Delhi

StateCommission

CC/601/2019

SH. ANIL KUMAR RAJPUT - Complainant(s)

Versus

M/S AVIVA LIFE INSURANCE CO. INDIA LTD. - Opp.Party(s)

YASHVANT SINGH

12 Jul 2019

ORDER

IN THE STATE COMMISSION : DELHI

(Constituted under Section 9 of the Consumer Protection Act, 1986)

Date of Arguments :12.07.2019

Date of order :30.07.2019

COMPLAINT NO.601/2019

In the matter of:

 

Shri Anil Kumar Rajput,

S/o. Shri G.S. Rajput,

R/o. H.No.1`27, Pocket-E,

Mayur Vihar, Phase-II,

Near Sanjay Lake,

•  

 

Versus

 

M/s. Aviva Life Insurance Company India Ltd.,

IInd Floor, Prakash Deep Building,

7 Tolstoy Marg,

New Delhi-110001.……Opposite Party

 

 

CORAM

Hon’ble Sh. O. P. Gupta, Member (Judicial)

1.     Whether reporters of local newspaper be allowed to see the judgment?                                                      Yes/No

2.      To be referred to the reporter or not?                                                                                                           Yes/No

Shri O.P. Gupta, Member (Judicial)

JUDGEMENT

1. The present complaint at the stage of admission is based on the averments that wife of the complainant purchased policy/ term  plan no.00125011 commencement w.e.f.13.07.12 for Rs.50 lakhs from OP. Before purchasing policy OP got various extensive and elaborate medical tests conducted from their referred diagnostic centre. OP charged premium of Rs.11,102/-. On 06.01.15, suddenly due to  recurrent seizures with recurrent vomiting with cough, she was admitted in Kailash Hospital & Heart Institute, Noida. Her condition deteriorated as on 13.01.15 she was declared dead due with  aspiration pneumonia with ICSOL with seizure disorder. Complainant is nominee of  his wife. He filed death claim with the OP. His claim was repudiated by OP vide letter dated 20.03.15 with the reason that insured was diagnosed of intracranial space occupying lesion (brain tumer), prior to signing proposal form.
2. The complainant filed review application which was also declined vide letter dated 24.06.16. The wife of the complainant was  diagnosed with the said disease for the first time when she was admitted in  hospital in 06.01.15. No treatment was taken earlier for the said disease by the insured. Therefore the question of concealing fact does not arise. Legal notice dated 22.04.17  was served which was replied vide letter dated 12.06.17. Hence this complaint for directing OP to pay Rs.50 lakhs which is the value of the policy and interest @24% per annum. He has also prayed for compensation of Rs.5 lakhs for mental and physical harassment, mental pain and agony, cost of litigation have also been claimed.
3. I have gone through the material on record and heard for the purpose for admission. Death took place on 13.01.15, OP repudiated the claim vide letter dated 20.03.15.,It is mentioned in para-5 of the complaint. Review application was declined vide letter dated 24.06.16 as mentioned in para-6 of the complaint. Complaint has been filed on 11.06.19 which is much beyond the period of two years prescribed under Section 24(A) Consumer Protection Act.
4. The counsel for the complainant submitted that the OP replied legal notice, vide reply on dated 12.06.17. From that  day the complaint is within limitation. He wanted to urge if the OP had not sent any reply, the complaint would have been time barred. But when the OP sent the reply denying the claim of the complainant, a fresh cause of action has arisen.
5. I am afraid if the argument can be accepted. Reply to legal notice does not constitute any fresh cause of action. The cause of action accrued on repudiation of claim vide letter dated 20.03.15. The complaint is bitterly barred by limitation and the same is dismissed in limine.
6. Copy of the order be sent to both the parties free of cost.
7. File be consigned to record room.

                                        

(O.P. GUPTA)                                                     

MEMBER (JUDICIAL)