Haryana

Bhiwani

CC/92/2020

Smt. Krishana - Complainant(s)

Versus

LIC - Opp.Party(s)

Rajender Makkar

22 Jul 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BHIWANI.

 

                                      Complaint Case No.  92 of 2020

                                      Date of Institution:   20.08.2020

                                      Date of Decision:     22.07.2024

 

Smt. Krishna Devi wife of Sh. Ram Chander son of Sh. Mange Ram R/o village Mundhal Khurd, Tehsil and District Bhiwani.

 

                                                       ….Complainant.

Versus

1. Life Insurance Corporation of India, (LIC) Karnal, P&SG Unit, Jeewan Parkash, 489 Model Town, Karnal, PIN 132001 through its Branch Manager.

 

2. The Bhiwani Central Cooperative Bank Ltd., Branch office: Mundhal, through its Branch Manager.

 

3. The Bhiwani Central Cooperative Bank Ltd., Bhiwani through its Branch Manager.

                      

....Opposite Parties. 

                      

COMPLAINT U/S 35 OF THE CONSUMER PROTECTION ACT, 2019.

 

Before: -   Mrs.Saroj Bala Bohra, Presiding Member.

               Ms. Shashi Kiran Panwar, Member.

              

Present:    Sh.Rajender Makkar, Advocate for complainant.

               Sh.Mukesh Jangra, Advocate for OP No.1.

               Sh.Balbir Sharma, Advocate for OPs No.2 & 3.

       

ORDER

 

Saroj Bala Bohra, Presiding Member.

 

1.             Brief facts of this case complaint are that son of complainant Naresh was having a Saving Account bearing No.003634007100564 with the OP No.2 and complainant was nominee for his son.  On the instructions of Naresh, OP No.2 bank debited an amount of Rs.258/- on 04.11.2019 as premium for insurance under the scheme Pradhan Mantri Jeewan Jyoti Bima Yojna (PMJJBY) for one year.  It is stated that son of complainant expired on 22.12.2019.  The complainant being mother, preferred claim before OP No.2 on 16.01.2020 submitting all necessary documents but the OP No.2 intimated vide letter dated 26.06.2020 that OP No.1 insurance company has rejected the claim on the ground that Death of the deceased is within the lien period.  Legal notice dated 14.07.2020 was served upon the OPs but of no avail. Hence, the present complaint has been preferred by complainant alleging deficiency in service on the part of OPs resulting into monetary loss besides mental and physical harassment. In the end, prayer has been made to direct the OPs to Rs.2.00 lac alongwith interest @ 18% per annum from the date of death till its realization.  Further to pay Rs.50,000/- towards compensation for harassment besides Rs.25,000/- as litigation expenses. Any other relief, to which this Commission deems fit, has also been sought.
2.           Upon notice, OP No.1 filed written statement raising preliminary objections qua maintainability of complaint, locus standi and complaint being false and frivolous. On merits, it is submitted that first premium was deducted by the OP Bank but not remitted to the answering OP within prescribed time. However, it was remitted on 02.12.2019 vide UTR No.AXISP00085799588. It is stated that as per prevailing scheme rules of PMJJBY, 2016, insurance benefit shall not available for death occurring during first 45 days from the date of enrollment into the scheme. Risk cover will start from the date of joining if the deposit premium is received within 15 days from the date of joining, “Lien clause is to be imposed accordingly.  In this case, date of joining the scheme would be treated as 02.12.2019 and customer died on 22.12.2019 i.e. after 20 days from joining the scheme.  The customer died within lien period of the policy i.e. 45 days, hence, claim was not payable.  In the end, denied for any deficiency in service on the part of answering OP and prayed for dismissal of the complaint with compensatory costs.
3.           OPs No.2 & 3 filed written statement raising preliminary objections qua maintainability of complaint, locus standi, cause of action, jurisdiction and complaint being time barred. On merits, it is submitted that premium was sent to the OP No.1 well in advance of death and it was for OP No.1 to settle the claim.  Further, claim was also immediately sent to the OP No.1 and is payable by OP insurance company. In the end, denied for any deficiency in service on the part of OP and prayed for dismissal of the complaint with costs.

4.                 Complainant in evidence, tendered her affidavit Ex.CW1/A alongwith documents Ex. C-1 to Ex. C-10 and closed the evidence.

5.                 On the other side, learned counsel for OP No.1 tendered in affidavit of Ms. Sunita, Manager as Ex. RW2/A alongwith documents Annexure R-31 to Annexure R-37 and closed the evidence.

6.                 On the other side, learned counsel for OPs No.2 & 3 tendered in evidence documents Annexure R-1 to Annexure R-30 and closed the evidence.

7.                 We have heard learned counsels for the parties and perused the record carefully.

8.                 From bank account statement (Annexure C-3), it is evident that premium of Rs.258/- towards the insurance under Pradhan Mantri Jeewan Jyoti Bima Yojna (PMJJBY) was deducted from the account of insured Naresh on 04.11.2019 by the OP bank. It is not in dispute that complainant died on 22.12.2019. It is clear from  statement for the period from 01.12.2019 to 31.12.2019 (Annexure R-34) placed on file by OP insurance company that the insurance premium pertaining to complainant was received to them on 02.12.2019. We have perused a letter dated 28.03.2019 titled Application of Lien Period of 45 days under PMJJBY (Annexure R-32) which says that ‘As per the prevailing Scheme rules of PMJJBY, for subscribers enrolling for the first time on or after 01.06.2016, insurance benefit shall not be available for death (due to any cause other than accident) occurring during the first 45 days from the date of enrollment into the scheme. Death due to accidental causes will be covered from day one of insurance coverage.’

9.                 After hearing learned counsel for the parties and going through the record, we have observed that insurance premium was received from the OP bank from complainant on 04.11.2019 and undisputedly, the insured died on 22.12.2019 thus the deceased life assured died after 49 days of the deduction of the premium by bank.  As per insurance policy, death claim is not payable to the family of insured if death is occurred within 45 days of enrolling into the scheme. The OP insurance company took its defence since the premium was received on 22.12.2019 and thus from such date the insured was enrolled into the scheme.

10.               From the above, we are of considered opinion that it is the dispute between the OP bank and OP insurance company that when it receive the premium and what was the reason behind the delay in remitting the same. But the material point is that insured person is entitled to the said lien period of 45 days from the date when premium was deducted from it. In such a situation, we are of the view that the OPs are deficient and negligent in providing proper services to the complainant which causes harassment as well as monetary loss to her. Hence, complainant is entitled to the claim under the policy. As per document Annexure C-2, complainant is nominee in the policy which is for a sum insured of Rs.2,00,000/-.  As such, the complaint is allowed and OPs, jointly and severally, are directed to comply with the following directions within 40 days from the date of passing of this order:-

(i)       To pay Rs.2,00,000/- (Rs. Two lacs) to the complainant alongwith simple interest @ 9% per annum from the date of filing of this complaint till actual realization.

(ii)      To pay a sum of Rs.10,000/- (Ten thousand) to the complainant as compensation for harassment.

(iii)     Also to pay a sum of Rs.55,00/- (Rs.Five thousand five hundred) as litigation expenses.

                     In case of default, all the aforementioned awarded amounts shall attract simple interest @ 12% per annum for the period of default. If this order is not complied with, then the complainant shall be entitled to the execution petition under section 71 of Consumer Protection Act, 2019 and in that eventuality, the opposite parties may also be liable for prosecution under Section 72 of the said Act which envisages punishment of imprisonment, which may extend to three years or fine upto rupees one lac or with both.  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:22.07.2024.