Haryana

Kaithal

69/21

Sandeep Kumar - Complainant(s)

Versus

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

Sh.Ajay Sharma

06 Jul 2023

ORDER

              BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KAITHAL.

                                                     Complaint Case No.69/2021.

                                                     Date of institution: 17.03.2021.

                                                     Date of decision:06.07.2023.

1. Sandeep Kumar (age 26 years).
2. Ram Mehar sons of Sh. Ram Dayal (age 29 years) r/o House No.343, Assandh Road Village Deoban, Tehsil and District Kaithal.

                                                                        …Complainants.

                        Versus

1. Life Insurance Corporation of India through its Senior Divisional Manager, Division Office Post Box No.106 “Jeewan Parkash”, 489, Model Town, Karnal-132001.
2. Life Insurance Corporation of India through its Chief Manager, BO near Geeta Bhawan Mandir, Kaithal, District Kaithal.

….OPs.

        Complaint under Section 35 of the Consumer Protection Act

CORAM:     SMT. NEELAM KASHYAP, PRESIDENT.

                SMT. SUMAN RANA, MEMBER.

                SH. SUNIL MOHAN TRIKHA, MEMBER.

       

Present:     Sh. Ajay Sharma, Advocate, for the complainants.   

                Sh. Sudeep Malik, Advocate for the OPs.

               

ORDER

NEELAM KASHYAP, PRESIDENT

        Sandeep Kumar and Ram Mehar-Complainants have filed this complaint under Section 35 of Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the OPs.

2.             In nutshell, the facts of present case are that the complainants’ mother namely Bima Devi W/o Ram Dayal (since deceased) had purchased an insurance policy No.146469135, with plan and term T & T; 936-21-15 with half yearly premium and sum assured of Rs.7,00,000/- from the OPs and got herself insured with the Ops by paying an amount of Rs.21,310/- as premium amount.  Unfortunately, the mother of complainants died on 06.08.2020 at her residence due to heart failure.  The complainants lodged the death claim with the Ops and submitted all the necessary documents but the OPs repudiated the claim of complainants vide letter dt. 15.01.2021 on the false ground that the life assured committed suicide and thereafter, the Ops transferred an amount of Rs.15,964/- through NEFT in the joint account of complainants.  The said repudiation of claim is stated to be wrong and illegal.  So, it is a clear cut case of deficiency in service on the part of OPs and prayed for acceptance of complaint.     

3.            Upon notice, the OPs appeared before this Commission and contested the complaint by filing their written version raising preliminary objections with regard to locus-standi; maintainability; cause of action; that there is no deficiency in service on the part of OPs.  The death claim under the policy has been rightly repudiated as the deceased had committed suicide within one year from the date of taking policy.  Thus, the policy became null and void in terms of policy contract and therefore, nothing was payable under the policy except refund of 80% of premiums paid (excluding extra premium) till date of death.  The amount of Rs.15,964/- has been refunded to nominees on 25.01.2021 as per terms and conditions of policy.  On merits, the objections raised in the preliminary objections are rebutted and so, prayed for dismissal of complaint.

4.             To prove his case, the complainants tendered into evidence affidavit Ex.CW1/A alongwith documents Annexure-C1 to Annexure-C15 and thereafter, closed the evidence.

5.             On the other hand, the OPs tendered into evidence affidavit Ex.RW1/A alongwith documents Annexure-R1 to Annexure-R10 and thereafter, closed the evidence.

6.             We have heard the learned Counsel for both the parties and perused the record carefully.

7.             Ld. counsel for the complainants has argued that the complainants’ mother namely Bima Devi W/o Ram Dayal (since deceased) had purchased an insurance policy No.146469135, with plan and term T & T; 936-21-15 with half yearly premium and sum assured of Rs.7,00,000/- from the OPs and got herself insured with the Ops by paying an amount of Rs.21,310/- as premium amount.  It is further argued that unfortunately, the mother of complainants died on 06.08.2020 at her residence due to heart failure.  The complainants lodged the death claim with the Ops and submitted all the necessary documents but the OPs repudiated the claim of complainants vide letter dt. 15.01.2021 on the false ground that the life assured committed suicide and thereafter, the Ops transferred an amount of Rs.15,964/- through NEFT in the joint account of complainants.  It is further argued that the said repudiation of claim is wrong and illegal.  So, it is a clear cut case of deficiency in service on the part of OPs.

8.             On the other hand, ld. counsel for the OPs has argued that the death claim under the policy has been rightly repudiated as the deceased had committed suicide within one year from the date of taking policy.  It is further argued that the policy became null and void in terms of policy contract and therefore, nothing was payable under the policy except refund of 80% of premiums paid (excluding extra premium) till date of death.  The amount of Rs.15,964/- has been refunded to nominees on 25.01.2021 as per terms and conditions of policy.   

9.             We have considered the rival contentions of both the parties.  The main question arises before us for consideration is that whether the OPs have repudiated the claim of complainants vide letter dt. 15.01.2021 as per Annexure-R1 on the ground that the deceased committed suicide within one year from the date of FPR rightly or not?  During the course of arguments, ld. counsel for the OPs has drawn our attention towards the Claim Enquiry Report as per Annexure-R5, wherein in Q.15, it is mentioned that “As reported, the health of the DLA was not good.  She has committed suicide.  But there is no PMR & FIR as told.”  Ld. counsel for the OPs has vehemently contended that vide letter dt. 06.10.2020 as per Annexure-R6, treatment record of Bimla (since deceased) was demanded from the complainant No.1 namely Sandeep but he did not submit the treatment record of Bima with the OPs.  Whereas, on the other hand, in rebuttal, the complainants have placed on file affidavits of Sh. Rajinder son of Sh. Gurdayal Singh, Sarpanch, Gram Panchayat, Deoban, Tehsil & Distt. Kaithal, Sh. Rajinder Kumar son of Sh. Bali Ram, Panch, Gram Panchayat, Deoban, Tehsil & Distt. Kaithal, Ms. Poonam wife of Sh. Dalsher Singh, Panch, Gram Panchayat, Deoban, Tehsil & Distt. Kaithal, Sh. Rohtash son of Sh. Karam Singh, Panch, Gram Panchayat, Deoban and Ms. Pushpa wife of Sh. Sandeep, Panch, Gram Panchayat, Deoban, Tehsil & Distt. Kaithal.  In all the affidavits, they have mentioned that Smt. Bimla Devi wife of Sh. Ram Dayal was permanent resident of Village Deoban, Tehsil and Distt. Kaithal and her death occurred on 06.08.2020 due to heart attack and before her death, there was no serious ailment to her.  All the aforesaid persons are respectable persons of the Village Deoban and they have clearly mentioned in their affidavits that the death of life assured namely Bima occurred due to heart attack.  Moreover, on the other hand, the OPs have not placed on file any medical report or resolution of Gram Panchayat duly signed by Sarpanch or other members that the life assured died due to committed suicide.  Mere allegations are not sufficient, those are necessary to be proved by cogent evidence.  So, we are of the considered view that there is deficiency in service on the part of OPs.

10.            Thus, as a sequel of aforesaid discussion, we direct the OPs to pay the amount of Rs.7,00,000/- alongwith other benefits due, if any, after deducting the amount of Rs.15,964/- which they have already paid to the complainants, to the nominee/complainants within 45 days from today, failing which, they shall be liable to pay interest @ 7% p.a. from the date of this order till its realization.  The OPs are further directed to pay Rs.10,000/- as physical harassment and mental agony as-well-as Rs.5,000/- as litigation charges to the complainant.  Hence, the present complaint is accepted accordingly.

11.            In default of compliance of this order, proceedings against OPs shall be initiated under Section 72 of Consumer Protection Act, 2019 as non-compliance of court order shall be punishable with imprisonment for a term which shall not be less than one month, but which may extend to three years, or with fine, which shall not be less than twenty five thousand rupees, but which may extend to one lakh rupees, or with both.  A copy of this order be sent to both the parties free of cost.  File be consigned to the record room after due compliance.     

Announced in open court:

Dt.:06.07.2023.

                                                                (Neelam Kashyap)

                                                                President.

 

(Sunil Mohan Trikha),           (Suman Rana),          

Member.                            Member.

 

Typed by: Sanjay Kumar, S.G.