Haryana

Ambala

CC/195/2014

MASTER GURVINDER SINGH - Complainant(s)

Versus

LIC - Opp.Party(s)

K.C.JAIN

28 Jun 2017

ORDER

 

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM:

                                                AMBALA

                                                Complaint Case No.      :         195 of 2014

                                                Date of Institution          :          31-07-2014

                                                Date of Decision            :         28-06-2017

Master Gurvinder Singh through his mother and natural guardian and next friend Smt. Salinder Kaur, wife of late Sh. Paramjit Singh son of Sh. Harbans Singh, near Saini Guga-Maddi, V & PO Saha, District Ambala. .

………….Complainant.

Versus

Life Insurance Corporation of India through its:-

1. Chief Manager, Branch Office, LIC of India, Jagadhari Road, Ambala Cantt.
2. Sr. Divisional Manager, LIC of India, Divisional Office, Model Town, Karnal.

…………Opposite Parties.

          Complaint Under Section 12 of the Consumer Protection Act.

 

CORAM:             SH. DINA NATH ARORA, PRESIDENT

                             MS. PUSHPENDER KUMAR, MEMBER

MS. ANAMIKA GUPTA, MEMBER

Present:-               Sh. K.C. Jain, Adv, counsel for complainant.

                             Sh. R.K. Jindal, counsel for the OPs.                  

ORDER.

                   In nutshell, brief facts of the complaint are that Sh. Paramjit Singh, father of complainant obtained Jeevan Chhaya Insurance Policy bearing No. 177520326 for Rs. 1,05,000/- under table and term 103-21 from Branch Office, LIC of India, Ambala cantt. i.e. OP No. 1. The said policy commenced w.e.f.      08-02-2011 and the complainant was made the nominee and his mother Smt. Salinder Kaur was made the appointee under the said policy as the nominee was/in minor. The policy was fully inforce, when the life assured died accidently on 14-02-2012 due to the inhaling of pesticides (Halogenated Organo Compound Group of Insecticide), while he was spraying the same on the wheat crop in his fields. It is submitted that all the required documents were duly submitted with the OPs but the death claim was repudiated by the OP No. 2 vide its letter No. Claim/REP/M/Suicide/12-13/24 dated 25-09-2012, wherein the OP No. 2 had falsely alleged that the deceased-life assured committed suicide within one year from the date of policy, the policy has become null and void in terms of the policy contract. It is further submitted that the life assured not committed suicide within one year of the policy, whereas the policy in question commenced w.e.f. 08-02-2011 and the assured had died on 14-02-2012 i.e. 6 days after expiry of one year. Further the life assured had not committed suicide as it is a hard fact that the assured had died of the insecticide while spraying the same on the wheat crop in his fields and a DDR bearing No. 27 (A) dated 14-02-2012 to that effect was duly got registered at policy station Industrial Area, Saha, District Ambala. Even the postmortem report bearing NO. 37 dated 15-02-2012 on the deceased, reveals that the cause of death in this case could be determined after the receipt of the reports from Chemical Examiner, Karnal, hence, to allege that the life insured had committed suicide is unfounded, imaginary and hence not sustainable. As such, OP had unlawfuly repudiated the death claim without the proper application of mind as the impugned decision is based on imagination and unfounded grounds, which clearly amounts to unfair trade practice and to grave deficiency in service.  Hence, the complainant prayed that the opposite parties may kindly be directed to pay the death claim along with interest of 18 % per annum, Rs. 25,000/- as compensation for causing undue harassment, mental agony and Rs. 22,000/- as litigation expenses to the complainant.  

2.                Upon notice, OPs appeared through counsel and raised preliminary objections qua maintainability and concealing of true facts by complainant. It is submitted that Sh. Param Jeet Singh deceased filled proposal form on 07-03-2011 for obtaining the Life Insurance Policy with date of commencement from 08-02-2011 and polcy NO. 177520326 was allotted to Sh. Param Jeet Singh deceased assured commencing risk from 07-03-2011 and Master Gurvinder son of deceased Sh. Param Jeet Singh was the nominee under the policy in question. The life assured Late Sh. Param Jeet Singh committed suicide by consuming pesticides with alcohol on 14-02-2012 the OPOs came to know about the cause of death of deceased only from the form No. 3816, which is produced by the complainant to the OPs for the settlement of the claim. The policy in question was dated back policy from 08-02-2011 and the date of proposal is 07-03-2011 and deceased assured committed suicide within one year from the date of risk i.e. 07-03-2011 and the “suicide clause” i.e. clause No. 6 of the policy bond was operative at that time. As such, the OPs have rightly repudiated the claim vide its order dated 14-09-2012. It is averred that there is no deficiency in service on the part of the opposite parties. As such, the OPs have prayed that the complaint may kindly be dismissed with costs.

3.                To prove his version, counsel for complainant tendered affidavit as Annexure CX alongwith documents as Annexures C1 to C-8 and closed the evidence. On the other hand, counsel for the OPs tendered affidavit of Balihar Singh as Annexure RX alongwith documents as Annexures R1 and R2 and closed the evidence.

4.                We have heard learned counsel for the parties at length and gone through the case file very carefully. The date of commencement of the policy is   08-02-2011 as per annexure C1 and C2, and the date of death of the life assured is 14-02-2012 as per death certificate. It is cleared from the above said documents that the difference between the date of commencement and the death of life insured is more than one year. Counsel for the complainant has argued that as per copy of DDR annexure C7, it is also proved that the deceased-life assured has not committed suicide but he was died due to inhaling of pesticides (Halogenated Organo Compound Group of Insecticide), while he was spraying the same on the wheat crop in his fields. He further argued that there is no document placed on the file by the OPs which can shows that the life assured had committed suicide.

5.                 Counsel for the OPs has contended that the present complaint is not maintainable as the complaint has been filed through his mother as a natural guardian but she has failed to mention in the complaint there she is not having any adverse interest and complaint has been filed in the interest of the minor master Gurvinder Singh. In this way, complainant failed to mention the ingredients of Order 32 Rule 1 & 2 of CPC at the time of presenting the case. We have perused the proposal form, the deceased has made Gurvinder Singh as nominee and the mother of the Gurvinder Singh as appointee. Rather all provision of the CPC are not applicable in the consumer complaint cases as the same is to be decided in summary way. So, the contention of the OP is not sustainable and the complaint is duly maintainable and Forum is duty bound to watch the interest of the minor.   

          Counsel for the OPs has further contended that the life assured Late Sh. Param Jeet Singh committed suicide by consuming pesticides with alcohol on 14-02-2012. The policy in question was dated back policy from 08-02-2011 and the date of proposal is 07-03-2011 and deceased assured committed suicide within one year from the date of risk i.e. 07-03-2011 and the “suicide clause” i.e. clause No. 6 of the policy bond was operative at that time. He further relied upon the case law 2011 (1) CPR 185 (NC) titled as Life Insurance Corporation of India v. Surat Mal Tak, which is not identical to the facts of the present case.  

6.                 In view of the aforesaid discussion, we are confirmed view that there is no sufficient evidence on the file, which can prove that the life insured had committed suicide and when, it is not proved then the question of suicide within one year from the date of commencement does not arise and Clause NO. 6 of the Policy is not applicable. Further we have perused the DDR annexure C7, there is no ingredient to prove that the life insured has committed suicide but he died due to inhaling of pesticides (Halogenated Organo Compound Group of Insecticide), while he was spraying the same on the wheat crop in his fields. Hence, we come to this conclusion that the opposite parties miserably failed to establish that the deceased policy holder had committed suicide rather it is an accidental death. Hence, we have no hesitation to hold that complainant is entitled the insured amount (death claim) amounting to Rs. 1,05,000/- along with other benefits, if any under the policy in question. In this way, OPs have wrongly withhold the genuine claim of the complainant. As such there is a deficiency on the part of the opposite parties. Accordingly, the complaint is allowed with costs and the OPs are directed to deposit the death claim amounting to Rs.1,05,000/- (along with other benefits, if any) alongwith simple interest @ 9% per annum from the date of filing of complaint to till its actual realization by way of demand draft in favour of the Forum. Thereafter, the said amount will be deposited in shape of fixed deposit in favour of the complainant master Gurvinder Singh till attaining the age of maturity. In case of failure to comply with the said direction within thirty days, the opposite party will liable to pay further interest @ 12% on the above amount from the period of default till its realization. OPs are further directed to pay the cost of proceedings amounting to Rs. 5,000/-.

                   Copies of this order be sent to the parties concerned, free of costs.  File be consigned to the record room after due compliance. 

 

Announced on :28.06.2017                                  (D.N. ARORA)

                                                                              PRESIDENT

 

    

          (PUSHPENDER KUMAR)

                                                                                      MEMBER

                                     

 

(ANAMIKA GUPTA)

                                                                             MEMBER