Tamil Nadu

North Chennai

95/2014

Ms.M.Misha,D/o.Mohanan - Complainant(s)

Versus

Manager, LIC of India, - Opp.Party(s)

V.Balamurugan

23 Dec 2016

ORDER

 

 

                                                            Complaint presented on:  16.05.2014

                                                                Order pronounced on:  23.12.2016

 

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, CHENNAI (NORTH)

    2^nd Floor, Frazer Bridge Road, V.O.C.Nagar, Park Town, Chennai-3

 

PRESENT: THIRU.K.JAYABALAN, B.Sc., B.L.,        PRESIDENT

                    TMT.T.KALAIYARASI, B.A.B.L.,           MEMBER II

 

FRIDAY THE 23^rd DAY OF DECEMBER 2016

 

C.C.NO.95/2014

 

 

Ms.M.Misha,

D/o. Mohanan,

9/3, 1^st Street,

Charles Nagar,

Chennai – 600 019.

                                                                                            ..... Complainant

 

..Vs..

	1.Manager (CRM), LIC of India, Divisional Office, C.47, II Avenue, Anna Nagar Plaza, Anna Nagar, Chennai – 600 040.   2.Branch Manager, LIC of India, Thiruvottiyur Branch, No.85-A, T.H.Road,   Chennai – 600 019.
	.....Opposite Parties

Date of complaint                                  22.05.2014

Counsel for Complainant                      : Mr.V.Balamurugan

Counsel for opposite parties                      : P.K.Ilavazhagan

 

 

O R D E R

 

BY PRESIDENT THIRU. K.JAYABALAN B.Sc., B.L.,

          This complaint is filed by the complainant u/s 12 of the Consumer Protection Act.1986.

1.THE COMPLAINT IS IN BRIEF:

          The Complainant brother M.Monojkumar taken a Life Insurance Policy, vide policy No.719593426 and 10.07.2011 through the agent N.V.Remya. The Complainants minor daughter P.Janushka  is the nominee for the said policy. The policy is for 25 years and risk coverage period commenced from 30.07.2011, the date which insured paid first premium. The sum assured under main plan is Rs.5,00,000/- and the sum assured under accident benefit is Rs.5,00,000/-. The premium for main plan is Rs.5,694/- and the premium for the accident benefit is Rs.725/- totaling a sum of Rs.6,419/- per quarterly and grace period of 30 days is also given for the payment of quarterly premium, the 1^st quarter from commenced from 30.07.2011. The Complainant paid 3 premiums continuously and the premium for 4^th quarter for the period 30.04.2012 to 29.07.2012. Unfortunately the said insured M.Manojkumar was died on 18.05.2012 in a motor accident. After the demise of the Complainant’s brother she approached the 2^nd Opposite Party and submitted claims application on 09.01.2013. There was no response for nearly six months and finally a letter dated 10.06.2013 received by the Complainant was informed that the policy stands lapsed on the date of death. Thereafter, the Complainant filed a petition dated 27.06.2013 to the insurance ombudsman and on his advise she sent a petition dated 16.07.2013 to the Zonal Manager, Zonal Office LIC building Chennai with a copy to Senior Divisional Manager. However the Complainant have not received any reply from the said Manager more than 8 months and hence the Complainant filed this Complaint for the deficiency and unfair trade practice committed by the Opposite Party for not settling the claim. The Complainant seeking relief to settle her the policy amount of Rs.10,00,000/- with compensation for mental agony with cost of the Complaint.

2. WRITTEN VERSION OF THE OPPOSITE PARTIES IN BRIEF:

          The Opposite Party admits that late M.Manoj Kumar had taken an Insurance policy bearing No-719593426 with the 2^nd Opposite Party under which he had nominated minor. P.Janushka and further to receive policy during minority of nominee, the Complainant here in was the appointee named in the policy. The said Insurance policy was taken by the Complainant for a sum of Rs.5,00,000/-. Under the said policy, the date of commencement was 10.07.2011 and the date of maturity is 10.07.2036. The payment of premiums are payable every quarterly i.e. on  10^th  July, October, January and April every year. As per policy conditions (2), a grace period of one month but not less than 30 days will be allowed for payment of yearly, half-yearly or quarterly mode of premium payment. If death occurs within this period and before the payment of the premium then due, the policy will still be valid and the sum assured is paid after deduction of the said premium as also unpaid premium is not paid before the expiry of the days of grace, the policy lapses. The first unpaid premium under the policy was due on 04/2012, wherein the last due 01/2012 had been paid on 01.02.2012. The policy has a grace period of 30 days for payment of premium. Since the grace period of 30 days for 04/2012 due was over by 10.05.201, the policy was in lapsed condition as on the date of death of life assured Mr.M.Manoj Kumar on 18.05.2012. Hence nothing is payable under the said policy as per the policy conditions. The Opposite Parties deny that the premium due dates commenced from 30.07.2011. The column No-2 of the policy clearly reveals that the date of commencement of policy is 10.07.2011. Due date 10^th and the mode of payment is quarterly. Therefore the duration for the quarterly dues as stated in para 4 of the Complaint is denied.  The date of commencement of policy is 10.07.2011 and as per the option exercised by the Life assured in his proposal form dated 29.07.2011. Further the Complainant was informed on 10.06.2013 itself that there is no claim liability as the policy stands lapsed as on the  date of death without acquiring any paid up value. There is no dereliction or Deficiency in Service on their part and the grace period of 30 days was over for 04/2012 due on 10.05.2012 and the policy was in lapsed condition as on the date of death of the life assured. Under these circumstances, the Opposite Parties submit that the claim of the Complainant under the policy was not maintainable as the policy lapsed prior to the death of life assured and accordingly the Opposite Parties are not liable to pay any amount under the policy and the Complainant is not entitled to any money under the lapsed policy. It is therefore prayed that this Hon’ble forum may be pleased to dismiss the above Complaint as devoid of merits and prays to dismiss the Complaint with costs.

3. POINTS FOR CONSIDERATION

          1. Whether there is deficiency in service on the part of the opposite parties?

          2. Whether the complainant is entitled to any relief? If so to what extent?

 

 

 

4. POINT NO :1

          The Complainant brother M.Monojkumar   applied through Ex.B1 proposal form to issue policy to him, as per his request Ex.B2 policy was issued to him and the said policy copy also filed by the Complainant in the Ex.A1 reply letter of the Opposite Party. The policy No. is 719593426. In the proposal form itself the Complainant mentioned that the policy dated back, indicate date 10.07.2011. In the policy date of commencement is 10.07.2011, date of commencing of risk 30.07.2011, date of maturity 10.07.36 and the premium for main plan is Rs.5,694, accident benefit  premium is Rs.725/- and thus total premium is Rs.6,419 and the sum assured for main plan is Rs.5,00,000/- and accident benefit sum assured is Rs.5,00,000/-. In the mode of payment of premium is quarterly and the due date is 10^th of quarterly month. As per Ex.B1 proposal form and Ex.B2 policy the quarterly premium is due on 10^th date of the commencing of the quarterly period. The conditions and the privileges enclosed in the Ex.B2 policy. In condition No:2 payment of premium has been dealt as follows:

2. payment of premium: A grace period of one month but not less than 30 days will be allowed for payment of yearly, half-yearly or quarterly premiums. If death occurs within this period and before the payment of the premium then due, the policy will still be valid and the sum Assured is paid after deduction of the said premium as also unpaid premiums falling due before the next anniversary of the policy. If the premium is not paid before the expiry of the days of grace, the policy lapses.

As per above condition from the due date the payment of premium   accepted for next 30 days.

          5. Admittedly the Complainant has paid three quarterly premiums to the Opposite Party. The Complainant pleaded in the Complaint that the 4^th quarter commenced from 30.04.2012 to 29.07.2012 has to be paid on or before 30.05.2015 but unfortunately the said insured  M.Monojkumar   died on 18.05.2012  and since the premium due to pay even after his death i.e till 30.05.2012 the Complainant is entitled for sum assured as per the policy and therefore the Opposite Party rejected the claim of the Complainant and sent Ex.A1 letter is not sustainable and by rejecting such claim the Opposite Party committed Deficiency in Service.

          6. The Complainant himself indicated in the Ex.B1 proposal form that the policy is  dated back, indicate date as 10.07.2011 and in the Ex.B1 policy also it is clearly mentioned the due date of premium is 10^th of commencing of the quarterly period. Therefore the 4^th quarter commencing from 10.04.2012 to 19.07.2012 and for the said period the new date of premium is due on 10.04.2012. As per Ex.B2 conditions of the policy, the grace period 30 days is given to the Complainant is due to pay on or before  09.05.2012 and only after such due date the insured met with an accident on 18.05.2012 and died. Therefore the contention of the Complainant that he has time to pay the 4^th quarter premium till 30.05.2012 is not accepted. Since the Complainant has not paid the 4^th quarter premium as indicated above, the Complainant is not entitled for sum assured as per Ex.B1 policy and the Opposite Party has not committed any deficiency in rejecting the claim of the Complainant and therefore we hold that the Opposite Party has not committed any Deficiency in Service to the Complainant.

 

 

 

7.POINT :2

Since the Opposite Parties have not committed any deficiency in service, the complainant is not entitled for any relief as prayed in the complaint and the complaint is liable to be dismissed.

          In the result the complaint is dismissed. No costs.

Dictated to the Steno-Typist transcribed and typed by her corrected and pronounced by us on this 23^rd   day of December 2016.

 

MEMBER – II                                                               PRESIDENT     

LIST OF DOCUMENTS FILED BY THE COMPLAINANT:

Ex.A1 dated 10.06.2013                   Reply letter

Ex.A2 dated 27.06.2013                   Claim submitted to Insurance Ombudsmen

Ex.A3 dated 16.07.2013                   Representation to Zonal Manager

Ex.A4 dated 22.07.2013                   Reply letter from Regional Manager, CRM

LIST OF DOCUMENTS FILED BY THE OPPOSITE PARTIES :

Ex.B1 dated NIL                     Proposal for Insurance on own life

Ex.B2 dated NIL                     LIC’s new Jeevan Share – 1

Ex.B3 dated 30.07.2011                   Counterpart

 

 

 

MEMBER – II                                                               PRESIDENT