Haryana

Yamunanagar

CC/53/2014

Jagmail Singh S/o Arjun Singh - Complainant(s)

Versus

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

V.K.Saini

06 Oct 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR.

 

                                                     Complaint No.53 of 2014.

                                                     Date of institution: 23.01.2014.

                                                     Date of decision: 06.10.2017.

Jagmail Singh, age 61 years, son of Sh. Arjun Singh, resident of Village Khera Brahmnan, P.O. & Tehsil Bilaspur, District Yamuna Nagar.

                                                                                               …Complainant.

                        Versus

1. The Life Insurance Corporation of India, SCO No.184-185, Sector-17, HUDA, Jagadhri-135003 through its Branch Manager.
2. The Life Insurance Corporation of India, Divisional Office, Jeevan Parkash, 489, Model Town, Karnal through its Divisional Manager.
3. The Life Insurance Corporation of India, Northern Zonal Office, Jeewan Bharti Cannaught Circus, New Delhi through its Zonal Manager. 

 

….Respondents.

BEFORE     SH. SATPAL, PRESIDENT

                SH. S.C.SHARMA, MEMBER.

                SMT.VEENA RANI SHEOKAND, MEMBER.

 

Present:     Sh. V.K.Saini, Advocate, for complainant.   

                Sh. Nirmal Singh Sinhmar, Advocate for the OPs.

               

                ORDER

         

(SATPAL, PRESIDENT)

1.                The complainant-Jagmail Singh has filed this complaint under section 12 of the Consumer Protection Act 1986, as amended up to date (hereinafter respondents will be referred as OPs). 

2.             Brief facts of the complaint, as alleged by the complainant, are that the son of complainant namely Kulwinder Singh purchased money back policy bearing No.177342077, date of commencement 25.06.2010, date of maturity 25.12.2020, mode of payment half yearly premium of Rs.3236/- for sum assured of Rs.1,00,000/-.  It is alleged that unfortunately, the son of complainant died on 19.03.2013 in a road-side accident at Sadhaura-Bilaspur Road near Saraswati Pool and post-mortem of dead-body was conducted in M.L.G. Hospital, Yamuna Nagar on 20.03.2013.  Information was given to Ops.  It is further alleged that at the time of taking the policy, the Ops assured the son of complainant that in case of death in road-side accident, the Ops will pay the double of the sum assured i.e. Rs.2,00,000/- + vested bonus but the Ops have paid only Rs.1,08,387/- to the complainant and have not made the payment/full claim of son of complainant.  The complainant also got served the legal notice dt. 30.11.2013 upon the Ops but the Ops did not redress the grievances of complainant.  So, it is a clear cut case of deficiency in service on the part of Ops and prayed for acceptance of complaint with the direction to Ops to make the full benefit of policy of son of complainant i.e. double of the sum assured + vested bonus as assured by the Ops and further to pay Rs.50,000/- as compensation for harassment and mental agony alongwith Rs.11,000/- as cost of proceedings to the complainant.  Hence, this complaint.

3.            Upon notice, the OPs appeared and filed their written statement raising preliminary objections with regard to locus-standi; maintainability; cause of action; that the complainant has concealed the true and material facts from this forum.  The true facts are that the policy of deceased was lying in lapsed condition since 25.12.2012 and the complainant is not entitled for any claim.  There is no deficiency in service on the part of Ops.  On merits, it is stated that the policy of the DLA was in lapsed condition on the date of death and as per the terms and conditions of the policy, nothing was payable under the policy but the OPs have paid the basic death claim under the policy on Ex-gratia basis on 24.10.2013 through NEFT for an amount of Rs.1,08,387/- as per Chairman Relaxations.  The other pleas raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.

4.             Ld. Counsel for the complainant tendered in evidence affidavit of complainant as Annexure-CW/A and documents Annexure-C1 to Annexure-C10 and closed evidence on behalf of complainant. 

5.             On the other hand, ld. Counsel for the Ops tendered in evidence affidavit of Sh. Balihar Singh as Annexure-RW/A alongwith documents Annexure-R1 to Annexure-R4 and closed evidence on behalf of Ops.    

6.             Arguments heard.  Ld. Counsel for the complainant argued that the son of complainant namely Sh. Kulwinder Singh had obtained a life insurance policy for a sum of Rs.1,00,000/- on his life on 25.06.2010 from the Ops.  Unfortunately, he met with an accident and died on 19.03.2013.  The Ops paid only Rs.1,08,387/- on account of insurance claim, whereas the complainant is entitled for further accidental benefits of Rs.1,00,000/- alongwith vested bonus.  The Ops had failed to make the payment of accidental benefits by adopting unreasonable attitude and prayed for acceptance of complaint. 

                On the other hand, ld. Counsel for the Ops argued that the policy in question was lying in lapsed condition since 25.12.2012 and as per terms and conditions of the policy, nothing is payable to the complainant.  The ld. Counsel for the Ops has submitted an authority cited in 1994(2) CLT page 324 (NC) titled as Life Insurance Corporation of India & another Vs. Smt. Shashi Gupta, wherein it has been held that “Ex-gratia payment-Assured had paid the first two premiums in full.  His death had occurred after the expiry of ‘day of grace’ but within three months of the due date of the first unpaid premium-Under the relaxation clause the complainant was only entitled to the extent of full sum assured together with the declared bonuses subject to recovery of the unpaid premium-An ex-gratia payment cannot be claimed as a matter of right-Purely in the discretion of the competent authority of the Corporation whether to sanction such payment or not.”  and prayed for dismissal of complaint.               

7.             After hearing the ld. Counsel for both the parties and on perusal of the record carefully and minutely, the foremost question which arises before us for consideration is whether the complainant is entitled for accidental benefits alongwith vested bonus or not?

                The plea of the complainant is that the son of complainant namely Sh. Kulwinder Singh had died in a road-side accident and as per the terms and conditions of insurance policy, the complainant is entitled for the accidental benefits alongwith bonus etc.  On the other hand, the plea of Ops is that the policy in question was lying in lapsed condition and as per terms and conditions of the policy, nothing is payable to the complainant but on Ex-gratia basis, an amount of Rs.1,08,387/- was paid to the complainant on 24.10.2013 through NEFT under Chairman Relaxations Policy and as per the said Relaxations Policy, the death accidental benefits are not payable under the terms and condition No.10(2) of the policy.

                In the present case, the policy in question was lying in lapsed condition since 25.12.2012 and the son of complainant had expired on 19.03.2013, meaning thereby the death of life assured had occurred after the expiry of grace period but within about three months of the due date of unpaid premium.  However, the Ops have under Chairman Relaxations Policy paid the sum assured amounting to Rs.1,00,000/- alongwith bonus after deducting unpaid premium to the complainant on 24.10.2013 through NEFT.  The complainant has not submitted any document from which it could be shown that the complainant has received the amount of Rs.1,08,387/- under protest.  Meaning thereby, the complainant is satisfied with the aforesaid payment.  As per terms and conditions of the policy, if the insured fails to deposit the premium amount on the due date or within grace period, then the policy goes into lapsed mode, thereafter the corporation is not liable to pay the claim amount.  In the present case, admittedly, the Ops have paid the sum assured alongwith bonus on Ex-gratia basis.  It is a settled principle that an ex-gratia payment cannot be claimed as a matter of right.  It is purely the discretion of the competent authority of the corporation whether to sanction such payment or not.  As per terms and conditions No.10(2) of the policy, accidental benefit is payable only when the policy is in force for full sum assured and as such the complainant is not entitled for accidental benefits. 

8.     Thus, as a sequel of above discussion, we do not find any merit in the present complaint and accordingly, the same is hereby dismissed with no order as to costs.  A copy of said order be supplied to the parties free of cost.  File be consigned to record-room after due compliance.      

Announced in open court:

Dated: 06.10.2017.

                                                            (SATPAL)

                                                            PRESIDENT.

 

 

(VEENA RANI SHEOKAND)         (S.C.SHARMA)

MEMBER                                           MEMBER