Haryana

StateCommission

A/114/2019

MAX LIFE INSURANCE CO. LTD. AND ANOTHER - Complainant(s)

Versus

PREETI - Opp.Party(s)

RAJESH KAUSHIK

10 Oct 2022

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION HARYANA, PANCHKULA

                                                      First Appeal No.114 of 2019

                                                 Date of Institution: 30.01.2019

                                                          Date of final hearing: 10.10.2022

Date of pronouncement: 30.12.2022

 

1.      Max Life Insurance Company Ltd., Branch Office, Near ICICI Bank, Sector-17, Kurukshetra through its Branch Manager.

2.      Max Life Insurance Company Ltd., Operation Centre, Plot No. 90A, Sector-18, Uthyog Vihar, Gurgaon-122015 through its Manager/Director.

…..Appellants

Versus

Preeti aged 30 years, daughter of Usha Rani, Resident of House No. 1739, Sector 7 U.E., Kurukshetra.

…..Respondent

CORAM:    S.P.Sood, Judicial  Member

                    Suresh Chander Kaushik, Member

                   

Present:-    Mr.Bhupender Singh, Advocate for the appellants.

                   Mr. Pardeep Chhokar, Advocate for the respondent.

 

                                                 ORDER

S P SOOD, JUDICIAL MEMBER:

          The present appeal No.114 of 2019 has been filed against the order dated 21.12.2018 of the District Consumer Disputes Redressal Forum, Kurukshetra (In short  Now “District Commission”) in complaint case No.55 of 2018, which was allowed.

2.       The brief facts of the case are that complainant’s mother has obtained life insurance policy No.779636778 from opposite parties and paid Rs.75,000/- in all by way of three consecutive premiums.  Unfortunately in the month of October, 2016 life assured passed away.  Being her nominee, complainant lodged the claim with OPs and submitted all the necessary and requisite documents. OPs issued cheque No.931463 dated 01.02.2016 amounting to Rs.25,661.49 paise in the name of deceased Usha Rani.  She requested OPs to pay the cheque of entire deposited amount that too in her own name but the OPs issued the cheque again and again in the name of her deceased mother Smt. Usha Rani.  Thus, there being deficiency in service on the part of the O.Ps, so this complaint.

3.      In its written version, OPs raised preliminary objections with regard to locus-standi, maintainability, cause of action, estoppels, jurisdiction, limitation and concealment of true and material facts and requested to dismiss the complaint. On merits, it was submitted that on 01.03.2010 insurance policy was issued in favour of Smt. Usha Rani and its annual premium was due on 28.02.2013, which was not paid by the insured. On 29.01.2013 intimation regarding renewal premium was sent but inspite of this, the insured did not pay the premium due and accordingly, vide letter dated 31.01.2016, the policy in question was terminated. Termination letter alongwith cheuqe of Rs.25,661.49 paise because the fund value being less than one Annual Target Premium in the name of Smt. Usha Rani was sent to life assured. Thus, there being no deficiency in service on the part of the O.Ps and requested to dismiss the complaint.

4.      After hearing both the parties, the learned District Commission, Kurukshetra has allowed the complaint vide order dated 21.12.2018, which is as under:-

“In the present case, the last installment was deposited by the insured person in the month of February, 2012.  The next installment was due in February, 2013.  The grace period of 30 days from due date shall be allowed for payment of contractual premium.  The policy can be revived at the Company’s sole discretion, within a period of Thirty Six (36) months from the date of lapse.  Meaning thereby, upto March, 2016, the policy can be revived according to policy but the Ops terminated the policy of insured person on 31.01.2016 i.e. wrong and illegal.  Moreover, as per policy, Ex.R1, at page No.3, it is mentioned that in case of dread disease, sum assured of Rs.1,25,000/-.  As per document submitted by the counsel of complainant, the insured person fell ill and also on bed ridden as per document Mark-B as the insured person was suffering from cancer.  The insured person was on bed, so, she could not give the installment of Ops.  It is also mentioned in the policy that in case, the policy-holder became suffer from dread disease, the Ops shall be liable to pay Rs.25,0,000/- +Rs.1,25,000/-.   But the Ops have not paid the said amount to the complainant.  Hence, in the facts and circumstances of the case, we are of the considered view that there is deficiency in service on the part of Ops.

10.            Thus, as a sequel of above discussion, we allow the complaint and direct the Ops to pay Rs.2,50,000/-+Rs.1,25,000/- and total Rs.3,75,000/- to the complainant and further to pay Rs.20,000/- as lump sum compensation on account of harassment, mental agony including litigation charges in the interest of justice.  Let the order be complied with within 30 days from the date of preparation of copy of this order, failing which, the complainant shall be entitled interest @ 9% p.a. from the date of order till its realization.  Both the Ops are jointly and severally liable.”

5.      Feeling aggrieved therefrom, O.Ps.-appellants have preferred this appeal.

6.      This arguments have been advanced by Sh. Bhupender Singh, learned counsel for the appellants as well as Sh. Pardeep Chhokar, learned counsel for the respondent. With their kind assistance the entire records as well as original record of the District Commission including whatever evidence has been led on behalf of  both the parties has also been properly perused and examined.

7.      Learned counsel for the appellant argued that insurance policy was issued to life assured on 01.03.2010. The annual premium was not paid even after intimation regarding renewal premium being due was issued dated 29.01.2013 to her.  Therefore OPs have rightly terminated the policy as per clause no. 14 (iii) vide termination letter dated 31.01.2016.  OPs has rightly issued cheque no.931463 dated 01.02.2016 amounting to Rs.25661.49 paise being the fund value in the name of life assured. Hence, the complainant was not entitled for the claim amount as prayed for.

8.      Learned counsel for the respondent argued that complainant’s mother paid Rs.75,000/- by way of three installments upto February, 2012. After that her mother fell ill and became bed ridden, so, she could not pay the due installment in time. Learned District Commission has rightly allowed the complaint of the complainant and prayed for dismissal of the appeal.  

9.                It is admitted that premium of the policy was paid upto February, 2012 by life assured. The life assured has not paid the premium since 28.02.2013 and policy was terminated on 31.01.2016. The fund value of the policy has been reduced and at present becomes Rs.29,749.56 paise, thus, the complainant is not entitled for the claim amount as her policy was terminated. Since, the last premium was paid in February, 2012 and next installment was due in February, 2013, which can be revived at company’s sole discretion within a period of 36 months, but OPs terminated the policy of the insured on 31.01.2016 i.e. before expiring the period of 36 months. So for all these reasons, the learned District Commission has rightly allowed the claim of the complainant. The learned District Commission had committed no illegality while passing the order dated 21.12.2018.  The appeal is also devoid of merits and stands dismissed.

10.    The statutory amount of Rs.25,000/- deposited at the time of filing the appeal be refunded to the respondent-complainant  against proper receipt and identification in accordance with rules, after the expiry of period of appeal/revision, if any.

11.              Applications pending, if any stand disposed of in terms of the aforesaid judgment.

12.              A copy of this judgement be provided to all the parties free of cost as mandated by the Consumer Protection Act, 1986/2019. The judgement be uploaded forthwith on the website of the commission for the perusal of the parties.

13.              File be consigned to record room.

 

30^th December, 2022          Suresh Chander Kaushik            S. P. Sood                                                                Member                                             Judicial Member    

S.K

(Pvt. Secy.)