DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, NARNAUL
CONSUMER COMPLAINT NO.159 of 2013
DATE OF INSTITUTION:- 16.08.2013
DATE OF ORDER:- 20.01.2015
Smt. Kavita widow of Shri Raj Kumar son of Shri Rattan Lal, Resident of village Khampura, Tehsil Narnaul, District Mahendergarh (Haryana)
……………COMPLAINANT
VERSUS
Life Insurance Corporation of India through Manager Branch Office Life Insurance Corporation of India, Opposite Mini Secretariat, Mahendergarh Road, Narnaul, Tehsil Narnaul, District Mahendergarh (Haryana)
………….. OPPOSITE PARTY
COMPLAINT U/S 12 OF CONSUMER PROECTION ACT
BEFORE :- Rajesh Jindal, President
Smt. Usha Yadav, Member
L. K. Nandwani, Member
Present:- Shri D. S. Siwatch, Advocate for the complainant.
Shri J. K. Yadav, Advocate for the opposite party
ORDER:-
Rajesh Jindal, President:
According to the complaint, brief facts are that Raj Kumar, husband of the complainant, during his life time, obtained a policy No.179164021 on 12.05.2012 under the table terms 179/20 for assured sum of Rs.2,00,000/- under mode of yearly premium of Rs.6942/- and deposited first instalment of Rs.6942/- vide receipt No.13996 dated 14.05.2012 with the office of the opposite party. The complainant has alleged that she is nominee of her husband under the aforesaid policy. The complainant has averred that her husband Raj Kumar died on 13.06.2013 due to electrocution and no instalment was due towards her husband. The complainant applied for claim with the opposite party after completing all the required formalities. The complainant requested the opposite party several times to pay the assured amount with accrued bonus and interest, but to no effect. The complainant has prayed that the opposite party be directed to pay insured amount of Rs.2,00,000/- with bonus, interest and accrued benefits thereon, besides claiming compensation for mental agony and harassing, totaling to Rs.5,00,000/- with interest at the rate of 18% per annum.
2. The opposite party filed reply admitting that Raj Kumar son of Shri Rattan Lal obtained the alleged policy with due date of commencement 12.05.2012. The complainant has not intimated the opposite party about the death of life assured. The opposite party has come to know regarding the said demise of deceased life assured only on receipt of this complaint. The deceased life assured did not deposit the premium due on 12.05.2013 even within the grace period of 30 days upto 11.06.2013 and afterward the policy in question was lapsed as per terms and conditions of the policy and resultantly as on the date of death of life assured i.e. on 13.06.2013, as alleged in the complaint, the policy was already lying in lapsed condition without acquiring any paid up value. Hence, the complainant is not entitled for any claim against this lapsed policy as per terms and conditions of the policy. The complainant has not submitted the original death certificate, original policy bond and claim forms in the office of the opposite party. There is no deficiency in service on the part of the opposite party. In the end, it is prayed that the complaint be dismissed with exemplary costs.
3. In order to make out her case, the complainant has placed on record her own supporting affidavit Annexure C-1, policy Annexure C-2, proposal deposit receipt dated 14.05.2012 Annexure C-3, supporting affidavit of Smt. Mamta Devi, Sarpanch, G.P. Khampura Annexure C-4, supporting affidavit of one Om Prakash son of Shri Kishan Lal, R/o Khampura Annexure C-5, claim form A-1 Annexure C-6, certificate Annexure C-7 and death certificate of Raj Kumar Annexure C-8.
4. In reply thereto, the opposite party has placed on record supporting affidavit of its Manager (legal) Mr. R. C. Mathur Annexure R-1, copy of policy Annexure R-2, Proposal Form Annexure R-3, copy of premium history Annexure R-4 and copy of status report of policy No.179164021 Annexure R-5.
5. We have gone through the record of the case carefully and have heard the learned counsels for the parties.
6. Learned counsel for the complainant reiterated the contents of the complaint. He submitted that first yearly instalment was paid by the assured Raj Kumar, the husband of the complainant, on 14.05.2012, thus the second yearly instalment was to be paid on 14.05.2013 and with grace period of one month upto 13.06.2013. The husband of the complainant expired on 13.06.2013 before the expiry of the grace period and as such the policy was in force as on the date of death of the assured. Hence, the opposite parties are liable to pay the claim to the complainant under the policy Annexure C-2. In support of his contention, he referred the judgment of Hon’ble Supreme Court of India rendered in case of New India Assurance Company Ltd. Versus M/s Zuari Industries Ltd. and others 2009 (4) RCR (Civil) 864.
7. Learned counsel for the opposite party reiterated the contents of the reply. He submitted that as on the date of death of assured, the policy in question stood lapsed, due to non-payment of early premium and which was to be paid upto 11.06.2013. Hence, no claim is payable by the opposite party to the complainant.
8. According to the opposite party, the date of commencement of the policy was 12.05.2012 and the date of commencement of the risk was 14.05.2012, the date when the first yearly premium was paid by the assured on 14.05.2012. Learned counsel for the opposite party could not explain before us how the grace period of 30 days shall be calculated from 12.05.2013, the date of commencement of the policy and not from the date of commencement of the risk on 14.05.2013. Learned counsel for the opposite party failed to bring to our notice any rule and regulation, case law etc. in support of his contention. Para No.2 of the terms and conditions of the policy in question reads as under:-
“Payment of premium: A grace period of one month but not less than 30 days will be allowed for payment of yearly, half yearly or quarterly premiums and 15 days for monthly premiums if death occurs within the period and before the payment of the premium then due, the policy will still be valid and the sum assured paid after deduction of the said premium as also unpaid premiums falling due before the next anniversary of the policy, if the premium is not paid before the expiry of days of grace, the policy lapses, The premium payable will be “total instalment premium” which is inclusive of (i) instalment premium for basic plan (ii) Instalment accident benefit rider premium, if opted for”.
After the perusal of above said terms and conditions, the question arises for the purpose of grace period of one month or 30 days, whether date of commencement of policy i.e. 12.05.2012 or the date of commencement of the risk i.e. 14.05.2012, out of two dates as mentioned above, which will be considered and is relevant for the purpose of counting the grace period. This position is not clear from Para No.2 of terms and conditions of the policy in question. Therefore, ambiguity suffices regarding the date which is relevant for the purpose of counting the grace period. Hon’ble Supreme Court of India in New India Assurance Company’s case (Supra) in Para No.31 of its judgment held as under:-
“Moreover in General Assurance Society Ltd. V. Chandmull Jain & Anr. AIR 1966 SC 1644 it was observed by a Constitution Bench of this Court that in case of ambiguity in a contract of insurance the ambiguity should be resolved in favour of the claimant and against the insurance company.”
The said case law has bearing in the present case. Taking into account every aspect of the case and the case law referred above, we are of the view that the policy in question was in force on 13.06.2013 when the assured/ husband of the complainant expired and thus the complainant is entitled for payment of insured amount of Rs.2,00,000/-. Accordingly, we direct the opposite party to pay Rs.2,00,000/- after deducting the amount of second annual premium, to the complainant within 45 days from the date of passing of this order, failing which the opposite party shall be liable to pay interest at the rate of 8% per annum from the date of passing of this order till the date of payment. No order as to cost.
Announced:-
20.01.2015
(Smt. Usha Yadav) (L. K. Nandwani) (Rajesh Jindal)
Member Member President,
District Consumer Disputes
Redressal Forum, Narnaul
