Haryana

Karnal

CC/245/2019

Rajinder Kumar - Complainant(s)

Versus

SBI Life Insurance Company - Opp.Party(s)

Gurvinder Pal Singh

20 Dec 2019

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM KARNAL.

 

                                                          Complaint No. 245 of 2019

                                                          Date of instt.03.05.2019

                                                          Date of Decision 20.12.2019

 

Rajinder Kumar son of Shri Buta Ram resident of House no.9, New Ramesh Nagar, ner Arya Samaj Mandir, Durga Rice Mill, Karnal thorough his wife Smt. Usha being his next friend.

                                                 …….Complainant.

                                              Versus

 

SBI Life Insurance Company, Main Market, near Kalra Sweets, Sector 13, Urban Estate, Karnal through his Branch Manager.

                                                                         …..Opposite Party.

 

           Complaint u/s 12 of the Consumer Protection Act. 

 

Before    Sh. Jaswant Singh……President. 

                Dr. Rekha Chaudhary…….Member

 

 Present Shri G.P.Singh Advocate for complainant.

                Shri N.K.Zak Advocate for opposite party.

 

                   (Jaswant Singh President)

ORDER:                    

 

                        This complaint has been filed by the complainant u/s 12 of the Consumer Protection Act 1986 on the averments that the complainant met with an accident and suffered injuries and is bed ridden, so he is filing the present complaint through his wife Smt. Usha being his next friend. The complainant had purchased a ULIP policy from the OP by the name of SBI Life Smart ULIP-Saving covers vide policy no.33030854710. The risk had started from 04.01.2010 for a term of nine years with maturity date being 03.01.2019. The sum assured under the said policy was Rs.3,00,000/-. The entire installments were paid by the complainant through his account no.3265000100036426 in Punjab National Bank Jundla Branch. On the maturity of the abovesaid policy, the complainant applied to the office of the OP for payment of maturity amount, however, the same was not paid to the complainant. Then, complainant sent a  notice dated 08.03.2019 through his counsel to the OP to release the payment of maturity amount. In response to the said notice, the counsel for the complainant was contacted by one Ashwani Vashist from the Chandigarh office of the OP, who asked the counsel for the complainant to sent a complete photocopy of passbook of account no.3265000100036426 of Punjab National Bank, Jundla Branch so that maturity amount may be transferred to the said account. Thereafter, complainant again got served a legal notice dated 09.04.2019 through his counsel upon the OP, informing him that the entire installments of the abovesaid policy were paid by the complainant through cheques payable on the said account. The said Ashwani Vashist promised to transfer the maturity amount within 2-3 days in the account of the complainant.

2.             Further, complainant has came to know that his son Vikram is making false and baseless applications to office of the OP, seeking the payment of maturity amount being nominee of the complainant. The said applications are meaningless and just to be ignored as nominee has no right or control over the maturity amount during the life time of insured. The complainant is not keeping good health and requires the money immediately for his further treatment. There is no reason for the OP to withhold the payment more so, when the said payment has to be transferred in the same account out of which the installments were paid to the OP. Withholding the payment of maturity amounts by the OP amounts to deficiency in service and unfair trade practice. Hence complainant filed the present complaint.

3.             Notice of the complaint was given to the OP, who appeared and filed written version stating therein that Life Assured, Mr. Rajinder Kumar was holding SBI Life Policy bearing no.330308854710 with date of commencement as 04.01.2010 for the Sum Assured of Rs.3,00,000/-. This policy was issued to Shri Rajinder Kumar based on his proposal form no.33566563 dated 29.12.2009. In the proposal form, complainant had appointed Mr.Vikram as his nominee and the relationship was stated as ‘son’. It is further stated that as per schedule II, Clause 2, maturity benefit, maturity, the policyholder (or in case of his/her death prior to payment of Maturity benefit, the applicable person, as defined in Schedule I) will receive the Fund Value. Fund Value will be calculated based on a Net Asset Value(NAV), which is higher of:

1. NAV as on date of Maturity, and

2. The highest of the 168 NAVs tracked on the respective reset dates.

 

The calculation of Maturity amount is given below:

NAV is 30.1329

Unit= 15007.50

Fund Value (FV)=30.1329x15007.50=452219/-.

 

The date of maturity of the policy of the Life Assured (LA), Shri Rajinder Kumar was 01.03.2019. Hence, the OP, vide Maturity Intimation letter dated 03.09.2018 requested the LA, Shri Rajinder Kumar to submit the required documents to enable the OP to disburse the maturity benefits amount under the policy to the LA. The OP has duly received the maturity discharge voucher wherein LA, have affixed his thumb impression alongwith an indemnity Bond for Payout without original policy documents and medical report as per which he was diagnosed to be a “Follow up case of Left Frontotemporoparietal decompressive  craniotomy with Evacuation of Left FTP clot on 28.07.2013 with Hydrocephalus and Cranioplasty with ostemyelitis skull bone.” Further, OP called for the maturity discharge voucher duly signed by the life assured, Mr. Rajinder Kumar and a letter confirming the bank account details in which the payout needs to be credited alongwith a self attested copy of the bank account proof vide letter dated 20.05.2019. Further, OP received a legal notice dated 04.05.2019 from nominee, Mr. Vikram, in which he has raised an objection to the payment of maturity claim proceeds stating that LA, Mr. Rajinder Kumar is not mentally fit to take rational decisions. As the life assured is alive, there is no locus standi for the nominee under the said policy. Accordingly, OP has replied to the notice of the nominee vide letter dated 28.05.2019. It is further stated that however, considering the peculiar nature of circumstances and in order to safeguard the interests of LA, as a matter of abundant precaution, the OP called for a medical certificate from a Government Civil Surgeon detailing his medical condition and inability to sign the documents and also a maturity discharge voucher with his thumb impression duly attested by a Government Medical Officer. OP wants to protect the interest of the LA and  hence has to take necessary precautionary measures to ensure that money reaches in the right hands. It is further stated that OP is willing to pay the maturity claim amount of Rs.4,52,219/- under the insurance policy to LA Mr. Rajinder Kumar or legal Guardian as may be certified and directed by this Forum. There is no deficiency in service on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

4.             Complainant tendered into evidence affidavit of Usha wife of complainant Ex.CW/A and documents Ex.C1 to Ex.C18 and closed the evidence on 11.10.2019

5.             On the other hand, OP tendered into evidence affidavit of Pallavi Garg Ex.OP1/A and documents Ex.OP1 to Ex.OP14 and closed the evidence on 02.12.2019.

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

7.             The case of the complainant in brief, is that, he purchased an SBI Life Insurance from the OP for the sum assured Rs.3,00,000/-. The date of maturity of the policy was 01.03.2019. After the maturity of the policy, complainant applied for OP to release the payment of maturity amount but OP did not pay the maturity amount.

8.             On the other hand, the case of the OP, in brief, is that OP is willing to pay the maturity claim amount of Rs.4,52,219/- under the insurance policy to LA Mr. Rajinder Kumar or legal Guardian as may be certified and directed by this Forum.

9.             Admittedly, life assured, Rajinder Kumar was holding SBI life insurance policy for the sum assured of Rs.3,00,000/-. The date of maturity of the policy was 01.03.2019. Life Assured have affixed his thumb impression alongwith an indemnity bond for payment. As per version of the OP, OP received a legal notice from Nominee Vikram, in which he raised an objection to the payment of maturity claim proceeds stating that life assured is not mentally fit to take rational decisions.

10.            OP has duly received the maturity discharge voucher through complainant, wherein life assured has affixed his thumb impression alongwith affidavit stating that he is unable to write or sign any document as he is paralyzed. Office of Civil Surgeon Karnal has issued certificate Ex.C18. As per Ex.C18 life assured is unable to write.

11.            OP is willing to pay the maturity claim amount of Rs.4,52,219/- under the insurance policy to life assured. Complainant has already submitted all the required documents with OPs to release the maturity claim amount. In the policy, life assured had appointed Vikram as his nominee. As per schedule II, clause 2, maturity benefits maturity, the policy holder will receive the fund value during his life time.

12.            Hence, in view of the facts and circumstances of the case, we are of the considered view that the complainant is entitle for maturity claim amount.

13.            Thus, as a sequel to abovesaid discussion, we allow the present complaint and direct the OP to release the maturity amount to the complainant in his bank account within 30 days from the receipt of copy of this order. We further direct the OP to pay Rs.20,000/- to the complainant on account of mental agony and harassment suffered by him and for the litigation expenses. It is made clear if the abovesaid amount is not paid by the OP within stipulated period then this amount will carry interest @ 9% per annum from the date of order till its realization. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:20.12.2019

                                                                       

                                                                  President,

                                                           District Consumer Disputes

                                                           Redressal Forum, Karnal.

 

                                                                                                       

                        (Dr. Rekha Chaudhary)

                            Member