BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, MOGA.
Complaint No.12 of 2015
Instituted On:05.02.2015
Decided On: 18.05.2015.
Amarjit Kaur aged about 62 years wife of Balwinder Singh, Mudki Road, Village Nathuwala Garbi, District Moga.
……..Complainant
Versus
Life Insurance Corporation of India, G.T. Road, Moga through its Manager.
……… Opposite Party
Complaint under Section 12 of the
Consumer Protection Act, 1986.
Coram: Sh.S.S.Panesar, President
Smt Vinod Bala, Member
Smt. Bhupinder Kaur Mamber
Present: Sh. Ashok Sharma Advocate Cl. for the complainant.
Sh. Vaneet Jaidka Adv. Cl. for the opposite party
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ORDER
(S.S.Panesar, President)
The complainant has filed the present complaint under Section 12 of the Consumer Protection Act, 1986 (herein-after referred to as ‘Act’) against Life Insurance Corporation of India, G.T. Road, Moga, through its Manager (herein-after referred to as ‘opposite party) directing it to pay Rs.5,00,000/- as sum assured on account of death of insured Bikramjit Singh alongwith interest @12% per mensum, Rs.1,00,000/- as compensation for causing mental tension and harassment besides Rs.25,000/- as litigation expenses and also to grant any other relief to which this Forum may deem proper.
2. Brief facts of the complaint are that deceased Bikramjit Singh son of complainant was insured with the opposite party for a sum of Rs.5,00,000/- vide policy No.133711093 and a sum of Rs.1,00,000/- vide policy No.133344802. Bikramjit Singh expired on 27.05.2014. After his death, complainant being the nominee of deceased Bikramjit Singh approached the opposite party for availing the claim. However, the opposite party made a payment of Rs.1,00,000/- with regard to policy No.133344802 but the opposite party did not make the payment of Rs.5,00,000/- regarding the other policy. The complainant approached opposite party for a number of times to get the claim amount but to no avail. Due to non release of claim amount by the opposite party, the complainant is suffering from mental, physical harassment and economic
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loss. Hence the present complaint.
3. Notice of the complaint was given to the opposite party. Opposite party appeared through counsel namely Sh. Vaneet Jaidka, Advocate and filed written reply contesting the same. Opposite party took
up preliminary objections that the present complaint is false and frivolous; that there is no deficiency in service; that deceased Bikramjit Singh son of the complainant was insured under policy No.133711093, which was valid from 11.06.2013 for Rs.5,00,000/-, who died in Dubai on 27.05.2014. As per death claim intimation letter form No.3783, 3785 death notification issued by Ministry of Health, United Arab Emirates, death certificate issued by Consulate General of India and other relevant documents the cause of death of insured was reported as ‘Asphyxia’ caused by hanging due to suicide committed by life insured. The claim was got investigated by opposite party, who found that the cause of death in this case was due to suicide. The policy in question had run only for 11 months & 16 days and in this case as the suicide clause was applicable, as per policy conditions the claim was repudiated being an early death claim in the standing committee of opposite party on 11.02.2015. Vide registered letter dated 16.02.2015, the intimation regarding repudiation of claim was given to the complainant. On merits, the preliminary objections have been reiterated and the allegations of the complaint have been denied and a prayer for dismissal of complaint with costs has been made.
4. In order to prove her case, counsel for the complainant
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tendered in evidence affidavit of the complainant Ex. C-1 and copies of documents Ex. C-2 to Ex. C-13 and closed the evidence.
5. To rebut the evidence of the complainant, counsel for the opposite party tendered affidavit of H.S. Gupta, Manager Ex. OP-1 along with copies of documents Ex. OP-2 to Ex. OP-10 and closed evidence on behalf of opposite party.
6. We have heard the learned counsel for the parties and have also carefully gone through the record.
7. The learned counsel for the opposite party has vehemently contended that there is no doubt that Bikramjit Singh son of the complainant was insured with the opposite party vide policy No.133711093 for a sum of Rs.5,00,000/-, copy of the insurance policy accounts for Ex. C-2. It is also not disputed that Bikramjit Singh committed suicide in Dubai. Since the insurance policy No.133711093 commenced w.e.f. 11.06.2013 and the insured committed suicide on 27.05.2014, therefore, the policy in question had run for a period of eleven months and sixteen days only. In view of Condition No.7 of the insurance policy, the claim of the complainant has rightly been repudiated because the insured committed suicide within a period of one year of the commencement of the policy. It is further contended that the claim of the complainant has rightly been repudiated under the terms and conditions of the policy in dispute and no fault can be found with the repudiation order, copy whereof Ex. O.P./10.
8. On the other hand, the learned counsel for the complainant has
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vehemently contended that no doubt insurance policy in dispute was issued on 11.06.2013. But, however, the insurance policy in dispute commenced w.e.f. 22.05.2013 as per agreement reached between insurer and the insured i.e. parties to the insurance agreement. Even, if the stand of the opposite party is treated to be correct, even then the insurance policy having commenced w.e.f. from 28.05.2013 and therefore, the suicide has been committed on 27.05.2014, shows that it has been committed after the lapse of one year of the commencement of the policy. It is further contended that the Condition No.7 has been wrongly applied to in the case of the complaint by wrongly interpreting the provisions. It is a fit case where the claim of Rs.5 lacs on the basis of the insurance policy No.133711093 is liable to be granted in favour of the complainant alongwith compensation to the tune of Rs. One lac for causing mental tension, harassment and agony, besides Rs. 25,000/- as costs of the litigation.
9. We have given thoughtful consideration to rival contentions.
10. It is admitted case of the parties that Bikramjit Singh son of Amarjit Kaur resident of Mudki Road, Village Nathuwala Garbi, District Moga was insured with the opposite party for a sum of Rs.5 lac. vide policy No.133711093, copy of the insurance policy accounts for Ex.C-2. It is also admitted that Bikramjit Singh had died on 27.05.2014 in Dubai. It is also not disputed that Bikramjit Singh committed suicide, copy of the death certificate accounts for OP/7. The bone of contention inter-se parties had been regarding the commencement of the insurance policy in dispute. It is
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the case of the complainant that since the insurance policy commenced w.e.f. 28.05.2013 and the insured having died on 27.05.2014, therefore, he had died after the lapse of one year of the commencement of the policy. On the other hand, it is the contention of the opposite party that the insurance cover commenced from w.e.f. 11.06.2013 i.e. on issue of the insurance policy, therefore, the insured died within a period of less than an year from the commencement of the policy. Therefore, as per Condition No.7 of the Insurance cover, claim of the complainant has rightly been repudiated. In the case in hand the sole contention inter-se parties relate to the question of date of commencement of the insurance policy. To solve this riddle, reliance can be had on Life Insurance Corporation of India Versus Surat Mal Tak R.P. No 41 of 2007 decided on 10.01.2011 by the Hon’ble National Consumer Disputes Redressal Commission, New Delhi, wherein it has been laid down that in the present case the policy was issued on 21.03.1996 and the insured had committed suicide on 08.03.1997 i.e. within one year of the commencement of the policy. Clause 6 of the policy would be squarely applicable and the respondent would not be entitled to the insured amount as the insured had committed suicide within one year of the taking of the policy. Further reliance can be had on Life Insurance Corporation of India & Anr. Vs. Dharam Vir Anand (1998) 7 SCC 348, wherein it has been laid down that relevant date for the purpose of suicide claim is the date on which the policy had been issued and not the date on which the risk under the policy had commenced by way
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of allowing it to be dated back.
11. Applying the ratio of the law laid down in the judgments (supra), no fault can be found with the repudiation order passed by the opposite party. It is no where disputed that the insured committed suicide within one year of the commencement of the insurance policy and the insurance policy in dispute in this case commenced w.e.f. 11.06.2013 i.e. the date on which insurance policy was issued. The insured committed suicide on 27.05.2014 i.e. within a period of one year of the commencement of the insurance cover and therefore, as per Condition No.7 of the insurance policy, the insured/complainant was not entitled to receive the insured amount. Condition No.7 of the insurance policy is reproduced as under for ready reference:-
“Suicide This policy shall be void if the Life Assured commits suicide (whether sane or insane at the time) at any time on or after the date on which the risk on the policy has commenced but before the expiry of one year from the date of commencement of risk under the policy and the Corporation will not entertain any claim by virtue of this policy except to the extent of third party’s bonafide beneficial interest acquired in the policy for valuable consideration of which notice has
been given in writing to the office where this policy is serviced, at least one calendar month prior to death”
12. Taking the case from any angle, the complaint as framed, is
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not maintainable. The claim of the claimant has rightly been repudiated. Instant complaint is nothing, but an abuse of process of the law. As such the instant complaint fails and the same is ordered to be dismissed. Copies of the order be sent to the parties free of cost immediately and thereafter the file be consigned to the record room.
(Bhupinder Kaur) (Vinod Bala) (S.S.Panesar)
Member Member President
Announced in Open Forum.
Dated:18.05.2015.
