Delhi

East Delhi

CC/971/2013

MO. SHAHID ANSARI - Complainant(s)

Versus

RAJIV BISWAS - Opp.Party(s)

23 Aug 2017

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM (EAST)

GOVT. OF NCT OF DELHI

CONVENIENT SHOPPING CENTRE, FIRST FLOOR,

SAINI ENCLAVE, DELHI – 110 092

 

 

C.C. NO.  971/13

 

Mohd. Shahid Ansari

S/o Shri Israr Ahmed Ansari,

9/4, Gali No. 1, West Laxmi Market

East Delhi – 110 051                                                             ….Complainant

 

Vs.

 

1. Shri Rajiv Biswas

Branch Manager – Bgartiya Jeevan Beema Nigam

Branch Off.: 11 S, 53-54, Goverdhan Building

Nehru Palace – 110 019

 

2. Shri S.K. Roy

Chairman of LIC

1^st Floor, J.B. Nagar Shopping Centre

Borivali, Mumbai.                                                             ….Opponent

 

 

Date of Institution: 18.11.2013

Judgment Reserved on: 22.08.2017

Judgment Passed on: 23.08.2017

CORUM:

Sh. Sukhdev Singh (President)

Dr. P.N. Tiwari  (Member)

 

Order By : Sh. Sukhdev Singh (President)

 

 

JUDGEMENT

          This complaint has been filed by Mohd. Shahid Ansari against General Manager, Shri Rajiv Biswas, Branch Manager, Bhartiya Jeevan Beema Nigam (OP-1) and Shri S.K. Roy, Chairman of LIC (OP-2) under Section 12 of the Consumer Protection Act, 1986. 

2.       The facts in brief are that the complainant got a policy known as Komal Jeevan – T. No. 159, having its no. as 115801711 in the name of his son Suhail Hassan on 04.11.2009, expired on 26.06.2010.  OP promised to give the amount not below the paid installment amount.  The complainant paid an amount of Rs. 15,031/- and received an amount of Rs. 14,363/-.  The sum assured was     Rs. 2,00,000/- having yearly payment of Rs. 15,031/-..  It has been stated that in the advertisement, it was mentioned that on the death of the life assured, the nominee will get the guaranteed the equal amount of the premium paid and guaranteed additions of Rs. 75/- per thousand.  The amount was stated to be transferred through NEFT or RTGS/online. 

          It has further been stated that the manager has asked bribe to clear the payment through NEFT/RTGS or they have sent the payment through cheque.  Thus, it has been stated that the advertisement was false and misleading; cheating by given false promise; deficiency in service; harassment etc.  Hence, the complainant have prayed for the amount as per promise/advertisement with 18% interest; compensation of             +Rs. 19,00,000/- on account of physical strain and mental agony and Rs. 1,000/- as cost of litigation, punishment and penalty against the accused etc. etc.

3. In reply of LIC, they have stated that as per policy conditions, if the life assured expired before the commencement of risk and in such event, provided the policy was in full force, then only all the premiums paid under the policy was to be refunded after deduction of additional premiums paid, hence, Rs. 14,363/- has been paid to the claimant under the case after deducting Premium Waiver Benefit which was clearly mentioned in Clause 2 of the special provisions of the policy.

          It has been stated that it was mentioned on the policy as the date of commencement as 04.11.2009 whereas the life assured expired on 26.06.2010 before the commencement of risk on 04.11.2016 i.e. after attaining the age of 7 of child immediate policy anniversary.  They have further stated that guaranteed addition were payable only after commencement of risk under this policy, but the life assured expired before the commencement of risk in this case no guaranteed addition was payable.  They have further stated that all the claims, payments were made through NEFT and accordingly, the requirements were called, but in this case as the life assured was minor, nominee master was absent and payment  to the proposer was not possible through NEFT as no such option was available in the module.  Hence, cheque was prepared in the name of Mohd. Shahid, who was proper under this policy. 

          They have further stated that the complainant requested to take a policy bearing no. 115801711 (Komal Jeevan Plan) which was issued to the life assured.  The policies of insurance being a contract, the relationship between the parties were governed by the terms and conditions of the policy.  The special provisions i.e. terms and conditions of the policy were as “This policy shall stand cancelled in case the Life assured shall die before the commencement of Risk and in such event, provided the policy was in full force, a sum of money equal to all the premium paid excluding the additional premiums paid for PWB and term Rider premium, if opted for, without any deduction whatsoever, shall become payable to the person entitled to the policy moneys”.       Thus, they have stated that they did not give any misleading advertisement and false representations or they made any cheating by giving false promise.  Thus, there was no deficiency on the part of OP. 

4. In support of its complaint, the complainant have examined   Shri Mohd. Sajid Ansari (AR) who have not deposed on affidavit, but have filed this evidence in the form of reply to the WS.  Though, the evidence filed was not proper, however, the same is read for the purpose of disposal of the complaint.  In this evidence, though he has made averments which were not required to be made, but for the purpose of this complaint, the relevant portion from this evidence is taken up.  In nut shell, he has stated that they were not communicated with regard to the terms and conditions stated in the policy.  He has further stated that on 29.06.2010, they informed to LIC about the death of Master Suhail (policy holder) and submitted the original documents to the concerned branch and they were informed by LIC, Nehru Place branch on 15.07.2011 that the original documents have arrived and advised to send them the death certificate attested by embassy.

          LIC (OP) have examined Ms. Nandita, working as Manager (L&HPF) at LIC, who have stated that LIC agent has approached the complainant at house no. 208, Tilak Khand, Giri Nagar, Kalkaji, New Delhi for LIC policy for the complainant’s child.  She has got exhibited proposal form (Ex.RW1/1).  She has stated that the policy commenced from 04.11.2009.  The terms and conditions of the policy were explained.  The bond has been exhibited as Ex.RW1/2.  She has also got exhibited calculation of payment sheet (Ex.RW1/3).  She has also narrated the other facts, which have been stated in the WS.

5. We have heard AR of the complainant and Ld. Counsel for OP and have perused the material placed on record.  It has been argued on behalf of OP that the complainant was explained all the terms and conditions of the policy.  He has further argued that there was no delay in making the payment.  The delay, if any, has occurred due to non submission of the documents by the complainant. 

          On the other hand, AR for the complainant have argued that they have timely submitted the documents and there was delay on the part of OP for getting the claim passed.  If the documents placed on record by the complainant  are gone through, it is noticed that on 15.07.2011, LIC (OP) have confirmed the original policy bond and copy of death certificate alongwith other documents and they have requested the complainant to send them the death intimation and death certificate attested by embassy of India. 

          Further, on 05.03.2013, they have acknowledged the receipt of death certificate alongwith other documents through another letter of dated 15.04.2013.  They have clarified with regard to the name of nominee.  Their letter of dated 13.07.2013 shows the cheque of      Rs. 14,363/- towards the payment of claim.  Thus, from this correspondence, it comes out that after completion of all the formalities, LIC (OP) have processed the claim and made the payment at the earliest.  There does not seem to be any delay as alleged by the complainant. 

          From the testimony of Ms. Nandita, Manager, and as per calculation of payment sheet (Ex.RW1/3), it is evident that they have made the payment as per terms and conditions of the policy.  Further, Ex.RW1/2, is Komal Jeewan Plan bond alongwith other documents.  When this policy has been issued alongwith other documents, the plea taken by the complainant that they were not informed with regard to the terms and conditions of the policy cannot be accepted.  The fact that the payment has been made as per terms and conditions of the policy, these terms and conditions were binding on both the parties, policy of insurance being a contract.  The fact that the payment has been made as per the terms and conditions of the policy, it cannot be said that there has been any deficiency on the part of LIC (OP).

          As far as other pleas with regards to the misrepresentation, fraud etc. are concerned, these are mere allegations which cannot be accepted without any proof.  Since, there has been no deficiency on the part of LIC, the complaint has no merit and the same deserve dismissal.  Hence, the same is dismissed.  There is no order as to cost.                 

          Copy of the order be supplied to the parties as per rules.

          File be consigned to Record Room.

 

 

(DR. P.N. TIWARI)                                                             (SUKHDEV SINGH)

     Member                                                                                   President