DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,
PATIALA.
Consumer Complaint No. 194 of 10.05.2016
Decided on: 25.1.2017
Gurjant Singh aged about 56 years S/o Sh.Jangir Singh R/o H.No.630/13 C/o G.S. Tailor, Warraich Colony, Majri Road, Samana, District Patiala.
…………...Complainant
Versus
- Life Insurance Corporation of India, Branch Samana, District Patiala, through its Branch Manager.
- Life Insurance Corporation of India, Divisional Office “Jeevan Prakash” Sector 17-B, Chandigarh.
- Zonal Manager, Life Insurance Corporation of India, Zonal Office “Jeevan Bharti”, Connaught Circus, New Delh-110001.
…………Opposite Parties
Complaint under Section 12 of the
Consumer Protection Act, 1986.
QUORUM
Smt. Neena Sandhu, President
Smt. Neelam Gupta, Member
ARGUED BY:
Sh.Sunil Kumar Garg, Adv.counsel for complainant.
Sh.Amit Kumar Bedi, Adv. counsel for opposite parties.
ORDER
SMT.NEENA SANDHU, PRESIDENT
Sh. Gurjant Singh has filed this complaint under Section 12 of the Consumer Protection Act,1986 ( hereinafter referred to as the Act) against the Opposite Parties (hereinafter referred to as the O.Ps.) praying for the following reliefs:-
To make the payment of Rs.2,50,000/- alongwith 18% p.a. interest from the date of death of his son i.e. 7.10.2105 till realization
- To pay Rs.2,00,000/- as compensation on account of mental agony and physical harassment
- To pay Rs.15,000/-as costs of litigation expenses,
- To pay any other additional or alternative relief, which this Forum may deem fit.
2. In brief, the case of the complainant is that his son Sukhwinder Singh (now deceased), on 27.7.2013 took four policies bearing Nos.165331791, 165331792, 165331793 for sum assured of Rs.50,000/-each and Policy bearing No.165331794 for the sum assured of Rs.1,00,000/- i.e. total sum assured Rs.2,50,000/- in case of natural death and Rs.5,00,000/-in case of accidental death. Since the commencement of these policies, his son regularly deposited the premiums as per the terms and conditions of the O.Ps. The last premium of the polices was deposited on 5.10.2015.His son met with a road side accident on 4.10.2015 and died on 7.10.2015. He being the nominee of the policies, lodged the accidental death claim of his son with the O.Ps. in December,2015. He completed all the formalities and submitted the relevant papers with the O.Ps. But to his utter surprise, the OPs paid Rs.2.5lac only and rejected the accidental claim vide their letter dated 26.12.2015 on the ground that the policies were lying in a lapsed condition, the premium was deposited on 5.10.2015 and the accident was occurred on 4.10.2015.The O.Ps. accepted the premium with late fee. He made representations dated 4.1.2016 to OP No.1 and 2.2.2016 to the Zonal office i.e. OP No.3 against the rejection of the accidental death claim . But the Ops. failed to take any action in this regard. He suffered a lot of financial loss, mental agony and harassment due to the poor services of the O.Ps. There is thus mal practice and deficiency in service on the part of the O.Ps.
3. On being put to notice, the OPs appeared and filed the written version taking preliminary objection that the complaint is not maintainable and is liable to be dismissed as Death Accident benefit (hereinafter referred to as DAB) under the policy in question is not payable as per terms and conditions of the policy as well as under the rules and regulations of the corporation. On merits, it is stated that the deceased life assured had purchased four policies bearing Nos.165331791, 165331792, 165331793 and 165331794 on 27.7.2013, from them. The premium paying mode was half yearly and regular premiums were deposited up-to January/2015. All the four policies had Accident benefit i.e. in case of death of the life assured, the claimant’s will be entitled to an amount equal to that of sum assured in addition to the amount of basic sum assured. It is denied if the deceased life assured had deposited all the premiums regularly. Rather it is stated that after Janaury, 2015, the next premium under all the policies was due in July,2015 and the premium due in July,2015 was deposited with late fee, on 5.10.2015 i.e.. after the occurrence of accident. It is admitted that they have settled and paid the claim for basic sum assured + Bonus under all the 4 policies on ex-gratia basis as per rules and regulations of the corporation and have declined “DAB” as per conditions laid down in “Accident Benefit”. It is denied if the complainant suffered mentally, physically as well as financially on account of their poor services. There is no deficiency in service or unfair trade practice on their part. The OPs denied all other averments made in the complaint and have prayed to dismiss the complaint.
4. In support of the complaint, the ld counsel for the complainant tendered in evidence Ex.CA sworn affidavit of the complainant, Ex.CB, sworn affidavit of Sh.Satnam Singh alongwith documents Exs.C1 to 10 and has closed the evidence of the complainant. The ld. Counsel for the O.Ps. tendered in evidence Ex.OPA, sworn affidavit of Sh.V.K.Arora, Manager L & HPF, LIC alongwith documents Exs.OP1 to OP6 and has closed the evidence of the Ops.
5. We have heard the ld. counsel for the parties and have also gone through the record of the case, carefully.
6. At the outset, the ld. counsel for the Ops vehemently argued that since on the date of accident i.e. 4.10.2015, all the policies in question were lying in lapsed condition, therefore, the complainant is not entitled to get the accidental benefits under the said policies. However, the Ops paid to the complainant, the basic sum assured plus bonus under all the policies on ex-gratia basis as per rules and regulations of the corporation. Hence, the complaint filed against the O.Ps. is liable to be dismissed, being devoid of merits.
The ld. Counsel for the complainant submitted that once the O.ps. on receipt of premium amount along with late fee and had reinstated/renewed, all the policies, during the life time of the life assured, then the O.Ps. cannot take this plea that the policies in question were lying in the lapsed condition on the date of death of the life assured. The O.Ps. were, thus, not justified in repudiating the claim of the complainant.
It may be stated that once the O.Ps. have accepted the premium amount along with late fee and reinstated/renewed all the policies during the life time of the life assured, then it does not lie in the mouth of the O.Ps. to say that the policies in question were lying in a lapsed condition on the date of the death of the life assured. They cannot be allowed to regal out from their liability to indemnify the complainant. Hence, complaint is allowed and the O.Ps. are directed in the following manner:-
1. To release the claim along with all the benefits as per terms and condition of the policy after deducting the amount already paid along with interest @ 9% per annum from the date of repudiation i.e. 26.12.2015 till its realization.
2. To pay Rs. 5000/- as compensation on account of mental agony and physical harassment.
3. To pay Rs. 5000/- as litigation cost.
The certified copies of the order be sent to the parties free of cost under the rules. Thereafter, file be indexed & consigned to the Record Room.
ANNOUNCED
DATED: 25.01.2017
(NEENA SANDHU)
PRESIDENT
(NEELAM GUPTA)
MEMBER
