BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL FORUM, KAITHAL.
Complaint no.34/12.
Date of instt.: 17.01.2012.
Date of Decision: 11.12.2014.
1. Smt. Savita Devi W/o Suresh Kumar Gautam 2. Sh. Suresh Kumar Gautam S/o late Ram Gopal Gautam, both residents of House No.962/20, Gali No.8, near Railway Line, Amargarh Colony Kaithal, District Kaithal.
……….Complainants.
Versus
1. I.D.B.I. Federal Life Insurance Company Limited, Registered Office: Ist Floor, Tradeview, Oasis Complex, Kamala City, P.B.Marg, Lower Parel (W), Mumbai-400013. Maharashtra through its Managing Director.
2. I.D.B.I. Federal Life Insurance Company Limited, Kaithal through its Branch Manager.
..……..Opposite Parties.
COMPLAINT UNDER SEC. 12 OF CONSUMER PROTECTION ACT, 1986.
Before: Sh. Rajbir Singh, Presiding Member.
Smt. Harisha Mehta, Member.
Present : Sh. S.V.Ravish, Advocate for complainants.
Sh. Amit Chaudhary, Advocate for the opposite parties.
ORDER
(RAJBIR SINGH, PRESIDING MEMBER).
The complainants have filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that Smt. Cheema Devi @ Semma Devi was legally wedded wife of Sh. Deepak Kumar Gautam, who was real son of complainants and no child was born from the said wedlock. It is alleged that one agent/advisor of Ops contacted the son and daughter-in-law of complainants (both since deceased) to get them insured and to obtain the life insurance policy of the Ops. It is further alleged that Deepak Kumar Gautam, son and Smt. Cheema Devi, daughter-in-law of the complainants agreed to execute the relevant papers and proposal form bearing application No.107078796 and was executed by Deepak Kumar and proposal form bearing No.107024497 was executed by Smt. Cheema Devi. It is further alleged that all the required documents were submitted with the proposal form executed by Deepak Gautam and Smt. Cheema Devi. It is further alleged that the scheme of policy opted was IDBI Federal termsurance protection plan and life of Smt. Cheema Devi and Deepak Kumar were insured for Rs.19,00,0000/- each of them and the term of policy were 30 years. It is further alleged that the mode of payment was on yearly basis. It is further alleged that unfortunately on 27.01.2011 Smt. Cheema Devi @ Seema Devi and her husband Sh. Deepak Kumar Gautam died in a sudden accident and fell in the Bakhra Canal near Kurukshetra in the area of Police Post 3rd Gate, Police Station Adarsh Thana, Thanesar, District Kurukshetra. It is further alleged that the post-mortem was conducted at Govt. Hospital Karnal regarding Deepak Kumar Gautam and post-mortem of Smt. Cheema Devi @ Seema Devi was conducted at L.N.J.P. Hospital Kurukshetra. It is further alleged that the complainants lodged the claim with the Ops and submitted all the necessary documents. It is further alleged that the claim qua deceased Deepak Kumar Gautam was released but the claim of deceased Smt. Cheema Devi was not released. It is further alleged that surprisingly near about 08.03.2011, the complainants shocked by opening an envelope which was addressed to Deepak Kumar Gautam deceased containing in the same a cheque bearing No.707688 dt. 03.03.2011 amounting to Rs.4360/- along with a letter written by Sr. Manager Dipin Maru regarding proposal No.300296239 life assured Cheema Devi in which it was mentioned that we regret to inform you that since “We have no received the documents requested by us to facilitate the proceeding of your proposal within stipulated time, but we have been constrained to refund your application, further it was mentioned that as a consequence of that we have processed a refund of initial premium paid by you “please find enclosed a cheque No.709688 of Rs.4360/- towards the same.” This way, the Ops are deficient in service. Hence, this complaint is filed.
2. Upon notice, the opposite parties appeared before this forum. Op No.1 filed written statement raising preliminary objections with regard to maintainability; cause of action; locus-standi; that the complainants are not consumers under the Act, in as much as there is no effective and binding contract of insurance between the Op No.1 and the deceased proposed insured and that the proposal for insurance did not culminate into a binding contract; that this Forum have no jurisdiction to entertain the present complaint since the complainants have failed to show any deficiency of service on the part of Op No.1 since the alleged claim of complainants was rejected by the Op No.1 only after due application of mind and the conclusion reached was a bonafide one; that the complicated question of law and facts are involved in the present complaint and for adjudication of which, only the Civil Court is the best platform; that on 02.02.2011, the Op No.1 received the death claim of late Mr. Gautam under policy No.4000274438 from Mr. Suresh Gautam to the effect that late Mr. Gautam expired on 27.01.2011. The said death claim was assessed by the Op No.1 and in accordance with the policy No.4000274438 issued by Op No.1, a death benefit amount of Rs.19,00,000/- was paid to Mr. Suresh Kumar Gautam vide cheque No.754491. The said cheque has been duly encashed by Mr. Suresh Kumar Gautam. It is submitted that by paying the said death claim amount, Op No.1 duly discharged its obligation under the policy No.4000274438 issued to late Mr. Gautam; that the Op No.1 did not accept the proposal made by late Mr. Gautam on the life of Mrs. Cheema Devi and Op No.1 is not liable to pay any amount in this regard. There is no deficiency in service on the part of answering Op. On merits, the contents of complaint are denied and so, prayed for dismissal of complaint.
3. Ld. Counsel for the Ops made statement on 14.08.2012 that the reply filed on behalf of Op No.1 be also read as reply on behalf of Op No.2.
4. In support of their case, both the parties submitted their affidavits and documents.
5. We have heard ld. counsel for both the parties and perused the case file carefully and minutely.
6. We have perused the complaint & reply thereto and also have gone through the evidence led by the parties.
7. Keeping in view all the facts and circumstances of the case, we found that the son and daughter-in-law of complainants applied for termsurance protection plan for their lives. Both son and daughter-in-law of complainants died on 27.01.2011 in a sudden accident. On 15th February, 2011, the complainants visited the office of Op No.2 and informed about the death of son and daughter-in-law of complainants. The complainants supplied all the relevant documents and claim form on 17.02.2011. The Ops issued the claim of Rs.19,00,000/- of deceased Deepak Kumar but claim of deceased Cheema Devi was not released. On 08.03.2011, the complainants received an envelope contained a cheque bearing No.707688 dt. 03.03.2011 amounting to Rs.4360/- (Annexure-14) and a letter written by Sr. Manager Dipin Maru regarding proposal No.300206239 life assured Cheema Devi (Annexure-15). In the letter written b Ops, it was mentioned that we regret to inform you that since “We have not received the documents requested by us to facilitate the proceeding of your proposal within stipulated time, but we have been constrained to refund your application, further it was mentioned that as a consequence of that we have processed a refund of initial premium paid by you “please find enclosed a cheque No.709688 of Rs.4360/- towards the same”. On the other hand, the Ops stated that the Op No.1 had received two applications for Termsurance Protection Plan from Mr. Deepak Kumar Gautam, one for his wife and other for himself. On 14.01.2011, the Ops received an application No.107078796 dt. 07.01.2011 for Termsurance Protection Plan duly signed and submitted by deceased Deepak Kumar along with premium amount of Rs.4778/-. After reviewing the all documents submitted by deceased Deepak Kumar, the Op company issued Termsurance Protection Plan bearing policy No.4000274438 on 24.01.2011 to Deepak Kumar. As far as policy of Cheema Devi is concerned, after reviewing the proposal of Cheema Devi, it was noted that Mrs. Cheema Devi had mentioned that her occupation was “business” and annual income was Rs.1,00,000/-. The Op No.1 noted that the said financial back ground was not commensurate with the proposed high risk cover of Rs.19,00,000/-. Vide letter dt. 17.01.2011, the company required late Mr. Gautam to provide the income proof of Mrs. Cheema Devi and financial questionnaire of Mrs. Cheema Devi. The company received the financial questionnaire dt. 19.01.2011 but income proof of Mrs. Cheema Devi was not received by Op No.1. A reminder letter dt. 06.02.2011 issued by Op No.1 to the proposer. It was also conveyed that if the said documents were not provided within the said time period, the said proposal will be cancelled and the initial premium deposit received by Op No.1 would be returned back to the proposer without any interest. It was also conveyed that the Op No.1 will commence the risk only from the date of issuance of the insurance policy. Due to non-submission of required documents, the policy was not issued to Cheema Devi. So, there is no contract between the company and Cheema Devi. As far as the death claim of Deepak Gautam is concerned, after assessment of death claim of Deepak, a death benefit amount of Rs.19,00,000/- was paid to complainant No.2 vide cheque No.754491 and the same cheque was encashed by complainant No.2. Regarding the death claim of proposed insured Cheema Devi, it was found that Cheema Devi had expired on 27.01.2011 and at that time, the policy was not in force. As the proposed insured expired before the issuance of policy and the complainants have claimed amount only on the basis of the application for insurance made with Op No.1 that is not admissible. A contract of insurance does not come into existence merely by submitting the application/proposal form that mere payment of money as initial premium deposit does not ipso facto constitute a valid and binding contract of insurance between the parties i.e. proposer and Op No.1. The insurance policy has to be issued after examination of proposal form. In this case, no policy has been issued. In this regard, we can rely upon the authority titled as LIC Vs. Sh. Gurnam Singh, bearing revision petition No.306 of 2004 decided by Hon’ble National Commission on 20.08.2007, wherein it has been held that “In any set of circumstances, in the present case, there is no unusual delay on the part of the LIC in processing the proposal form submitted by the deceased. Proposal form was submitted on 15.10.2001 and she died on 13.11.2001. In between, LIC sought relevant information and the contract of insurance was not finalized. Therefore, the insurance company rightly repudiated the claim.” The authorities submitted by ld. Counsel for the complainant reported as LIC Vs. Mrs. V.Jeeva, 1997(1) CPC page 100; Express Resorts and Hotels Ltd. Vs. OIC, 2005(1) CPC page 696 and LIC Vs. Smt. Baljit Kaur, 1997(2) CPC page 426 are not applicable to the present case because the facts of these authorities are different from the present case. So, it is crystal clear from the above facts that the Ops are not found deficient on their part.
8. Thus, in view of above discussion, we find no merit in the present complaint and dismiss the same. A copy of this order be sent to both the parties free of cost. File be consigned to the record room after due compliance.
Announced.
Dt. 11.12.2014.
(Harisha Mehta), (Rajbir Singh),
Member. Presiding Member.
