Haryana

Kurukshetra

291/2016

Anil Kumar - Complainant(s)

Versus

ICICI - Opp.Party(s)

J.R.Saini

14 Mar 2018

ORDER

BEFORE THE  DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KURUKSHETRA.

 

Complaint case no.291/16.

Date of instt.26.10.2016. 

                                                Date of Decision: 14.03.2018.

Anil Kumar son of Rishi Pal Saini, resident of village Bhawani Khera, Tehsil Thanesar, District Kurukshetra.

•  

                        Versus

1. ICICI Prudential Life Insurance Company Limited, ICICI Prudential Life  Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai, through its Directors.
2. ICICI Prudential Life Insurance Company Limited, Branch Office, SCO No.133, Sector-17, Kurukshetra through its Branch Manager.
3. Deepak Mallhi son of Prem Chand, resident of near Bharat Gas agency, Shankar colony, village Kishanpura, PO, Pipli, District Kurukshetra.
4. Sanjeev Kumar son of Jagdish Chand, resident of House No.397, Shankar Colonyh, Kishan Pura, Pipli, District Kurukshetra.

………Opposite parties.

 

       Complaint under section 12 of Consumer Protection Act.            

                                                                                      

 

Before                Sh. G.C. Garg, President.    

         Sh. Kapil Dev Sharma, Member

 

Present :            Sh. Manish Saini, Adv. for complainant.

                        Sh. Karan Tanwar, Adv. for Ops No.1&2.

                        OPs No.3 & 4 exparte.

 

ORDER

 

                           This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Anil Kumar against ICICI Prudential Life Insurance Company and others, the opposite parties.

2.                     It is stated in the complaint that the complainant has taken a life insurance policy for his mother, namely Kusum Lata for a sum of Rs.1,20,000/- and then OP No.4 filled the proposal form after receiving the premium of Rs.12,185/- and at that time they have also taken necessary documents. The Ops have issued policy bearing No.15585140. Thereafter, the complainant has further deposited four installments of premium on 9.4.2012, 31.5.2013, 5.5.2014 and 28.5.2015 on behalf of Kusum Lata. The mother of the complainant died on 14.12.2015 and then the complainant laid a claim for payment of amount towards the policy of insurance. Then the Ops No.1 and 2 have demanded original policy along with death certificate etc. The complainant submitted all the necessary required documents to the Ops. The complainant requested the Ops to pay the claim amount but the Ops have rejected the claim of complainant and sent a cheque amounting to Rs.69,415.74 paisa only on 28.1.2016 after violating the terms and conditions of the policy. Thereafter the complainant visited the office of Ops many a times and requested to pay the remaining amount of Rs.1,20,000/- minus Rs.69415.74 paisa = Rs.50,585/- but the Ops postponed the matter on one pretext or the other and lastly refused to pay the remaining amount. Hence, it amounts to deficiency in service on the part of Ops. So, the present complaint has been moved by the complainant with the prayer to direct the Ops to pay Rs.50,585/-,Rs.30,000/- as damages/compensation for mental agony and physical harassment.

3.            Upon notice, opposite parties appeared. Opposite parties No.1 & 2 contested the complaint by filing written statement alleging therein that the complainant has not approached to this Forum with clean hands, that as per the terms of the policy contract if the policy is not suitable, the policy holder may get his/her policy reviewed by returning the policy and policy documents within 15 days (Free Look Period) from the day of policy holder received the policy. The insurance company will return the premium paid to the policy holder after making certain documents specified therein. In the present case, a copy of the proposal form duly signed by the policy holder is also sent to the life assured along with the policy document thereby giving an opportunity to the life assured to re-examine the replies made her in the proposal and get the details rectified in case of any discrepancy(s) in the replies to the questions in the proposal form. The complainant after receipt of subject policy and documents did not approach the answering OP and got his subject policy cancelled within free look period implying that he duly accepted the subject policy and its documents with its terms and conditions. The policy holder never approached the answering OP with any grievance pertaining to the subject policy. The answering OP received a claim intimation form dated 27.1.2016 informing the Ops company about the death of Mrs. Kusum Lata on 14.12.2015. After careful evaluation of the records of the company accepted the claim as per clause 2.4 of the policy terms and conditions and paid a sum of Rs.69,415.74 paisa through NEFT to Axis Bank, account No.912010018581686 of complainant Anil Kumar. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of answering Ops and as such, the complaint of the complainant is liable to be dismissed with costs. On merits, the contents of the complaint were denied to be wrong. Preliminary objections were repeated. Prayer for dismissal of the complaint was made. 

4.            OP No.3 has failed to come present and as such, he was proceeded exparte vide order dated 9.12.2016.

5.             Opposite party no.4 contested the complaint by filing separate written statement alleging therein that the complainant was fully satisfied with the insurance policy which was got issued by the answering Op being the advisor of Ops No.1 & 2; that only function of the answering OP is to get issue the insurance policy which has been rightly and legally got issued to the complainant by the answering OP. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of answering Op and as such, the complaint of the complainant is liable to be dismissed with costs. On merits, the contents of the complaint were denied to be wrong. Preliminary objections were repeated. Prayer for dismissal of the complaint was made.  However, lateron the Op No.4 also failed to appear and as such, he was proceeded exparte on 13.03.2018.    

6.            Both the parties have led their respective evidence to prove their version.

7.             We have heard learned counsel for the parties and have gone through the record carefully.

8.             It is contended that deceased Kusum Lata widow of Sh. Rishi Pal Saini took the insurance policy for an amount of Rs.1,20,000/- and deposited five installments i.e. Rs.12,185/- at the time of filling the proposal form and four installments on dt. 09.04.2012, 31.05.2013, 05.05.2014 and 28.05.2015.  However, Kusum Lata expired on 14.12.2015 and the complainant applied for the insured amount and Rs.69,415.74 paise were only paid and the remaining amount of Rs.50,585/- was not paid by the Ops.  In this regard, one document Ex.C8 is there which clarifies the above-said amount. 

9.             The Hon’ble Punjab and Haryana High Court, Chandigarh in an authority titled as Birla Sun Life Insurance Co. Ltd. Vs. Keshav Lal & others cited in 2008(3) RCR (Civil) 637 has held that when efforts are being made by the insurance company to raise false pleas to repudiate the claims.  The insurance company was asked to be fair in dealings and not to cheat the clients and not to repudiate claims by sticking to some hidden clauses.

                We have gone through the above-said authority.  The same is applicable to the facts of present case.  The complainant is entitled to remaining amount of Rs.50,585/-.

10.            Thus, as a sequel of above discussion, the complaint of the complainant is allowed and we direct the Ops No.1 & 2 to pay Rs.50,585/- to the complainant alongwith interest @ 6% p.a. from the date of filing of present complaint i.e. 26.10.2016 till its realization.  The complainant is also entitled to Rs.5,000/- as lump sum compensation for harassment and mental agony as well as litigation charges.  The order; be complied within a period of 60 days, failing which, penal action under Section 27 of the Consumer Protection Act, 1986 would be initiated against the opposite parties No.1 & 2.  Copy of this order be communicated to the parties free of cost.  File be consigned to record after due compliance.

Announced:    

Dt.14.03.2018.                                        (G.C.Garg)

                                                            President

            (Kapil Dev Sharma).

                                Member