Haryana

Yamunanagar

CC/814/2013

Satish Kumar s/o Sh.Bal Kishan, - Complainant(s)

Versus

LIC of India - Opp.Party(s)

Gulab Singh

03 Jul 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

                                                                                    Complaint No. 814 of 2013

                                                                                    Date of institution: 13.11.2013 

                                                                                    Date of decision: 03.07.2017

 

Satish Kumar, aged about 35 years, son of Shri Bal Kishan, resident of Main Bazar, Radaur, Tehsil Jagadhri, District Yamuna Nagar.

 

                                  …Complainant.

                                                            Versus

1. Life Insurance Corporation of India, Opp. Madhu Hotel, Yamuna Nagar, through its Manager.
2. Life Insurance Corporation of India, near HDFC Bank Sector 17 HUDA, Jagadhri, District Yamuna Nagar through its Manager.
3. Life Insurance Corporation of India, Regional Office, Karnal, through its Regional Manager.

                                                                                                                                                                                                                                                                                                                                                             …Respondents.

 

BEFORE:         SH. ASHOK KUMAR GARG…………….. PRESIDENT.

                        SH. S.C.SHARMA………………………….MEMBER.

                        SMT. VEENA RANI SHEOKAND..……… MEMBER

 

 

Present:           Shri Gulab Singh, Advocate for complainant.

                       Shri Sushil Garg, Advocate for OPs.

 

 

ORDER (ASHOK KUMAR GARG, PRESIDENT)

 

 

1.                     The present complaint has been filed by Shri Satish Kumar husband of the complainant, being nominee of deceased Smt. Usha Rani who was insured, under section 12 of the Consumer Protection Act. 1986 against the respondents (hereinafter referred as OPs).

2.                     Brief facts of the complaint, as alleged in the complaint, are that wife of the complainant had obtained an insurance policy bearing No.174796939 on 28.03.2006 for a sum assured of Rs.1,00,000/- and paid premium amount of Rs.1095/- vide receipt No.0978268 dated 12.08.2006. Unfortunately, on June, 2006, wife of the complainant expired. Thereafter, the complainant approached the OPs and intimated regarding death of policy holder but the official of the OPs put off the matter with one pretext or the other. Finding no alternative, the complainant got served a legal notice dated 03.06.2013. Even, after the service of notice, stated above, the complainant many a times visited the offices of the OP No.1 and 2 with the above said request  but all in vain. Lastly prayed for directing the OPs to pay sum assured Rs.1,00,000/- against the policy in question and also to pay compensation as well as litigation expenses.

3.                     Upon notice OPs Insurance Company appeared and filed its written statement taking some preliminary objections such as present complaint is beyond limitation under the provision of law as the present complaint has been filed on 13.11.2013 whereas Smt. Usha Devi (Deceased Life Assured) expired on 23.06.2006 i.e. after a period of near about 7 years 5 months; the complainant has arisen no cause of action; complainant has concealed the true and material facts; this forum has no jurisdiction to entertain and try the present complaint; the OP insurance company has rightly and legally repudiated the claim pertaining to the policy in question and on merit  it has been submitted that as per record, a policy bearing No.174796939 was issued to Smt. Usha Devi (DLA) for a sum insured of Rs.1 lac TT 14-25-25, commencing from 28.03.2006  having premium of Rs.1080 payable quarterly and Sh. Satish Kumar husband of the Policy Holder was the nominee under the policy in question. It has been further submitted that as per record, the first premium amount was paid on 31.03.2006 and next quarterly premium due on 28.06.2006 was paid on 12.08.2006 along with late fee, after the death of DLA. It has been further mentioned that the deceased life assured Smt. Usha Devi expired on 23.06.2006 as per death certificate and the policy in question was in force and Sh. Satish Kumar husband of the since deceased Smt. Usha Devi is nominee therein, however, it has been specifically denied that the complainant is entitled to claim or interest because the claim is time barred as the complainant gave intimation of death of policy holder in the Branch, after the expiry of three (03) years. The claim was time barred by law of limitation and competent authority rightly and legally repudiated the claim under due intimation through registered letter dated 17.05.2011 to the complainant. Even Shri Gulab Singh, Advocate who issued legal notice dated 03.06.2013 was intimated through reply dated 01.07.2013 intimating the repudiation of claim under the policy. Lastly, prayed for dismissal of the complaint.

4.                     In support of his case, learned counsel for the complainant  tendered into evidence affidavit of Shri Satish Kumar, Complainant as Annexure CW/A, photocopy of Insurance policy as Annexure C-1, photocopy of receipt of first premium as Annexure C-2, photocopy of death certificate as issued by Death & Birth, Registrar as Annexure C-3, photocopy of letter dated 04.10.2012 as Annexure C-4, copy of legal notice along with postal receipts and acknowledgment as Annexure C-5 and C6 and closed the evidence on  behalf of complainant.

5.                     On the other hand, counsel for the OPs tendered into evidence affidavit of Shri Balihar Singh, Manager as Annexure RW/A, copy of repudiation letter dated 17.05.2011 as Annexure R-1, photocopy of death certificate as Annexure R-2, attested copy of Insurance policy along with its terms and conditions as Annexure R-3, photocopy of intimation letter dated 02.05.2011 as Annexure R-4, photocopy of proposal form as Annexure R-5, photocopy of Ration Card as Annexure R-6, photocopy of Claim Form as Annexure R-7, photocopy of affidavit dated 28.02.2013 as Annexure R-8, photocopy of premium receipt as Annexure R-9, photocopy of reply of Legal Notice as Annexure R-10, photocopy of status report of the policy as Annexure R-11 and closed the evidence on behalf of OPs.  

6.                     We have heard the learned counsel for parties and have gone through the, pleadings as well as documents placed on the file very carefully and minutely.

7.                     It is not disputed that the policy bearing No. 174796939 on 28.03.2006 for a sum assured of Rs.1,00,000/- was obtained by the wife of the complainant and paid premium amount of Rs.1095/- vide receipt No.0978268 dated 12.08.2006 which is duly evident from the photocopy of (Annexure C-1). It is also not disputed that life assured Smt. Usha Devi expired on 23.06.2006 which is duly evident from the coy of death certificate as (Annexure C-3).

8.                     The only grievance of the complainant is that the OPs Insurance company has wrongly and illegally repudiated the claim of the complainant vide its repudiation letter dated 17.05.2011 (Annexure R-1). Learned counsel for the complainant argued that policy in question was inforce at the time of death of wife of the complainant and the Insurance Company is legally liable to pay the sum insured of Rs.1 lac.

9.                     On the other hand, learned counsel for the OPs Insurance Company argued at length that the claim of the complainant has been rightly and legally repudiated by the OP Insurance Company vide its repudiation letter dated 17.05.2011 (Annexure R-1) as the deceased Smt. Usha Devi (Life Assured) died on 23.06.2006 whereas the claim was lodged with the OPs Insurance Company after a period of more than 3 years i.e. on 02.05.2010 and draw our attention towards the intimation letter dated 02.05.2010 (Annexure R-4) and also further draw our attention towards the affidavit of the complainant submitted with the OPs Insurance Company on 28.02.2013 (Annexure R-8) in which the complainant has admitted this fact that he lodged the claim with the OPs Insurance Company after a gap of more than 3 years. Learned counsel for the OPs further argued that as the complainant lodged the claim after a period of more than 3 years and not submitted any documents showing the cause of death i.e. Postmortem, any treatment record of any hospital, DDR and FIR etc. Hence, the claim of the complainant has been rightly repudiated by the OPs insurance company. Learned counsel for the Ops further argued that even at the time of depositing second premium on 12.08.2006 the complainant did not disclose the fact to the Ops Insurance Company  that her wife had already expired on 23.06.2006 and played the fraud with the OPs Insurance Company by depositing second quarterly premium on 12.08.2006 just to extract the claim from Insurance Company due to the reasons best known to him. Learned counsel for the OPs further draw our attention towards the remaining terms and conditions mentioned in the Insurance Policy and argued that , it may be the case of suicide, murder or otherwise in the absence of any cause of death it cannot be presumed that there was no violation of the terms and conditions of the Insurance policy in question. Learned counsel for the OPs further argued that even the complainant has failed the present complaint, after a gap of more than 2 ½ years from the date of repudiation of claim as the present complaint has been filed on 13.11.2013 whereas the complaint of the complainant was repudiated vide registered letter dated 17.05.2011. Learned counsel for the OPs further argued that the cause of action was arisen to the complainant at the time of death of her wife on 23.06.2006 whereas the present complaint has been filed on 13.11.2013 i.e. after a period of more than 7 years 5 months and after a long time OPs Insurance Company could not investigate the matter in question regarding the death of her wife. Lastly prayed for dismissal of the complaint.

10.                   After hearing both the parties we are of the considered view that the complaint of the complainant is hopelessly time bared as from the perusal of death certificate (Annexure C-3), It is duly evident that the life assured/deceased Usha Devi expired on 23.06.2006, the present complaint has been filed on 13.11.2013 i.e. after a period of 7 years 5 months. Further, it is also duly evident that claim of the complainant was repudiated by the OP Insurance Company vide its repudiation letter (Annexure R-1) on 17.05.2011 and the present complaint has been filed on 13.11.2013 i.e. after a period of 2 years and 6 months. As per section 24A of the Consumer Protection Act, which is reproduced here as under:

Section 24A. Limitation period:

1) The District Forum, the State Commissioner or the National Commission shall not admit a complaint unless it is filed within two years from the date on which the cause of action has arisen.

(2) Notwithstanding anything contained in sub-section (1), a complaint may be entertained after the period specified in sub section (1), if the complainant satisfies the District Forum, the State Commission or the National Commission, as the case may be that he had sufficient cause for not filing the complaint within such period.

            Provided that no such complaint shall be entertained unless the National Commission, the State Commission or the District Forum, as the case may be records its reasons for condoning such delay.

11.                   After going through the above noted provision, it is clear that complaint of the complainant is hopelessly time barred. In the present case, the complainant has neither disclosed any ground for condonation of delay nor has moved any application for condonation of delay separately.

12.                   On the other angle also, the complainant has not disclosed single iota of word regarding cause of death of his wife, neither placed on file any copy of Postmortem  report treatment record of any hospital or DDR and FIR to prove that his wife died due to that reason and in the absence of any cause of death it cannot be presumed that there was no violation of terms and conditions of the Insurance policy on the part of the deceased.

13.                   Resultantly, in the circumstances noted above, we are of the considered view that that the claim of the claimant has been rightly repudiated by the OPs Insurance Company vide its letter dated 17.5.2011 (Annexure R-1). Further, the complainant has totally failed to prove his case and there is no merit in the present complaint and even the complaint of the complainant is hopelessly time barred. Hence, the same is hereby dismissed with no order as to cost. Copies of this order be supplied to the parties concerned as per rules. File be consigned to the record room after due compliance.

Pronounced in open court:

Dated: 03.07.2017.

 

 

 

		(ASHOK KUMAR GARG) PRESIDENT,DCDRF, YAMUNA NAGAR.
(VEENA RANI SHEOKAND) MEMBER	(S.C.SHARMA) MEMBER