DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, BARNALA, PUNJAB.
Complaint Case No: CC/78/2023
Date of Institution: 05.07.2023
Date of Decision: 03.12.2024
Gian Kaur aged about 64 years widow of Tirlochan Singh son of Jangir Singh resident of Patti Ramdas, Village Pakhoke, District Barnala-148103.
…Complainant
Versus
1. Reliance Nippon Life Insurance Company Limited, Above Delhi Tractor 7 Combine, Dr. Siddana Hospital Wali Gali, Pakka College Road, Barnala, through its Branch Manager.
2. Reliance Nippon Life Insurance Company Limited, Registered Office, H-Block, 1st floor, Dhirubhai Ambani Knowledge City, Navi Mumbai (Maharashtra)-400710, Mumbai through its MD.
…Opposite Parties
Complaint Under Section 35 of the Consumer Protection Act, 2019.
Present: Sh. Anuj Mohan Adv counsel for complainant.
Sh. Dhiraj Kumar Adv counsel for opposite parties.
Quorum.-
1. Sh. Ashish Kumar Grover: President
2. Sh. Navdeep Kumar Garg : Member
(ORDER BY ASHISH KUMAR GROVER PRESIDENT):
The complainant has filed the present complaint under Section 35 of the Consumer Protection Act 2019 against Reliance Nippon Life Insurance Company Limited, Above Delhi Tractor 7 Combine, Dr. Siddana Hospital Wali Gali, Pakka College Road, Barnala, through its Branch Manager & others (in short the opposite parties).
2. The facts leading to the present complaint are that the complainant is senior citizen old widow lady and is a rustic villager. It is alleged that the husband of the complainant namely Tirlochan Singh has expired on 27.10.2022 at Village Paklhoke and the husband of the complainant during his lifetime had purchased one insurance policy from the OP's on 09.10.2012 namely Reliance Cash Flow Plan bearing policy No. 50414730 and the basic sum assured under the said policy was Rs. 2 lakh and the yearly premium under the said policy was Rs. 26,545.67/-. It is further alleged that said Tirlochan Singh had paid the premium under the said policy upto the year 2019. It is alleged that under the money back scheme of the said policy an amount of Rs. 50,000/- was paid on 30.09.2016 and Rs. 50,000/- was paid on 09.10.2019 to said Tirlochan Singh. It is alleged that in the month of August 2019, the husband of complainant received a phone call from Mumbai, wherein one official alleging himself as a Sr. Manager of OP's company asked the husband of complainant that their company has issued a new plan, wherein the customers of the OP's company who had already purchased policy of the OP company and as per the status of your earlier policy, you will invest an amount of Rs. 1,05,000/- approximately in single time then you will not need to pay the future installments/premium of the earlier policy and the basic sum assured will be double of your earlier policy i.e. from Rs. 2 lakh to Rs. 4 lakh. It is further alleged that on believing the assertion of the said official, the husband of complainant showed his willingness in the said proposal/plan and the said person told the husband of complainant that their local agent will come for the detail plan. Thereafter, one Sukhbir Singh visited the house of complainant and he also assured the complainant and her husband for good return and also asked that you will need not to deposit the future installments/premium of the above said policy, as such the complainant and her husband handed over the cheque bearing No. 003561 of Rs. 1,05,269/- dated 26.08.2019 drawn on Punjab Gramin Bank, Pakho Kalan to the agent of OP's and the said agent also took the particulars of the complainant and her family and also took the signatures of the husband of the complainant. It is further alleged that the said agent of the OP's also asked to the husband of the complaint that on the death of the insured the basic sum assured will be paid Rs. 4 lakh by the company and issued a receipt to the husband of the complainant. It is further alleged that unfortunately the husband of the complainant has expired on 27.10.2022 at Village Pakhoke and after his death the complainant lodged the death claim of Tirlochan Singh with the OP company alongwith all the requisite documents and the complainant was shocked that the OP's had paid only Rs. 49,296.72/- to the bank account of the complainant. It is alleged that the complainant approached the OP's and asked about the less payment, then the officials of the OP's told to the complainant that the husband of the complainant had purchased new policy in the year 2019 in which the yearly premium was Rs. 1,05,269/- and after paying the first premium next year premium was not paid by the husband of the complainant and as such the alleged policy lapsed and the payment of Rs. 1,05,269/- has been forfeited by the OP company and in the earlier policy the husband of the complainant had not paid the premium after 2019 and as such only an amount of Rs. 49,296.72/- was paid towards full and final settlement. It is alleged that the complainant told him that the agent who took the payment from her husband never disclosed about the investment in the life insurance policy and he never consented for the same and the agents of the OP's wrongly and illegally by taking the complainant and her husband under allurement and dark got invested their hard earned money into insurance policy, which was never opted by the husband of the complainant. It is further alleged that the complainant and her husband came to know that the agent of the OP's have cheated them and grabbed their hard earned money by disclosing wrong averments. The complainant requested the opposite party No. 1 to pay the death claim of Rs. 4 lakh to her. However, OP No. 1 flatly refused to extend any help to the complainant by saying that as per the terms & conditions of the policy no amount is payable. The above said act of the opposite parties amounts to deficiency in service and unfair trade practice on the part of opposite parties. Hence, the present complaint is filed for seeking the following reliefs.-
- The opposite parties may be directed to release the death claim amount of Rs. 4,00,000/- alongwith interest @ 18% per annum and also directed to pay the amount of Rs. 1,05,269/- alongwith interest @ 18% per annum.
- To pay Rs. 1,00,000/- towards mental agony and harassment.
- Further, to pay Rs. 22,000/- as litigation expenses.
3. Upon notice of this complaint, the opposite parties appeared and filed written version by taking legal objections interalia on the grounds that the complaint filed by the complainant is not maintainable and is liable to be dismissed as the complainant has attempted to misguide and mislead the Commission. It is alleged that the policy bearing No. 50414730 (old policy) was issued on 09.10.2012 on the life of Mr. Tirlochan Singh and the DLA had paid last premium on 09.04.2019 under the said policy and thereafter, failed to pay the renewal premiums therefore, the policy acquired paid-up status and the premium mode under the said policy was "half yearly" and the DLA had paid 15 No. of half yearly premiums, total amounting to Rs. 2,00,682/-. The answering opposite parties had received death claim intimation under the subject policy and upon receipt of the claim intimation, the claim was assessed and accordingly, the paid-up benefits were paid to the complainant as per the terms and conditions of the said policy. It is further alleged that late. Mr. Tirlochan Singh had purchased one more policy from the answering opposite party on the life of his son i.e., Mr. Surinder Singh bearing policy No. 53552401 (new policy) and the said policy was issued on 10.09.2019. It is further alleged that late. Mr. Tirlochan Singh is proposer and Mr. Surinder Singh is Life Assured and the proposer has paid only one premium, thereafter failed to pay the renewal premiums therefore, the said policy is foreclosed due to non-payment of premiums. It is further alleged that the policy bearing No. 53552401 is issued on the life of Mr. Surinder Singh and the death benefits, if any are payable only upon the death of the Life Assured and not upon death of the proposer. Therefore, no death benefits are payable under the policy bearing No. 53552401 since under the said policy, the proposer had died. Further, the said policy is foreclosed hence, no policy benefits are payable as per the terms and conditions of the policy. It is further alleged that it is clearly mentioned under the policy document of policy bearing No. 50414730 that the policy holder need to pay premium for 13 years. Further, the insurance is a contract and both the parties are abided by the terms and conditions of the policy contract and the company cannot travel beyond the terms and conditions of the policy. It is further alleged that with respect to the new policy, the matter is barred by limitation as per section 69 of the Insurance Act since, the policy was issued on 10.09.2019 and the present complaint is filed with respect to the new policy in July-2023 i.e., after a period of 3 years and the cause of action arisen when the policy was issued in September-2019. Further, the complaint with respect to the new policy is pre-matured since the policy holder never approached the company complaining about any grievance under the said policy.
4. On merits, it is submitted that the answering opposite parties received proposal/application form bearing No. D-3672221 duly filled and signed by the policy holder i.e, late. Mr. Tirlochan Singh under policy bearing No. 50414730 seeking insurance on his life under the 'Reliance Nippon Cash Flow Plan" and proposal/application form bearing No. TI-994247 duly filled and signed by the policy holder i.e., Late. Mr. Tirlochan Singh under policy bearing No. 53552401, seeking insurance on the life of his son i.e., Mr. Surinder Singh under the "Reliance Nippon Life Milestone Plan". It is further alleged that the answering opposite parties, after receipt of duly filled proposal forms along with the other requisite documents and the amount of first yearly premium deposit had issued the subject policies in question. It is alleged that the answering opposite parties had paid survival benefits under policy bearing No. 50414730 as per the policy terms and conditions to the policy holder vide cheque bearing No. 439426 dated 04.10.2016 which was encashed on 27.10.2016 and cheque bearing No. 462696 dated 10.10.2019 which was encashed on 04.11.2019 and the said payouts were admittedly received by the policy holder. It is further alleged that the answering opposite parties received claim intimation under the policy bearing No. 50414730 from the complainant being Nominee and upon receipt of the claim, the claim was assessed and as per the records, it was noted that the policy was under "Paid-Up" status due to non-payment of premium. Thus, the answering opposite parties, as per the terms and conditions of the policy paid the paid-up under the policy bearing No. 50414730 since the premiums under the said policy was paid till 09,10 2010 thereafter, he failed to pay requisite premium under the policy. It is further alleged that no claim intimation is received under policy bearing No. 53552401. It is alleged that the answering opposite parties had paid the paid-up value amount of Rs. 49,296.72/- towards full and final settlement under policy bearing No. 50414730 as per the terms and conditions of the said policy which was admittedly received by the complainant and the company has communicated about claim settlement to the complainant vide letter dated 31.12.2022. All other allegations of the complaint are denied and prayed for the dismissal of complaint.
5. Ld. Counsel for complainant has suffered the statement that I do not want to file any rejoinder.
6. To prove the case the complainant tendered into evidence affidavit of Gian Kaur as Ex.C-1, copies of premium receipts from 28.11.2014 to 22.11.2021 as Ex.C-2 to C-12, copy of policy and First payment receipt as Ex.C-13, copy of death certificate of Tirlochan Singh as Ex.C-14, copy of cheque bearing No. 00356l as Ex.C-15, copy of Bank passbook of Gian Kaur as Ex.C-16, copy of Initial premium deposit receipt as Ex.C-17 and closed the evidence.
7. The opposite parties tendered into evidence affidavit of Swapnil Malvi as Ex.OPs-1, copy of policy alongwith documents as Ex.OPs-2 (containing 62 pages), copy of payment confirmation as Ex.OPs-3 (containing 5 pages), copy of claim form as Ex.OPs-4 (containing 13 pages), copy of letter dated 31.12.2022 as Ex.OPs-5, copy of letter dated 29.08.2023 as Ex.OPs-6, copy of postal tracking report as Ex.OPs-7 (containing 4 pages) and closed the evidence.
8. We have heard the learned counsel for the parties and have gone through the record on the file. Written arguments filed by the opposite parties.
9. Ld. Counsel for the complainant argued that the husband of the complainant namely Tirlochan Singh has expired on 27.10.2022 at Village Paklhoke and the husband of the complainant during his lifetime had purchased one insurance policy from the opposite parties on 09.10.2012 namely Reliance Cash Flow Plan bearing policy No. 50414730 and the basic sum assured under the said policy was Rs. 2 lakh and the yearly premium under the said policy was Rs. 26,545.67/-. It is further argued that said Tirlochan Singh had paid the premium under the said policy upto the year 2019. It is further argued that under the money back scheme of the said policy an amount of Rs. 50,000/- was paid on 30.09.2016 and Rs. 50,000/- was paid on 09.10.2019 to said Tirlochan Singh. It is further argued that in the month of August 2019, the husband of complainant received a phone call from Mumbai, wherein one official alleging himself as a Sr. Manager of opposite parites company asked the husband of complainant that their company has issued a new plan, wherein the customers of the insurance company who had already purchased policy of the company and as per the status of your earlier policy you will invest an amount of Rs. 1,05,000/- approximately in single time then you will not need to pay the future installments/premium of the earlier policy and the basic sum assured will be double of your earlier policy i.e. from Rs. 2 lakh to Rs. 4 lakh. It is further argued that one Sukhbir Singh visited the house of complainant the complainant and her husband handed over the cheque bearing No. 003561 of Rs. 1,05,269/- dated 26.08.2019 drawn on Punjab Gramin Bank, Pakho Kalan to the agent of opposite parties and the said agent also took the particulars of the complainant and her family and also took the signatures of the husband of the complainant. It is further argued that unfortunately the husband of the complainant has expired on 27.10.2022 and after his death the complainant lodged the death claim of Tirlochan Singh with the insurance company alongwith all the requisite documents and the complainant was shocked that the opposite parties had paid only Rs. 49,296.72/- to the bank account of the complainant. It is further argued that the complainant approached the opposite parties and told that the husband of the complainant had purchased new policy in the year 2019 in which the yearly premium was Rs. 1,05,269/-. It is further argued that the agent who took the payment from her husband never disclosed about the investment in the life insurance policy and he never consented for the same and the agents of the opposite parties wrongly and illegally got invested their hard earned money into insurance policy which was never opted by the husband of the complainant. It is further argued that the complainant requested the opposite parties to pay the death claim of Rs. 4 lakh to her, however, the opposite parties flatly refused to do soby saying that as per the terms & conditions of the policy no amount is payable.
10. On the other hand, Ld. Counsel for the opposite parties argued that the opposite parties received proposal/application form bearing No. D-3672221 duly filled and signed by the policy holder i.e, late. Mr. Tirlochan Singh under policy bearing No. 50414730 seeking insurance on his life under the 'Reliance Nippon Cash Flow Plan" and proposal/application form bearing No. TI-994247 duly filled and signed by the policy holder i.e., Late. Mr. Tirlochan Singh under policy bearing No. 53552401 seeking insurance on the life of his son i.e., Mr. Surinder Singh under the "Reliance Nippon Life Milestone Plan". It is further argued that the opposite parties after receipt of duly filled proposal forms along with the other requisite documents and the amount of first yearly premium deposit had issued the subject policies in question. It is further argued that the opposite parties had paid survival benefits under policy bearing No. 50414730 as per the policy terms and conditions to the policy holder vide cheque bearing No. 439426 dated 04.10.2016 which was encashed on 27.10.2016 and cheque bearing No. 462696 dated 10.10.2019 which was encashed on 04.11.2019 and the said payouts were admittedly received by the policy holder. It is further argued that no claim intimation is received under policy bearing No. 53552401. It is further argued that the opposite parties had paid the paid-up value amount of Rs. 49,296.72/- towards full and final settlement under policy bearing No. 50414730 as per the terms and conditions of the said policy. It is further argued that with respect to the new policy, the matter is barred by limitation as per Section 69 of the Insurance Act, as the policy was issued on 10.9.2019 and the present complaint is filed with respect to the new policy in July-2023 i.e. after a period of 3 years and the cause of action arisen when the policy was issued in September-2019.
11. We have gone through the facts and evidence produced by the parties. In order to prove their case the opposite parties have placed on record copy of insurance policy bearing No. 50414730 (old policy) i.e. Ex.O.Ps-2 which shows the date of commencement 9/10/2012 and the premium term as 13 years, frequency of payment half yearly i.e. Rs. 13,427.98, date of benefit and date of last premium 9th October 2025. The specific case of the opposite parties is that DLA had paid last premium on 09.04.2019 under the said policy and thereafter failed to pay the renewal premiums therefore, the policy acquired paid-up status. The DLA had paid 15 No. of half yearly premiums and the opposite parties had received death claim intimation under the subject policy and upon receipt of the claim intimation, the claim was assessed and accordingly the paid-up benefits i.e. Rs. 49,296.72/- towards full and final settlement under the policy bearing No. 50414730 were paid to the complainant as per the terms and conditions of the said policy which was received by the complainant and the company has communicated about claim settlement to the complainant vide letter dated 31.12.2022 i.e. Ex.O.Ps-5 and this fact is proved from the bank passbook of Gian Kaur complainant i.e. Ex.C-16. The complainant in her complaint has alleged that the said Tirlochan Singh had paid the premium under the said policy upto the year 2019.
12. Further, regarding the second policy bearing No. 53552401 of deceased Tirlochan Singh, Ld. Counsel for the opposite parties specifically argued that late. Mr. Tirlochan Singh had purchased one more policy (new policy) on the life of his son i.e., Mr. Surinder Singh and the said policy was issued on 10.09.2019 and late. Mr. Tirlochan Singh is proposer and Mr. Surinder Singh is Life Assured and the proposer has paid only one premium thereafter failed to pay the renewal premiums therefore, the said policy is foreclosed due to non-payment of premiums. It is further argued that the death benefits, if any are payable only upon the death of the Life Assured and not upon death of the proposer, therefore no death benefits are payable under the policy bearing No. 53552401 since under the said policy, the proposer had died and the said policy is foreclosed hence, no policy benefits are payable as per the terms and conditions of the policy. Ld. Counsel for the opposite parties further argued that with respect to the new policy the matter is barred by limitation as per section 69 of the Insurance Act as the policy was issued on 10.09.2019 and the present complaint is filed with respect to the new policy in July-2023 i.e., after a period of 3 years and the cause of action arisen when the policy was issued in September-2019 and the complaint with respect to the new policy is pre-matured since the policy holder never approached the company complaining about any grievance under the said policy.
13. We have gone through the second insurance policy bearing No. 53552401 which was produced by the opposite parties as Ex.O.Ps-2. It is clearly established from the said policy that Mr. Tirlochan Singh was the proposer of the said policy and Mr. Surinder Singh son of Tirlochan Singh was insured under the policy. It is also established from the said policy that the first installment was paid by the deceased Tirlochan Singh in the year 2019. The specific case of the opposite parties is that the policy has been lapsed due to non deposit of further premium installment of the policy No. 53552401. As per the policy if the deceased Tirlochan Singh did not want to continue further with the said policy then he can approach the opposite parties within free look cancellation period. The complainant has failed to produce any cogent evidence to prove her case. The complainant has already got the insurance claim in the first policy bearing No. 50414730 and this fact is also admitted by the complainant. The complainant is not entitled to get any claim under the policy bearing No. 53552401 as Tirlochan Singh was not insured under the said policy and the policy has already been lapsed.
14. Therefore, in view of the above said facts and circumstances we are of the considered view that there is no deficiency in service or unfair trade practice on the part of the opposite parties and the complainant has failed to prove her case by producing cogent, reliable and trustworthy evidence.
15. In view of the above discussion, there is no merit in the present complaint and the same is dismissed without costs. Copy of the order be supplied to the parties free of costs. File be consigned to the records after its due compliance.
ANNOUNCED IN THE OPEN COMMISSION:
3rd Day of December, 2024
(Ashish Kumar Grover)
President
(Navdeep Kumar Garg)
Member
