BEFORE THE DISTT. CONSUMER DISPUTES REDRESSAL FORUM; FATEHABAD.
Complaint case No.30 of 2017.
Date of Instt.: 31.01.2017.
Date of Decision: 11.09.2017.
Surjit Singh son of Dhanpat Singh, resident of village Bhirdana, Tehsil & District Fatehabad.
..Complainant.
Versus
1. Life Insurance Corporation of India, Branch Office, above Arorvansh Dharamshala, Dharamshala Road, Fatehabad, Tehsil and District Fatehabad through its Branch Manager.
2. The Manager (C.R.M.), Life Insurance Corporation of India, S.C.O. No.3-4-5, Sector -1, HUDA, Rohtak, Tehsil & District Rohtak.
..Opposite Parties/Respondents.
Complaint U/S 12 of the CP Act,1986
Before: Sh.Raghbir Singh, President.
Sh.R.S.Panghal, Member.
Smt. Ansuya Bishnoi, Member.
Present: Sh.Sukhbir Dhaka, Advocate for complainant. Sh.S.K.Dharnia, Advocate for opposite party.
ORDER
Briefly stated, the facts of the present complaint are that daughter of the complainant namely Suman had got insured herself with the opposite parties vide Insurance policy No.179599456 for a sum assured of Rs.3,00,000/-. The proposal for the policy was filed on 23.09.2014. Payment of premium of Rs.7097/- was made by her and the date of maturity of said insurance policy was 28.02.2035. The said insurance policy was under LIC’s Endowment plan and the complainant is nomine of said insurance policy. Unfortunately said Suman, daughter of complainant died on 30.12.2014. The complainant being nominee of Suman (life assured) informed the OPs about the death of her daughter and all the requisite documents were submitted by complainant to OPs but till date the complainant has not been released the benefits of insurance policy nor assigned any reason for the same by the Ops. So, there is deficiency in service on the part of OPs and the complainant is entitled to get all the benefits in respect of the insurance policy along with interest @ of 12% per annum. The complainant has suffered mental agony and harassment at the hands of opposite parties and as such he is also entitled for compensation of Rs.50000/-. Hence, this complaint.
2. On notice, the opposite parties appeared through their counsel and resisted the claim of the complainant by filing reply to the complaint wherein several preliminary objections such as maintainability, locus standi, concealment of material facts and cause of action etc. have been taken. It has been submitted by OPs that policy of Life Insurance is a contract of good faith, wherein life assured are under obligation to disclose all the facts and information pertaining to his/her health, and education etc. at the time of taking up the policy and in filing of the proposal form.
It is further averred in the written version that the deceased had withheld correct information regarding her educational qualification at the time of taking the insurance policy with the Ops. In the proposal form dated 23.09.2014 the deceased had shown her educational qualification as under Metric, whereas at the time of submitting the claim, the complainant (father of deceased) had submitted the affidavit dated 27.07.2016 that her daughter Suman had studied only upto 2nd standard. Hence, in view of above facts, the insurance policy in question was obtained by the life assured by concealing the actual position of her educational qualification, in order to garb the money from the Ops.
It is further submitted by the Ops that the life assured had died on 31.12.2014 and after submission of claim, the complaint had been instructed by the OP to submit the educational qualification certificate of her daughter but the same has not been submitted till now and the complainant has filed the present complaint and the same is pre-mature stage because the claim of the complainant is under process and Ops are awaiting the school certificate of Life Assured.
Ops also contended that as per circular U&R/84/2013 dated 07.03.2013 of the insurance policy obtained by deceased life assured, if any person is illiterate or having qualification upto 8th standard, the insurance policy may be issued only for Rs.2 Lac with own income and the Deceased Life Assured has shown herself under matric and has got insured her life for sum of Rs.3 lac under the aforesaid policy, for which she was not eligible and these facts clearly shows the malafide and dishonest intention right from the very beginning because she was only education of passing the 2nd class. In view of above facts, Ops have prayed for dismissal of the complaint.
In evidence, the complainant has tendered his affidavit as Ex.CW1/A and documents i.e. Legal Notice as Ex.C1, receipts as Ex.C2 and C3, death certificate of Suman as Ex. C4, copy of LIC’s New Endowment Plan as Annexure C1.
On the other hand, in evidence, the Ops have tendered affidavit of Gurveen Kaur, Manager(Legal) as Annexure RW1/A and documents; Proposal Form as Annexure R1, copy of agent/CLIA Confidential Report/MHR as Annexure R2, copy of policy as Annexure R3, copy of Affidavit of Surjit Singh as Annexure R4, copy of death claim of deceased Suman as Annexure R5 & copy of letter dated 7.03.2013 as Annexure R6.
3. We have heard the arguments advanced by learned counsel for both the parties and gone through the case file carefully.
4. After giving thoughtful consideration, this Forum is of the considered view that the present complaint is pre-mature and the complainant had to furnish the request documents to the OP before filing the present complaint and get his claim decided. In the reply to the complaint, it has been clearly mentioned by the OPs that the claim is under process and awaiting for the school certificate of the deceased/life assured. Since, the claim is under consideration and has not been repudiated so far, so the complainant has no cause of action to file the present complaint. Accordingly, we dispose of this complaint with liberty to the complainant to submit the requisite documents if any before the Ops-insurance company and the Ops-insurance company is hereby directed to decide the claim of the complainant as per terms and conditions of the policy within a period of one month. In case the complainant is aggrieved with the decision to be taken by the OPs, in that eventuality he may file a fresh complaint against the decision of the Ops. A copy of this order be supplied to both the parties free of cost as provided in the rules. File be consigned after due compliance.
ANNOUNCED IN OPEN FORUM. Dt.11.09.2017
(Raghbir Singh)
President
(Ansuya Bishnoi) (R.S.Panghal) District Consumer Disputes
Member Member Redressal Fourm,Fatehabad
