DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, PUNJAB.

 

Complaint Case No : CC/208/2022

Date of Institution   : 12.09.2022

Date of Decision    : 24.04.2024

 

Vipan Singla son of Raj Kumar Singla resident of H.No. B-XI-985, Gali No. 4, K.C. Road, Barnala, District Barnala, Punjab.          

                          …Complainant Versus

M/s Life Insurance Corporation of India, Opp. Improvement Trust Barnala Office, Near Fuwara Chowk, Barnala, through its Branch Manager.  

                              …Opposite Party

Complaint Under Section 35 of Consumer Protection Act, 2019.

Present: Sh. R.K. Singla counsel for complainant.

Sh. J.R. Garg counsel for opposite party.

Quorum:-

1. Sh. Jot Naranjan Singh Gill : President

2.Smt. Urmila Kumari : Member

 

ORDER

JOT NARANJAN SINGH GILL, PRESIDENT

1. The present complaint has been filed under Section 35 of the Consumer Protection Act 2019, (amended upto date) against M/s Life Insurance Corporation of India (hereinafter referred as opposite party).  

2. The facts leading to the present complaint are that the father of the complainant purchased Wealth Plus Plan on 31.3.2010 vide insurance policy No. 164710466 from the opposite party and nominated the complainant in the said policy. As per policy the insured has to deposit an installment of Rs. 50,000/- continuously for 3 years and the father of the complainant deposited the same on 31.3.2010, 29.3.2011 and 24.3.2012 and the father of the complainant was insured for sum of Rs. 2,50,000/- which five times annualized premium i.e. Rs. 50,000/- per annum which would have been payable on any unforeseen event and the opposite party also would have issued units against the deposit of premium. It is further alleged that on maturity the unit value would have been paid to the insured. But the opposite party neither issued the units nor issued the insurance as per plan to the father of the complainant. Thereafter, the father of the complainant approached the opposite party many times to get the detail of units allotted and copy of insurance policy, but all in vain. Ultimately on 16.5.2018 the father of the complainant wrote a letter to the opposite party to get the detail of units and to get the maturity value of the units and further asked to get the insurance policy as per the scheme. On this the opposite party wrote an undated registered letter but neither gave detail of units nor issued the insurance policy. As per the said letter the opposite party said that the insured will get the maturity amount of allotted units and also mentioned that according to terms and conditions of the policy the risk cover of the insured under the policy will remain intact for two years after the payment of maturity amount. Thereafter, the father of the complainant received a detail of allotted units i.e. 4247.825, 4668.243 and 5031.063 totaling 13947.131 and surprised to note that the opposite party has deducted many units without mentioning any reason and justification. The opposite party mentioned that the insured has 6582.212 units and paid the maturity value of Rs. 1,13,258/- only on 25.9.2020 through NEFT. It is further alleged that on 28.12.2020 unfortunately the father of the complainant died and the complainant submitted claim form alongwith desired documents for the settlement of claim to the opposite party to get the insured amount of Rs. 2,50,000/- and also asked for maturity value of deducted units i.e. 7364.919. The opposite party avoided the complainant on one pretext or the other and ultimately on 20.8.2022 flatly refused to accede the request of the complainant. Thus, the above said act and conduct of the opposite parties falls under the deficiency in service and unfair trade practice on the part of opposite party. Hence, the present complaint is filed for seeking the following reliefs.- 

i)To pay a sum of Rs. 2,50,000/- the insured amount alongwith interest @ 18% per annum from the date of payment till realization. 

ii)To pay the maturity amount of balance 7364.919 units, alongwith interest @ 18% per annum from the date maturity till realization. 

iii)To pay  Rs. 50,000/- as mental agony and harassment and 11,000/- as litigation expenses.   

3. Upon notice of this complaint, the opposite party appeared and filed written version taking preliminary objections interalia on the grounds that the complainant has no locus-standi to file the present complaint. The present complaint is wholly misconceived, groundless and unsustainable in law. The present complaint is baseless and is flagrant abuse of the process of law. It is submitted that due claim under the policy No. 164710466 has already been disbursed to the claimant as per terms and conditions of the policy. The complainant has not come with clean hands. The present complaint is not maintainable being time barred. It is submitted that no claim has been lodged by the complainant or the deceased Life assured with the opposite party as on due date of maturity 28.3.2018 but filed the same on 9/2020 and maturity claim was paid on 25.9.2020 to the father of the complainant. 

4. On merits, it is admitted to the extent that father of complainant purchased Wealth Plus Plan (801-08-03) under Policy No. 164710466 and had deposited yearly premium of Rs. 50,000/- for three years i.e. total amount of Rs. 1,50,000/- was deposited. It is further submitted that it was a unit linked plan and in case of maturity claim the policyholder was eligible for bid value (number of units available in your account as on date of maturity X net asset value as on date of maturity) and units under the policy were subject to deduction of (i) Premium Allocation Charges, (ii) Mortality Charges (iii) Policy administration Charges (iv) Service Tax Charges (v) Misc. Charges as per condition 5 of the policy mentioned on the policy bond and accordingly the units available under the policy for realization @ Rs. 15.4619 were 6582.212 as on date of maturity. So, the payment of the maturity claim comes to Rs. 101774/- (No. of Units-6582.212 X NAV-15.4619). It is further submitted that the opposite party has also paid interest of Rs. 12,415/- on delayed claim payment and deducted the Income Tax of Rs. 931/- on the same and hence total amount of claim came to Rs. 1,13,258/- which was paid as maturity claim to the father of the complainant. It is admitted that the father of the complainant was insured for Rs. 2,50,000/- upto 28.3.2020 as extended risk cover period of 2 years from the date of maturity i.e. 28.3.2018 as mentioned on the policy schedule itself under Clause (b)-Death Benefits on page No. 2. It is further submitted that the policy was purchased on 31.3.2010 and the date of maturity was 28.3.2018 but even after the date of maturity the complainant's father had not deposited the relevant/requisite documents with the opposite party for release of maturity claim amount. Thereafter, on 25.9.2020 the payment was made on complainant's father depositing the relevant documents and the same was received without any protest by the father of the complainant. The policy was got matured on 31.3.2018 and as per terms and conditions of the policy the risk coverage under the policy remained intact for extended period of two years from the date of maturity i.e. 31.3.2018 till 28.3.2020 as mentioned on the second page of the policy bond under the clause(b)-Death Benefit. In the instant case father of complainant died on 28.12.2020 i.e. after the expiry of period of two years from the date of maturity and termination of the risk cover on 28.3.2020, as such the legal heirs of the deceased life assured are not entitled to any claim whatsoever under the policy. The date of payment maturity claim has no relevancy but the extended risk cover starts from the date of maturity till the expiry of two years i.e. 28.3.2020. Hence, there is no deficiency in service on the part of opposite party and prayed for the dismissal of complaint with heavy costs. 

5. Ld. Counsel for the complainant has suffered statement that I do not want to file any rejoinder on behalf of complainant. 

6. To prove the case the complainant tendered into evidence his own affidavit Ex.C-1, copies of premium receipts Ex.C-2 to Ex.C-4, copy of letter dated 16.5.2018 Ex.C-5, copy of letter regarding wealth plus plan Ex.C-6, copy of statement of account Ex.C-7 (containing 2 pages), copy of statement of account of PNB Ex.C-8 (containing 2 pages), copy of death certificate Ex.C-9 and closed the evidence. 

7. To rebut the case the opposite party tendered into evidence copy of maturity claim payment dated 25.9.2020 Ex.O.P-1 (containing 2 pages), copy of status report of policy Ex.O.P-2, copy of claim payment voucher Ex.O.P-3, copy of receipt Ex.O.P-4 (containing 2 pages), copy of cancelled cheque Ex.O.P-5, copy of acknowledgment receipt of NEFT dated 25.9.2020 Ex.O.P-6, copy of maturity claim dated 19.5.2018 Ex.O.P-7 (containing 2 pages), copy of terms and conditions Ex.O.P-8 (containing 3 pages), copy of policy Ex.O.P-10 (containing 2 pages), affidavit of Rajesh Bhatia Ex.O.P-11 and closed the evidence. 

8. We have heard the learned counsel for the parties and have gone through the record on file. 

9. Ld. Counsel for complainant argued that the complainant purchased Wealth Plus Plan on 31.3.2010 vide insurance policy No. 164710466 from the opposite party and nominated the complainant in the said policy and as per policy the insured has to deposit an installment of Rs. 50,000/- continuously for 3 years and the father of the complainant had deposited the same on 31.3.2010, 29.3.2011 and 24.3.2012 (Ex.C-2 to Ex.C-4) and the father of the complainant was insured for sum of Rs. 2,50,000/- which five times annualized premium i.e. Rs. 50,000/- per annum which would have been payable on any unforeseen event and the opposite party also would have issued units against the deposit of premium. It is further argued that on maturity the unit value would have been paid to the insured but the opposite party neither issued the units nor issued the insurance as per plan to the father of the complainant. It is also argued that on 16.5.2018 the father of the complainant wrote a letter (Ex.C-5) to the opposite party to get the detail of units and to get the maturity value of the units and further asked to get the insurance policy as per the scheme and on this the opposite party wrote an undated registered letter Ex.C-6 but neither gave detail of units nor issued the insurance policy and as per the said letter the opposite party said that the insured will get the maturity amount of allotted units and also mentioned that according to terms and conditions of the policy the risk cover of the insured under the policy will remain intact for two years after the payment of maturity amount. It is argued that the father of the complainant received a detail of allotted units (Ex.C-7) i.e. 4247.825, 4668.243 and 5031.063 totaling 13947.131 and surprised to note that the opposite party has deducted many units without mentioning any reason and justification and the opposite party mentioned that the insured has 6582.212 units and paid the maturity value of Rs. 1,13,258/- only on 25.9.2020 through NEFT (Ex.C-8). It is further argued that on 28.12.2020 (as per Ex.C-9) unfortunately the father of the complainant died and the complainant submitted claim form alongwith desired documents for the settlement of claim to the opposite party to get the insured amount of Rs. 2,50,000/- and also asked for maturity value of deducted units i.e. 7364.919, but the opposite party avoided the complainant on one pretext or the other and ultimately on 20.8.2022 flatly refused to accede the request of the complainant. 

10. Ld. Counsel for the opposite party argued that the due claim under the policy No. 164710466 has already been disbursed to the claimant as per terms and conditions of the policy (as per Ex.O.P-1). It is further argued that no claim has been lodged by the deceased Life assured with the opposite party as on due date of maturity 28.3.2018 but filed the same on 9/2020 and maturity claim was paid on 25.9.2020 to the father of the complainant. It is further argued that it was a unit linked plan and in case of maturity claim the policyholder was eligible for bid value (number of units available in your account as on date of maturity X net asset value as on date of maturity) and units under the policy were subject to deduction of (i) Premium Allocation Charges, (ii) Mortality Charges (iii) Policy administration Charges (iv) Service Tax Charges (v) Misc. Charges as per condition 5 of the policy mentioned on the policy bond and accordingly the units available under the policy for realization @ Rs. 15.4619 were 6582.212 as on date of maturity, so the payment of the maturity claim comes to Rs. 101774/- (No. of Units-6582.212 X NAV-15.4619) and the opposite party has also paid interest of Rs. 12,415/- on delayed claim payment and deducted the Income Tax of Rs. 931/- on the same and hence total amount of claim came to Rs. 1,13,258/- which was paid as maturity claim to the father of the complainant (as per Ex.O.P-2 & Ex.O.P-3). It is further argued that the policy was purchased on 31.3.2010 and the date of maturity was 28.3.2018 but even after the date of maturity the complainant's father had not deposited the relevant/requisite documents with the opposite party for release of maturity claim amount and on 25.9.2020 the payment was made on complainant father depositing the relevant documents and the same was received without any protest by the father of the complainant. It is also argued that the policy was got matured on 31.3.2018 and as per terms and conditions of the policy the risk coverage under the policy remained intact for extended period of two years from the date of maturity i.e. 31.3.2018 till 28.3.2020 as mentioned on the second page of the policy bond under the clause(b)-Death Benefit. It is further argued that in the instant case father of complainant died on 28.12.2020 i.e. after the expiry of period of two years from the date of maturity and termination of the risk cover on 28.3.2020, as such the legal heirs of the deceased life assured are not entitled to any claim whatsoever under the policy and the date of payment maturity claim has no relevancy but the extended risk cover starts from the date of maturity till the expiry of two years i.e. 28.3.2020, hence there is no deficiency in service on the part of opposite party. 

11. However, perusal of the file shows that the opposite party has already paid the claim amount of Rs. 1,13,258/- to the father of the complainant on 25.9.2020 alongwith interest as per the units available in the account of policy as date of maturity through NEFT and this fact is shows from Ex.O.P-3 copy of claim payment voucher. Moreover, this fact is also admitted by the complainant at Para No. 3 in his complaint and the same also shows from copy of statement of account of PNB at Page No. 2 of Ex.C-8. 

12. The allegation of the complainant is that the father of the complainant received a detail of allotted units i.e. 4247.825, 4668.243 and 5031.063 totaling 13947.131 and surprised to note that the opposite party has deducted many units without mentioning any reason and justification. The opposite party mentioned that the insured has 6582.212 units and paid the maturity value of Rs. 1,13,258/- only on 25.9.2020 through NEFT. On this the opposite party has submitted that it was a unit linked plan and in case of maturity claim the policyholder was eligible for bid value (number of units available in your account as on date of maturity X net asset value as on date of maturity) and units under the policy were subject to deduction of (i) Premium Allocation Charges, (ii) Mortality Charges (iii) Policy administration Charges (iv) Service Tax Charges (v) Misc. Charges as per condition 5 of the policy mentioned on the policy bond and accordingly the units available under the policy for realization @ Rs. 15.4619 were 6582.212 as on date of maturity, so the payment of the maturity claim comes to Rs. 101774/- (No. of Units-6582.212  NAV-15.4619). The opposite party has also paid interest of Rs. 12,415/- on delayed claim payment and deducted the Income Tax of Rs. 931/- on the same and hence total amount of claim came to Rs. 1,13,258/- which was paid as maturity claim to the father of the complainant (as per Ex.O.P-2 & Ex.O.P-3). The another allegation of the complainant is that the father of the complainant was insured for a sum of Rs. 2,50,000/- as the risk cover of the insured under the policy will remain intact for two years after the payment of maturity amount as mentioned in the undated letter (Ex.C-6) of the opposite party which was written by the opposite party to the complainant vide which it is mentioned that the insured has not submitted the claim papers with them so far, enable them to release the due amount under the said policy. It is further mentioned that since this is Unit Linked Plan and in case of Maturity insured is eligible for Bid Value (No. of Units available in account as on date of Maturity X Net Asset Value as on date of  Maturity). It is further mentioned in Ex.C-6 that according to terms and conditions of the policy your risk cover under the policy will remain intact for 2 years after the payment of Maturity Amount. On the other hand, the perusal of file it shows that the maturity date of the policy was 31.3.2018 and the extended period of 2 years from the date of maturity was 31.3.2018 till 30.3.2020 and in the present case the maturity value of Rs. 1,13,258/- alongwith interest was paid to the insured during his lifetime on 25.9.2020 and the insured was died on 28.12.2020. Therefore, we are of the view that the opposite party had paid the maturity amount to the insured on 25.9.2020 instead of 31.3.2018 i.e. after the gap of almost two years and six months from the date of maturity. We have also gone through the copy of policy Ex.O.P-8 vide which in the column of (b)Death Benefit: In the event of death of the Life Assured within the policy term, when the cover is in full force, an amount equal to the Sum Assured under the Basic plan together with the Policyholder's Fund Value shall become payable. Guarantee of NAV shall not be applicable. In the event of death of the Life Assured after the policy term, but before the expiry of extended life cover period an amount equal to the Sum Assured under the Basic Plan shall become payable. But in the present case the insured had died on 28.12.2020 after the expiry of extended period i.e. 30.3.2020. So, the complainant is not entitled for the sum assured of Rs. 2,50,000/-. Further, in Ex.O.P-1 Office Note dated 25.9.2020 it is mentioned that we received discharge form and cancelled cheque from policy holder for Maturity claim settlement due on 31.3.2018 under plan 801-08-03 but policy holder did not submit policy bond because he did not receive it from office and he had written complaint also, so as per directions of MGR.CRM please allow us to release the payment without policy bond. Therefore, we are of the view that maturity payment was delayed due to the fault of opposite party by not providing the policy bond to the policyholder. It amounts to deficiency in service by the opposite party.  

13. In view of the above discussion, the present complaint is partly allowed and the opposite party is directed to pay only the interest @ 7% per annum on the above said already paid amount of Rs. 1,13,258/- to the complainant from the date of maturity i.e. 31.3.2018 till realization i.e. 25.9.2020. The opposite party is further directed to pay Rs. 15,000/- on the account of consolidated amount of compensation alongwith litigation expenses to the complainant. 

14. Compliance of the order be made within the period of 45 days from the date of the receipt of the copy of this order.

15. Copy of this order be supplied to the parties free of costs as per rules. File be consigned to the records after its due compliance. 

ANNOUNCED IN THE OPEN COMMISSION:

       24th Day of April, 2024

 

            (Jot Naranjan Singh Gill)

            President

 

(Urmila Kumari)

Member