BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.
CONSUMER COMPLAINT NO.55 of 2014
DATE OF INSTITUTION: - 25.02.2014
DATE OF ORDER: -28.12.2015
- Kumari Shistri minor daughter o Balwan Singh son of Balwant Singh.
- Balwant Singh son of Shri Sheo Chand minor through grand father Balwant Singh, residents of Shivji Marg, near Shiv Mandir, Vidya Nagar, Bhiwani.
……………Complainant.
VERSUS
- Life Insurance Corporation of India, Rohtak through its Authorized Signatory.
- Life Insurance Corporation of India, Branch Office, Bhiwani through its Branch Manager.
………….. Opposite Parties.
COMPLAINT U/S 12 & 13 OF CONSUMER PROECTION ACT
BEFORE :- Shri Rajesh Jindal, President
Shri Balraj Singh, Member
Smt. Ansuya Bishnoi, Member
Present: - Shri Kuldeep Vashisth, Advocate for complainants.
Shri M.S. Parmar, Advocate for Ops.
ORDER:-
Rajesh Jindal, President:
The brief facts of the case are that policy No. 173062354 was issued on the life of Shri Balwan Singh for a sum assured of Rs. 50,000/- with date of commencement 28.03.2002, plan & term 75-20, mode half yearly, installment premium Rs. 1593/- and another policy No. 173884028 was also issued on the life of aforesaid Balwan Singh for a sum assured of Rs. 1,00,000/- with date of commencement 28.03.2004, plan & term 150-30, mode half yearly, installment premium Rs. 537/- and the nominee was Balwan Singh. The life assured had paid the installments regularly. In the month of July 2009, the life assured had suffered suddenly infection and swelling in both legs on 07.07.2009 and despite his treatment at CMC Hisar and Delhi, his both legs were removed by Doctors in operation and waiver of premium due. The life assured had intimated the agent about the accident and agent assured that there is no need to deposit the policy amount. After taking the treatment, the life assured on 12.10.2011 had submitted that the disability certificate and form no. 52/89 and 52/180 but no reply was given by the agent. The complainants alleged that the life assured had died on 18.04.2013 due to disability. It is alleged that on 06.02.2014 a registered legal notice was issued by the complainants to the Ops but no reply was given. The complainants further alleged that due to the act and conduct of the respondents, they had to suffer mental agony, physical harassment and financial losses. Hence, it amounts to deficiency in service on the part of OPs and as such they had to file the present complaint for seeking compensation.
2. On appearance, OPs filed written statement and submitted that the policy was in lapsed condition on the death of the life assured i.e. 18.04.2013 so as per terms and conditions of the insurance policy nothing is payable under the policy. It is submitted that the life assured Balwan Singh during his life time never suffered permanent disability due to any accident, rather he suffered suddenly infection and swelling in both legs on 07.07.2009 and ultimately both lower limbs (legs) were removed by operation. It is submitted that such disability does not come within the ambit of an accident and as such the competent authority has regretted the disability benefit claim vide order dated 23.07.2013 by applying his judicial mind and information of the rejection was duly conveyed to the life assured on 05.08.2013. It is submitted that the Ops never received any intimation of death of the life assured. It is further submitted that since the policies were lying lapsed on account of non payment of premium due on 28.09.2009 last account date 18.03.2009 in respect of policy no. 173062354 and on account of non payment of premium due on 28.09.2010 last account date 31.03.2010 in respect of policy no. 173884028 so the complainants are also not entitled to the insurance claim after the death of the life assured. Hence, in view of the facts and circumstances mentioned above, there is no deficiency in service on the part of OPs and complaint of the complainant is liable to be dismissed with costs.
3. Both the parties filed documents alongwith supporting affidavit to prove their respective versions.
4. We have gone through the record of the case carefully and have heard the learned counsels for the parties.
5. Learned counsel for the complainant reiterated the contents of the complaint. He submitted that the life assured Balwan Singh has lost his both legs and ultimately died on 18.04.2013. He submitted that the Ops are liable to pay the accident benefit and the sum insured of both the policies in question to the complainants. He further submitted that the premiums due for the both policies could not be paid by the life assured due to his disability which was informed to the Ops.
6. Learned counsel for the opposite parties reiterated the contents of the reply. He submitted that at the time of death of the life assured, both the policies were lying in lapsed condition. Hence no sum insured amount is payable to the complainants. He further submitted that the life assured lost his both legs due to infection and disability was not caused by accident. Hence no accident benefit is payable to the complainants.
7. It is undisputed that the life assured has lost his both legs due to infection, as contended by complainants in the complaint. Admittedly, at the time of death of the life assured both the policies in question were lying lapsed on account of non-payment of premiums.
8. This complaint has been filed by the minor daughter of the complainant and his father who is the nominee in the policy that the money is needed to the complainants for bringing up of OP no. 1, who is minor daughter of the complainant. Taking into account the totality of the facts of the case and considering the contention of the complainant no. 1 who is minor daughter of the complainant, we are of the view that the amount of premiums deposited by his father Balwan Singh life assured in both policies, be refunded to the complainant no. 1 for her needs. Accordingly, we direct the Ops to pay the amount of premiums deposited against both the policies in question be refunded to the complainant alongwith interest @ 6 per cent per annum from the date of deposit till the date of payment. The amount be paid in the name of the complainant no. 1, the minor daughter of the Balwan Singh life assured and be deposited in the nationalized bank in her name in the shape of fixed deposit till the date of her attaining majority. The said fixed deposit receipt be paid to complainant no. 1 with the permission of this District Forum. Certified copies of the order be sent to the parties free of costs. File be consigned to the record room, after due compliance.
Announced in open Forum.
Dated: 28-12-2015.
(Rajesh Jindal)
President,
District Consumer Disputes
Redressal Forum, Bhiwani.
(Ansuya Bishoni), (Balraj Singh),
Member. Member.
