides. It is rather exploitation of the customer and more or less fraud on the public. Such practice should be strongly depricated".

11.           Further, we find that as per the policy document Ex.OPs1&3/2 under the head  lapsed policies  the OPs have submitted that " if  any premium  remains unpaid  15 days after the due date during the first 3 years  of the policy, the policy will be altered to lapsed status and no benefits  would be payable. The company  may choose, at its sole discretion, to offer a discretionary surrender value.  So, we find that when the OPs have discretionary power to pay the surrender value under the lapsed policy instead of repudiating the claim,  the OPs have should paid the surrender value keeping in view of the circumstances of the case.        

12.           So, in view of the facts mentioned above, we find that the Ops No.1&3 are deficient in service and accordingly we partly allow the complaint and direct the OPs no.1 and 3 to pay the surrender value  after considering the two installments of the premium  along with interest @9% per annum from the date of filing of the complaint till realization as per terms of the policy. We further  direct the OPs no.1 and 3 to pay a sum of Rs.10,000/- being mental tension and agony and Res.5000/- as litigation expenses.

13.           This order of ours shall be complied with within 30 days from the receipt of copy of the order. Copy of the order be supplied to the parties free of charge. File be consigned to records in due course.

                Announced.

March 16, 2016.

 

 

 

     ( Sarita Garg)        ( K.C.Sharma)     (Sukhpal Singh Gill)                                                                                        

      Member                 Member                    President

      BBS/-