Complainant Avtar Singh through the present complaint filed U/S 12 of the Consumer Protection Act (for short, C.P.Act.) has prayed for the issuance of the necessary directions to the opposite party  to make the payment of Rs.7,99,924/- alongwith interest @ 18% per annum from the death of his mother till its payment. Opposite parties be further directed to pay compensation amounting to Rs.20,000/- for unnecessary harassment, physical pain and mental agony alongwith Rs.10,000/- as litigation expenses to him, in the interest of justice.

 2.      The case of the complainant in brief is that Sukhwinder Kaur widow of Sh.Harbans Singh resident of village and post office Sohal, Tehsil and District Gurdaspur was his mother who was hale and hearty and obtained  insurance policy No.21590458 dated 10.6.2015 from the opposite party no.4 who was authorized agent of the Company was sitting in PNB, V.P.O. Sohal on said date after depositing the amount of Rs.50,000/- by withdrawing the said amount from her Account No.7451001700016912, Punjab National Bank, Sohal and she was to pay annual premium of Rs.49,999/- upto 30th May every year for ten years. The policy was effective from 10.6.2015. After due verification the opposite parties issued Insurance Policy to his mother. His mother was insured for Rs.7,99,924/- and he was nominated in the said Insurance Policy and such he is consumer of the opposite parties. He has further pleaded that his mother had died on 26.1.2016 due to sudden Heart Attack, although she was hale and hearty. He informed to the opposite party no.4 about her death alongwith death certificate in order to get the insured amount of Rs.7,99,924/- payable to him being nominee of his deceased mother. He approached to the opposite party no.3 and 4 a number of times but of no use. The opposite party no.4 remained giving assurance to him that he will get the insured amount soon but till nothing has been done inspite of many visits to her and now she has been transferred to Punjab National Bank, Kahnuwan, Tehsil and Distt.Gurdaspur. Ultimately he also sent a legal notice to the opposite parties through his counsel on 12.6.2016 but of no use. Thus, there is deficiency in service on the part of the opposite parties. Hence this complaint.

3.       Upon notice, the opposite parties appeared through their counsel and filed their written reply taking certain preliminary objections. On merits, it was submitted that on the basis of the information provided in the proposal form dated 29.05.2015, a policy bearing No.21590458 was issued on 29.05.2015. The Policyholder was Mrs. Sukhwinder Kaur and the complainant was the insured under the said Policy. As per the principles of Insurance Law and as per the terms of the Policy Contract, it is only upon the death of the “Person Insured” that the nominee is liable to receive the death benefits, as per the terms of the policy Contract. The complainant has filed the present complaint claiming death benefit upon the death of Mrs.Sukhwinder Kaur. Under the Policy No.21590458, the complainant i.e. Mr.Avtar Singh is the Insured Person and Mrs.Sukhwinder Kaur was the Policyholder. As such, the complainant is not entitled to claim any death benefit under the said Policy. The complainant has not submitted any death claim intimation with the opposite party at any point of time.  It was next submitted that the complainant is not entitled to receive any death benefit under the said Policy and as such, there has been no deficiency in service on the part of the opposite party. All other averments made in the complaint have been vehemently denied and prayed for dismissal of the complaint with costs. 

4.      Notices issued to the opposite parties no.2 and 4 had been received back. Case called several times, but none had come present on their behalf. Therefore, they were proceeded against exparte vide order dated 16.3.2018.

5.         Counsel for the complainant tendered into evidence affidavit of complainant Ex.CW1/A and of  Sh.Mela Singh son of Sh.Atma Singh Ex.CW-2/A, of Sh.Mohan Singh son of Sh.Charan Singh Ex.CW-3/A, of Sh.Ranjit Singh son of S.Chanan Singh Ex.CW-4/A, of Sh.Som Raj Lambardar Ex.CW-5/A and of Sh.Samson Member Panchyat Ex.CW-6/A aldongwith Mark –A (Pages 1 to 23) and closed the evidence,

6.            Counsel for the opposite parties no.1 and 3 tendered into evidence affidavit of Rajeev Sharma son of Sh.Lekhram  Sharma Ex.OP-W-1,3/A, alongwith the other documents exhibited as Ex.OP-1,3/1 62 pages and closed the evidence.

7.      We have intently heard the learned counsels for both the sides in the back drop of the legally applicable merit of the supporting evidence/ document(s) as produced by the litigating parties in order to statutorily resolve the inter-se dispute (in accordance with the provisions of the Consumer Protection Act’ 1986) prompting the present complaint that was first filed as CC # 390/2016 and subsequently withdrawn on 22.05.2017 on account of some technical defects with permission accorded to re-file it on same cause of action.

8.       We observe that the present complainant here has alleged that Sukhwinder Kaur (since demised) during her life time had purchased the Life Policy, in question, on her own life with her complainant son as her legal heir nominee. Incidentally, there has been no conflict (of interests) between the litigants as to the commencement date of the Policy (29.05.2015); Annual Regular Premium (Rs.49,999/-); and its Sum Assured; however, there have been conflicting claims as to the most vital issue of the ‘life-assured’. The complainant asserts that her deceased mother Sukhwinder Kaur has been the life-assured as well as the holder of the related Policy whereas the OP insurers claim that Sukhwinder Kaur deceased has been the holder of the Policy with her complainant son Avtar Singh as its ‘life-assured’ and as such during his life-time the policy is not payable before maturity. The OP insurers in support have produced its affidavit Ex.OP1,3/A along with the Proposal and Policy documents (Ex.OP1,3/1) that do prove the issuance of the related (purchased) policy with the complainant Avtar Singh as the life-assured and his mother Sukwinder Kaur (since deceased) as the holder of the Policy. Thus, the OP insurers have herein dutifully proved their rebuttal claim so far as its (the policy’s) technical aspects have been in issue as the prime conflict.

9.       However, we further find that the complainant has herein alleged miss-selling of the related Policy by the OP’s authorized representative agents (including the herein titled OP4 ex-parte litigant) and the OP insurers have inadvertently but tamely issued the said Policy without an investigation/application of mind/scrutinizing probability to further aggravate the issue. The complainant in turn has produced affidavits from five nos. of respectable persons (Ex.CW2/A to Ex.CW6/A) of the local area besides his own affidavit (Ex.CW1/A) all deposing in unison that Sukhwinder Kaur deceased has been the life-assured to the related policy with Avtar Singh complainant son as the legal heir nominee. He has also produced the proposal and other documents (23 pages) marked ‘A’. We find as to somehow the OP insurers had not raised the present rebuttal issue in its written reply to the first complaint # 390/2016 filed on the same cause of action. 

10.     In the light of the all above, we find that the representative agents have indeed sold the instant Policy through ‘miss-selling’ for collateral reasons like harvesting of business/achieving of targets vide adoption of unfair trade practices and unscrupulous exploitation of illiterate consumers amounting to deficiency in service and that lines them up along with principals to an adverse statutory award under the applicable Act. The OP4 Agent has also preferred to be proceeded against ex-parte and it can be judicially (but discretionary) presumed that he had no defense to prosecute.

11.     We, hereby partly allow the present complaint and thus ORDER the titled opposite party insurers to honor the Policy as to have been issued with Sukhwinder Kaur deceased as its ‘life-assured’ and to pay its death claim with full benefits to the present complainant (as its legal-heir nominee) besides to pay him an amount of Rs.10,000/- as compensation for harassment and cost of litigation within a period of 30 days of the receipt of the copy of these orders otherwise the aggregate awarded amount shall attract interest @ 9% PA from the date of the orders till actually paid. It shall however be the own prerogative of the OP insurers so as how to recover the awarded amount from its delinquent officials/agents/representative etc.

12.     Copy of the order be communicated to the parties free of charges. After compliance, file be consigned to record.

                                                                                (Naveen Puri)

                                                                                    President.     

ANNOUNCED:                                                              (Jagdeep Kaur)

July 04, 2018.                                                                Member.

*MK*