Haryana

Bhiwani

CC/109/2019

Haro om - Complainant(s)

Versus

LIC - Opp.Party(s)

Ajay Verma

25 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BHIWANI.

 

                                                          Consumer Complaint No. : 109 of 2019

                                                     Date of Institution                      : 11.04.2019

                                                               Date of order                     : 25.07.2024

 

Hariom son of Sh. Singh Ram Jalandhara R/o Near City School, Kaunt Road, Dadri Gate, Bhiwani, Tehsil and District Bhiwani.

 

           ……Complainant.

 

Versus

 

Life Insurance Corporation of India, LIC Road, Near Mini Secretariat,

Bhiwani through its Branch Manager.

…… Opposite Party.

 

COMPLAINT U/S 12 OF CONSUMER PROECTION ACT, 1986.

 

BEFORE:       Mrs. Saroj Bala Bohra, Presiding Member.

  Ms. Shashi Kiran Panwar, Member.

 

Present:-        Sh. Ajay Verma, Advocate for complainant.

           Sh. M.L. Sardana, Advocate for OP.

 

ORDER:

 

Shashi Kiran Panwar, Member.

 

1.                 Brief facts of this case are that complainant had taken an insurance policy No.174456782 from OP on 28.01.2006 by paying premium of Rs.1945/- and date of maturity is 28.01.2026. The last due premium is on 28.07.2025. The sum insured under the plan is Rs.2,50,000/- i.e. Rs.1.00 lac as basic plan, another sum of Rs.1.00 lac for accidental benefit  and further Rs.50,000/- as bonus after completion of monthly installments upto 10 years.  It is alleged that on 08.02.2016, complainant met with an accident. FIR No.67 dated 09.02.2016 under Section 279,337,338 IPC was registered in this regard at P.S. Sadar Bhiwani on the statement of complainant. Due to the said accident, complainant became 100% disable.  So, complainant lodged claim with OP by submitting all necessary documents.  But the claim was repudiated vide letter dated 21.03.2018 on the ground that the policy was not in force at the time of accident. Hence, the present complaint has been preferred seeking directions against the OPs to pay sum insured amount + accidental benefit + bonus amount totaling Rs.2,50,000/- alongwith interest @ 18% per annum from the date of accident till realization. Further to pay Rs.50,000/- on account of mental and physical harassment and a sum of Rs.22,000/- towards litigation expenses.

2.                 Upon notice, OP appeared and filed written statement submitting therein that the policy in question was issued to complainant commencing from 28.01.2006 for sum assured of Rs.1.00 lac and nominee is Sunhari (wife). But no benefit of insurance policy could be given as it was in lapse condition on the date of accident as premium which was due to be paid in July 2015 was not paid. The accident occurred on 08.02.2016 whereas the policy was revived on 17.02.2016.  Further it is averred that as per terms and conditions of policy disability is required to be occurred within 180 days from the date of accident. In the present case, disability occurred after the expiry of such period, as such, the benefit under the policy was not payable to the complainant. Hence, claim was repudiated vide letter dated 21.03.2018. In the end, denied for any deficiency in service and prayed for dismissal of the complaint with costs.

3.                 On behalf of complainant, his affidavit CW1/A alongwith documents Annexure C-1 to Annexure C-15 were filed and closed the evidence on 26.02.2021.

4.                 On the other hand, affidavit Ex.RW1/A of Smt. Sunita Matta, Manager (Legal) alongwith documents Annexure R-1 and Annexure R-2 were filed and closed the evidence on 20.09.2022. Later on OP was also allowed to file documents Annexure R-3 and R-4 in evidence on 18.04.2024.

5.                 We have heard learned counsel for the parties and perused the record minutely. Written arguments on behalf of OP filed. The counsel for OP has relied upon case law delivered by the Hon’ble Supreme Court of India, titled Life Insurance Corporation of India & Anr. Vs. Sunita decided on 29.10.2021. We have carefully gone through the aforementioned judgment.

6.            At the outset, as per repudiation letter dated 21.03.2018 (Annexure C-4) reveals that claim to complainant has been denied by OP on the ground that the policy was not in force on date of accident. Hence disability benefit is not payable as per T&C of policy.

7.            The premium under the policy is payable half yearly to the tune of Rs.1945/-. We have perused the premium deposit statement (Annexure R-4) which reveals that complainant was not paying the premium of insurance regularly and he paid last premium of the policy on 23.03.2015 as Rs.4045/- i.e. two installments. But prior to it, there was already installment(s) were due under the policy, therefore on the day of accident i.e. 08.02.2016, the policy was in lapsed condition, however, which later on renewed on 17.02.2016. To prove his case, complainant failed to place on record any document which could show that on the day of accident the complainant was covered under the policy. As such, we are of the view that the benefits were rightly denied to the complainant by OP. The case cited supra are of much helpful in deciding the present case. Accordingly, we do not find any merits in the case and the same is hereby dismissed with no order as to costs. Certified copies of this order be sent to the parties concerned, free of costs, as per rules. .  File be consigned to the record room after due compliance. 

Announced.

Dated: 25.07.2024.