Punjab

Sangrur

CC/361/2016

Roshni - Complainant(s)

Versus

Life Insurance Company - Opp.Party(s)

Shri Inderpal Singh Dhandly

19 Sep 2016

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, SANGRUR.

                                                             

                                                Complaint No.  361

                                                Instituted on:    25.04.2016

                                                Decided on:       19.09.2016

Roshni W/o Shri Nahar Singh and Nahar Singh son of Jangir Singh, residents of VIPO Jhaloor, Tehsil Sunam, District Sangrur.

                                                        …Complainants

                                Versus

Life Insurance Company, Railway Road, Sangrur through its Branch Manager.

                                                        …Opposite party

 

For the complainant  :               Shri I.P.S.Dhandly,Adv.

For OP                     :               Shri Amit Goyal, Adv.

 

Quorum:   Sukhpal Singh Gill, President

                K.C.Sharma, Member

                Sarita Garg, Member

               

Order by : Sukhpal Singh Gill, President.

 

1.             Smt.Roshni and Shri Nahar Singh, complainants (referred to as complainant in short) have preferred the present complaint against the opposite party (referred to as OP in short) on the ground that the son of the complainants namely Sukhwinder Singh (referred to as DLA in short) got insured from the OP vide policy number 164687279 dated 28.12.2010 for Rs.1,00,000/- and the policy was to mature on 28.12.2025. 

 

2.             The case of the complainant is that the DLA met with a road side accident on 14.12.2015 and died on 16.12.2015 during his treatment at PGI Chandigarh, of which FIR number 126 dated 15.12.2015 was registered at PS Lehra. It is further averred that the complainant paid all the instalments, but the grievance of the complainant is that the OP did not pay the accidental claim. Further case of the complainant is that the complainant was surprised to see when the OP deposited an amount of Rs.1,19,008/- on 15.3.2016 in the account, but without any accidental claim.  The complainant approached so many times to the Op to pay the claim on account of accidental benefit, but all in vain despite serving of legal notice dated 29.3.2016 upon the OP. Thus, alleging deficiency in service on the part of the OP, the complainant has prayed that the OP be directed to pay Rs.1,00,000/- on account of accidental claim along with interest and further claimed compensation and litigation expenses.

 

3.             In reply filed by OP, preliminary objections are taken up on the grounds that the complaint is not maintainable, that the complainant has no cause of action and locus standi to file the present complaint. On merits, it is admitted that the DLA was insured for Rs.1,00,000/-, but it is denied that the Op wrongly repudiated the claim on account of accidental benefit.  It is stated further that the at the time of obtaining the policy in question, the DLA was minor and proposal was made by his father on behalf of minor DLA and there is no column in the proposal form for accidental benefit on the life of minor child and no premium was charged from him for accidental benefit rider. In fact accidental benefit rider is not applicable to the policy for the minor and the same has to be taken additionally by the DLA after attaining the age of majority by payment of extra premium.  It is stated that the due amount of Rs.1,19,008/- has already been paid on account of basic sum assured along with refund of premium.  The other allegations levelled in the complaint have been denied.

 

 

4.             The learned counsel for the complainant has produced Ex.C-1 affidavit, Ex.C-2 copy of legal notice, Ex.C-3 to Ex.C-14 copies of receipts, Ex.C-15 copy of bank account statement, Ex.C-16 copy of PMR, Ex.C-17 copy of FIR, Ex.C-18 copy of statement of Sukhjinder Singh, Ex.C-19 copy of medical certificate and closed evidence. On the other hand, the learned counsel for OP has produced Ex.OP-1 affidavit, Ex.OP-2 copy of proposal form, Ex.OP-3 copy of sample application form, Ex.OP-4 copy of insurance policy, Ex.OP-5 copy of payment voucher and closed evidence.

 

5.             We have carefully perused the complaint, version of the opposite parties and heard the arguments of the learned counsel for the parties. In our opinion, the complaint merits dismissal, for these reasons.

 

6.             It is an admitted fact between both the parties that the DLA, Shri Sukhwinder Singh was insured for Rs.1,00,000/- with the OP under policy number 164687279 which commenced on 28.12.2010. It is further not in dispute that the DLA died an accidental death on 16.12.2015 in the PGI Chandigarh, where his post-mortem was also conducted.  It is further an admitted fact that the OP has already paid an amount of Rs.1,19,008/- to the complainant on 15.3.2016 by transferring the same in the account.

 

7.             In the present case, the complainant has disputed the non-payment of the claim amount of Rs.1,00,000/- on account of accidental benefits by the OP.  But, the stand of the Op is that the due claim amount of Rs.1,19,008/- has already been paid and nothing is due more, as the DLA was not insured under the accidental benefit policy, as no premium was paid by the DLA, as the DLA was minor at the time of obtaining the policy in question, as the proposal was made by his father, but thereafter the DLA or his father never opted to get the DLA insured even under accidental rider policy.  We have also perused the copy of insurance policy on record Ex.C-4, where the column ”Instalment Accident Benefit Premium” is shown as 0.00 meaning thereby the Op did not charge any premium on account of the accidental benefit, as such, we feel that the OP cannot make responsible for repudiating the claim on account of accidental benefit.  We may mention that the same is the position in the document Ex.OP-4, which clearly shows that no premium was paid by the complainant on account of accidental benefit rider, as such, we feel that the complainant has failed to prove his case by producing cogent, reliable and trust worthy evidence on record to show that he was entitled to get the claim on account of accidental death of the DLA.  In the circumstances, we are of the considered opinion that the OP has already paid the due amount of Rs.1,19,008/- to the complainant on 15.3.2016 and nothing more is payable to the complainant on account of accidental death benefit.

 

8.             In view of our above discussion, we dismiss the complaint of the complainant. However, the parties are left to bear their own costs.

 

9.             A copy of this order be issued to the parties free of cost. File be consigned to records.

                Pronounced.

                September 19, 2016.

 

                                                (Sukhpal Singh Gill)

                                                     President

                               

 

                                                   (K.C.Sharma)

                                                        Member

 

 

                                                  (Sarita Garg)

                                                         Member