BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KAITHAL.
Complaint Case No.312 of 2018.
Date of institution: 22.11.2018.
Date of decision:25.10.2019.
1.Mukesh Devi @ Mukesh Rani age 36 years, wd/o Ram Mehar.
2. Renu (minor) d/o Ram Mehar.’
3. Paras son of Ram Mehar (minor) son of Ram Mehar,
Minors petitioners No.2 & 3 through their mother/natural guardian Mukesh Devi @ Mukesh Rani petitioner No.1, all rs/o Village Manas Tehsil & Distt. Kaithal.
…Complainant.
Versus
- Punjab National Bank Metlife India Insurance Company Ltd. (Regd. Office) Brigade Seshamahal, 5, Vani Vilas Road, Basavanagudi, Bangalore-560004 (Karnatka).
- P.N.B. Metlife India, Insurance Company Ltd., Unit Nos.103-104, 2nd floor, Ocean Heights, K-4, Sector-18, Noida (U.P.).
- Punjab National Bank, Ambala Road, Kaithal, through its Branch Manager, Kaithal.
….Respondents.
Before: Sh. D.N.Arora, President.
Sh. Rajbir Singh, Member.
Smt. Suman Rana, Member.
Present: Sh. Balwan Singh Johar, Advocate, for the complainants.
Sh. Balbir Bansal, Advocate for the OPs.No.1 & 2.
Sh. D.S.Punia, Adv. for the Op No.3.
ORDER
D.N.ARORA, PRESIDENT
The complainants have filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that the husband of complainant No.1 namely Ram Mehar (since deceased) purchased an insurance policy No.21134386 for the sum of Rs.1,20,000/- from the Ops. It is alleged that the deceased Ram Mehar was paying the monthly installments of the policy regularly and nothing was due on the date of death of Sh. Ram Mehar. After the death of deceased Ram Mehar, the complainant No.1 being the nominee lodged the claim with the Ops with the Ops No.1 & 2 and submitted all the necessary documents but the Ops No.1 & 2 repudiated the claim of complainants vide letter dt. 08.08.2018. The said repudiation of claim is wrong and illegal. So, it is a clear cut case of deficiency in service on the part of Ops and prayed for acceptance of complaint. Hence, this complaint.
2. Upon notice, the OPs appeared before this Forum and contested the complaint by filing their replies separately. Ops No.1 & 2 filed the reply jointly raising preliminary objections with regard to locus-standi; maintainability; that the present complaint is hopelessly time-barred as the life assured Ram Mehar was allegedly died on 11.09.2013 and neither any intimation nor any claim was lodged with the answering Ops; that the policy in question was commenced on 31.07.2013 and the DLA was allegedly died on 11.09.2013 within a period of 42 days from the date of commencement of the policy. No claim was lodged with the answering Ops, therefore, the answering Ops have lost their valuable rights to investigate the genuineness of the death of DLA. The early death of insured clearly proves that the policy in question was taken by the DLA with malafide intention to play fraud with the answering Ops. There is no deficiency in service on the part of Ops. On merits, it is stated that as per the terms and conditions, the policy was automatically terminated after the completion of 5 years and the surrender value of Rs.12,356.38 paise was sent to the insured vide cheque No.907858. The other objections raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.
3. Op No.3 filed the reply raising preliminary objections with regard to locus-standi; maintainability; cause of action and evasively denied all the facts contained in the complaint and so, prayed for dismissal of complaint.
4. The complainant tendered into evidence affidavit Ex.CW1/A and documents Annexure-C1 to Annexure-C4 and thereafter, closed the evidence.
5. On the other hand, the Ops No.1 & 2 tendered into evidence affidavit Ex.RW1/A and documents Annexure-R1 to Annexure-R15 and thereafter, closed the evidence. Op No.3 did not tender any evidence despite availing several opportunities, so, the evidence of Op No.3 was closed vide court order dt. 02.09.2019.
6. We have heard the learned Counsel for both the parties and perused the record carefully.
7. Undisputedly, the husband of complainant No.1 namely Ram Mehar (since deceased) purchased an insurance policy No.21134386 for the sum of Rs.1,20,000/- from the Ops. According to the complainants, the deceased Ram Mehar was paying the monthly installments of the policy regularly and he died on 11.09.2013 and nothing was due on the date of death of Sh. Ram Mehar. After the death of deceased Ram Mehar, the complainant No.1 being the nominee lodged the claim with the Ops No.1 & 2 and submitted all the necessary documents but the Ops No.1 & 2 repudiated the claim of complainants vide letter dt. 08.08.2018. Ld. counsel for the complainants placed reliance upon the case law cited in 2005(3) CPJ page 118 (NC) titled as Murari Woollen Mills Ltd. Vs. UII.
8. We have considered the rival contentions of both the parties. The Ops No.1 & 2 have taken specific stand in the written statement that the policy in question was commenced on 31.07.2013 and the DLA was allegedly died on 11.09.2013 within a period of 42 days from the date of commencement of the policy. It is clear that the husband of complainant No.1 namely Ram Mehar died on 11.09.2013 and the claim was lodged by the complainants with the Ops No.1 & 2 in the year 2018 i.e. after the lapse of 5 years, so, the Ops have lost their valuable rights to investigate the genuineness of the death of DLA and the Ops could easily come to this conclusion what was the reason regarding early death of deceased whether it is a natural death or any other reason. The Insurance company could also investigate the claim of complainants if it is filed immediately, then they can easily ascertain whether the deceased has concealed any true and material facts at the time of obtaining the policy. The Ops have drawn our attention towards the terms and conditions Annexure-R6, wherein it is clearly mentioned as per clause 2.1.1 Death Benefit: If the insured dies before attaining age 60 during the policy term and while the policy is in force, then we will pay you or the nominee the highest of:
(a) The Regular Premium Fund Value as on the Relevant Date.
Admittedly, the insured died before attaining the age of 60 years and at the time of death, the age of insured was 28 years, as is clear from the Annexure-C1 proposal form wherein the date of birth of insured is shown as 01.09.1985 and he died on 11.09.2013. Therefore, as per the terms and conditions, the policy was automatically terminated after the completion of 5 years and the surrender value of Rs.12,356.38 paise was sent to the insured vide cheque No.907858 vide letter dt. 08.08.2012 Annexure-C2. So, in view of facts and circumstances of the case, the Ops have rightly repudiated the claim of complainant. Hence, we find no deficiency in service on the part of Ops. The authority submitted by ld. counsel for the complainants is not disputed but the same is not applicable to the facts of instant case.
9. Thus, as a sequel of above discussion, we find no merit in the present complaint and accordingly, the same is hereby dismissed. No order as to costs. A copy of said order be supplied to the parties free of costs. File be consigned to record-room after due compliance.
Announced in open court:
Dt.:25.10.2019.
(D.N.Arora)
President.
(Suman Rana), (Rajbir Singh)
Member Member.
