Haryana

Ambala

CC/271/2010

HARBANS LAL - Complainant(s)

Versus

LIFE INSURANCE COORPORATION - Opp.Party(s)

JAIDEEP PRASHAR

14 Jul 2015

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, AMBALA.

            Complaint Case No.    : 271 of 2010

Date of Institution       : 16.06.2010

             Date of Decision         : 14.07.2015

Harbans Lal son of Shri Rai Singh R/o village Berkheri, Tehsil Naraingarh, District Ambala.

                                                                                               

                                                                                                                                                                          ……Complainant.

                                                                                                      Versus

1.         Life Insurance Corporation, Division office (Jeevan Parkash), Sector 17-B Chandigarh through its Manager/authorized signatory.

2.         Smt. Darshana Devi wife of Sh. Mohinder Singh (Aanganwari worker), R/o village Berkheri, Tehsil Naraingarh, District Ambala.                                                                                                                                                             ……Opposite Parties.

Complaint Under Section 12 of the Consumer Protection Act

CORAM:        SH. A.K. SARDANA, PRESIDENT.

                        SH. ANIL SHARMA, MEMBER.

                        MS. ANSUYA BISHNOI, MEMBER.                       

Present:          Sh. Jaideep Parashar, Adv. for complainant.

                        Sh. R.K. Jindal, Adv. for OP No.1.

                        OP No.2 exparte.

 ORDER.

1.                     Brief facts of the complaint are that complainant’s son Suryakant got insured himself vide LIC policy known as Jeewan Madhur-micro insurance bearing No.164018505 dated 17.04.2009 with OP No.1 through OP No.2 and a sum of Rs.500/- was paid on 28.03.2009 towards the first premium. As per terms & conditions of the Policy, Rs.500/- was to be paid on monthly basis for a period of five years to the extent of Rs.30,000/- whereas on maturity sum assured was Rs.25390/- and death benefit  sum assured was Rs.30,000/-.  It has been further submitted that Suryakant also got himself insured through another similar policy from the Ops having similarly terms and conditions vide policy No.164018576 dated 24.04.2009 and complainant is nominee in both the insurance policies. Suryakant expired on 22.05.2009 in a road side accident and after his death complainant submitted the claim application to OP No.1 alongwith requisite documents and the OP No.1 issued a cheque in the sum of Rs.55,600/- dated 10.09.2009 in the name of complainant being nominee against the claim of policy No.164018576.  Complainant inquired about refund of policy No.164018505, upon which, OP No.1 told the complainant that a similar person cannot get himself insured twice under the same policy and further told  the complainant that his son has wrongly answered the question No.4-‘particulars of previous micro insurance policies’ as ‘No’ and thus the claim of complainant has been repudiated.  So, a  legal notice dated 23.04.2010  got served upon OP No.1 which was answered vide reply dated 28.04.2010 stating that wrong answer was given to question No.4 and the claim has rightly been rejected.  Having no alternative, present complaint has been filed by the complainant seeking relief as per prayer clause.

2.                     Upon notice, OP No.1 appeared through counsel and filed written statement on 17.01.2011 but later on an application for amendment of written statement was filed by the OP No.1 which was allowed by the Forum vide order dated 24.09.2012. Amended written statement filed raising preliminary objections qua non-maintainability of complaint, no territorial jurisdiction as well as mis-joinder & Non-joinder of necessary parties etc..  On merits, it has been admitted that both the policies mentioned in the complaint have been issued by them in the name of Suryakant-son of complainant. But the complainant did not disclose the fact of taking the previous similar Jeewan Madhur Micro Insurance Policy by replying the wrong answer in the proposal form  of the later policy whereas as per terms & conditions of LIC Jeevan Madhur Micro Insurance Policy, a  person can take benefit of this policy upto maximum sum assured of Rs.30,000/-. Thus, a prayer for dismissal of complaint with costs has been made by the OP No.1 on the premise that there is  no any deficiency in service on the part of answering OP.

                        OP No.2 did not bother to appear despite service through registered notice, as such, she was proceeded against exparte vide order dated 01.07.2011.

3.                     In evidence, the counsel for complainant tendered affidavits Annexures CA,CA-1 & CA-2  alongwith documents Annexures C-1  to Annexure C-8 on behalf of complainant and closed the evidence whereas on the other hand, the counsel  for OP No.2 tendered in evidence affidavit Annexure RX of Sh. Ajay Gupta, the then Manager (L&HPF) LIC, Divisional Office, Karnal alongwith documents Annexures R-1 to R-4 and closed the evidence on behalf of Ops.

4.                     We have heard the learned counsel of parties and gone through the record. The main grievance of the complainant is that his son namely Suryakant got insured himself from the OP No.1 vide policy No.164018505 dated 17.04.2009 and No.164018576 dated 24.04.2009 but the OP No.1 settled the claim of policy No. 164018576  whereas repudiated the claim of the policy bearing No.164018505 which is illegal and prayed for acceptance of the complaint against the Ops.

                        On the other hand, learned counsel for the OP No.1 argued that a person can take the benefit of LIC Jeewan Madhur Micro Insurance Policy upto maximum sum assured of Rs.30,000/-.  The deceased life assured Surya Kant was already having policy No.164018505 of sum assured of Rs.30,000/- issued on 17.04.2009 as such as per the terms & conditions of the policy in question, he cannot take the another similar policy, but he intentionally, fraudulently by concealing the facts of previous policy in the proposal form have taken the another similar policy bearing No.164018576 of Rs.30,000/- sum assured on 24.04.2009, as such the answering OP legally, rightly declined the claim of the policy No.164018505. Counsel for OP No.1 further argued that the complainant submitted the claim form of policy No.164018576 dated 24.04.2009 firstly  instead of submitting the claim form of both the policies together, intentionally &  fraudulently, so that this would not come in the knowledge of OP Insurance Co. about the existence of other policy. After receiving the claim of policy No.164018576, which was released bonafidely by OP No.1 without the knowledge  of another similar policy on 29.09.2009, complainant submitted the claim form for claiming the amount of policy No.164018505 with the answering OP which was rightly declined by the OP as per the  terms & conditions of the policy in question as a person cannot take the benefit of LIC Jeewan Madhur Micro Insurance Policy more than sum assured of Rs.30,000/-. The counsel for the OP No.1 vehemently argued that  the policies were issued to the insured on good faith but the complainant concealed the true facts as such there is no deficiency in service on the  part of the OP No.1 in declining the claim of the complainant qua policy No.164018505.

5.                     In view of the above discussed facts and as per Annexure R-4 placed on record by the Ops, it is clear that a person can take  the benefit of Micro Insurance Policy only one time and upto maximum of Rs.30,000/- but the deceased-life assured have taken two polices by giving wrong answer to subsequent policy as ‘No’. In the present case, the complainant has already received the benefit of policy subsequent issued vide policy No.164018576 by getting a  cheque in the sum of Rs.55,600/- dated 10.09.2009.  Accordingly, the complaint is devoid of merits and is dismissed with no order as to costs. Copies of this order be sent to the parties concerned, free of costs. File be consigned to the record room after due compliance.  

 

Announced:14/07/2015                                                                     Sd/-

                                                                                                 (A.K. SARDANA)

                                 PRESIDENT              

 

                                                                                                            Sd/-

                           (ANIL SHARMA)

                                                                                                            MEMBER

                                                                                                           Sd/-

                    (ANSUYA BISHNOI)

                                                                                                            MEMBER