Chandigarh

DF-I

CC/152/2021

Dr Inusha Panigrahi - Complainant(s)

Versus

Manager, MAX Life Insurance Co. Ltd. - Opp.Party(s)

S.P Yadav

17 May 2023

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-I,

U.T. CHANDIGARH

 

                    

Consumer Complaint No.	:	CC/152/2021
Date of Institution	:	8.3.2021
Date of Decision	:	17.5.2023

 

Dr. Inusha Panigrahi, Professor and In-charge of Genetic Metabolic Unit, Department of Pediatrics and Advance Pediatrics Centre (APC), PGIMER, Chandigarh permanent resident of house No.3169, Sector 27, Chandigarh PIN Code 160027.

.

… Complainant

V E R S U S

1. Manager, MAX LIFE Insurance Co. Ltd. SCO 36-37-38, Madhya Marg, Sector-8, Chandigarh PIN Code 160019.
2. General Manager, Max Life Insurance Company Limited, 3^rd, 11^th and 12^th floor, DLF Square Building, Jacaranda Marg, DLF City Phase-II, Gurugram (Haryana)-122002.
3. Chairman Insurance Regulatory and development authority of India 9^th floor, United India Towers, Basheerbagh, Hyderabad, Telangana, PIN Code 500029.

 .  … Opposite Parties

 

CORAM :	PAWANJIT SINGH	PRESIDENT
	SURJEET KAUR SURESH KUMAR SARDANA	MEMBER MEMBER

                       

ARGUED BY		Sh. S.P. Yadav counsel for complainant alongwith complainant in person. Sh. Nitesh Singhi counsel for OPs No.1&2. OP No.3 exparte.

Per surjeet kaur, Member

1. Briefly stated the complainant purchased two policies bearing No.355497876 i.e. Whole Life Participation to Age 100 and 429128440 i.e. Max Life Smart Invest Pension-Fund Coverage  with a intention to cover and secure the life risk of the complainant as well as fulfill all the obligation and duties towards the family. The premium of the said policies were to be paid through ECS mode. It is alleged that suddenly the complainant received a cheque of Rs.426/-   from the  Insurance company mentioning that the policy No.355497876 i.e. Whole Life Participation to Age 100 got lapsed in 2012.  It is stated that the Bank of the complainant wherein the salary of the complainant is credited clarified that there is no fault at their end. It is alleged that the policy has been intentionally made  lapsed by the OPs insurance company with a intention to grab the premium of Rs.49,998/-  and also to run away from the liability of the sum assured to the tune of Rs.7,70,175/-.  The complainant approached the OPs many a time to redress his grievance and even sent legal notice dated 9.2.2021 but to no avail. Alleging the aforesaid act of Opposite Parties deficiency in service and unfair trade practice on their part, this complaint has been filed.
2. The Opposite Parties NO.1&2 in their  reply stated that the  complainant purchased the policy in question at her own sweet will and without any pressure. All the benefits under the policy are governed under the insurance agreement/settlement terms and conditions, which cannot be violated by the either of parties.  It is denied that the OPs have intentionally made the policy in question lapsed and averred that the complainant be put to strict proof to prove the alleged allegations. Denying any deficiency  in rendering service on its part  all other allegations made in the complaint has been  denied being wrong.
3. OP No.3 did not turn up despite due service, hence vide order dated 11.06.2021 it was proceeded against exparte.
4. Complainant chose not to file rejoinder.
5. Contesting parties led evidence by way of affidavits and documents.
6. We have heard the learned counsel for the contesting parties and gone through the record of the case.
7. The sole grouse of the complainant through  the present complaint is that her policy  Whole Life Participation to Age 100  having coverage of Rs.7,70,175/-  was kept in lapse mode illegally by the OPs No.1&2 despite receiving regular premiums.  The premiums of the said policy was paid through ECS mode  but as per allegation of  the complainant she received  a cheque of Rs.426/-  (Annexure C-1)  from the OPs No.1&2 Insurance company intimating her that her policy got lapsed in the year 2012.
8. The stand taken by the OPs No.1&2 is that the complainant purchased  the policy at her own choice  and as per terms and conditions only the same kept in the lapsed mode. Hence, there is no deficiency on the part of the OPs No.1&2.
9. After going through the documents on record it is abundantly clear from the affidavit of the complainant that she took the policy in question in the year 2008 and premium thereof was paid through ECS mode w.e.f. 1.12.2008 to 1.8.2012 as is also apparent from the statement of accounts placed on record by the complainant. But the OPs for the reasons best known to them kept the policy in question, in lapsed mode on 1.2.2012.
10. The OPs have not clarified the reasons as to why the policy was kept on lapsed mode but during the oral arguments it was argued by the counsel for the OPs No.1&2 that it was a technical error. Even no clarification with regard to the amount of Rs.426/- sent to the complainant was given.  It is a matter of fact that it is duly admitted by the OPs  No.1&2 that the complainant paid amount of Rs.49,998/- towards the premium of the policy in dispute  and as on today the policy is in lapsed mode.
11. In view of foregoing we are of the opinion that the act of the OPs  No.1&2 for not providing proper services and forcing the complainant to indulge in the present unnecessary litigation proves deficiency in service on their part.  
12. In view of the above discussion, the present consumer complaint succeeds and the same is accordingly allowed. OPs No.1&2 are directed as under:-

1. to refund the premium amount  of Rs.49,998/- to the complainant with interest @9% P.A. from the date of keeping the policy in lapse mode till realization.
2. to pay 50,000/- to the complainant as compensation for causing mental agony and harassment to him;
3. to pay Rs.20,000/- to the complainant as costs of litigation.

13.      This order be complied with by the OPs No.1&2 within thirty days from the date of receipt of its certified copy, failing which, they shall make the payment of the amounts mentioned at Sr.No.(i) & (ii) above, with interest @ 12% per annum from the date of this order, till realization, apart from compliance of direction at Sr.No.(iii) above.
14. Complaint qua OP No.3 stands dismissed.  
15.      Certified copies of this order be sent to the parties free of charge. The file be consigned

			sd/- [Pawanjit Singh]
			President
			Sd/-
			[Surjeet Kaur] Member   Sd/-
			[Suresh Kumar Sardana]
mp			Member