Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 400
Instituted on : 31.08.2018
Decided on : 04.10.2023
- Mamta daughter of late Sunil Kumar
- Naveen minor son of late Sunl Kumar minor through sister Mamta residents of village Kiloi Khas Tehsil & District Rohtak.
......................Complainant.
Vs.
- IDBI Federal Life Insurance Co. Ltd., now known as Ageas Federal Life Insurance Company Limited, 22nd Floor, A Wing, Marathon Futurex, N M Joshi Marg, Lower Parel(East), Mumbai-400013 through its Incharge.
- Somesh Kumar Nandal, Agent Code1000054120 resident of Tilak Nagar, Rohtak.
...........…….Opposite parties.
COMPLAINT U/S 35 OF CONSUMER PROTECTION ACT,2019
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR.VIJENDER SINGH, MEMBER
Present: Complainant in person with Sh. J.K.Bidla, Advocate.
None for opposite party No. 1.
Opposite party no. 2 already exparte.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per complainant are that husband of the complainant obtained policy no. 4000590462 which was issued by the opposite parties. The husband of the complainant has died on 01.11.2017. At the time of obtaining policy, the husband of the complainant has appointed the complainant as nominee. Being nominee and legal heir, the complainant applied for death claim of Rs.1,47,040/- but the opposite parties have passed the claim of Rs.73225.92/- instead of Rs.1,47,040/-. The remaining amount of claim has been wrongly withheld by the opposite parties. The complainant sent all the required documents to the opposite parties. The complainant requested the opposite parties to pay the remaining death claim but they do not pay any heed towards the genuine request of the complainant and refused to pay the remaining claim. The act of opposite party is illegal and amounts to deficiency in service. Hence this complaint and it is prayed that opposite parties may kindly be directed to pay remaining death claim of Rs.73,814/- alongwith interest @ 18% per annum from the date of withholding till its actual realization. It is also prayed that opposite parties be directed to pay Rs.50,000/- as compensation and litigation expenses to the complainant as explained in relief clause.
2. After registration of complaint, notices were issued to the opposite parties. Opposite party No.1 filed its reply submitting therein that they issued policy to the deceased Life Assured Sunil wherein the petitioner was a nominee with 100% share. The date of the application was on 27.07.2013 and the policy was issued on 30.07.2013. The term of the policy was for a period of 15 years. The premium payment term was for a period of 10 years. The sum insured for the policy in the name of the DLA is Rs.1,47,040/-. The premium payable for the policy in the name of the deceased Life Assured is Rs.14,629.5/- yearly for a period of 10 years. The DLA has paid only three renewal premiums for the above policy i.e. upto year 2016 and thereafter no premiums were paid. He paid a total amount of Rs.58,036.22/- towards of the policy. The opposite party No. 1 had issued renewal notice to DLA for payment of premium due. Further they failed to pay the renewal premium for the year 2017. Since, the renewal premium remain unpaid for the year 2017, the policy acquired paid up status. It is further submitted that on 28.12.2017, the opposite party no. 1 received death claim intimation from the complainant informing the date of death of the DLA on 01.11.2017 alongwith supporting documents. Upon receipt of the documents, the opposite party no. 1 raised a requirement on 06.01.2018. The opposite party no. 1 evaluated the death claim and noticed that the policy was in paid up status. Accordingly, the death claim was paid considering the paid up value factor as envisaged under Sub-clause 5.2(paid up value upon death) of clause 5. Applying the formula provided under 5.2, paid up value on death of DLA was determined at Rs.73,225.92/-. The said amount of Rs.73,225.92/- was accordingly transferred to the complainant’s account. All the other contents of the complaint were stated to be wrong and denied and opposite parties prayed for dismissal of complaint with costs. Notice issued to opposite party no. 2 received back served but none appeared on his behalf. As such, opposite party no. 2 is proceeded against exparte vide order dated 05.10.2018 of this Commission.
3. Ld. Counsel for the complainant in his evidence has tendered affidavit Ex.CW1 & Ex.CW2, documents Ex.C1 to Ex.C12 and has closed his evidence on dated 11.10.2022. Ld. counsel for the opposite party no. 1 failed to produce his evidence. As such, evidence of opposite party no.1 was closed by Court order dated 31.05.2023.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case the complainant has filed the present case on the ground that opposite parties have paid the amount of Rs.73225.92/- against the claim amount of Rs.147040/- on account of death claim of her husband. On the other hand, opposite party has submitted that the DLA has paid only three renewal premiums for the above policy i.e. upto year 2016 and thereafter no premiums were paid. Since, the renewal premium remain unpaid for the year 2017, the policy acquired paid up status. The paid up value on death of DLA was determined at Rs.73,225.92/- and the said amount was transferred to the complainant’s account. On the other hand contention of ld. counsel for the complainant is that the policy holder already given cheque on 05.07.2017 and cheque encash date is 10.07.2017 while the policy due date was July 2017. Hence the policy was not in lapsed
condition. To prove the alleged version, two documents have been placed on record as ‘Annexure-JN-A’ & ‘Annexure-JN-B’. Document annexure-JN-A’ is a document regarding change of name of company, as per which the name of the company has been changed from IDBI Federal Life Insurance company to AGEIS Federal Life Insurance Company Limited. Perusal of ‘Annexure –JNB’ itself shows that an amount of Rs.14457/- has been received by the Aegis Federal Life Insurance company on account of policy no.4000590462 on dated 11.07.2017. Meaning thereby the premium was paid by the life assured well within time with the insurance company i.e. Aegis Federal Life Assurance Company. Hence the opposite party failed to prove the fact that life assured failed to pay the renewal premium for the year 2017. We have also observed that in the present case simply a written statement has been filed by the respondent no.1 Sh. Soni George, Deputy Vice President-Legal IDBI Federal Life Insurance Company. As per our view it is the duty of the company IDBI that they should inform the concerned Fora/Commission about the change of name of the company that the name of the Company has been changed from IDBI Federal Life Insurance Co. Ltd., to Ageas Federal Life Insurance Company Limited. But such information has not been provided by the company in the present case. Moreover simply written statement has been filed and thereafter even the power of attorney and other documents have not been placed on record by the company. Hence there is deficiency in service on the part of opposite party No.1 and opposite party No.1 is liable to pay the remaining claim amount to the complainant. It is also observed that Smt. Sunita complainant had died during the pendency of the complaint and now the Mamta and Naveen are the legal heirs of life assured.
6. In view of the fact and circumstances of the case we hereby allow the compliant and direct the opposite party No.1 to pay the amount of Rs.73814/-(Rupees seventy three thousand eight hundred and fourteen only) alongwith interest @ 9% p.a. from the date of filing the present complaint i.e. 31.08.2018 till its realization and shall also pay a sum of Rs.5000/-(Rupees five thousand only) as compensation on account of deficiency in service and Rs.5000/-(Rupees five thousand only) as litigation expenses to the L.Rs of deceased Sunil Kumar namely Mamta(daughter of deceased Life assured Sunil Kumar) and Naveen(son of deceased Life assured Sunil Kumar) in equal share. Order shall be complied within one month from the date of decision.
7. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
04.10.2023.
........................................................
Nagender Singh Kadian, President
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Tripti Pannu, Member.
……………………………….
Vijender Singh, Member
