Haryana

Karnal

CC/465/2019

Bimla - Complainant(s)

Versus

Reliance Nippon Life Insurance Company Limited - Opp.Party(s)

J.B. Arya

15 Feb 2022

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                       Complaint No. 465 of 2019

                                                        Date of instt.24.07.2019

                                                        Date of Decision:15.02.2022

 

Bimla, aged about 35 years widow of Shri Ram Phal resident of village Barsi Tehsil Bawani Khera, near Sunder Nahar, District Bhiwani.

 

                                               …….Complainant.

                                              Versus

 

Reliance Nippon Life Insurance Company Ltd. SCO 135, 1^st floor above Dr. Pathak Hospital, Sector-12 Karnal through its Branch Manager.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 12 of the Consumer Protection Act, 1986 and after amendment Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

                   

 Argued by: Shri J.B.Arya, counsel for complainant.

Shri A.K.Vohra, counsel for opposite party.

 

                    (Jaswant Singh President)

ORDER:   

                

                   The complainant has filed the present complaint Under Section 12 of the Consumer Protection Act, 1986 as after amendment under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that husband of complainant Shri Ram Phal purchased Reliance Endowment Plan Policy bearing no.52302468 on 25.07.2015 sum assured of Rs.3,55,000/-. The premium of policy is payable in half yearly installments of Rs.12470.72/-. Husband of complainant deposited one installment in the said policy. Complainant is the nominee in the said policy. Unfortunately, husband of complainant died on 20.08.2015 due to heart attack and deceased never got any treatment, so Post Mortem Report (PMR) was not conducted. Complainant being nominee, approached the OP, for the life claim amount of her deceased husband. On the instruction of the OP complainant deposited all the original documents with the OP for settlement of the claim. Firstly, OP has assured the complainant to make the payment of assured amount but OP paid an amount of Rs.12470.72 through cheque but same was not encashed and further OP also sent a cheque of Rs.137/- on 24.09.2018 drawn on HDFC Bank towards settlement of claim. It is further averred that firstly, OP assured the complainant for whole claim amount but OP has refunded only the premium amount. The insurance policy purchased by the husband of complainant during his life time and authorized person/official of OP has verified each and every fact prior to issuance of policy. The decision of not making the full claim amount is illegal, null and void and not binding upon the right of the complainant. Complainant being wife and nominee of said Ram Phal is legally entitled to get claim amount from OP.  Complainant requested the OP several times for settlement of the claim but OP did not pay any heed to the request of complainant. In this way there was deficiency in service on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed written version raising preliminary objections with regard to maintainability: locus standi; estoppel; jurisdiction and concealment of true and material facts. On merits, it is pleaded that the claim of the complainant was duly processed and considered and same was not found payable, hence it was repudiated, vide speaking letter dated 13.04.2016, due to the fact that the life assured Mr. Ram Phal had purchased Reliance Endownment Plan policy bearing no.52302468 on 25.07.2015 and at the time of obtaining the policy, deceased had not disclosed in the proposal form that he had already purchased a policy from PNB Met Life Insurance Company prior to purchase of the policy in question from the OP. Thus, non-disclosure of other insurance policy in the proposal form dated 25.07.2015 despite of being specifically asked about in question 22 of the proposal form. If, the policy holder had disclosed the same in the proposal form, the OP would have not issued the subject policy. It is further pleaded that insurance in question is based on utmost good faith and both parties are bound by the terms and conditions of the contract of insurance. It is further pleaded that if the complainant is not satisfied with the decision of the OP, then in that case, the complainant can write to Grievance Redressal Officer or to write to Ombudsman in the region of complainant. Without exhausting the remedies suggested by the OP, the complainant filed the complaint directly before this Commission. It is further pleaded that this Commission has no jurisdiction to try and entertain the present complaint as the life assured was resident of village Alakhpura District Bhiwani, the policy was purchased in District Bhiwani, the death certificate was issued by PHC Alakhpura of the life assured, so this Commission has no jurisdiction to decide the present complaint. It is further pleaded that the life assured paid first installment of the abovesaid policy. The said policy ran for 26 days only as the life assured had expired on 20.08.2015. It is denied that life assured died all of sudden and never got any treatment. It is pleaded that life assured was suffering from Cancer and taking treatment from PGI Rohtak and Jindal Hospital, Hisar. It is denied that life assured died due to heart attack. It is further pleaded that OP paid an amount of Rs.12,470/- through cheque under provisions of insurance conditions due to non-disclosure of the another insurance policy in the proposal form. It is further pleaded that according to policy conditions of the OP, all benefit shall cease, and however all the premiums paid were refunded by the OP. So, accordingly the first premium paid by the life assured was refunded to the complainant through cheque under the conditions of the policy in question. It is further pleaded that the life assured applied for both policy in two days. Life assured disclosed his occupation as Business (shop owner-Agriculture products sale) with annual income of Rs.2,00,000/- but during investigation it was found that there was no such shop and the life assured was a farmer. Hence, there is no deficiency in service on the part of the OP while repudiating the claim of the complainant. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Complainant tendered into evidence her affidavit Ex.CW1/A, policy schedule Ex.C1, first premium receipt Ex.C2, copy of cheque of Rs.137/- Ex.C3, copy of Aadhar card of complainant Ex.C4, death certificate Ex.C5, copy of email by OP to complainant Ex.C6 regarding refund of the premium amount, copy of cheque of Rs.12,471/-Ex.C7, copy of cheque of Rs.14,476/- Ex.C8 and closed the evidence on 08.01.2020 by suffering separate statement.

5.             On the other hand, OP tendered into evidence affidavit of Hansa Rani Ex.RW1/A, repudiation letter Ex.R1, investigation report Ex.R2, report of Sarpanch Ex.R3, death certificate Ex.R4 and closed the evidence on 24.11.2021 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties

7.             Learned counsel of complainant while reiterating the contents of the complaint, has vehemently argued that husband of complainant namely Ram Phal (since deceased) had obtained a life insurance policy dated 25.07.2015  and the insured amount was of Rs.3,55,000/-. On 20.08.2015 the husband of complainant had died due to heart attack. Thereafter, complainant being nominee, applied for the insurance claim under the abovesaid policy with the OP, but OP refused to pay the same and refund the premium amount of to the complainant for settlement of claim.  He further argued that deceased life assured was not having any disease or medical history at the time of obtaining the policy and prayed for allowing the complaint. Learned counsel for complainant relied upon the authority in case titled as Life Insurance Corporation of India Versus Vijay Pal Singh (bunch of the cases) decided on 03.11.2021 (NC)  and Bajaj Allianz Life Insurance Company Limited Vs. Santosh and another in CWP no.24862 of 2017 decided on 02.11.2017 by Hon’ble Punjab and Haryana High Court, Chandigarh.

8.             Per contra, learned counsel of OP while, reiterating the contents of written version, has vehemently argued that at the time of obtaining the policy deceased had not disclosed in the proposal form that he had already purchased a policy from PNB Met Life Insurance Company prior to purchase of the policy in question from the OP. He further argued that the policy in question was issued on 25.07.2015 and the life assured died on 20.08.2015 within twenty six days of insurance policy. The claim falls in the category of early claim. During the claim investigation, it was found that the life assured was suffering from cancer and was under treatment for the same. This fact was not disclosed by the deceased life assured at the time of issuing of the policy. He further argued that OP had already paid an amount of Rs.12470/- through cheque under provisions of insurance conditions due to non-disclosure of the insurance policy in the proposal form. He further argued that this Commission has no jurisdiction to try and entertain the present complaint. Hence prayed for dismissal of the complaint. Learned counsel for the OP relied upon the judgment of Hon’ble Supreme Court in case titled as Reliance Life Insurance Co. Ltd. and others Versus Rekhaben Nareshbhai Rathod 2019(2) RCR.

9.             After hearing the arguments of both the parties, we firstly decide that whether this Commission has territorial jurisdiction to decide the present complaint or not?

10.           It is submitted by the learned counsel for the complainant that OP is running its business through branch office at Gharaunda, District Karnal and thus this Commission has territorial jurisdiction to entertain and try the present complaint. On perusal of the documents placed on file, it reveals that complainant and policy holder is/was resident of village Alakhpura, District Bhiwani. The policy in question purchased by the life assured at Bhiwani. The life assured expired in the jurisdiction of District Bhiwani and the death certificate also issued by PHC Alakhpura, District Bhiwani. Thus, no cause of action accrued within the territorial jurisdiction of District Karnal. In view of the law laid down by Hon’ble Supreme Court in case Sonic Surgical Versus National Insurance Company Ltd. 2010(1) CPC page 379  this Commission has no territorial jurisdiction to entertain and adjudicate the present complaint merely on the ground that the branch office situated at Gharaunda, District Karnal. Hence, plea taken by the complainant has no force.

11.           In view of law laid down, facts and circumstances of the case and without going into the merits of the case, the complaint is dismissed for want of territorial jurisdiction. However, the complainant is at liberty to file the complaint in the court of the competent jurisdiction as per provision of law and in that eventuality, complainant will be entitled to the benefit of Section 14(2) of Limitation Act and the time taken during the pendency of this complaint shall be exempted. No order as to costs. Parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated: 15.02.2022

                                                               

                                                              President,

                                                 District Consumer Disputes

                                                 Redressal Commission, Karnal.

                                       

                 (Vineet Kaushik)              

                      Member