District Consumer Disputes Redressal Commission ,Faridabad.
Consumer Complaint No. 342/2022.
Date of Institution: 23.06.2022.
Date of Order: 16.01.2023.
Smt. Pinki Devi aged 37 years W/o late Shri Utpal Dass S/o Shri Amar Chand Dass R/o House No.1229, Dabua colony, NIT, Faridabad.
…….Complainant……..
Versus
1. Pramerica Life Insurance Limited (Erstwhile DHFL Premerica Life Insurance Company Limited) Registered office at 4th floor, Building NO. 9, Tower-B, Cyber City, DLF City, Phase-III, Gurugram, Haryana – 122002 through its Principal Officer/Authorized person.
Local Office at: Second floor, SCO-3, HUDA Staff Colony, Sector-16, Faridabad (Haryana) – 121002.
2. Aadhar Housing Finance Ltd. Branch office at: 2nd floor, Rear Portion, A-7/1, Samdhan Chambers, Neelam Bata Road, NIT, Faridabad, Haryana – 121001.
Registered office at: 2nd floor NO.3, JVT Towers, 8th-A, Main road, Sampangi Rama Nagar, Hudson Circle, Bangalore, Karnataka – 560 027.
…Opposite parties……
Complaint under section-12 of Consumer Protection Act, 1986
Now amended Section 34 of Consumer protection Act 2019.
BEFORE: Amit Arora……………..President
Mukesh Sharma…………Member.
Indira Bhadana………….Member.
PRESENT: Sh. Hitesh Parashar, counsel for the complainant.
Sh. Manish Chhoker, counsel for opposite party No.1.
Opposite party No.2 exparte vide order dated 20.12.2022.
ORDER:
The facts in brief of the complaint are that the complainant had availed an Aadhar Housing Loan of Rs.9,94,549/- under Pradhan Mantri Awas Surkasha Yojna against property bearing MCF No. D-236, Khewat No. 123/116min. Khatoni NO. 174min. Rect No. 35, Killa No. 8(8-0), Dabua Colony, Mauja Dabua, Tehsil Badkhal, District Faridabad from the opposite party No.2 vide loan NO. 406175 and A/c. No. 00000828 sanction on dated 22.08.2020 and the same loan amount had disbursed on 31.08.2020 in the bank account of the complainant for a period from 31.08.2020 to 30.08.2030. The EMI installment of the said loan was Rs.10,553/- per month. Opposite party No.2 told the complainant as well as her husband that it was mandatory to issue a life insurance policy against the aforesaid aadhar finance loan amount to save the future and interest qua repayment of loan amount as it was very evident and understood that if the person expired after taking a housing loan in that eventuality, the remaining loan amount would be paid by the insurance company i.e opposite party No.1 to opposite party No.2. As per the terms and conditions of opposite party No.2, the husband of the complainant namely Mr. Utpal Dass S/o Shri Amar Chand Dass
obtained insurance policy from opposite party No.1 – insurance company vide policy certificate No. GC00003802GNY00), Plan-A, valid from 31.08.2020 to 30.08.2030 i.e 10 years, premium of Rs.21,334.99 and sum assured of Rs.9,30,067/-. The complainant had incorporated/entered an nominee in the aforesaid insurance policy. Thereafter the complainant had been paying the installment of loan amount to the opposite party No.2 regularly and continuously without any delay. During that period the husband of the complainant namely Mr. Utpal Dass S/o Shri Amar Chand Dass had died on 30.11.2020. After the death of husband of the complainant contacted with the officials of the opposite parties and told about the unfortunate death of her husband as well as co-applicant. It was pertinent to mention that the complainant also contacted with opposite party No.1 and to pay the sum assured as per the Life Insurance Policy issued by them in the name of the husband of the complainant who had died then the opposite parties Nos.1 & 2 told the complainant that to continue the remaining installments of housing loan for the period till the realization of sum assured as per the life insurance policy and the opposite party No.2 also assured the complainant that after the date of death of her husband (insured person) all the installments paid by the complainant would be refunded back to her. Thereafter the complainant had been paying the regular and continuous installments to opposite party No.2 and approached the opposite party No.1 to release the sum assured amount of the life insurance policy then the opposite party No.1 linger on the matter form one pretext to another and thereafter opposite party No.2 told the complainant to pay another installment then the complainant had paid the last installment of Rs.15,775/- to opposite party No.2. The complainant wrote letter and reminder to the opposite parties vide letter dated 20.04.2022 & 11.05.2022 vide which the complainant requested the opposite party No.2 to refund the amount to her which
the opposite party No.2 had directly and illegally got from the opposite party No.1 and the remaining loan amount should be paid by opposite party No.1 in future entirely. The said letter and reminder were sent through speed post to the opposite parties on the last known addresses of opposite parties. Despite of service of said letter and reminder the opposite parties neither gave any reply to the letter and reminder nor refund/pay the sum assured as per the life insurance policy. The aforesaid act of opposite parties amounts to deficiency of service and hence the complaint. The complainant has prayed for directions to the opposite parties to:
a) pass an award of Rs.9,30,067/- alongwith interest @ 18% p.a. in favour of the complainant and against the opposite party No.1 towards the clam insured amount under the said Aadhar Housing Finance Limited.
b) pay Rs.1.00,000/- as compensation for causing mental agony and harassment .
c) pay Rs. 21,000 /-as litigation expenses.
2. Opposite party No.1 put in appearance through counsel and filed written statement wherein Opposite party No.1 refuted claim of the complainant and submitted that the complainant had approached this Hon’ble Commission with unclean hand and suppressed the material facts from this Hon’ble Commission regarding reason of repudiation clearly mentioned under repudiation letter dated 15.12.2021. The policy in question was issued on 31.08.2020 and the death of life assured occurred on 30.11.2020 i.e. within 3 months of issuance of policy. Thereafter on receipt of claim intimation, the opposite party conducted investigation and found that, the husband of the complainant had left heavenly abode by committing suicide and this was happened within one year of the commencement of the policy. As per the Post Mortem Examination Report, the
life assured committed suicide on 30.11.2020. As per the terms of the policies under its Exclusion clause (a), “if the Insured Member commits suicide, whether sane or insane at the time, within one year from the Coverage Commencement date as stated in the schedule, then the Company shall be limited to a refund of 80% of the premium received”. The opposite party just after receiving the claim intimation, refunded the amount as per the terms of the policy. Opposite party No. 1 denied rest of the allegations leveled in the complaint and prayed for dismissal of the complaint.
3. Case called several times since morning but none appeared on behalf of opposite party No.2. Hence, opposite party No2 was hereby proceeded against ex-parte vide order dated 20.12.2022.
4. The parties led evidence in support of their respective versions.
5. We have heard learned counsel for the parties and have gone through the record on the file.
6. In this case the complaint was filed by the complainant against opposite parties– Pramerica Life Insurance Limited with the prayer to: a) pass an award of Rs.9,30,067/- alongwith interest @ 18% p.a. in favour of the complainant and against the opposite party No.1 towards the clam insured amount under the said Aadhar Housing Finance Limited. b) pay Rs.1.00,000/- as compensation for causing mental agony and harassment . c) pay Rs. 21,000 /-as litigation expenses.
To establish his case the complainant has led in his evidence, Annx.C-1 – letter dated 24.1.2022,, Annexure C-2 – Loan details, Annexure C-3 – List of documents,, Annexure C-4 – Welcome letter, Annexure C-5 – Certificate of
insurance, Annexure C-6 – Death certificate, Annexure C-7 – payment receipt, Annexure C-8 – letter dated 20.4.2022, Annexure C-9 – second reminder.
On the other hand counsel for the opposite party N.1strongly agitated
and opposed. As per the evidence of the opposite party No.1 Ex.RW1/A - affidavit of Shri Sahil Mahajan, Authorized Representative of Premerica Life Insurance Limited having its registered head office at 4th floor, Building No.9, Tower B, DLF Cyber City Phase-3, Gurgaon, Haryana, Ex.R-1 – Aadhar Shila, Ex.R-2 – Post Mortem Examination Report, Ex.R-3 – letter dated 15.12.2021.
7. As per Post Mortem Examination Report vide Ex.R-2 in which it has been mentioned that “Information supplied by the police and/or Hospital Record As per information provided by police FANSI KA FANDA LAGAKAR.”. It has also been mentioned in Post Mortem Examination Report in Opinion
“Cause of Death
In my opinion the cause of death in this case is Asphyxia due to handing which is antemortem in nature and sufficient to cause death in ordinary course of nature.
8. It is evident from letter dated 15.12.2021 vide Ex.R-3 in which it has been mentioned that “Claim evaluation reveals that late Mr. Utphal Dass committed suicide and as per Policy Terms & Conditions Section – Seven (A) –
Suicide: if the Insured Member commits suicide, whether sane or insane at the time, withbin one year from the Coverage Commencement Date as stated in the Schedule, then the liability of the Company shall be limited to a refund of 80% of the premium received.
As per the deceased committed suicide within one year from the date of the policy
commencement we are refunding premium of Rs.14,464/- towards the full and final settlement for certificate of insurance NO. GC00003802GNY00.
The claim amount of Rs. 14464 has been paid to Aadhar Housing Finance Limited dated on 09.12.2021 vied Transaction No. SIN3817Q0015277..
9. After going through the evidence led by the parties, the Commission is of the opinion that no deficiency in service on behalf of opposite parties have been proved. Hence, the complaint is dismissed. Copy of this order be given to the parties concerned free of costs and file be consigned to record room.
Announced on: 16.01.2023. (Amit Arora)
President
District Consumer Disputes
Redressal Commission, Faridabad.
(Mukesh Sharma)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
(Indira Bhadana)
Member
District Consumer Disputes
Redressal Commission, Faridabad.
