Chandigarh

StateCommission

A/115/2021

Mrs Saroj Widow - Complainant(s)

Versus

Max Life Insurance Co. Ltd. - Opp.Party(s)

Ajay bhardwaj, Rahul Dev Singh Adv.

06 Apr 2023

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION, U.T. CHANDIGARH

[ADDITIONAL BENCH]

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Appeal No	:	A/115/2021
Date  of  Institution	:	22/12/2021
Date   of   Decision	:	06/04/2023

 

 

 

 

 

Saroj widow of Raju [since deceased], resident of House No.1844, Sector 52, Chandigarh.

…. Appellant

 

V E R S U S

 

[1]    Max Life Insurance Co. Limited, Plot No.90-A, Sector 18, Gurugram, Haryana, through its Authorized Representative.

 

[2]    The Branch Manager, Max Life Insurance Co. Limited, Regd. Office: 419, Bhai Mohan Singh Nagar, Rallmajra, Tehsil Balachaur, District Nawanshahar, Punjab.

 

[3]    The Branch Manager, Max Life Insurance Co. Limited, SCO 36-37-38, Madhya Marg, Sector 8-C, Chandigarh.

…… Respondents

 

BEFORE:   MRS. PADMA PANDEY       PRESIDING MEMBER

          PREETINDER SINGH        MEMBER

 

PRESENT	:	Sh. Gurjot Singh, Advocate for the Appellant.
		Sh. Nitesh Singhi, Advocate for the Respondents.

 

PER PREETINDER SINGH, MEMBER

 

 

This appeal is directed against the order dated 13.01.2020, rendered by the District Consumer Disputes Redressal Commission-I, U.T. Chandigarh (for brevity hereinafter to be referred as “the Ld. Lower Commission”), vide which, it dismissed the Consumer Complaint bearing no.CC/520/2018, in the following terms:-

“10. In view of the abovesaid record, we derive the conclusion, policy had already lapsed during the lifetime of deceased Sh.Raju. As such, the claim was rightly repudiated and action of the OPs does not in any way tantatmount to deficiency in service. The complaint being meritless is accordingly dismissed, leaving the parties to bear their own costs.

 

2.      Before the Ld. Lower Commission, it was the case of the Appellant/ Complainant that on 17.11.2017 her deceased husband namely, Sh.Raju took Max Life Monthly Income Advantage Plan covering the minimum risk of his life upto the amount of Rs.9,28,160.39 on monthly premium of Rs.4,702/-. It was averred Sh.Raju expired on 13.3.2018 and the complainant (widow), being nominee under policy, had submitted the original policy bond on 05.07.2018 to OPs, who sought some more documents, which were accordingly submitted. However, when the Appellant/complainant received a meagre amount of Rs.14,072/- only on 24.07.2018, she got served a legal notice upon the Respondents/OPs. However, the Respondents/OPs repudiated her claim on the ground that policy had lapsed on January 15 and as such, there was no coverage on the date of death i.e. 13.03.2018. Hence, the aforesaid Consumer Complaint was filed before the Ld. Lower Commission, alleging deficiency in service and unfair trade practice on the part of the Respondents/Opposite Parties.

 

3.      Upon notice, the Respondents/OPs resisted the consumer complaint on the ground that parties are bound by the terms & conditions of the policy. It was asserted that the next premium due was 15.01.2018, which was not deposited as it was bounced due to insufficient balance and the agreed grace period was 15 days which means it was to be deposited on or before 31.03.2018 while the life assured expired on 13.03.2018 and the policy had lapsed. On these lines, the cause was sought to be defended and a prayer for dismissal of the Complaint was made.

 

4.      On appraisal of the pleadings and the evidence adduced on record, Ld. Lower Commission dismissed the consumer Complaint of the Appellant/ Complainant, as noticed in the opening para of this order.     

 

5.      Aggrieved against the aforesaid order passed by the Ld. Lower Commission, the instant Appeal has been filed by the Appellant/Complainant.

 

6.      We have heard the Learned Counsel for the Parties and have gone through the evidence and record of the case, along with written arguments advanced on behalf of the Appellant/Complainant,  with utmost care and circumspection.

 

7.      The core question that falls for consideration before us is as to whether the Ld. Lower Commission has rightly passed the impugned order by appreciating the entire material placed before it. 

 

8.      After giving our thoughtful consideration, to the contentions raised and material on record, we are of the considered opinion, that the instant Appeal is liable to be dismissed for the reasons to be recorded hereinafter.

 

9.      It is evident from the payment acknowledgement receipt (Annexure C-4) that the policy was operative from 17.11.2017 and the amount received was Rs.9,405/-.Ld. Counsel for the Appellant/Complainant submitted that the life assured/deceased (husband of the Complainant) paid total three premiums, therefore, policy was subsisting. However, we are not impressed with the same, in as much as, the premium receipts available on record showed, the last premium was received in the month of November 2017 and thereafter, two more premiums were received by the Respondents/OPs which were post death and as such, the claim of the Appellant/Complainant was rejected since the policy in question was in lapsed state on the date of death.  In this backdrop, on the strength of premium receipt, placed on record by the Appellant/ complainant herself, the Ld. Lower Commission has rightly observed that the duration for which the premium received was from 15.11.2017 to 14.12.2017 and therefore, the next premium due on 15.12.2017, which was not paid upto 31.12.2018, though the admitted grace period was 15 days as per the documents.

 

10.      Ld. Counsel for the Appellant/ Complainant further submitted that the Ld. Lower Commission while dismissing the Complaint has erroneously recorded its findings relying upon life insurance premium receipt dated 31.03.2018. However, we do not find any merit in the same, in as much as, the duration for which premium received was from 01.01.2018 to 31.03.2018 and the date of deposit of the premium is 31.03.2018 and not as sought to be projected by the Ld. Counsel for the Appellant/ Complainant i.e. March1808 (8^th March 2018). 
11.      At any rate, the premium was due on 01.01.2018 which was paid on 31.03.2018 and the date of death of the life assured (Sh.Raju) was 13.03.2018, which clearly showed that on the date of deposit i.e. 31.03.2018 the life assured had already expired and the policy was in a lapsed state. The Ld. Lower Commission has, therefore, righty held that question of the revival does not arise as the grace period had already expired on 01.01.2018 and even the said amount was not deposited by the deceased/life assured (Sh.Raju), but by some other person on his behalf. Hence, to our mind, the premium payment receipt dated 31.03.2018 heavily relied upon by the Appellant/Complainant to contend that the policy was not in a lapsed state, would be of any help to her.

 

12.      For the sake of repetition, it is relevant to point out here that there are ostensible contradictions between the submissions put forth on behalf of the Appellant/complainant and the premium receipt dated 31.03.2018 (for the duration 01.01.2018 to 31.03.2018), as by the said date the life assured had already expired on 13.03.2018. The Ld. Lower Commission has thus rightly observed that this was just to hoodwink the Respondent/OP (Insurance Company) and to submit the claim as if the policy was in a running mode and had not lapsed. Eventually, in order to straighten the things and set rest the controversy involved, the Ld. Lower Commission validly noted the documentary evidence available on record i.e. Annexure C-5, Annexure R-3, Annexure R-4 and Annexure R-8 in para 9 of its order to conclude that the policy had already lapsed during the lifetime of deceased Sh.Raju and the claim was rightly repudiated and action of the Respondents/OPs does not in any way tantatmount to deficiency in service.

 

13.      In nutshell, the Ld. Lower Commission while rejecting the claim of the Appellant/Complainant has rightly held that there was no deficiency in service or unfair trade practice on the part of the Respondents/OPs. To our mind, no case is therefore made for any interference in the findings recorded ibid by the Ld. Lower Commission. 

 

14.      No other point was urged, by the Ld. Counsel for the Parties.

 

15.      It is demonstrable from a reading of the impugned Order of the Ld. Lower Commission that it is certainly not an order passed without reasons or without applying the judicious mind. The facts and circumstances of the case have been gone into, weighed and considered, and due analysis of the same has been made. It also does not appear to be an order passed without taking into account the available evidence.

 

16.      In the wake of the position, as sketched out above, we are dissuaded to interfere with the impugned order rendered by the Ld. Lower Commission. The appeal being bereft of merit is accordingly dismissed and the order of the Ld. Lower Commission is upheld.

 

17.      The pending application(s), if any, stand disposed off in terms of the aforesaid order.

 

18.      Certified copies of this order be sent to the parties free of charge.

 

19.      The file be consigned to Record Room, after completion.

Pronounced

06^th Apr., 2023                                

Sd/-

                                  (PADMA PANDEY)

PRESIDING MEMBER

 

 

Sd/-

(PREETINDER SINGH)

MEMBER

“Dutt”