NCDRC

NCDRC

FA/1480/2017

SAMUEL MASIH - Complainant(s)

Versus

LIFE INSURANCE CORPORATION OF INDIA & ANR. - Opp.Party(s)

MR. UPDIP SINGH

02 Sep 2024

ORDER

NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION
NEW DELHI
 
FIRST APPEAL NO. 1480 OF 2017
(Against the Order dated 19/05/2017 in Complaint No. 304/2016 of the State Commission Punjab)
1. SAMUEL MASIH
S/O. SH. JAMAL MAISH VILLAGE DIAL BHATT, POST OFFICE GAG GOES MAHAN, TESTILY ANAL
DISTRICT-AMRITSAR
...........Appellant(s)
Versus 
1. LIFE INSURANCE CORPORATION OF INDIA & ANR.
DIVISIONAL OFFICE-4-5, DISTRICT SHOPPING COMPLEX, RAMJET AVENUE AMRITSAR,
PUNJAB
2. M/S. LIFE INSURANCE CORPORATION OF INDIA
THROUGH ZONAL OFFICER, JEEWAN UDYOG BUILDING NEAR BUS STAND, CITY CENTRE SHCME,
AMRITSAR
...........Respondent(s)

BEFORE: 
 HON'BLE MR. SUBHASH CHANDRA,PRESIDING MEMBER
 HON'BLE DR. SADHNA SHANKER,MEMBER

FOR THE APPELLANT :

Dated : 02 September 2024
ORDER

For the Appellant         Mr Updip Singh and Ms Deepinder Kaur

                                Advocates (VC)  

                                      

For the Respondents    Mr Avanish Kumar, Advocate (Physical)           

ORDER

 

PER SUBHASH CHANDRA

 

1.      This appeal under Section 17 of the Consumer Protection Act, 1986 (in short, the “Act”) is directed against the order dated 19.05.2017 of the Punjab State Consumer Disputes Redressal Commission, Chandigarh in Complaint no. 304 of 2016 dismissing the complaint in view of the complexity of facts and the fact that the parties were already litigating the issue before the Civil Court with regard to the claim under the life insurance policies.

2.     We have heard the learned counsel for the parties and perused the records.

3.     The relevant facts of the case, in brief, are that one Mrs Kathreen had purchased the following life insurance policies from the respondent (i) Amulya Jeewan -2 Policy No. 473921231 for a sum assured of Rs 25,00,000/- and (ii) New Jeewan Anand Policy No. 473921231 for Rs.5,00,000/-. After Mrs Kathreen expired, the appellant and her legal heirs are litigating before the Civil Court in the Court of Civil Judge (Junior Division), Ajnala in Civil Suit No. CS/409/2016 in suit titled Baldina Vs. LIC of India. Consumer Complaint No. 304 of 2016 was filed by the appellant herein before the State Commission which was decided on 19.05.2017, on contest, wherein it was held that

“Keeping in view the complexity of facts and the fact that the parties are already litigating before the Civil Court on the issue with regard to the claim of the policies and the law laid down by the Hon’ble National Commission in CITI Communications vs Bank of Rajasthan Ltd., III (2014) CPJ 109 the complaint is dismissed with liberty to the complainant to avail the remedy before appropriate for a”.

This order is impugned before us with the prayer to set it aside and to award the relief prayed for with litigation cost.    

4.      On behalf of the appellant it was argued that Mrs Kathreen, the wife of the appellant had obtained two policies for life insurance on 03.05.2014 from the respondent insurance company with the appellant as her nominee. Due to the death of the Life Assured on 11.09.2014 resulting from electrocution in the bathroom, claims were filed under the Policies which were repudiated by the respondent insurance company. On 14.03.2016 a legal notice was sent to respondent by the appellant and thereafter CC No. 304 of 2016 was filed before the State Commission which was dismissed on 19.05.2016. Alleging arbitrary dismissal of its complaint, appellant has approached us in Appeal. It is submitted that the respondent had settled one Policy No 472947743 and despite several efforts, claims under the two policies in question were not settled. According to the appellant, this constituted deficiency in service and unfair trade practice under the Act apart from mental harassment. Compensation of Rs 5,00,000/- lakhs along with interest @ 18% has therefore been sought apart from Rs 1,00,000/- for mental agony and Rs 22,000/- as litigation costs in addition to the claims under the Policies. According to the appellant the State Commission erred in not acknowledging that he was the nominee and there was no need to implead his daughter in the array of opposite parties. It also erred in going by the evidence by way of affidavit of the Manager (Legal) of the respondents that there was a valid FIR, PMR and PIR with regard to the death of the Life Assured which was not substantiated through proof in the Written Version. According to the appellant the death of the LA was accidental and there was no role of the appellant in it. It was argued that in the absence of any proof or evidence with regard to the involvement of the appellant, the respondent had refused to settle the claim. It was also contended that the Civil Court had also not issued any order restraining the respondents from releasing the claim amounts. It was alleged that the respondents were using coercive tactics which was contrary to the IRDA’s circulars dated 24.09.2015 and 14.12.2023

5.      Per contra, the contention of the respondents is that in view of the early claim preferred in respect of the LA, the matter was investigated as per Section 45 of the Insurance Act. As per the Investigator’s report,

Though the wife the DLA has been insured for a big sum assured of about Rs 31.25 lakh (accidental 36.25 lakhs) in two policies in the year 2014, the husband’s insurance is too meagre and almost negligible as compared to these. The previous life cover of the DLA was just Rs 50,000/-. The husband has been an agent of LIC for several years.

 

The brother of the DLA insists that the claimed death by accidental electric shock has actually been on account of the plotted conspiracy by the husband of the deceased who is also the nominee in the policies to eliminate her to gain from the death claim proceeds. He has been making efforts to get the case reopened by the authorities so that the facts should be established. He maintains that the needful has been done to intimate the Amritsar Police Station (Dehat) by way of a written complaint and action would follow soon. He adds that he has also launched a formal complaint with the authorities concerned in LIC.

 

According to the respondent, one death claim under Policy no. 472947743 was settled. The appellant had approached the Ombudsman who dismissed the complaint vide order dated 14.03.2016 and another complaint to the State Human Rights Commission was also disposed of on 05.05.2015. The appellant’s daughter, Baldina, approached the respondent seeking withholding of the release of the claim amount. The said Baldina had also filed a suit for permanent injunction against payment under the insurance policy to the appellant and had impleaded the respondent. The said matter was pending before the Civil Court. It was denied that the respondent had acted contrary to the policy or the law and that the appellant had signed a discharge voucher voluntarily.

6.      From the foregoing, it is apparent that the State Commission has relied upon the judgement in CITI Communications (supra) wherein it had been held that

It is well settled that any litigant while approaching any judicial fora has to mention the true and correct facts. Suppression of material facts will lead to the dismissal of the petition at the threshold itself. The fora below have given a finding of fact that petitioners had suppressed the material facts about the earlier litigations pending between the parties. Moreover, as per the facts and circumstances of the case petitioners do not fall within the meaning of ‘consumer’ as defined under the Consumer Protection Act 1986 (for short, the ‘Act’).

7.      The State Commission has discussed the complaint on the basis of the fact that the matter involved criminal charges which were beyond the scope of adjudication in summary proceedings under the Consumer Protection Act, 1986. From the record, it is evident that the appellants daughter has filed a case which is pending before the appropriate court. In light of the discussion above and the facts and circumstances of this case, we do not find any reason to disturb the well reasoned finding of the State Commission. The first appeal is accordingly dismissed with liberty to approach the appropriate forum once the civil suit in the matter is finally adjudicated. There shall be no order as to costs.

8.      Pending IAs, if any, also stand disposed with this order.

 
......................................
SUBHASH CHANDRA
PRESIDING MEMBER
 
 
.............................................
DR. SADHNA SHANKER
MEMBER

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