Order by:

Sh.Amrinder Singh Sidhu,  President.

1.       The  complainant  has filed the instant complaint under section 35 of Consumer Protection Act, 2019 on the allegations that the Complainant had purchased the policy namely LIC’s New Jeevan Anand (with profits) bearing No. 134180656 from Opposite Parties again premium amount of Rs.53,370/- with sum assured of Rs.10 lakhs and the premium was payable yearly basis. The commencement of the policy was w.e.f. 13.12.2016. Under this policy, the Complainant was insured  upto 13.12.2036 i.e. for 20 years  for LIC’s Accidental death and disability benefits rider, with date of maturity 13.12.2037.  Further alleges that the second premium was due in the month of December, 2017, but due to oversight, the Complainant could not deposit the second premium of the policy in question. Further neither any notice was ever served upon the Complainant by the Opposite Parties for the payment of the premium. In the year 2019, one day, when the Complainant was going through his policy record, he found that he could not deposit the premium due to oversight. The Complainant immediately approached the office of Opposite Party No.1 office and requested to deposit the two due premiums, but the officials of the Opposite Parties refused to accept the premium and informed him that the policy is in lapsed status and premium can not be deposited for the same.  When the officials of the Opposite Parties refused to get deposited the due premiums from the Complainant, then the Complainant asked them to return his amount deposited on account of first premium, but to no effect.  However, thereafter, the Managing Director of LIC Sh.Vipin Anand told the Complainant that the LIC policies can  be revived even when there is a gap of  two years.  The complainant  again visited the 1 again visited the 1 office for the revival of the policy in question, but despite of the repeated requests, the officials of the Opposite Parties refused to entertain his request for the revival of the policy in question. In this regard, recently, the LIC   has offered a unique opportunity to the policy holders i.e. Fantastic opportunity for policy holders as LIC allows  revival beyond 2 years.  As per this opportunity, the Complainant has a right to get the policy in question revived.  Moreover, at the time of issuing the policy in question as mentioned above, alongwith this cover note, the Opposite Parties never issued any terms and conditions of the policy documents and so the alleged  terms and conditions, particularly the exclusion clause of the policy in question is not binding upon the insured. Hence, the repudiation of the claim of the complainant  has been made  by the Opposite Parties on the false and frivolous grounds. Thereafter, the complainant approached the Opposite Parties time and again for revival of the policy and to get deposit the remaining due premiums against the policy in question,  but  the Opposite Parties  flatly refused to admit the rightful claim of the Complainant, as such, there is deficiency in service on the part of the Opposite Parties.  Vide instant complaint, the complainant has sought the following reliefs.

a)       To direct the Opposite Parties to revive the policy in question after deposit the due premiums from the  Complainant and an amount of Rs.2 lakh  be allowed to be paid by the opposite parties on account of compensation due to mental tension and harassment caused by the complainant besides the cost of complaint amounting to Rs.20,000/- or any other relief to which this Hon’ble Consumer Commission, Moga may deem fit be granted in the interest of justice and equity.    Hence, the present complaint.

2.       On notice,  Opposite Party appeared through counsel and contested the complaint  by filing the written version taking preliminary objections therein inter alia that the present complaint is not maintainable; that there is no deficiency in service on the part of the Opposite Party.  It is submitted that the complainant obtained the policy bearing No. 134180656 on 13.12.2016 for a sum assured of Rs.10 lakhs by paying premium of Rs.53,370/- yearly under table term 815/21/21 for a term of 21 years. First unpaid premium under the policy is on 12/2017. At the time of taking of said policy, the policy holder did not disclose about his previous policy  No. 134179084 obtained fro Opposite Parties on 28.07.2016 which was also for a sum assured of Rs.10 lakhs. As and when, the Opposite Parties came to know about the previous policy, it immediately wrote a  registered letter  dated 28.09.2017 to the complainant calling for special reports which were required before the completion of fresh proposal as the sum assured of both the policies were to be considered by clubbing the amount of sum assured under both the policies as per rules, but the complainant did not respond to the letter due to which, the Opposite Party suspended  the risk under the said policy so that the policy holder can not  continue with the same. The present status of the policy is ‘PURIFCN OFF’ i.e. risk coverage suspended. In response to letter dated 28.09.2017 calling for special reports, the policy holder responded on 01.08.2019 that he could not complete the test reports and requested to cancel the policy and refund of the premium amount under policy No. 134180656 by enclosing his canceled cheque No.000016 alongwith letter. As the time period as on letter dated 01.08.2019 was beyond the  cooling off or free look period, the premium amount could not be refunded as per the policy condition.            On merits, Opposite Parties took up the same and similar pleas as taken up by them on the preliminary objections.    All other allegations made by the complainant are totally wrong and specifically denied and it is, therefore, prayed that the present complaint is not maintainable and the same deserves dismissal.  

3.       In order to prove his case, the complainant has tendered into evidence his affidavit Ex.C1 alongwith copies of documents Ex.C2 to Ex.C10 and closed his evidence.

4.       On the other hand, to rebut the evidence of the complainant, Opposite Parties tendered  into evidence affidavit of Sh.Ramesh Kumar Manager (Legal) Ex.Ops1 & 2/A alongwith copy of document Ex.OP1 & 2/B to Ex.OP1 & 2/M and closed the evidence. 

5.       We have heard the ld.counsel for the parties  and also gone through the documents placed on record.

6.       During the course of arguments, ld.counsel for the complainant as well as ld.counsel for Opposite Party have  mainly reiterated the facts as narrated in the complaint as well as written reply respectively. We have perused the rival contentions of the parties and also gone through the record on file. The main contention of the complainant is that in the year 2019,  when the Complainant was going through his policy record, he found that he could not deposit the premium due to oversight. The Complainant immediately approached the office of Opposite Party No.1 office and requested to deposit the two due premiums, but the officials of the Opposite Parties refused to accept the premium and informed him that the policy is in lapsed status and premium can not be deposited for the same.  When the officials of the Opposite Parties refused to get deposited the due premiums from the Complainant, then the Complainant asked them to return his amount deposited on account of first premium, but to no effect. On the other hand, ld.counsel for the Opposite Parties has repelled the aforesaid contention of the ld.counsel for the complainant on the ground that admittedly, the complainant obtained the policy bearing No. 134180656 on 13.12.2016 for a sum assured of Rs.10 lakhs by paying premium of Rs.53,370/- yearly under table term 815/21/21 for a term of 21 years. First unpaid premium under the policy is on 12/2017. At the time of taking of said policy, the policy holder did not disclose about his previous policy  No. 134179084 obtained from Opposite Parties on 28.07.2016 which was also for a sum assured of Rs.10 lakhs. As and when, the Opposite Parties came to know about the previous policy, it immediately wrote a  registered letter  dated 28.09.2017 to the complainant calling for special reports which were required before the completion of fresh proposal as the sum assured of both the policies were to be considered by clubbing the amount of sum assured under both the policies as per rules, but the complainant did not respond to the letter due to which, the Opposite Party suspended  the risk under the said policy so that the policy holder can not  continue with the same. The present status of the policy is ‘PURIFCN OFF’ i.e. risk coverage suspended. In response to letter dated 28.09.2017 calling for special reports, the policy holder responded on 01.08.2019 that he could not complete the test reports and requested to cancel the policy and refund of the premium amount under policy No. 134180656 by enclosing his canceled cheque No.000016 alongwith letter. As the time period as on letter dated 01.08.2019 was beyond the  cooling off or free look period, the premium amount could not be refunded as per the policy condition.  To prove its assertion, the Opposite Parties has proved on record the policy document Ex.Ops1 & 2/B alongwith its terms and conditions,  copy of  status report of policy in question Ex.Ops 1 & 2/C and D, copy of registered letter dated 28.09.2017 written by the Opposite Parties to the complainant Ex.Ops1 & 2/E, copy of letter written to Branch Manger, B.O.Moga dated 08.11.2017 regarding the suspension of risk under the policy in question Ex.OP1 & 2/F, letter written by the complainant to Branch Manager of Opposite Parties Ex.OP1 & 2/G, copy of cancelled cheque Ex.OP1 & 2/H, copy of NEFT mandate form Ex.OP1 & 2/I, copy of policy Ex.OP1 & 2/J, copy of guidelines Ex.OP1 & 2/K.  Moreover, the complainant was having sufficient time to revive the policy in question, because as the time period as on letter dated 01.08.2019 was beyond the  cooling off or free look period, the premium amount could not be refunded as per the policy condition.    On the other hand, the complainant has failed to rebut these documents by producing any iota of evidence with regarding to make any request for the revival of the policy in question with the requisite time as framed under the guidelines of IRDA and hence, we hold that there is no deficiency in service on the part of the Opposite Parties.               

7.       Hence, keeping in view the facts and circumstances of the case, we find no merit in the complaint and the same stands dismissed. Keeping in view the peculiar circumstances of the case, the parties are left to bear their own costs. Copies of the order be furnished to the parties free of cost. File be consigned to record room after compliance.

8.       Reason for delay in deciding the complaint.

This complaint could not be decided within the prescribed period because the government has not  appointed any of the Whole Time Member in this Commission for about 3 years i.e. w.e.f. 15.09.2018 till 27.08.2021 as well as due to pandemic of COVID-19.

Announced in Open Commission.