Present (1) Nisha Nath Ojha,
District & Sessions Judge (Retd.) President
(2) Smt. Karishma Mandal,
Member
Date of Order : 30.10.2017
Nisha Nath Ojha
- In the instant case the Complainant has sought for following reliefs against the Opposite parties:-
- To direct the opposite parties to issue certificate of the insurance policy mentioned above in favour of the complainant.
- To direct the opposite parties to pay Rs. 90,000/- ( Rs. Ninety Thousand only ) as compensation and mental agony.
- To direct the opposite parties to pay Rs. 8,000/- ( Rs. Eight Thousand only ) as litigation costs.
- The facts of this case lies in a narrow compass which is as follows:-
The complainant has asserted that she is a senior citizen who purchased a policy under the scheme of money plus from opposite party no. 1. The proposal form of the insurance policy was submitted on 13.08.2007 along with the cheque of Rs. 10,000/-of State bank of India, Patna City drawn in favour of Life Insurance Corporation of India. Thereafter opposite party issued proposal review slip on 14.08.2007. Thereafter medical examiner report and agent report were also issued on the same date as will appear from annexure – 1, 2 and 3.
It is further asserted that the premium of the above mentioned insurance policy amounting to Rs. 10,000/- paid through cheque was debited from the account of the complainant and was encashed in account of Life Insurance Corporation of India but despite repeated request and assurance of the opposite parties the policy certificate was not received by complainant. Then for this purpose the complainant met the opposite party no. 3 time and again lastly opposite party no. 3 denied to issued said certificate and opposite party no. 2 did not respond positively.
The main grievance of the complainant is that despite her best effort opposite party did not intimated or gave any information regarding the issue of certificate.
It goes without saying that in absence of any intimation regarding the issuance of policy certificate the complainant was not able to pay next premium.
On behalf of opposite parties a written statement has been filed admitting the encashment of amount of Rs. 10,000/- submitted through cheque. In Para – 3 and 4 of the written statement the following facts have been asserted, “that since at the time of submission of the proposal in question the age of the complainant/proposer was 63 years, the competent authority did not accept the said proposal and hence the question of issuance of relevant policy bond did not arise.”
“that under the circumstances, the said proposal could not be resulted in the policy and no policy bond was issued to the complainant/proposer.”
On behalf of complainant a rejoinder has been filed stating therein that the opposite party do not reveal the age limit for insurance coverage and issuance of policy certificate and has wrongly stated that the age limit of 63 years because evidently from perusal of insurance policy scheme the age limit under the said insurance policy is 65 years and not 63 years as will appear from annexure – 4 ( annexed in rejoinder petition).
It has been further stated that after encashment of premium amount, no any information about rejection of the policy was provided to the complainant within reasonable time i.e. 30 days as will appear from sec 43 of insurance act and after 5 years the opposite parties offered to return the premium amount which is against law.
Heard the learned counsel for the parties and narrated the facts asserted by both the parties.
The encashment of premium amount of Rs. 10,000/- by opposite parties stands admitted by opposite parties. It is only stated that as the complainant age was about 63 years hence the higher authorities did not approved the issuance of policy certificate.
From bare perusal of annexure – 4 it is crystal clear that maximum age of entry in insurance is 65 years. Apart from it if the higher authority did not approve the issuance of policy certificate to the complainant for her being 63 years of age then it was duty of opposite parties to intimate this fact within reasonable time i.e. 30 days as provided in sec 43 of insurance act but admittedly this has not been done and after several years the opposite parties have offered to return her premium amount which not proper and against the principle of natural justice as well as statute of the insurance law.
For the discussion made above we find and hold that by not intimating the complainant about non approval of policy within 30 days as well as not complying annexure – 4 the opposite parties have committed serious deficiency.
For the discussion made above we direct the opposite parties to issue policy certificate at once latest within the period of two months from the date of receipt of this order or certified copy of this order failing which opposite parties will pay Rs. 50/- ( Rs. Fifty only ) to the complainant for each day delay till its final payment.
The complainant is also directed to comply the terms and conditions of the policy after issuance of policy certificate.
Opposite parties are further directed to pay Rs. 10,000/- ( Rs. Ten Thousand only ) to the complainant by way of compensation and litigation costs within the period of two months.
Accordingly this complaint stands allowed to the extent referred above.
Member President
