Haryana

Ambala

CC/44/2016

Chander Kanta - Complainant(s)

Versus

Life Insurance Corporation of India. - Opp.Party(s)

Baikunth Nath

15 Dec 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM:

                                                AMBALA

 

                                                Complaint Case No.      :         44 of 2016.

                                                Date of Institution                   :         11.01.2016.

                                                Date of Decision            :         15.12.2017.

 

Chander Kanta wife of Shri Jaspal Sharma resident of House No.447/3, Basant Vihar, Ambala City.

………….Complainant.

Versus

Life Insurance Corporation of India, Jeewan Jyoti Building, Jawahar Lal Nehru Marg, Ambala Cantt through its Branch Manager.

…………Opposite Party.

          Complaint Under Section 12 of the Consumer Protection Act.

CORAM:             SH. DINA NATH ARORA, PRESIDENT

                             MS. PUSHPENDER KUMAR, MEMBER

MS. ANAMIKA GUPTA, MEMBER

 

Present: -              Complainant in person with Sh.Baikunth Nath, Advocate.                                 Sh. G.S.Antal, counsel for the OP.

                  

ORDER

 

                             In nutshell, brief facts of the complaint are that son of complainant (Shiv Kumar) had purchased an insurance policy bearing No.178397610 vide proposal No.12774 dated 28.03.2014. Insured Shiv Kumar, who was unmarried, died in rail accident on 01.12.2014 and regarding this inquest report No.247 dated 02.12.2014. After the death of insured the complainant approached the OP and claimed benefits of above said policy by submitting requisite documents with it but the OP rejected the claim of the complainant vide letter dated 28.10.2015 on the false and frivolous grounds. However, the OP has released the basic amount of the another policy bearing no.176391478 vide proposal No.11129 dated 06.12.2008.  The complainant requested the OP many a times and even got served a legal notice upon it to release the policy amount and accidental benefits but to no avail.  The act and conduct of the Op clearly amounts to deficiency in service and unfair trade practice on its part. In evidence the complainant has tendered affidavit Annexure CX and document Annexure C1 to Annexure C6.

2.                Upon notice, OP appeared and contested the complaint by filing reply and submitted that the present complaint is not maintainable and the complainant has no locus standi to file the same. The DLA Shiv Kumar had purchased polcy No.178397610 for sum assured of Rs.2 lac under table No.815-21 with date of commencement 28.03.2014 but as per policy condition No.7 mentioned in clause SUICIDE :           This policy shall be void 1. If the life assured (Whether sane or insane) commits suicide at any time within 12 months from the date of commencement of risk and the corporation will not entertain any claim under this policy except to the extent of 80 % of premiums paid excluding all taxes, extra premium and riders premiums if any provided the policy is force, claim is not payable. The DLA has committed suicide  alongwith female friend by jumping from the train on 01.12.2014 and this fact proves from the investigation of CIA GRP, Ambala Cantt.  The claim has rightly been repudiated  and even the DLA has committed suicide within one year from the date of commencement of policy and the suicide clause was operative. The DLA was having another policy and the claim regarding this has already been paid without the accident benefit as the DLA was minor at the time of purchasing the policy in question.  As per terms and conditions of the policy bond  it is clearly mentioned that if the LA committed suicide within one month from the date of commencement of policy or from the date of revival of policy, the corporation will not entertain any claim. The suicide is not an accident and AB claim is also not payable in the case of suicide. Other contentions made in the complaint have been controverted and prayer for dismissal of the complaint has been made. In evidence, the OP has tendered affidavit Annexure RA and documents Annexure R1 to Annexure R7.

3.                          We have heard learned counsel for the parties at length and gone through the case file very carefully.

4.                          The grievance of the complainant is that the OP has not released the policy amount alongwith others benefits to her and illegally repudiated the same without any reason despite the fact that all the requisite documents have been submitted with it.

                             Per contra, it has been argued that as per policy condition No.7 mentioned in clause SUICIDE: This policy shall be void 1. If the life assured (Whether sane or insane) commits suicide at any time within 12 months from the date of commencement of risk and the corporation will not entertain any claim under this policy except to the extent of 80 % of premiums paid excluding all taxes, extra premium and riders premiums if any provided the policy is force, claim is not payable. The DLA has committed suicide  alongwith female friend by jumping from the train on 01.12.2014 and this fact proves from the investigation of CIA GRP, Ambala Cantt. The claim has rightly been repudiated and even the DLA has committed suicide within one year from the date of commencement of policy and the suicide clause was operative.

5.                          Perusal of Annexure R1 reveals that initially the complainant in her statement recorded by the GRP, Ambala Cantt. stated that her son died due to jumping before the train and had committed suicide but she was not satisfied with the proceedings of the police as her son died from the train and in this incident received injuries and died. During proceedings of the police, she had further narrated that she had given the statement while remaining under shock and depression and when she verified all the facts then her son has not committed suicide rather her son died due to injuries after receiving from the train.  Upon this the police has also enquired the matter again on 19.03.2015 and recorded the statement of the eyewitness/co-passenger  Poonam, Shiv Kumar had died due to fallen from the train and he had not committed suicide. In the present case said Poonam (eye witness/co-passenger) has not tendered her affidavit regarding committing suicide/death of Shiv Kumar after falling from the train incidentally.

                   We have also perused Annexure R3 i.e. inquest report wherein the SHO has opined that  The cause of death of deceased is due to suicide. None is to be blamed please.

                   The police during proceedings have further recorded the statement on 19.03.2015 of Chanderkanta /complainant and after recording the statement of complainant following remarks have been made that during investigation it was found that earlier the death of Shiv Kumar has been declared being suicide  but when the complainant did not satisfy with the earlier report then the investigating officer further opined that as per eye witness Poonam Shiv Kumar had fallen from the train per chance and died due to sustaining of injuries. The IO has not categorically give any findings rather relied upon the statement of complainant and alleged eye witness. In such situation it was necessary for the I.O. also to record the statement of Poonam who has been allegedly shown as eye witness.

                    In the present case Police has given the two  investigation report Annexure R-3 dated 05.01.2015  the investigation officer has given clearly opinion that the cause of death of diseased is due to suicide, None is to be blamed and police has also given another investigation report Annexure R-1/C-4 dated 19.03.2015 same was accepted by DSP, Ambala on 30.03.2015 but  investigation officer has not given the specific finding qua the diseased has fallen from the train as per chance  and died in rail accident  due to sustain the injuries.  

                    Hence, in view of above discussed factual as-well-as legal position, we are of the considered view that the present complaint is hereby dismissed being not maintainable. Moreover, in order to resolve the controversy elaborating evidence is required and this Forum cannot decide the matter in summarily manner because there are two version available on the case file given by the police. However, the complainant is at liberty to approach at appropriate Court/forum if he so advised and in that eventuality, the period of litigation before this Forum shall not be counted towards the period of limitation for approaching appropriate court/forum.  Exemption of time spent before this Forum is granted in terms of the judgment of the Hon’ble Supreme Court of India in the case titled “ Laxmi Engineering Works versus PSG Industrial Institute  (1995) 3 SCC page 583 Assistant of this Forum is directed to handover original documents, if any, on the file to the parties concerned on proper receipt and verification. It is made clear that if any document has been annexured by both the parties, they can obtain the certified copy as per law. Copy of this order be supplied to both the parties free of cost.  File be consigned after due compliance.

 

Announced on:15.12.2017     

                                                                                                                   

 

(Pushpender Kumar)    (Anamika Gupta)                      (D.N.Arora)

Member                         Member                            President

                                                                         District Consumer Disputes                                                                         Redressal Forum, Ambala.