Haryana

Yamunanagar

CC/632/2011

Rakesh Kumar s/o Jasmer Singh - Complainant(s)

Versus

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

Pardeep Rathore

13 Feb 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR

 

                                                                                          Complaint No. 632 of 2011.

                                                                                          Date of institution: 14.06.2011  

                                                                                          Date of decision: 13.02.2017

 

1. Rakesh Kumar aged about 28 son of Late Shri Jasmer Singh.
2. Smt. Pushpa Devi wife of late Shri Makeet @ Mukesh.
3. Rajan aged about 11 years, minor son of late Shri Makeet @ Mukesh, minor through his mother Smt. Pushpa Devi being next friend and natural guardian.
4. Balbiri Devi wife of Late Jasmer Singh, all resident of village Chintpur, Post Office Lalhari Kalan, PS Bilaspur, District Yamuna Nagar.

 

                               …Complainants.

                                    Versus

1. Life Insurance Corporation of India, Regional Office, Karnal Division, Karnal, through its Regional Manager.
2. Life Insurance Corporation of India, Branch Office, Yamuna Nagar, through its Branch Manager.

                                                                                                                                      ...Respondents

                                                                                                                         

 

BEFORE:         SH. ASHOK KUMAR GARG…………….. PRESIDENT.

                         SH. S.C.SHARMA………………………….MEMBER.

 

Present:           Shri Pardeep Rathore, Advocate for complainant.

                         Shri Sushil Garg, Advocate for OPs.

 

ORDER  (Ashok Kumar Garg, President)

 

1                      The present complaint has been filed under section 12 of the Consumer Protection Act 1986 praying therein that respondents (hereinafter referred as OPs) be directed to release the insured amount of Rs.1,00,000/-  along with interest and also to pay compensation as well as litigation expenses.

2.                     Brief facts of the present complaint, as alleged in the complaint are that complainant No.1 is real brother of the deceased late Shri Makeet @ Mukesh whereas the complainants No.2 and 3 are the widow and son respectively and complainant No.4 is mother of the deceased late Shri Makeet @ Mukesh. During his life time Shri Makeet @ Mukesh had taken one Insurance Policy from the OPs bearing No.171770544 which was valid from 28.03.1999 to 28.03.2029. The installments of the said policy was half yearly. Unfortunately, Shri Makeet @ Mukesh had died on 23.02.2011 upon which the complainants lodged claim with the OP Insurance Company and completed all the formalities. However, complainant were surprised to receive one cheque of Rs.8976/- from the OPs insurance company in the name of complainant No.1 whereas the OPs were legally bound to pay the insurance of Rs.1,00,000/-  along with interest and other benefits as per terms and conditions of the Insurance Company. After receiving the aforesaid cheque complainant visited the office of the OP no.2 i.e. branch office but the officials of the OPs put of the matter on one pretext or the other and ultimately refused to pay any heed to the genuine request of the complainants. The complainants also wrote a letter dated 13.04.2011 to the OPs but all in vain. Hence, this complaint.  

3.                     Upon notice, OPs appeared and filed its written statement jointly by taking some preliminary objection such as there is no deficiency in  service on the part of the OPs; As per the terms of the policy the OPs has paid a sum of Rs.8976/- vide cheque No.765398 dated 23.05.2011 in favour of the complainant No.1 and as such the liabilities stands discharged on the part of the OPs; complainant have arisen no cause of action, this forum has no jurisdiction to entertain and decide the present complaint and on merit it is admitted that a policy No.171770544  under T&T No.111-30 for a sum of Rs.1 lac was issued in the name of Shri Makeet @ Mukesh with effect from 31.03.1999 having a premium of Rs.498/- payable under half yearly mode. However, the policy in question was lying under the lapse condition on the date of death since 03/2010 i.e. from First Unpaid Premium (FUP) under that policy and date of death is 23.02.2011. It has been further admitted that complainant No.1 was the nominee under the policy in question. Since the policy in question was lying in lapsed condition on the date of death of the life assured, so only notional paid up value i.e. (total premium paid less total extra premium paid) was payable under policy in question and accordingly the OPs paid notional paid up value of Rs.8976/- vide cheque No.765398 dated 23.05.2011 to the complainant No.1 being nominee. Hence, there is no deficiency in service or unfair trade practice on the part of the OPs, lastly prayed for the dismissal of the compliant.

4.                     In support of his case complainant No.1 tendered into evidence his affidavit as Annexure CW/A, photocopy of death certificate as Annexure C-1, photocopy of first page of Insurance policy as Annexure C-2, photocopy of intimation letter as Annexure C-3, photocopy of claim form as Annexure C-4 and C-5 and closed the evidence on behalf of complainant.

5.                     On the other hand, learned counsel for the OPs tender into evidence affidavit of Shri Balihar Singh, Manager Legal, LIC as RW/A and photocopy of status report of policy bearing No. 171770544 as Annexure R-1, photocopy of forwarding letter, calculating amount sent to the complainant as Annexure R-2 and R-3 and photocopy of Insurance policy as Annexure R-4 and closed the evidence on behalf of OPs. However, some documents Annexure R1 to R6B were also tendered by the OPs along with written statement.

6.                     We have heard the counsels of both the parties and have gone through the pleadings as well as documents placed on the file very carefully and minutely.

7.                     The only version of the complainants is that the deceased Shri Makeet @ Mukesh was insured for Rs.1,00,000/- vide policy No.171770544  which was commenced from 28.03.1999 and the deceased was regularly paying the installments to the OPs Insurance Company but the OPs Insurance Company wrongly and illegally withheld the insured amount of Rs.1,00,000/- whereas the complainants are entitled to get the full sum insured of Rs.1,00,000/-. Learned counsel for the complainants referred the case law titled as “Shashi Gupta Versus Life Insurance Corporation of India and another, 1995(2) CPC, Page No.14 (SC)”.

8.                     On the other hand learned counsel for the OPs Insurance Company argued at length that policy in question was lying in the lapse mode since first unpaid premium i.e. 03/2010 whereas date of death is 23.02.2011. Hence, paid up value of Rs.8976/- as per terms and conditions of the Insurance Policy became payable and the same has been paid vide cheque No.765398 dated 23.05.2011 to the complainant.

9.                     Learned counsel for the OPs draw our attention towards condition No.2 (Annexure R-6) which is reproduced here as under:

 Policy Lapsed: If life assured expired after days of grace and if at least 5 full years premium have been paid and also policy has completed 5 years as on date of death, then only notional paid up value i.e. (total premiums paid less total extra premium paid) is payable as death claim. Loyalty addition is not payable. While calculating notional paid up value, DAB premium need not to be deducted. If deaths occurs within 5 years and policy is in lapsed condition, then noting is payable.

           

            Learned counsel for the OPs further referred the case law titled as “ Branch Manager, LIC of India and another Vs. Sri Ranganath, Revision Petition No.4159 of 2012, decided on 11.03.2014 by the National Commission wherein it has been held that

“As the policy lapsed before death of insured, no claim was payable under the policy and petitioner rightly repudiated the claim but District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal and revision petition is to be allowed. Consequently, revision petition filed by the petitioner is allowed and impugned order dated 04.06.2012 passed by the Karnataka State Commission, Bangalore in appeal No.596/2012 and order of District Forum dated 16.02.2012 passed in Complaint No.82/2011 is set aside and complaints stands dismissed with no order as to costs”.

Further learned counsel for the OPs referred the titled as “Life Insurance Corporation of India and others Vs. Neelamma 2012(3), CPJ 610 (NC) which is reproduced here as under:

Consumer Protection Act, 1986- Section 2(1) (g), 21 (b) Insurance (Life) Death Claim- Non Payment of premium-policy lapsed- Claim repudiated- Alleged deficiency in service-District Forum allowed complaint- State Commission dismissed appeal- Hence revision-Policy was obtained on 27.02.2006 and premium was to be paid quarterly- Payment due on 27.02.2007 was not paid and insured died on 12.05.2007-Insured died after lapse of policy –Repudiation justified. 

 

            Learned counsel for the OPs further referred the case law titled as “Jiwan Spinner Pvt. Ltd. Vs. New India Insurance Co. Ltd 2013(1) CLT” which is reproduced here as under:

Consumer Protection Act, 1986- Section 2(1) (g), 21 (b)- Insurance Claim-Acceptance of Insurance Claim amount by signing discharge voucher-Held by State commission that it is well settled law that once the claim has been accepted by the claimant without any objection by signing discharge voucher in full and final settlement of claim offered by the Insurance company, thereafter, the claimant cannot be allowed to reopen his claim seeking any further relief.

 

10.                   Lastly learned counsel for the OPs argued that as the policy in question was in lapsed a mode, hence OP insurance company has rightly settled the claim of the complainants and has paid the amount of Rs.8976/- as notional paid up value against policy in question as per its terms and conditions. Hence, there is no deficiency in service or unfair trade practice on the part of OPs and lastly requested for dismissal of the complaint.        

11.                   After hearing both the parties, we are of the considered view that there is no deficiency in service or unfair trade practice on the part of the OPs, as the counsel for the complainants has totally failed to convince this Forum that complainants are entitled to get sum insured of Rs.1,00,000/-. Further, the complainants have also failed to prove that policy in question was not in lapsed mode as neither any receipt for depositing the installments paid for the month of 03/2010 and after that 09/2010 have been placed on file nor any particulars for depositing the same has been disclosed by the complainants. Further, it is not the case of the complainants that they ever revived the policy in question after paying the due installments from the OPs Insurance Company. In the present case, as per version of the OPs, Insurance Policy in question was lapsed since First Unpaid Premium (FUP) i.e. 03/2010 and deceased Makeet @ Mukesh died on 23.02.2011 i.e. after a grace period of 30 days. The facts of the case law titled as “Life Insurance Corporation of India and others Vs. Neelamma 2012(3), CPJ 610 (NC) (Supra) are fully applicable to the facts of the present case as in that case also insured died after lapse of the policy and repudiation done by the OPs Insurance Company was justified by our Hon’ble National Commission. The facts of the case referred by the counsel for the complainant are not disputed but not helpful in the present case.

12.                   On the other angle also, the complainants had already received the amount of Rs.8976/- vide cheque No.765398 dated 23.05.2011 against the discharge voucher duly executed by the complainant No.1 which is duly evident from the copy of Annexure R-6/A and in the citation of the Hon’ble National Commission titled as “Jiwan Spinner Pvt. Ltd. Vs. New India Insurance Co. Ltd 2013(1) CLT, Page No.647” (Supra) it has been held that it is well settled law that once the claim has been accepted by the claimant without any objection by signing discharge voucher in full and final settlement of claim offered by the insurance company, thereafter, the claimant cannot be allowed to reopen his claim seeking any further relief.

13.                   In the circumstances noted above and going through the case law referred by the counsel for the OPs, we are of the considered view that claim of the complainants has been rightly settled by the OPs Insurance Company and there is no merit in the present complaint and the same is hereby dismissed with order as to cost. Copies of this order be supplied to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Pronounced in open court:

Dated: 13.02.2017.

                                                                                          (ASHOK KUMAR GARG)

                                                                                           PRESIDENT

                                                                                           DCDRF Yamuna Nagar

 

 

                                                                                          (S.C.SHARMA)

                                                                                           MEMBER