DISTRICT CONSUMER DISPUTES REDRESSAL FORUM,

PATIALA.

                                      Complaint No. CC/15/223 of 6.10.2015

                                      Decided on:        5.5.2016

Sukhwinder Kaur D/o Late Sh.Jit Singh R/o village Badla, P/O. Miranpur, Tehsil & District Patiala.

                                                                   …………...Complainant

                                      Versus

1.      P.N.B. Met Life India Insurance Co.Ltd., SCO 3266/1, Sheranwala Gate, Patiala through its Branch Manager.

2.      P.N.B. Met Life India Insurance Co.Ltd.,101, Techniplex 1, Techniplex Complex, Veer Savarkar Flyover, Off  SV Road, Goregaon, West Mumbai-400082, through its Chairman/Director.

                                                                   …………….Ops

                                      Complaint under Section 12 of the

                                      Consumer Protection Act.

                                      QUORUM

                                      Sh. A.P.S.Rajput, President

                                      Smt.Neelam Gupta, Member

                                      Smt.Sonia Bansal,Member                               

Present:

For the complainant:   Sh.N.S.Sarwara , Advocate

For Ops:                       Sh.Amit Kumar, Advocate            

                                         ORDER

A.P.S.Rajput, PRESIDENT

1. Complainant Sukhwinder Kaur D/o Late Sh.Jit Singh  s/o Sh.Mohinder Singh, r/o village Badla P.O.Miranpur Tehsil and District Patiala has filed this complaint against the opposite parties (hereinafter referred to as the Ops) under Section 11 to 14 of the Consumer Protection Act,1986( for short the Act). The brief facts of the complaint are as under:
2. It is the case of the complainant that her father Sh. Jit Singh s/o Sh.Mohinder Singh, has purchased  Endowment Plan policy bearing No.21212201 dated 13.12.2013 known as Met Suvidha Participating plan for  a sum of Rs.11,50,000/- from Ops . The complainant is the nominee of the said policy. It is averred that Sh.Jit Singh paid three  premiums to the tune of Rs.40731/-each half yearly.
3. It is averred that due to sudden chest pain her father died on 31.12.2014. After the death of her father, the complainant approached the Ops for the release of the amount of the policy. The Ops demanded death certificate of the deceased alongwith the original policy, ID proof and cancelled cheque of the account of the nominee i.e. complainant..The complainant submitted all the documents  with the Operation Executive of Op no.1.
4. It is averred in the complaint that after verifying the factum of death of Sh.Jit Singh from his village, the Ops assured that the payment of the said policy will be paid within 6 months as per IRD instruction but the Ops failed to make any payment to the complainant. The complainant wrote letters dated 11.5.2015 and 17.7.2015  to Op no.1 but no reply was received. The complainant also sent e-mails to GRO (Grievance Redressal Office) at Mumbai on 2.9.2015 and 4.9.2015. G.R.O. replied the e-mails and demanded some documents from the complainant which were sent on 8.9.2015 and again on 9.9.2015 and vide e-mail dated 10.9.2015 it was intimated that the documents were received by Op no.2.The complainant again sent an e-mail to Op no.2 on 16.9.2015 regarding the payment of the insurance claim.A reminder dated 18.9.2015 was also sent to Op no.2but no amount has been paid by the Ops and wrongly repudiated the claim of the complainant.Thus the complainant has suffered mental agony and physical harassment at the hands of the Ops and there is deficiency of service on the part of the Ops. Hence this complaint with a prayer for a direction to the Ops to release the amount of the insurance policy i.e. Rs.11,50,000/- alongwith 18% per annum interest and Rs.5,00,000/- as damages.
5. Notice of the complaint was issued against the Ops who appeared through Sh.Amit Kumar,Advocate but the Ops despite having availed of ample opportunities failed to file the written version.
6. In order to prove her case, the complainant tendered in evidence Ex.CA her sworn affidavit alongwith documents Exs.C1 to C8 and her counsel closed the evidence.
7. The ld. counsel for the complainant has submitted that the main controversy involved in the present complaint is that the deceased father of the complainant had taken 4 life insurance policies from the OPs. He stated that due to sudden chest pain the  father of the complainant died, thereafter the complainant being the nominee of her father filed the claim, by repeatedly fulfilling the formalities, as it is evident from the material placed on record alongwith e-mails exchanged between the parties i.e Ex.C-4 & Ex.C7(colly).The ld. counsel submitted that after supplying all the documents the OPs repudiated the claim of the complainant vide email dated 18.09.2015 i.e Ex.C-3(colly) stating “case not accepted due to Non disclosure of other insurance company policy”. He also submitted that the OPs had themselves issued the policy knowing, that other policies were also existing and had been regularly receiving the premiums for the same. The ld. counsel pleaded that since the policies were taken from the same Company i.e OPs, therefore it was not the case of  Non disclosure of other insurance policy. He also pleaded that firstly the OPs should not have issued the second, third and fourth policy, if they could not reimburse the claim and thereupon had also been accepting premiums for the said policy. The ld. counsel argued that the act and conduct of the OPs clearly proves that they have indulged in unfair trade practice and acted against the Rules, Regulations and Instructions issued by the IRDA.
8. After hearing the Ld. Counsel for the complainant and going through the pleadings and evidence produced , as well as written submissions and oral submission, it is evident from welcome letter i.e Ex.C-1 and  annexed copy of insurance policy that the deceased father of the complainant had taken life insurance policy no.21212201 dated 12.12.2013 and he had been paying the premiums regularly. It is also established from  Met Life Attending Physician Statement i.e Ex.C-5, Declaration of complainant i.e Ex.C-6 and the emails exchanged between the parties i.e Ex.C-4 & Ex.C7(colly) that the complainant had been repeatedly providing the requisite documents and completed all the formalities. It is pertinent to mention that the OPs clearly violated the guidelines of IRDA in deciding the claim within a stipulated period of 6 Months.
9. It is, ampler clear from the Policies placed on record in all the 4 complaints, that all the said policies were issued by the same Company i.e OPs and despite the fact being in their knowledge, of existence of the first policy, the OPs had issued total 4 Policies in the name of deceased father of the complainant. In our opinion the OPs have indulged in unfair trade practice and committed deficiency of service by repudiating the claim of the complainant in an arbitrary manner.
10. Accordingly, in view of our aforesaid discussion, we direct the OPs to pay sum of Rs.11,50,000/- being the claim amount to the complainant being the beneficiary as per clause 21 of the terms and conditions of the policy. We also find complainant to be entitled to compensation on account of mental harassment amounting to Rs.10,000/- alongwith litigation cost of Rs.5000/-.
11. The OPs  are further directed to comply with the order of this Forum within 45 days from the date of receipt of this Order. In case OPs   fail to comply with the same, within the stipulated period, the OPs shall be liable to pay 9 % interest per annum from the date of institution of the complaint till its realization, on the aforesaid awarded amount. The present complaint is hereby accepted.  
12. The arguments on the complaint were heard on  3.5.2016 and the order was reserved. Now the order be communicated to the parties. Copy of the order be sent to the parties free of cost and thereafter the file be consigned to the record room.
13.  

Dated: 5.5.2016

               Sonia Bansal           Neelam Gupta                        A.P.S.Rajput

        Member                Member                                  President