Haryana

Ambala

CC/297/2018

Raj Bala - Complainant(s)

Versus

LIC - Opp.Party(s)

In Person

05 Mar 2020

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

 

                                                          Complaint case No.:  297 of 2018.

                                                          Date of Institution   :  05.09.2018.

                                                          Date of decision    :  05.03.2020.

 

Raj Bala wife of Late Shri Srichnad Chaudhary resident of House No.178, Housing Board Colony, Baldev Nagar, Ambala City aged 47 years.

……. Complainant.

                                                    Versus

 

1. Life Insurance Corporation, Ambala City through its Branch Manager.
2. Life Insurance Corporation of India, St. Floor, Yogakeshema Control Office, Jeevan Bhima Marg, Nariman Point, Mumbai, Maharashtra-4000021.

     ….…. Opposite Parties.

 

Before:        Smt. Neena Sandhu, President.

                   Smt. Ruby Sharma, Member.

Shri Vinod Kumar Sharma, Member.         

                            

Present:       Ms. Chander Mohini Sharma, Advocate, counsel for the                                        complainant.

                   Shri Dev Batra, Advocate, counsel for the OPs.

 

ORDER:     SHRI VINOD KUMAR SHARMA, MEMBER.

 

Complainant has filed this complaint under Section 12 of the Consumer Protection Act, 1986 (hereinafter referred to as ‘the Act’) against the Opposite Parties (hereinafter referred to as ‘OPs’) praying for issuance of following directions to them:-

1. To pay Rs.1,00,000/- balance amount of Insurance Policy alongwith interest @24% p.a. from the date of purchase of the policy in question till its realization.
2. To pay interest @24% p.a. on the amount of insurance policy of Rs.2,00,000/-  from the date of purchase of the policy in question till its realization.
3. To pay Rs.1,00,000/- as compensation for the mental agony and physical harassment suffered by the complainant.
4. To pay Rs.5500/- as litigation expenses.  
   382.  

Any other relief which this Hon’ble Forum may deem fit.

 

Brief facts of the case are that complainant is a widow lady having two sons and out of which one son namely Ravinder Kumar had been died on 16.08.2018, in a road side accident. OP No.1 is the Branch Office of OP No.2 and the OP No.2 is the registered office of the OP No.1. At the time when son of the complainant namely Ravinder Kumar was 13 years old, she purchased an Insurance Policy No.176421401 from the OP No.1 for her son. The amount of policy was of Rs.1,00,000/- and the premium of the policy was of Rs.1765/- per month. At the time of purchasing the LIC Policy by the complainant, the OP No.1 assured the complainant that after the payment of all the premiums OP will pay the entire amount of insurance to the complainant. OP No.1 further assured and informed the complainant that during the continuation of the policy, if the son of the complainant dies in a road side accident after the age of 18 years, then double the amount of policy i.e. Rs.2,00,000/- will be paid by the OP. On the assurance of the OP No.1, complainant purchased the policy in question. On 16.02.2018, son of the complainant died in a road side accident and thereafter as per terms and conditions of the policy, the complainant lodged the claim before the OP no.1 and submitted all the relevant documents. After completing all the requisite formalities, OP no.1 only released the amount of Rs.1,00,000/- to the complainant instead of Rs.2,00,000/-. OP No.1 also not paid the interest on the amount of the policy. Complainant is legal heir of deceased Ravinder Kumar and is having right to claim the amount of the policy in question. Son of the complainant also availed the benefit of AB 10 (Accidental Benefit) after attaining the majority as per the terms and policy of the OP and other documents directed by OPs. Complainant had paid the premium of above said insurance policy as per the terms and conditions of the OP No.1 and the OPs are under obligation  to pay the amount of interest of policy amount as well as more amount of Rs.1,00,000/- as assured and informed by the OP to the complainant. Complainant requested OPs several times to make the payment, but of no avail. Complainant made an application dated 02.07.2018, before the OP No.1 and received the reply of the OP No.1 and from the reply the complainant came to know that the OPs have revoked the claim of remaining Rs.1,00,000/- of the complainant. Complainant also made a complaint to the police regarding this, but no satisfactory action has been taken and even the complainant served a legal notice dated 18.07.2018, upon the OPs, but the problem of the OPs was not resolved by the OPs till today, which amounts to deficiency in service. Hence, the present complaint.

2.                Upon notice, OPs No.1 & 2 appeared through counsel and filed written version taking preliminary objections regarding maintainability, no locus standi, no jurisdiction to entertain the present complaint. On merits, it is stated that the date of the death of life assured Shri Ravinder Kumar is 16.02.2018 and not 16.08.2018 as per death certificate submitted alongwith death intimation & claim forms. The policy No.176421401 was issued in the name of Shri Ravinder Kumar, Table & Term 179/20, sum assured Rs.1,00,000/- with half yearly premium of Rs.1765/-, date of commencement 21.01.2009. As per record the age of life assured was 17 years at the time of taking policy. Neither accident benefit rider was provided nor was its premium ever received by the OPs. LIC’s Accidental Death and Disability Benefit Rider is available on payment of additional premium. But this benefit is not available under the policy to the minors. However, this Rider could be made available on completion of age of 18 years on receipt of specific request from the life assured and payment of additional premium, if found eligible as per the underwriting rules of the Corporation, the same is decided accordingly & if permissible premium is enhanced & additional premium of accident benefit rider is received & even policy is also amended accordingly. But nothing of this sought was ever happened. Neither “Accident Benefit Rider” was available at the time of issuance of the policy, life assured being minor & even thereafter on becoming major he never applied for the same nor did he deposited additional premium to that effect. Intimation of death claim under the policy was received on 09.04.2018 and basic claim was paid for Rs.1,00,000/- on 27.04.2018 to Smt. Raj Bala as per terms and conditions of policy. The premium was charged for Rs.1765/- from 01/2009 to 01/2018 and this premium is for basic plan only. Reply to the legal notice was sent vide registered letter dated 17.08.2018.  Denying rest of the allegations made in the complaint, prayed for dismissal of the present complaint.

3.                Complainant alongwith her counsel tendered affidavit her affidavit as Annexure CA alongwith documents Annexure C1 to C10 and closed her evidence. On the other hand, Ld. counsel for the OPs tendered affidavit of Shri Ravi Mohan, Manager (L&HPF), O/o LIC of India, Divisional Office, Karnal as Annexure OP-A alongwith documents Annexure OP-1 to OP-12 and closed the evidence on behalf of the OPs

4.                We have heard the Ld. counsel for the parties and carefully gone through the case file.

5.                 Ld. Counsel for the complainant reiterated the version as mentioned in the complaint and prayed for allowing the present complaint.

6.                Similarly, the learned counsel for the OPs reiterated the version as mentioned in its written version and prayed for dismissal of the present complaint.

7.                Ld. counsel for the complainant argued that complainant purchased a life Insurance Policy No.176421401 for a premium of Rs.1765/- per month, for her son namely Ravinder Kumar, at the time when her son was 13 years old. At the time of taking policy complainant was assured by the OP No.1 that if son of the complainant died in a road accident after attaining the age of 18 years, then double amount of Rs.2,00,000/- will be paid by the OPs. On 16.02.2018, son of the complainant died in a road side accident and thereafter complainant lodged the claim with the OP No.1 after submitting all the requisite documents. After completion of all the formalities, OP No.1 paid Rs.1,00,000/- to the complainant. As the son of the complainant opted for Accidental Benefit, then OPs were liable to pay Rs.1,00,000/- more as accidental benefit as assured by them, but they failed to do so. Complainant made several requests to the OPs, but of no avail. Complainant also made an application dated 02.07.2018, with the OP No.1 and received the reply from which she came to know that the OPs have revoked the claim of remaining Rs.1,00,000/- of the complainant. Complainant also served a legal notice dated 18.07.2018 upon the OPs, but of no avail. By not paying the remaining amount of Rs.1,00,000/- of accidental benefit, OPs have committed deficiency in service. On the other hand Ld. counsel for the OPs argued that  date of death of life insured was 16.02.2018 and not 16.08.2018. Policy in question was issued in the name of Ravinder Kumar under Table & Term 179/20, for a sum assured of Rs.1,00,000/- on half yearly premium of Rs.1765/-. Date of commencement of the policy was 21.01.2009. The insured was 17 years of age at the time when he took insurance policy.  Neither accidental benefit rider was provided nor its premium ever received by the OP. LIC’s accidental death and disability benefit rider is available on payment of additional premium. But this benefit is not available under the policy to the minors. This benefit is not available under the policy to the minors. However, this could be made available on completion of 18 years on receipt of specific request from the life assured and payment of additional premium, if found eligible as per the underwriting rules of the corporation, the same is decided accordingly & if permissible premium is enhance and additional premium of accident benefit rider is received and even policy is also amended accordingly. On receiving the intimation of the death claim on 09.04.2018, the basic claim was paid for Rs.1,00,000/- on 27.04.2018 to Smt. Raj Bala as per the terms and conditions of the policy. Only a premium of Rs.1765/- was paid by the insured from 01.2009 till 01/2018. No additional premium for taking accidental benefit was ever paid by the insured. Reply to the legal notice dated 04.07.2018, was also sent to the complainant, explaining the reason for non payment of accidental claim. As such, OPs are not deficient in providing the services and prayed for dismissal of the present complaint.   

                    From the policy document, Annexure C-1/OP-1 & OP-2, it is evident that the Life Assured, late Mr. Ravinder Kumar had purchased the policy in question from the OPs, for sum assured of Rs.1,00,000/-, for the term of  20 years, having maturity date 21.01.2029 and half yearly premium of Rs.1765/- was to be paid. From the policy document it is also evident at the time of taking policy Life Assured was 17 years of age and the insurance policy was proposed by her mother Smt. Raj Bala. Life Assured died on 16.02.2018, due to road side accident as is evident from the death certificate Annexure C-3, FIR dated 16.02.2018, Annexure C-4, and medical reports Annexure C-4. Complainant being the legal heir of her son had lodged the claim with the OPs. The OPs after completion of all the formalities released the sum assured amount Rs.1,00,000/- to the complainant. In the present case complainant has pleaded that at the time of taking policy she was assured that after the attaining the age of majority, if her son dies in a road side accident, then an extra amount of Rs.1,00,000/- will be paid to her as accidental benefit, but OPs failed to pay the accidental benefit of Rs.1,00,000/-. On the other hand Ld. counsel for the OPs pleaded that neither any accidental benefit was opted by insured nor any extra premium for the said benefit was ever paid by the insured. From the policy Annexure C-1/OP1 and OP2, it is quite clear nowhere in the policy it was mentioned that insured was entitled for any additional amount of Rs.1,00,000/- as accidental benefit. However, from the account statement of the insurance policy in question Annexure OP10, no extra premium was ever paid by the insured in reference to the accidental benefit. Nor any amended policy has been placed on record by the complainant to prove this fact. No cogent and convincing evidence has been adduced by the complainant to prove that insured had opted for the accidental benefit, by paying extra premium, while taking the policy in question. Meaning, thereby the Life Assured had taken the policy on normal basis. Neither any additional accidental benefit was ever opted by the son of the complainant nor any premium for said benefit was ever paid. In view of the aforesaid discussion, we are of the considered opinion that OPs have not committed any deficiency in service by not paying the accidental benefit. The present complaint filed by the complainant is devoid of merits. Consequently, we dismiss the present complaint, with no order as to costs. Certified copies of this order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced on : 05.03.2020.

(Vinod Kumar Sharma)            (Ruby Sharma)               (Neena Sandhu)

           Member                            Member                            President

                                                                                       DCDRF, Ambala