Haryana

Yamunanagar

CC/946/2011

Preeto Devi W/o Raj Kumar - Complainant(s)

Versus

Parveen Bansal S/o Anand Parkash - Opp.Party(s)

None for complainant.

05 Sep 2016

ORDER

BEFORE THE PRESIDENT DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA NAGAR AT JAGADHRI.

                                                                                                Complaint No. 946 of 2011.

                                                                                                Date of institution: 06.09.0211

                                                                                                Date of decision: 05.09.2016.

Preeto Devi aged about 48 years widow of Shri Raj Kumar s/o Bachna Ram, resident of VPO Balchhappar, Tehsil Jagadhri, District Yamuna Nagar.                                                                                                                                                              

                                                                                                                                                    …Complainant.

                                                                   Versus

1. Parveen Bansal son of Anand Parkash, r/o Main Market Bilaspur, Distt. Yamuna Nagar. (Authorized agent of Life Insurance Corporiation of India).
2. The Branch Manager, Life Insurance Corporation of India, having its Branch Office S.C.O. 184-185, Sector-17, HUDA, Jagadhri, District Yamuna Nagar.
3. Life Insurance Corporation of India having its Divisional Office Karnal through its Managing Director.

                                                                                                                                                    …Respondents.

 

BEFORE:         SH. ASHOK KUMAR GARG, PRESIDENT.

                        SH. S.C.SHARMA, MEMBER.

 

Present: None for complainant.

              Sh. Rajiv Kaushish, Advocate, counsel for respondent No.1.

              Sh. S.C.Garg, Advocate, counsel for respondents No.2 & 3.  

 

ORDER

 

1.                     Complainant  Preeto Devi filed the present complaint under section 12 of the Consumer Protection Act, 1986 praying therein that the respondents (hereinafter referred as OPs) be directed to pay the premium amount alongwith all the benefits of the insurance policy in question alongwith interest and also to pay compensation as well as litigation expenses.

2.                     Brief facts of the present complaint, as alleged by the complainant, are that the husband of the complainant during his life time got himself insured though the OPs vide insurance policy bearing No. 176535493 and a date of commencement was 28.04.2009 for a sum insured of Rs. 1,00,000/-. The husband of the complainant paid the amount of premium of insurance himself up to 28.04.2010 and had deposited the three premiums against this policy but the OPs had not issued any receipt in favour of the husband of the complainant for the last premium. Unfortunately, on 18.08.2010, the husband of the complainant had died at Gaba Hospital, Yamuna Nagar and after his death the complainant met with OPs for the benefits of insurance policy but the OPs did not give any satisfactorily reply to the complainant and the matter was prolonged on one pretext or the others and lastly, the complainant sent a legal notice dated 20.07.2011 to the OPs No.2 & 3 but of no use. Hence, there is a great deficiency and negligence in service on the part of OPs.Hence, this complaint.

3.                     Upon notice, OPs appeared and filed its written statement separately. Op No.1 filed his written statement by taking some preliminary objections such as the present complaint is legally not maintainable in the present Forum against the OP No.1 because the Op No.1 is just an agent of LIC of India. The job of Op No.1 is to promote the people for getting them insured by taking insurance policies of LIC of India. When any person had taken insurance policy of LIC of India on the promotion of an agent, the agent has become entitled to incentive for his job. The agent has neither involvement in the official work of LIC nor he is collecting the premium from the parties. After taking the policy, the policy holder is incumbent to deposit the premium within the stipulated period as per the respective policy and if the policy holder failed to pay the premium within stipulated period, then the policy of the policy holder had been lapsed and he cannot take any benefit on the basis of the policy. The husband of the complainant failed to pay the premium within stipulated period, so the policy in the name of her husband had been lapsed, so, the complainant is not legally entitled to any claim on the basis of lapsed policy; complainant has got no locus standi to file and maintain the present complaint; complainant is legally estopped by her own act and conduct from filing the present complaint, no jurisdiction to try and hear the present complaint; no relationship of consumer and supplier and on merit controverted the pleading taken in the complaint and reiterated the stand taken in the preliminary objections and lastly prayed for dismissal of complaint.  

4.                     OPs No.2 & 3 filed its written statement by taking some preliminary objections such as the policy bearing No. 176535493 in question was in lapsed condition on the date of death of life assured, so, nothing is payable to the complainant; no locus standi to file the present complaint and on merit it has been admitted to the extent that OP No.1 i.e. Mr. Parveen Bansal was the agent of OPs No2 & 3 but he was not authorized to collect the renewal premium on behalf of OPs No.2 & 3. As per agreement between life assured and LIC of India, policy in question was issued in the name of Sh. Raj Kumar deceased for a sum of Rs. 1,00,000/- with the date of commencement dated 28.04.2009, on 10.06.2009, Term Table 91-20-20 and installment premium of Rs 3250/- was payable as half yearly. Only two half yearly premium due on 04/2009 and 10/2009 was paid under the abovesaid policy and thereafter the next premium for the month of April 2010 was not paid by the life assured and therefore, policy in question was in lapsed condition on the date of death as per death certificate dated 18.08.2010. It has been further mentioned that as per death certificate supplied by the complainant, the date of death of the life assured was 18.08.2010 at Dr. R.K.Gupta Hospital Yamuna Nagar but there is alternation on it with place of death at Gaba Hospital. As the policy in question was in lapsed condition on the date of death and paid up has not been acquired in the policy in question so nothing is payable under the policy in question as per terms and conditions of the insurance policy. Regarding this, complainant was duly informed vide letter dated 12.09.2011. It has been admitted that legal notice dated 20.07.2011 was received from the complainant and upon the same OPs requested the complainant vide letter dated 25.08.2011 to send the requisite documents i.e. Original policy bond, original death certificate and intimation regarding the death of the life assured. The complainant never visited the office of the OPs on several times as alleged in the complaint. On receiving all the requisite documents from the complainant, OPs Insurance Company enquired the matter and it was found that the policy in question was in lapsed condition for non payment of premium in the month of April 2010 and as per terms and conditions nothing was payable by the OPs to the complainant. Lastly, it has been stated that no deficiency in service or unfair trade practice on the part of OPs Insurance Company and prayed for dismissal of complaint.

5.                     To prove the case, counsel for the complainant tendered into evidence affidavit of complainant as Annexure CX and photo copies of documents such as copy of ration card as Annexure C-1, Copy of death certificate as Annexure C-2, Copy of insurance policy as Annexure C-3, Copy of premium receipt as Annexure C-4, Copy of premium receipt as Annexure C-5 and closed the evidence on behalf of complainant.  

6.                     On the other hand, counsel for the OP No.1 failed to tender any evidence, hence evidence was closed by court order dated 07.05.2015.

7.                     Counsel for the OPs No.2 & 3 tendered into evidence affidavit of Sh. P.K.Sexena, Manager, Legal, LIC of India Karnal as Annexure RX and photo copies of documents such as  copy of insurance policy now Janraksha as Annexure R-1, Copy of status report of policy as Annexure R-2, Copy of Form No. 16G as Annexure R-3, Copy of letter dated12.09.2011 as Annexure R-4, Copy of death certificate as Annexure R-5, Copy of letter dated 25.08.2011 as Annexure R-6, Copy of letter dated 25.09.2011 as Annexure R-7 and closed the evidence on behalf of OPs No.2 & 3.  

8.                     We have heard the learned counsel for both the parties and have gone through the pleadings as well as documents placed on file very minutely and carefully.

9.                     It is  not disputed that during the life time husband of the complainant Raj Kumar now deceased got himself insured with OPs No.2 & 3 vide insurance policy bearing No. 176535493 which was commenced w.e.f. 28.04.2009 for a period of 20 years for a sum of Rs. 1,00,000/- which is duly evident from Insurance Policy (Annexure R-1). It is also not disputed that on 18.08.2010 husband of the complainant had died at Gaba Hospital, Yamuna Nagar which is also evident from the copy of death certificate (Annexure C-2). Learned counsel for the complainant argued at length that complainant deposited/paid the three installments out of which 2 installments were deposited with the office of OPs No.2 & 3 and last third insurance premium was paid to the agent i.e. OP No.1. However, OP No.1 had not deposited the same with the OPs No.2 & 3. Learned counsel for the complainant further argued that deceased Raj Kumar died during the currency of insurance policy, so, the complainant was duly entitled to get the benefits being legal heir as well as nominee of deceased Raj Kumar.

10.                   On the other hand, counsel for the OPs argued at length that husband of the complainant (deceased RajKumar) had deposited only 2 installments of Rs. 3250/- each first on 04/2009 and second on 10/2009 and he failed to deposit the third installment which was due on 04/2010 and due to non payment of third installment policy in question was in lapsed mode at the time of death of the husband of the complainant i.e. on 18.08.2010. Learned counsel for the OPs further argued that as the husband of the complainant had only paid only 2 installments and policy in question was in lapsed mode, so, no paid up value has been acquired in the policy in question and nothing is payable and lastly requested for dismissal of complaint and referred the case law titled as Harshad J. Shah and Another Versus LIC of India & Others, 1997(5) SCC page 64 wherein it has been held that until  and unless complainant proves that LIC by its conduct had induced complainant to believe that Op No.1 acting as agent was authorized to receive the premium on behalf of LIC, LIC cannot be held responsible for the amount of premium received by agent.

11.                   Learned counsel for the OPs further referred the case law titled as LIC of India Versus Neelamma, Revision Petition No. 3438 of 2012 decided on 02.08.2013 and further referred the case law titled as National Insurance Co. Ltd. Versus Mehboob Khan, 2012 (2) CPR page 76 (NC) and also referred the case law titled as LIC of India Versus Yog Raj Chauhan, Revision Petition No. 3447 of 2012. Lastly referred the case law titled as LIC of India Versus Dharamshila Kunwar, Revision Petition No. 1205 of 2015, decided on 04.08.2015 National Commission wherein it has been held that “ insured himself being agent of the LIC was well aware about the conditions of the policy. When policy stood lapsed on the date of insured’s death, complainant was not entitled to any claim on the basis of this policy and learned District Forum committed error in allowing complaint and learned State Commission further committed error in dismissing appeal and revision petition is to be allowed.”

12.                   After hearing both the parties at length and going through the law cited above, we are of the considered view that there is no deficiency in service on the part of OPs as the complainant has totally failed to prove that deceased husband of the complainant made the payment of third installment of the premium and policy in question was not in lapsed mode. We have perused the terms and conditions of the insurance policy carefully and minutely wherein it has been mentioned under clause 4 “Non Forfeiture Regulations”: If at least two years premium had been paid and any subsequent premium be not paid full death cover is continue for a period of 3 months from the due date of the first unpaid premium. From the perusal of this clause it is clear that complainant was entitled to get the benefits if the policy remains continue for a period of 2 years but in the present case policy in question was ran only one year as the husband of the complainant had only paid two half yearly installments of Rs. 3250/- each i.e. on 04/2009 and 10/2009 and the policy in question was in lapsed mode at the time of death of the insured Raj Kumar, so, the claim of the complainant has been rightly repudiated by the Ops Insurance Company vide its letter dated 12.09.2011 (Annexure R-4). Further the complainant has nowhere pleaded that LIC by its conduct adduced the complainant to believe that Op No.1 was authorized to receiving the premium on behalf of OPs No.2 & 3, so, the pleas taken by the complainant that he had paid 3^rd installment to the Agent i.e. OPNo.1 is also not tenable as the same view has been held in case titled as Harshad J. Shah and Another Versus LIC of India & Others(supra).

13.                   In the circumstances noted above, we are of the considered view that the complainant has totally failed to prove her case, hence, we have no option except to dismiss the present complaint and the same is hereby dismissed with no order as to costs. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

Announced: 05.09.2016.        

                                                                                    (ASHOK KUMAR GARG )

                                                                                    PRESIDENT,

 

                                                                                     

                                                                                    (S.C.SHARMA )

                                                                                     MEMBER.