Haryana

Ambala

CC/230/2015

Chander Kanta - Complainant(s)

Versus

LIC - Opp.Party(s)

Baikunth Nath

15 Dec 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM:

                                                AMBALA

 

                                                Complaint Case No.      :         230 of 2015.

                                                Date of Institution                   :         21.08.2015.

                                                Date of Decision            :         15.12.2017.

 

          Chander Kanta wife of Shri Jaspal Sharma resident of House No.447/3, Basant Vihar, Ambala City.

………….Complainant.

Versus

          Life Insurance Corporation of India, Jeewan Jyoti Building, Jawahar Lal Nehru Marg, Ambala Cantt through its Branch Manager.

…………Opposite Party.

          Complaint Under Section 12 of the Consumer Protection Act.

CORAM:             SH. DINA NATH ARORA, PRESIDENT

                             MS. PUSHPENDER KUMAR, MEMBER

MS. ANAMIKA GUPTA, MEMBER

 

Present: -              Complainant in person with Sh.Baikunth Nath, Advocate.                                          Sh. G.S.Antal, counsel for the OP.

                  

ORDER

 

                             In nutshell, brief facts of the complaint are that son of complainant (Shiv Kumar) had purchased an insurance policy bearing No.176391478 vide proposal No.11129 dated 06.12.2008. Insured Shiv Kumar, who was unmarried, died in rail accident on 01.12.2014 and regarding this inquest report No.247 dated 02.12.2014.  After the death of insured the complainant approached the OP and claimed benefits of above said policy by submitting requisite documents with it. The OP, thereafter, transferred a sum of Rs.1 lac min the bank account of the complainant on 04.06.2015 but withhold a sum of Rs.1 lac i.e. accidental benefits without disclosing any reason.  The complainant requested the OP many a times and even got served a legal notice upon it but to no avail.  The act and conduct of the Op clearly amounts to deficiency in service and unfair trade practice on its part. In evidence the complainant has tendered affidavit Annexure CX and documents Annexure C1 to Annexure C6.

2.                Upon notice, OP appeared and contested the complaint by filing reply and submitted that the DLA was minor (DOB 27.01.1992) at the time of taking the policy in question (06.12.2008 proposal date) and no accident benefit is granted under the policy in the case of minor. No premium for accidental benefit is charged on the life of a minor and the proposal was accepted through proposer Sh.Jaspal Sharma, father of life assured under policy No.176391478 under table term 179-20 with date of commencement 06.12.2008 and the policy was without accidental benefit.  The proposal was accepted for basic Sum assured without accidental benefit. The life assured was to appoint nominee but it was not done so and he died without valid nomination, therefore, succession certificate was required for basic claim under the policy. The claim of the complainant was settled as per policy terms and that too was accepted by complainant being fully satisfied. Other contentions made in the complaint have been controverted and prayer for dismissal of the complaint has been made. In evidence, the OP has tendered affidavit Annexure RA and documents Annexure R1 to Annexure R5.

3.                          We have heard learned counsel for the parties at length and gone through the case file very carefully.

4.                          The grievance of the complainant is that the OP has not given accidental benefit of the policy to her and illegally withheld the same without any reason despite the fact that all the requisite documents have been submitted with it.                              Per contra, it has been argued that DLA was minor (DOB 27.01.1992) at the time of taking the policy in question (06.12.2008 proposal date) and no accident benefit is granted under the policy in the case of minor. No premium for accidental benefit is charged on the life of a minor and the proposal was accepted through proposer Sh.Jaspal Sharma, father of life assured under policy No.176391478 under table term 179-20 with date of commencement 06.12.2008 and the policy was without accidental benefit.  The proposal was accepted for basic Sum assured without accidental benefit. The life assured was to appoint nominee but it was not done so and he died without valid nomination, therefore, succession certificate was required for basic claim under the policy. The claim of the complainant was settled as per policy terms and that too was accepted by complainant being fully satisfied.

5.                          Undisputedly, the son of the complainant had obtained a policy   (New Bima Gold Table No.179 Annexure R3) from OP for sum assured of Rs.1 lac. The life assured died on 02.12.2014 as is evident through death certificate Annexure C3. It is also not disputed that the OP had transferred an amount of Rs. 1 lac in the bank account of the complainant (Annexure C4) being basic assured amount. Now, the counsel for the complainant has drawn the attention of this Forum towards proposal form Annexure C1 wherein it is clearly mentioned that the purpose for taking insurance policy was Saving and Risk case and learned counsel for the complainant also drawn our attention   towards the policy terms and conditions wherein it has not mentioned that the minor cannot be given accidental benefit. OP has only repudiated the claim regarding accidental benefit only on the ground that Shiv Kumar was minor at the time of taking policy. On the other hand counsel for the OP has pointed out that as per Annexure R2 status report the premium regarding accidental benefit has not been taken. Counsel for the OP also pointed out that as per the policy Annexure R3 Accidental Benefit Rider option has also not been exercised as per Special provisions mentioned in the column of Accidental Benefit Rider Option. As per Section 11 Accidental Benefit: If the Accident Benefit is opted for, at any time when this policy is inforce for the full Sum Assured, if the life assured before the date of expiry of policy term or before the policy anniversary on which the age nearer birthday of the life assured is 70 years whichever is earlier, is involved in an accident resulting in either permanent disability as hereinafter defined or death and the same is proved to the satisfaction of the corporation.

                   We have gone through the material available on the case file. It is clear that proposal form placed on the file by the parties as Annexure C1/R1 duly signed by the father of the minor DLA.  

                   It is not disputed that at the time of taking the policy the DLA was minor. The OP has specifically taken a ground that it was open for the DLA to opt for accidental benefit after obtaining the age of majority but it has not been done so. Hon’ble National Commission in case titled as Rajender Kumar Rastogi Vs. LIC of India Revision Petition No.3232 of 2006 decided on 02.12.2010  has held that It is not disputed before us that the insured was a minor at the time of taking the policy. As per rules, the accidental benefit could not be extended to a minor. The minor on attaining the majority could opt for the accidental benefit on payment of requisite amount of premium. Since no such option was exercised, the insurance company was not liable to pay the accidental benefits.

                     Keeping in view the above facts and circumstances as well as the law laid down in above cited case law we have no hitch to reach at a conclusion that it would not be proper to hold the insurer liable for the deficiency if the DLA has not exercised as per Special provisions mentioned in the column of Accidental Benefit Rider Option. There is nothing on the file to show that the OP was deficient in providing service to the complainant. Accordingly, we dismiss the present complaint leaving the parties to bear their own costs. Copy of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance. 

Announced on:15.12.2017     

                                                                                                                   

 

(Pushpender Kumar)    (Anamika Gupta)                      (D.N.Arora)

Member                         Member                             President

                                                                   District Consumer Disputes                                                                                 Redressal Forum, Ambala.