BEFORE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, FATEHABAD.
Complaint No.: 23 of 2016.
Instituted on: 12.01.2016.
Date of order: 01.12.2016.
Kamla Devi wife of late Krishan Lal son of Sheochanda resident of Dhani Gopal Tehsil & District.
….. Complainant.
Versus
1.Life Insurance Corporation of India Branch Fatehabad District Fatehabad through its Branch Manager.
2.Life Insurance Corporation Divisional Office, Rohtak District Rohtak through its Divisional Manager Life Insurance Corporation Divisional Office, Rohtak District Rohtak.
….Opposite parties.
Complaint U/s 12 of the Consumer Protection Act
BEFORE: Sh. Raghbir Singh, President.
Smt. Ansuya Bishnoi, Member.
Present: Shri Virender Jakher, Advocate for the complainant.
Shri Parveen Kumar Jora, Advocate for the OPs.
ORDER:
Complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986.
2. The facts of the case are that the husband of the complainant had obtained an insurance policy No.176841408 dated 28.01.2009 for a sum assured of Rs.50,000/- and the installments/premium qua the said policy had been paid by him regularly. She had been appointed as nominee of the life assured. It has been further averred that due to illness the husband of the complainant was brought to CMC, Delhi Road, Hisar but on 03.02.2014 the life assured died due to heart attack. After the death, the complainant contacted the OPs and submitted the requisite documents and also completed all the formalities for settlement of the claim but the Ops did not settle the same. The complainant kept on visiting the OPs besides serving them with legal notice but all in vain. Due to the act and conduct of the OPs the complainant has not only suffered mental agony and harassment but she also suffered financial loss which amounts to deficiency in service on their part. In evidence the complainant has tendered her affidavit Ex.CW1/A and documents Annexure C2 to Annexure C15.
3. On notice, the OPs appeared and resisted the claim of the complainant by filing reply taking preliminary objections such as maintainability, locus standi and cause of action etc. It has been submitted that Krishna Kumar was insured vide policy No.176841408 under plan & term 106-15-12 for a sum assured of Rs.50,000/-. The life assured had to pay half yearly premium @ Rs.2985/- but he did not pay the same regularly as the last premium was paid on 12.02.2013 which was due from 07/2012 to 01/2013. Thereafter he failed to pay the premium qua the policy in question resulting into lapsing of the policy from 07/2013 till the time of death i.e. 03.02.2014. The paid up value to the tune of Rs.10900/- was paid by NEFT on 29.09.2014 as per terms and conditions. It has been further submitted that an amount of Rs.15,000/- was paid to the life assured on 13.02.2013. There is no deficiency in service on the part of the Ops and the complainant is not entitled for any relief/compensation. In evidence, the Ops have tendered affidavit Ex.RW1/A and documents Ex.R1 to Ex.R3.
4. We have heard learned counsel for both the parties and have gone through the case file carefully.
5. Learned counsel for the complainant in his arguments has contended that the opposite parties have not acted fairly and have wrongly not released the genuine claim of the complainant for which life assured was insured. It cannot be said that policy was lapsed before the death of life assured as he had regularly paid the premium amount. The complainant has also contented that as per Annexure C-1 i.e. Renewal Premium Receipt issued by the Ops, next premium was not due, meaning thereby that no premium was payable after 1.03.2012. Therefore, the claim of the complainant has been wrongly repudiated.
6. On the other hand, learned counsel for the opposite parties has contended that in the present case the life assured died on 03.02.2014 and on that day the policy had already lapsed as the life assured had not deposited the installment of premium which was due in 07/2013 (FUP). The complainant is not entitled for any claim on account of lapsed policy and in support of his contentions, he has relied upon judgments of the Hon’ble National Commission in cases titled as Challa Samba Reddy Vs. LIC of India & Anr. Revision Petition No.2184 of 2013 decided on 6.5.2015, Life Insurance Corporation of India & anr. Versus Manikappa N. Bhandari IV (2015) CPJ 386 (NC). He has also relied judgment of the Hon’ble Supreme Court of India in case titled as Life Insurance Corporation of India Versus Mani Ram III (2005) CPJ 31 (SC).
7. We have considered the rival contentions of the parties. First of all, we would like to mention undisputed facts that husband of the complainant namely Krishna Lal got himself insured with the opposite parties vide insurance policy No.176841408 for a sum assured of Rs.50,000/- and the policy commenced from 28.02.2009 which was to be matured on 28.01.2024. The premium payable was Rs.2985/- half yearly and the date of last premium was 28.07.2020. It is also not in dispute that complainant Smt. Kamla Devi is nominee in the said insurance policy.
8. From the above-said facts and circumstances of the present case, the first and foremost question which arises as to whether the policy in the present case was lapsed on 03.02.2014 i.e. the date when the life assured expired on account on account of non-payment of premium by the life assured? The condition No.2 of the policy reads as under:-
“Payment of premium: A grace period of one month but not less than 30 days will be allowed for payment of yearly, half yearly or quarterly premiums and 15 days, for monthly premium. If death occurs within this period and before the payment of the premium then due, the policy will still be valid and the Death Benefit paid after deduction of the said premium as also unpaid premium/s falling due before the next anniversary of the policy. If the premium is not paid before the expiry of the days of grace, the policy lapses.
9. The fact regarding payment of premium on 12.02.2013 is not disputed. As per Ops the next premium was due in 07/2013 (FUP) and it is clearly mentioned in condition No.2 of the policy that a grace period of one month but not less than 30 days will be allowed for payment of yearly, half yearly or quarterly premiums and 15 days, for monthly premium. If death occurs within this period and before the payment of the premium then due, the policy will still be valid and the Death Benefit paid after deduction of the said premium as also unpaid premium/s falling due before the next anniversary of the policy and if the premium is not paid before the expiry of the days of grace, the policy lapses. As the premium was due in 07/2013, the life assured was to pay the same within the grace period of one month. The complainant has failed to prove on record that the installments which were due in 07/2013 and thereafter were paid by the life assured before the date of his death i.e. 03.02.2014. Therefore, we have no hitch to reach at a conclusion that the policy was in a lapsed condition on the date of death of life assured and therefore, the complainant is not entitled to the sum assured as per the terms and conditions of the policy. Therefore, the Insurance Corporation is not legally liable to make payment and the claim of the complainant has been rightly rejected. The contention of the counsel for the complainant that as per Annexure C-12 the further premium was not to be deposited is not tenable as in the policy itself it has been specifically mentioned that the life assured will have to pay half yearly installment upto last date of premium i.e. 28.07.2020.
10. Keeping in view the above discussion and the verdict made in the above cited case laws, the present complaint deserves dismissal. Accordingly, we dismiss the present complaint with no order as to costs. A copy of this order be supplied to the parties free of costs. File be consigned to the record room after due compliance.
Dt.01.12.2016. (Raghbir Singh)
President,
District Consumer Disputes
Redressal Forum, Fatehabad.
(Ansuya Bishnoi)
Member
