Chandigarh

DF-I

CC/520/2018

Mrs. Saroj - Complainant(s)

Versus

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

Jatinder Pal Singh

13 Jan 2020

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM-I,

U.T. CHANDIGARH

 

                    

Consumer Complaint No.	:	CC/520/2018
Date of Institution	:	18/10/2018
Date of Decision	:	13/01/2020

 

 

Mrs. Saroj widow of Mr. Raju (since deceased) resident of House No.1844, Sector 52, Chandigarh.

… Complainant

V E R S U S

1. Max Life Insurance Co. Ltd., Plot No.90A, Sector 18, Gurugram, Haryana through its authorized signatory.
2. The Branch Manager, Max Life Insurance Company Ltd., Regd. Office : 419, Bhai Mohan Singh Nagar, Rallmajra, Tehsil Balachaur, District Nawanshahar, Punjab.
3. The Branch Manager, Max Life Insurance Company Ltd., SCO No.36-37-38, Madhya Marg, Sector 8C, Chandigarh.

… Opposite Parties

CORAM :	SHRI RATTAN SINGH THAKUR	PRESIDENT
	MRS. SURJEET KAUR	MEMBER
	SHRI SURESH KUMAR SARDANA	MEMBER

                                               

ARGUED BY	:	Sh. Jatinder Pal Singh, Counsel for complainant
	:	Sh. Nitesh Singhi, Counsel for OPs

 

Per Rattan Singh Thakur, President

1.      In brief the allegations are, the deceased Sh. Raju, husband of the complainant, on 17.11.2017, had obtained a 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/-. Her husband, deceased Sh. Raju had expired on 13.3.2018 and the complainant (widow), being nominee under policy, had submitted the original policy bond on 5.7.2018 to OPs. However, more documents were sought which were submitted, but, the complainant had received part of the amount i.e. Rs.14,072/- only on 24.7.2018 in her account maintained with Axis Bank. Subsequent thereto, notice was issued, however, her claim was not acceded to. It was repudiated by the OPs on the ground, policy had lapsed on January 15, as such, there was no coverage on the date of death i.e. 13.3.2018. Maintained, said ground is incorrect as duration for which premium received was 1.3.2018 to 31.3.2018. As such, it tantamounts to deficiency in service. Hence, the complainant filed present consumer complaint and prayed for refund of the remaining assured amount alongwith interest, compensation quantified to the tune of Rs.5.00 lakhs and litigation charges of Rs.2.00 lakhs.
2.     OPs filed their joint written reply, contested the consumer complaint and raised the plea, parties are bound by the terms and conditions of the policy. The claim of the OPs is, next premium due was 15.1.2018 which was not deposited as it was bounced due to insufficient balance in his account. The agreed grace period was 15 days which means it was to be deposited on or before 31.3.2018 while the life assured expired on 13.3.2018 and the policy had lapsed. On these lines, the cause is sought to be defended.
3.     Replication was filed and averments made in the consumer complaint were reiterated.
4.     Parties led evidence by way of affidavits and documents.
5.     We have heard the learned counsel for the parties and gone through the record of the case. After appraisal of record, our findings are as under:-
6.     Per pleadings of the parties, the case of the complainant is, he had paid two monthly installments in advance and another installment in December 2017 in total three installments, therefore, policy was still subsisting. Part of Annexure C-4 is payment acknowledgement receipt, which shows policy was operative from 17.11.2017 and the amount received was Rs.9,405/-.  Therefore, these were two installments. While in the written statement there is clarification, the last premium was received in the month of November 2017, post that two premiums were received which were post death and as such, complainant is not entitled for any benefits under the policy because the policy in question stood lapsed on the date of death. This reply seems to be probable as in the contingency of death in a particular month, premium was deemed to have been deposited in advance. 
7.     Not only this, there is another life insurance premium receipt dated 10.12.2017 in which it was mentioned premium is received from 15.11.2017 to 14.12.2017. This document has come from the possession of the complainant admitting it to be genuine. It is a relied on document of the complainant which shows the last premium paid was upto 14.12.2017, therefore, the next premium due on 15.12.2017. The said premium was not paid upto 31.12.2018, though the admitted grace period was 15 days as per the documents and pleadings of the parties. Thus, this policy appears to have been lapsed on 1.1.2018 while the life assured died on 13.3.2018. 
8.     Our attention was also drawn to life insurance premium receipt at page 23 which shows the duration for which premium is received 1.1.2018 to 31.3.2018 and the date of deposit of the premium is 31.3.2018.  This shows, the premium was due on 1.1.2018 which was paid on 31.3.2018 and the date of death of Sh. Raju is 13.3.2018 which means on the date of deposit i.e. 31.3.2018 he had already expired and the policy was in a lapsed state and the question of its revival does not arise as the grace period had already expired on 1.1.2018 and even this amount was not deposited by the deceased, Sh. Raju but by some other person on his behalf when he had already died and during his life time the policy had lapsed. Hence, this receipt at page 23 dated 31.3.2018 of the premium amount from 1.1.2018 to 31.3.2018 will not come to the rescue of the nominee of the life assured i.e. the present complainant. The calculation as argued on behalf of the complainant is erroneous. It is self contradictory and premium on behalf of deceased, Sh. Raju was deposited from 1.1.2018 to 31.3.2018 and at that time he had already expired on 13.3.2018 and this is just to hoodwink the Insurance Company and to submit the claim as if the policy was in a running mode and had not lapsed. 
9.     A perusal of Annexure C-5 also shows vide this communication the claim of the complainant was repudiated on the ground policy had expired on 15.1.2018 even if the grace period is counted from 15.1.2018. Not only this, so much so, Annexure R-3 dated 30.11.2018 issued by the OPs shows it was a policy lapsed intimation and last premium shown to have been due on 15.1.2018 and the policy had lapsed on 30.1.2018 and he was accordingly intimated. Even within the grace period, the amount was not deposited. Annexure R-4 is again a policy lapsed intimation dated 30.4.2018 which also shows intimation was sent qua the policy having been lapsed even after the alleged deposit of three installments on 31.3.2018 and at that time the life assured had already expired. Annexure R-8 is the intimation letter dated 28.7.2018 which shows the premium was due on 15.1.2018 and since the renewal premium was not paid, the policy lapsed on expiry of the grace period of 15 days which had expired within a fortnight to be computed from 15.1.2018. 
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.
11.     Certified copies of this order be sent to the parties free of charge. The file be consigned.

	Sd/-	Sd/-	Sd/-
13/01/2020	[Suresh Kumar Sardana]	[Surjeet Kaur]	[Rattan Singh Thakur]
hg	Member	Member	President