DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,
PATIALA.
Consumer Complaint No. 327 of 19.8.2016
Decided on: 7.3.2018
1. Usha Rani widow of Jaswinder Singh
2. Kamaljit Singh Minor son of Jaswinder Singh
3. Sonia Rani minor daughter of Jaswinder Singh
Minors through their natural guardian and next friend Usha Rani.
4. Jarnailo wife of Jatna Ram
All residents of village Chaprar, Tehsil & District Patiala.
…………...Complainants
Versus
Life Insurance Corporation of India, divisional Office: Chhoti Baradari, Patiala through its Divisional Manager.
…………Opposite Party.
Complaint under Section 12 of the
Consumer Protection Act, 1986.
QUORUM
Smt. Neena Sandhu, President
Smt. Neelam Gupta, Member
ARGUED BY:
Sh.N.K.Gupta,Advocate, counsel for complainants.
Sh.Amit Kumar Bedi, Advocate, counsel for
opposite parties.
ORDER
SMT.NEENA SANDHU, PRESIDENT
Complainants have filed this complaint under Section 12 of the Consumer Protection Act,1986 ( hereinafter referred to as the Act) against the Opposite Party (hereinafter referred to as the O.P.) praying for giving directions to it for the following reliefs:-
- To pay Rs.57,300/-, remaining insured /claim amount alongwith upto date interest
- To pay Rs.30,000/- as compensation for causing mental agony and physical harassment ;
- To pay Rs.11,000/- as litigation expenses and also
- To grant any other relief,which this Forum may deem fit.
2. The brief facts of the complaint are that Sh.Jaswinder Singh, husband of the complainant No.1, father of complainants No.2&3 and son of complainant No.4, during his lifetime got himself insured with OP vide policy No.163649015, for a sum of Rs.75000/-. The policy in question was issued on 28.12.2008. He paid all the installments regularly. The last installment was paid on 13.4.2015.It is stated that Sh.Jaswinder Singh died on 19.5.2015 at PGI, Chandigarh due to Refractory Cardiogenic Shock. Intimation of his death was duly given to the OP. Thereafter complainants submitted claim form alongwith all relevant documents with the OP. The OP instead of paying Rs.75,000/- issued cheque no.493710 dated 27.4.2016 for a sum of Rs.17,700/- in lieu of the claim amount. The complainants approached and requested the OP for the disbursement of the remaining amount but it did not pay any heed to the request of the complainant. Ultimately a legal notice dated 15.6.2016 was served upon the OP but it gave a vague reply to the legal notice and refused to pay any amount. The act and conduct of the OP amounted to deficiency in service which caused mental agony and physical harassment to the complainants.
3. On being put to notice, the OP appeared and filed the written version taking preliminary objections that the complaint is not maintainable as the OP has already settled the claim of the complainants by paying paid up value under the policy in question. On merits , it is admitted that deceased namely Sh.Jaswinder Singh had taken policy No.163649015 (Money Back with Profits & Accident Death benefit) with date of commencement as 28.12.2008, term of 20 years and the sum assured was Rs.75000/-.The premium amount was Rs.2506/- to be paid half yearly i.e. in the months of June and December of every year. The policy in question was to mature in 12/2028. It is stated that life assured was not regular in depositing the premiums due to which the policy in question lapsed. The lapsed policy was reinstated/revived only on the basis of signed personal statement/declaration dated 31.7.2013 by paying due premium since 12/2012 uptill 06/2013. It is further stated the life assured had concealed material information about his state of health at the time of reinstatement/revival of the policy in question. The last premium was deposited by the life assured on 13.4.2015 and he died on 19.5.2015. An amount of Rs.17700/-was paid to the complainants towards full and final settlement of the claim under the policy in question. There is no deficiency of service on the part of the OP. After denying all other averments made in the complaint, it was prayed to dismiss the complaint.
4. On being called to do so, the ld. counsel for the complainant has tendered in evidence Ex.CA affidavit of the complainant Smt.Usha Rani alongwith documents Exs.C1 to C6 and closed the evidence of the complainant.
The ld. counsel for the OP has tendered in evidence Ex.OPA, affidavit of Sh.V.K.Arora, Manager L&HPF,LIC of India alongwith documents Exs.OP1 to OP9 and closed evidence of OP.
5. We have heard the ld. counsel for the parties, gone through the written arguments filed by the ld. counsel for the parties and have also gone through the record of the case, carefully.
6. The ld. counsel for the complainant has submitted that after the death of the life assured, late Sh. Jaswinder Singh, the complainants being his legal heirs had lodged the claim with the OP. The OP had paid Rs.17,700/- instead of Rs.75,000/- i.e. total sum assured value. The OP is thus liable to pay the remaining amount of Rs.57,300/-alongwith upto date interest.
On the contrary, the ld. counsel for the OP has submitted that due to non payment of the premium installments in time, the policy in question was lapsed. The same was got revived on 31.7.2013 by the life assured by concealing the true facts about the status of his health. As per term No.4 of the policy , which reads as under:
“For non feature regulations, if after atleast three full years premiums have been paid in respect of this policy any subsequent premiums being not duly paid, this policy shall not be wholly void, but shall subsist as a paid up policy for a reduced sum payable on the date of maturity or at the life assurd’s prior death, provided the paid up sum assured is not less than Rs.250/-…………..”,
the complainants were entitled to get the paid up value, and an amount of Rs.17,700/- was paid to the complainant vide cheque dated 27.4.2016.As such the complaint filed by the complainants is liable to be dismissed.
7. From the copy of admission card, Ex.OP1, issued by PGIMER, Chandigarh, it is evident that the life assured Late Sh. Jaswinder Singh had taken treatment for coronary artery disease , from the said hospital, for the period from 15.7.2013 to 18.7.2013.But the life assured at the time of revival of the policy had not mentioned the said fact in his personal statement/declaration, as is evident from the copy of proposal form, Ex.OP2. In term No.5 of the policy in question, it is mentioned that, if a person withheld the material information regarding his / her state of health, at the time of filling up proposal form for insurance, the insurance company can forfeit the amount paid by the life insured. In the present case, the life assured had paid the premiums for more than three full years, therefore, as per term no.4 of the policy, referred above, the complainants being the legal heirs of the life assured were entitled for paid up value. The OP had already paid the amount of Rs.17,700/- as paid up value to the legal heirs of the deceased life assured. As such no deficiency of service can be attributed upon the OP.
8. In view of the aforesaid discussion, we do not find any merit in the complaint. Consequently, we dismiss the same without any order as to costs. Certified copies of this order be sent to the parties free of cost under the Rules. Thereafter file be indexed and consigned to the Record Room.
ANNOUNCED
DATED:7.3.2018
NEENA SANDHU
PRESIDENT
NEELAM GUPTA
MEMBER
