BEFORE THE DISTRICT CONSUMER DISPUTES

REDRESSAL COMMISSION, JALANDHAR.

Complaint No.09 of 2020

      Date of Instt. 08.01.2020

      Date of Decision: 09.02.2021

Meena Kumari aged 23 years wife of late Shri Gurpreet Singh S/o late Shri Teja Singh R/o House No.6/2643, Mohalla Udham Singh Nagar, Tehsil Nakodar, District Jalandhar.

..........Complainant

Versus

1.       Life Insurance Corporation of India, Branch Manager/Senior    Branch Manager, Opposite Bus Stand, Nakodar, District    Jalandhar-144040

2.       Life Insurance Corporation of India, Branch Manager/Senior    Branch Manager, [Main Branch] Pucca Bagh, Milap Chowk, Jalandhar-144001

3.       Life Insurance Corporation of India, Corporate Office,    Yogakshema Building, West Wing, Zonal Office, Jeevan Bima      Marg, P. O. Box No.19953, Mumbai 400021, Maharashtra.

….….. Opposite Parties

Complaint Under the Consumer Protection Act.

Before:        Sh. Kuljit Singh             (President)

Smt. Jyotsna                   (Member)

Present:       Sh. Gurpreet Rai, Adv. Counsel for the Complainant.

                   Sh. M. S. Sachdev, Adv. Counsel for the OPs No.1 to 3.

 Order

Kuljit Singh (President)

1.                The instant complaint has been filed by the complainant, wherein alleged that the complainant purchased an insurance policy from OP No.1 vide Policy No.134299772 and the policy commencement/proposal date was 07.04.2017, for a sum assured of Rs.2,00,000/- with a frequency annual payment/installment premium of Rs.10,602/-. The maturity date of the policy was 07.04.2038. The complainant is the nominee in the said insurance company, being the wife of the late Shri Gurpreet Singh. That unfortunately the complainant’s husband died a natural death on 27.12.2018. That even as per the proposal application form was filled up by the agent of the OPs according to the rules and regulations to which the husband of the complainant was neither having any illness or was suffering from any disease, disability etc. nor was any bad habit of smoking, drinking etc. The husband of the complainant was an able bodies person and was having a very good health.

2.                That at the time of taking insurance policy, the OPs representative assured the complainant and her husband that in the event of death full amount of insurance cover will be given to the nominee, in this case the complainant. That the information regarding death of the husband of the complainant was given to the OPs on February 2019 alongwith the death certificate of the husband of the complainant and other relevant documents, but nothing was done by the OP. Thereafter, the matter was taken up with the head office number of time, but no reply or insured amount was given to the complainant. The facts and circumstances narrated in the complaint prima facie proves that there was a serious deficiency on the part of the OPs in rendering proper service to the complainant and the officials of the OPs acted negligently and carelessly in details with the case of the complainant and as such, necessity arose to file the present complaint with the prayer that the complaint of the complainant may be accepted and OPs be directed to pay insured amount of Rs.4,00,000/- against the insured policy and further OPs be directed to pay compensation of Rs.50,000/- for causing mental tension and harassment to the complainant and Rs.15,000/- as litigation expenses alongwith interest @ 18% per annum.

3.                Notice of the complaint was given to the OPs, who filed reply and contested the complaint by taking preliminary objections that the present complaint is not maintainable and the same is liable to be dismissed with special and compensatory costs. The brief facts of the case, which would facilitate this Forum to dismiss the present complaint are as follows, That as per record of the OPs, Sh. Gurpreet Singh had taken a policy bearing No.134299722 for a sum assured of Rs.2,00,000/- by paying a yearly premium of Rs.10,602/- on 07.04.2017. However, the said insurance policy stands lapsed due to unpaid premium which was due for 04/2019 and the present status of the said policy is “Lapsed-Wout”. The branch office Nakodar of the OPs has not received any intimation with regard to death of the policy holder or claim papers till date. This consumer complaint itself is pre-mature and is liable to be dismissed. Even otherwise, the policy has already been lapsed and on this score alone, this complaint as such, is not maintainable and the same is liable to be dismissed with costs. It is further alleged that no ground is made out for allowing this complaint, so on this score alone, this complaint is liable to be dismissed with costs and further alleged that no cause of action has accrued to the complainant to file the present complaint and as such, the same is liable to be dismissed with special and compensatory costs. That complainant has got no locus-standi to file the present complaint and the same is liable to be dismissed and further alleged that there is no deficiency in service nor there is any ground for allowing this complaint, hence on this score alone, this complaint is liable to be dismissed with costs. On merits, the factum in regard to purchased of insurance policy by the complainant is admitted, but the other allegations as made in the complaint are categorically denied and lastly submitted that the complaint of the complainant is without merits, the same may be dismissed.

4.                Rejoinder to the written statement filed by the complainant, whereby reasserted the entire facts as narrated in the complaint and denied those of the written statement.

5.                In order to prove their respective versions, both the parties produced on the file their respective evidence alongwith documents at the time of filing the complaint.

6.                We have heard the learned counsel for the respective parties and have also gone through the case file as well as written arguments submitted by counsel for the complainant, very carefully.

7.                Precisely, the case of the complainant is only that she had purchased an insurance policy from OP No.1 for a sum assured of Rs.2,00,000/- with a frequency annual payment/installment premium of Rs.10,602/- and the maturity of the policy was 07.04.2038, copy of the insurance policy is Ex.C-1 and unfortunately, the complainant’s husband died on 27.12.2018, copy of the death certificate is Ex.C-3 and at the time of taking policy, the OPs representative assured the complainant and her husband that in the event of death full amount of insurance cover will be given to the nominee, but the OPs failed to do so and as such, the present complaint filed by the complainant.

8.                On the other hand, the OPs admitted that the complainant purchased an insurance policy for a sum assured of Rs.2,00,000/- by paying a yearly premium of Rs.10,602/- on 07.04.2017, but the said insurance policy stands lapsed due to unpaid premium which was due for 4/2019 and the present status of the said policy is “Lapsed Wout” and further submitted that the OPs has not received any intimation with regard to death of the policy holder or claim papers till date.

9.                To prove the case of the complainant, the counsel for the complainant produced on the file affidavit of the complainant Ex.CA, Copy of Computerized Slip of insurance policy Ex.C-1, Copy of Aadhar Card Ex.C-2, Copy of Death Certificate of Gurpreet Singh Ex.C-3 and Copy of insurance policy Ex.C-4.

10.              To rebut the evidence of the complainant, the counsel for the OPs produced on the file one affidavit of Harmesh Chander, Manager (Legal & HPF) Ex.OP-1/A, wherein he submitted in Para No.2 of preliminary objections that the branch office Nakodar of the OPs has not received any intimation with regard to death of the policy holder or claim papers till date.

11.              After considering the overall facts and circumstances, one thing is clear that the death of complainant’s husband occurred on 27.12.2018, copy of death certificate is Ex.C-3. But if we see the claim form, then one thing is clear that the claim form is not properly filled by the complainant, in Column No.3 simply mentioned the hospital name ‘Kamal Hospital, Nakodar’ without any slip and secondly, the claim form is not exhibited. In the rejoinder the complainant submitted that the OPs and his agents deny the request of death claim of complainant’s husband and ultimately, the complainant filed the consumer complaint. No doubt, the complainant has brought on the file claim form, but it has not been acknowledged by any of the official of the OPs. If the insurance claim has not been filed by the complainant with all the details like hospital details, then how she can say there is any negligence, unfair trade practice on the part of the OPs. So, accordingly, we find that the complaint of the complainant is premature and accordingly, the complainant is directed to file insurance claim alongwith all the relevant documents and also fulfill the requisite formalities and thereafter, the OPs will settle the claim of the complainant according to terms and conditions. The complainant will submit the claim form and other documents as well as fulfill the formalities and thereafter, the OPs will take 30 days to settle the claim of the complainant on either side and after that, if the complainant will not satisfy with the settlement of the claim by OPs, then the complainant has liberty to file a fresh complaint and accordingly, this complaint is disposed off. This complaint could not be decided within stipulated time frame due to rush of work.

12.               Copies of the order be supplied to the parties free of cost, as per Rules. File be indexed and consigned to the record room.

Dated                                       Jyotsna                           Kuljit Singh

09.02.2021                              Member                          President