BEFORE THE DISTRICT CONSUMER DISPUTES
REDRESSAL FORUM, JALANDHAR.
Complaint No.375 of 2016
Date of Instt. 05.09.2016
Date of Decision: 19.09.2017
Navjit Kaur W/o Balwinder Singh R/o H. No.11, Mohalla No.25, Jalandhar Cantt.
..........Complainant
Versus
Life Insurance Corporation Branch CAB Jeevan Jyoti Building 3rd Floor Pucca Bagh Milap Chowk, Jalandhar through its Manager.
….… Opposite party
Complaint Under the Consumer Protection Act.
Before: Sh. Karnail Singh (President)
Sh. Parminder Sharma (Member)
Present: Sh. Robin Budhiraja, Adv Counsel for the complainant.
Sh. MS Sachdev, Adv Counsel for the Opposite Party.
Order
Karnail Singh (President)
1. This complaint presented by the complainant, wherein alleged that the son of the complainant namely Manjit Singh aged about 20 years had unfortunately died in a road side accident on 26.09.2015. The above said road side accident was occurred at the flyover of Lamba Pind, Jalandhar while deceased was coming to home from DAV College on his bike No.PB08-CW-0484. That the FIR No.0216 dated 05.11.2015 has been registered at P.S., Division No.8, Jalandhar, against the unknown vehicle, who had stroked the bike of the deceased son of the complainant. That a LIC policy No.131346821 dated 11.03.2000 of sum assured Rs.50,000/- was holding on the name of above said deceased son of the complainant. The proposer of this LIC policy was Sh. Balwinder Singh, who is the husband of the complainant. When the above said policy was taken by the husband of the complainant on the name of her deceased son Manjit Singh, then at that time, her deceased son was minor nearly age about 5 years.
2. That the mode of payment of above said policy was quarterly installment of Rs.766/- and the date of maturity of the policy was 11.03.2016 and the date of last payment by installment was 11.12.2015. The complainant alongwith his husband paid regularly quarterly installment as mentioned in the policy schedule. After six months of the death of her son, the complainant approached the OP for death claim amount i.e. Rs.1,00,000/-, which is double of sum assured Rs.50,000/- as per rules of LIC policy with all the required documents regarding the policy. The OP has received all the documents and accepted the claim of the complainant and demanded two month procedure time for payment of Rs.1,00,000/-. That after two months from the date of receiving the documents, when the complainant approached the office of OP then at that time, OP has demanded one month more time for payment. In next month i.e. June 2016, the complainant again approached the office of the OP, at that time, OP told the complainant that her claim of Rs.1,00,000/- has not been approved by the Head Office because the deceased son after attaining his majority has not submitted one form that is why Rs.85,000/- was only approved. That submission of that particular document has not been mentioned in the policy. Moreover, neither this thing has been informed by agent at the time of policy framed nor any intimation was given by orally or in writing to the complainant's family by department of the OP. This is the duty of OP to inform the policy holder about the filling of the form, when minor policy holder was being mature. The OP cheated the complainant and also cheated her deceased son by concealing the above said facts. The OP by adopting this illegal tactics used to cheat may be other policy holders as cheated the complainant and her deceased son. The OP has misused his powers and chair, which has given to OP for welfare and helping the general public by Govt. of India. Due to above acts of the OP caused mental tension, pain, agony, harassment, loss of precious time of the complainant for which the complainant is entitled to recover the compensation /damages and litigation expenses etc and further alleged that there is a deficiency in service on the part of the OP and as such the instant complaint filed with the prayer that the complaint of the complainant may be accepted and OP be directed to pass the accidental claim of the complainant i.e. Rs.1,00,000/- and also be directed to pay compensation/damages to the tune of Rs.20,000/- and litigation expenses of Rs.10,000/-.
3. Notice of the complaint was given to the OP, who appeared through his counsel and filed reply, whereby contested the complaint by taking preliminary objections that the complaint is pre-mature, hence the same is liable to be dismissed with special and compensatory costs and 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 stated that till date, no death claim intimation has been served upon the Servicing Branch, so, on this score alone, this complaint is liable to be dismissed 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 and even the complainant has got no locus standi to file the present complaint and the same is liable to be dismissed and further alleged that the complaint is time barred. It is further averred that a policy bearing No.131346821 was taken in the name of Manjot son of Shri Balwinder Singh for a sum assured of Rs.50,000/- and the same was commenced on 11.03.2000 with the Table Term 102-16 and the mode of payment of premium was quarterly and the duration of the policy was 16 years, which was to last in March, 2016. The quarterly premium of the policy was Rs.766/- and the age at the entry, of the life assured was 4 years. As per the facts, which have been mentioned, are that Manjot, Life Assured has died on 26.09.2015. However, the death claim intimation has not so far been received till date, by the Servicing Branch, CAB Jalandhar. The OP is ready to settle the claim for basic sum assured on receipt of all the claim requirements as per the rules and procedure by the CAB. It is to be mentioned herein that the Double Accident Benefit has not been availed by the insured by paying additional premium on attaining the age of majority of the Life Assured, hence as per the terms and conditions of the policy, the Double Accident Benefit is not payable. There is no question of paying any amount or interest or costs because admittedly the application/claim form as per the rules and regulations has not been filed. On merits, the factum in regard to purchase a policy in the name of deceased is not denied but the remaining allegations as made by the complainant is categorically denied and lastly submitted that the complaint of the complainant is without merit and the same may be dismissed.
4. In order to prove the case of the complainant, counsel for the complainant tendered into evidence affidavit of the complainant Ex.C1 and some documents Mark C-2 to Mark C-4 and closed the evidence.
5. Similarly counsel for the OP tendered into evidence affidavit Ex.OP-A alongwith some documents Ex.OP/1 to Ex.OP/3 and closed the evidence.
6. We have heard the learned counsel for the respective parties and also scanned the file very minutely.
7. From the perusal of the pleadings, it reveals that the factum in regard to taking a policy in the name of the deceased Manjit Singh is not denied and as per the insurance policy the sum assured is also admittedly Rs.50,000/- and further it is also not denied by the OP that the insured Manjit Singh has died in road side accident on 26.09.2015 but the plea taken by the OP is only that the complainant is not entitled for double accident benefit as the insured had not paid additional premium on attaining the age of majority and further alleged that the OP is ready to settle the claim for basic sum assured on the receipt of all the claim requirements as per the rules and procedure by the CAB and it is also alleged by the OP that no application/claim form as per the rules and regulations filed by the complainant and in the absence of application/claim form and other required documents, it is not possible for the OP to settle the claim. So, it means that the version of the OP is established because the complainant has not mentioned or explained in the complaint on which date they submitted a claim or intimation in regard to death of the deceased Manjit Singh, even no documents have been placed on file by the complainant to prove that they have ever filed any claim form to the OP. So, with these observations, we find that the claim of the complainant is pre mature because first of all, the complainant has to file a claim form then the same will be settled by the OP and if there is any deficiency for less amount is awarded by the OP, then complainant has right to come in the Consumer Forum.
8. So, in the light of above detailed discussion, we find that the instant complaint of the complainant is dismissed being pre-mature and the complainant is directed to submit a claim form and other required documents to the OP and thereafter the OP will decide the claim of the complainant within two months from the date of receipt and if after settlement of claim, the complainant is not satisfied with the said claim then complainant is at liberty to file a fresh complaint in the Consumer Forum. Parties will bear their own cost. Complaint could not be decided within stipulated time frame due to rush of work.
9. 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 Parminder Sharma Karnail Singh
19.09.2017 Member President
