Haryana

StateCommission

A/754/2016

PNB METLIFE INDIA INSURANCE CO. - Complainant(s)

Versus

KAUSHALYA DEVI - Opp.Party(s)

UMESH KUMAR KANWAR

22 Aug 2017

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                 

                                                         First Appeal No.754 of 2016

Date of Institution: 17.08.2016

                                                               Date of Decision: 22.08.2017

 

1. Manager, PNB Metlife India Insurance Co. Ltd. (formally known as Metlife) Ground Floor, SCF-139, Sec.17, Main Market Faridabad 121002 (HR), through Mr. V Prashanth Senior Manager-Legal.
2. PNB Metlife India Insurance Co. Ltd. (formally known as Metlife) having its Registered Office at Unit No.701, 702 and 703, 7^th Floor, West Wing, Raheja Towers, 26/27, M G Road, Bangalore-560001 through Mr.V Prashanth, Senior Manager-Legal.

…..Appellants

Versus

 

Kaushalya Devi W/o Shri K.L. Kalra H.No.2759, Ist Floor, H-Block Sector-49, Sainik Colony Faridabad-Haryana.

                                      …..Respondent

 

CORAM:             Mr. R.K.Bishnoi, Judicial Member.

                             Mrs. Urvashi Agnihotri, Member.                                                                                                                                        

Present:              Mr.Umesh Kanwar, Advocate counsel for the appellants.

Mr.Sanjay Kumar, Advocate counsel for the respondent.

                                                   O R D E R

R.K.BISHNOI, JUDICIAL MEMBER:

          It was alleged by the complainant that she obtained four met Smart Premier (whole life plan) policies from opposite parties (O.Ps.-appellants)  for sum assured of Rs.5,25,000/- each. She paid premiums regularly for three years, but, due to financial problem, she could not pay premium which was due on 31.12.2012. Policies were terminated by the O.ps and she received cheques of Rs. 13135/- each.  She approached O.Ps. for reinstatement of said policies.  O.Ps. told her to return foreclosure cheques to them, pay her due premium immediately and medical declaration form thereafter her policies would come in force. She submitted due premium through cheque alongwith forms and cheques for Rs.13,135/- for all four policies in branch as required by insurance company, but, policies did not come into force despite payment. The complainant was informed that the policies could not be revived until her medical test is again conducted as per terms of policy. The above said act amounts to unfair trade practice on the part of the O.Ps. She was not given any advance notice before terminating said policies.

2.      Opposite parties (O.Ps.) filed reply controverting her averments and alleged that  policies were issued by O.Ps. on the basis of proposal forms furnished by her.  She did not remit payments due for 30.12.2012.  O.Ps. refunded the foreclosure amount of Rs.13135.18 for each vide cheque No.164625 to 164628 to her, but, on 04.03.2013 she returned said cheques and remitted payment of Rs.15,000/- each alongwith declaration of Good Health form for reinstatement of said policies.  She did not furnish medical tests, so her policies were not  reinstated. Foreclosure amount of Rs.13,135.18/- for each policy had been refunded to her vide cheque Nos.190684 to 190687. Objections about complaint time barred, cause of action etc. were also raised and requested to dismiss complaint.

3.      After going through the evidence produced by both the parties and hearing their counsels, learned District Consumer Disputes Redressal Forum, Faridabad (In short “District Forum”)  allowed complaint vide impugned order dated 22.03.2016 and directed as under:-

 “Resultantly complaint is allowed. Opposite parties are directed to reinstate the  said policies of the complainant on payment of all due premiums to the date of reinstatement and to pay Rs.2200/- as compensation towards mental tension as well as  harassment besides Rs.1100/- as litigation expenses to the complainant within 30 days from the date of receipt of this order. ”

4.      Feeling Aggrieved, therefrom, O.Ps. have preferred this appeal.

5.      Arguments heard.  File perused.

6.      Learned counsel for appellants vehemently argued  that policy lapsed on 31.12.2012 and she applied for renewal after four months. As per clause 2 of insurance policy pertaining to re-instatement she was to provide medical certificate which she did not provide. As per clause 21 of the policy if the premium is more than the surrender value the policy cannot be re-instated.  In the present case the surrender value was Rs.13135/- which was more than Rs.15,000/- so also she was not entitled to get the policies re-instated.  Learned District Forum failed to take into consideration these aspect and wrongly ordered to renew the policy, so impugned order dated 22.03.2016 be set aside. 

7.      This argument is of no avail. Complainant wrote letter Annexure C-5 about re-instatement of policy, wherein it was alleged that due date for renewal was 30.12.2012 and with grace period, it comes to 30.01.2013. Within two months she applied for renewal of insurance policy whereas she was entitled to get the same reinstated within two years from the date of lapse.  In this letter it was specifically alleged by her that condition of medical be waived, but, O.Ps. have failed to show any document vide which this request was declined. It means that O.Ps. accepted her request. On the basis of surrender value the request of complainant cannot be declined.  It can vary from time to time, so these arguments are of no avail.  The findings of learned District Forum is well reasoned based on law and facts and cannot be disturbed.  Resultantly appeal fails and the same is hereby dismissed.

8.      The statutory amount of Rs.1650/- deposited at the time of filing the appeal be refunded to the appellants  against proper receipt and identification in accordance with rules.

 

August 22nd, 2017      Urvashi Agnihotri                                R.K.Bishnoi,                                                               Member                                              Judicial Member                                                         Addl. Bench                                        Addl.Bench                

S.K.