BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KAITHAL.
Complaint Case No.171 of 2018.
Date of institution: 26.06.2018.
Date of decision:08.05.2019.
Pardeep Kumar S/o Sh. Tara Chand, aged 39 years, r/o Ward No.11, Tehsil Kalayat, Distt. Kaithal.
…Complainant.
Versus
- SBI Life Insurance Co. Ltd., 8th Floor, Tower-II, seawood, grand central, seawoods, Nerul Node, Navi Mumbai-400706, Maharashtra.
- Chief Operating Officer, SBI Life Insurance Co. Ltd. Central processing centre, 7th floor (D wing) and 8th floor, seawoods great central tower-2, plot No.R-1, Sector-40, seawoods Nerul Node, Navi Mumbai.
- Rajiv Kaushik (UM) SBI Life Insurance Co. Ltd., SC 321, 2nd floor, sector-20, HUDA, Kaithal.
- Parveen Singla s/o late Sh. Nasib Singh (Insurance Advisor) r/o Ward No.9 near Durga Mandir, Main Bazar Kalayat, Distt. Kaithal.
….Respondents.
Before: Sh. D.N.Arora, President.
Sh. Rajbir Singh, Member.
Smt. Suman Rana, Member.
Present: Sh. M.K.Nirwani, Advocate, for the complainant.
Sh. Amit Kaushik, Advocate for the OPs.No.1 to 3.
Sh. Vipul Singla, Adv. for Op No.4.
ORDER
D.N.ARORA, PRESIDENT
The complainant has filed the present complaint under Section 12 of Consumer Protection Act, 1986, with the averments that the Op No.3 contacted the complainant through Op No.4 for purchasing of SBI Life Smart Humsafar Policy and the complainant had purchased the above-said policy worth Rs.10,00,000/- vide proposal No.1WQD781745 and also deposited the amount of Rs.29,917/- vide proposal receipt dt. 08.01.2018. It is alleged that the office of Ops sent the letter dt. 23.01.2018 for medical testing of the complainant and the same was done on 25.01.2018 and thereafter, the office of Ops have sent the intimation on mobile regarding completion of medical test. It is further alleged that on 29.01.2018 the wife of complainant suddenly died and the information was given to the Op No.3 through Op No.4 and the Op No.3 visited the house of complainant. It is further alleged that surprisingly the office of Ops returned the amount of Rs.29,917/- in the account of complainant as per letter dt. 05.02.2018 and also informed that the proposal cannot be considered without assigning any reason. It is further alleged that the complainant sent the application for review of claim vide proposal on 18.04.2018 which was duly replied by the Ops on 21.05.2018 by alleging that the complainant has attended the medical examination on 25.01.2018 and the company has received the medical report on 31.01.2018 and also reported that the life assured Ms. Pinki Kumari died on 29.01.2018 that before the date of receipt of medical requirements so contract was never concluded as on the date of death of Ms. Pinki Kumari. 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 to 3 filed the joint reply raising preliminary objections that the complainant has submitted the proposal under the SBI Life Smart Hamsafar Plan to insure himself and wife Smt. Pinki vide proposal dt. 08.01.2018. In the instant case, during the primary assessment of the proposal, the answering Ops have raised the requirement for medical examination vide letter dt. 23.01.2018. The complainant underwent medical examination on 25.01.2018 which was Thursday, thereafter on 26.01.2018, it was National Holiday and 27.01.2018 & 28.01.2018 were Saturday and Sunday respectively. Therefore, the medical examination report was not received by the answering Ops before 29.01.2018. However, before the medial reports were received by the answering Ops, Smt. Pinki died on 29.01.2018, hence, the proposal was cancelled by the answering Ops on 30.01.2018 and refunded the premium of Rs.29,917/- on 31.01.2018 through direct credit to the complainant’s bank account No.35040577605. There is no deficiency in service on the part of Ops. On merits, the objections raised in the preliminary objections are reiterated and so, prayed for dismissal of complaint.
3. Op No.4 filed the reply 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 Ex.C1 to Ex.C15 and thereafter, closed the evidence.
5. On the other hand, the Ops No.1 to 3 tendered into evidence affidavit, Ex.RW1/A and documents Ex.R1 to Ex.R5 and thereafter, closed the evidence. Op No.4 tendered into evidence affidavit, Ex.RW4/A and thereafter, closed the evidence.
6. We have heard the learned Counsel for both the parties and perused the record carefully.
7. From the pleadings and evidence of the case, it is not disputed that the complainant had submitted the proposal form No.1WQD781745 and deposited the amount of Rs.29,917/- vide proposal receipt dt. 08.01.2018 for purchasing the policy worth Rs.10,00,000/-. According to the complainant, the Ops sent the letter dt. 23.01.2018 for medical test of the complainant and the same was done on 25.01.2018 and thereafter, the Ops have sent the intimation on mobile regarding completion of medical test. The complainant contended that on 29.01.2018 the wife of complainant suddenly died and the same was duly informed to the Op No.3 through Op No.4 but the Ops returned the amount of Rs.29,917/- in the account of complainant. Ld. counsel for the complainant placed reliance upon the order dt. 04.05.2017 passed by Hon’ble National Commission in case titled as Met Life India Insurance Co. Ltd. Vs. Urvashi Goyal & another bearing first appeal No.163 of 2012 and order dt. 11.01.2012 passed by Hon’ble State Commission, Punjab in case titled as Urvashi Goyal Vs. M/s. Met Life Insurance Company.
On the other hand, ld. counsel for the Ops contended that the in the present case, the Ops have raised the requirement for medical examination vide letter dt. 23.01.2018 and the complainant underwent medical examination on 25.01.2018 which was Thursday, thereafter on 26.01.2018, it was National Holiday and 27.01.2018 & 28.01.2018 were Saturday and Sunday respectively. Therefore, the medical examination report was not received by the Ops before 29.01.2018, however, when the medial reports were received by the Ops No.1 to 3, Smt. Pinki died on 29.01.2018, hence, the proposal was cancelled by the Ops on 30.01.2018 and refunded the premium of Rs.29,917/- on 31.01.2018 through direct credit to the complainant’s bank account No.35040577605. Ld. counsel for the Ops placed reliance upon the case law cited in 2018(2) CPJ page 299 titled as Om Prakash Agarwal Vs. HDFC Standard Life Insurance Co. Ltd. and others (NC); 2018(1) CPR page 443 titled as Asha Devi Vs. LIC (NC); 2017(2) CLT page 80 titled as Chukkapalli Suresh Vs. Met Life India Insurance Co. Ltd. (NC) and 1984 AIR page 1014 titled as LIC Vs. Raja Vasireddy Komalvalli Kamba and others (SC).
8. We have considered the rival contentions of both the parties and perused the letter dt. 23.01.2018 Ex.C4 which was written by the Ops to the complainant and in the said letter, it is mentioned as under:-
“Our obligation to cover the risk begins only after the contract is completed through policy issuance after submission of the requirements”.
We have also perused the proposal deposit receipt dt. 08.01.2018 Ex.C14, wherein it is mentioned that “Insurance cover would commence only on acceptance of risk by SBI Life and issue of the policy contract by SBI Life from the date indicated therein”. Moreover, the complainant has given undertaking in the proposal form Ex.R1 that “In the event that this proposal is not converted into a policy, I agree that the Company has the right to recover from me, any medical expenses incurred by the Company. I understand that the contract will be governed by the provisions of the Indian Insurance Act, 1938 and other applicable Statues and prevailing laws in India and that the risk cover will not commence until a written acceptance of this proposal is issued by the Company and that the risk cover and other benefits under the policy shall be subject to the terms and conditions contained in the contract of assurance”. The complainant has also put his signatures on the said proposal form Ex.R1.
We can rely upon the case law LIC Vs. Raja Vasireddy Komalvalli Kamba (supra), wherein Hon’ble Supreme Court has held that “Binding contract not arising until the person to whom offer is made signifies acceptance-Acceptance is complete only when communicated to offeror-Mere receipt and retention of premium is not acceptance”. We can also rely upon the case law titled as Asha Devi Vs. LIC (supra), wherein in para No.9, the Hon’ble National Commission has taken the view of Hon’ble Supreme Court in case titled as Life Insurance Corporation of India Vs. Raja Vasireddy Kamalavalli Kamba and others wherein it was held as under:-
“A contract of insurance will be concluded only when the party to whom an offer has been made accepts it unconditionally and communicates his acceptance to the person making the offer. Though in certain human relationships, silence to a proposal might convey acceptance but in the case of insurance proposal, silence does not denote consent and no binding contract arises until the person to whom an offer is made says or does something to signify his acceptance. Mere delay in giving an answer cannot be construed as an acceptance, as, prima facie, acceptance must be communicated to the offeror. Similarly the mere receipt and retention of premium until after the death of the applicant or the mere preparation of the policy document is not acceptance”. The authorities submitted by ld. counsel for the Ops are fully applicable to the facts of instant case, whereas the authorities submitted by ld. counsel for the complainant are not disputed but the same are not applicable to the facts of instant case.
So, from the facts and circumstances of the case, it is clear that the Ops called the complainant for medical test on 23.01.2018 and the complainant underwent medical examination on 25.01.2018 which was Thursday, thereafter on 26.01.2018, it was National Holiday, 27.01.2018 and 28.01.2018 were Saturday and Sunday respectively. Therefore, when the medical reports were received by the Ops, Smt. Pinki died on 29.01.2018. Hence, the proposal was cancelled by the Ops on 30.01.2018 and refunded the premium amount of Rs.29,917/- on 31.01.2018 through direct credit to the complainant’s bank account No.35040577605. So, this Forum does not find any deficiency in service on the part of Ops.
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 cost. File be consigned to record-room after due compliance.
Announced in open court:
Dt.:08.05.2019.
(D.N.Arora)
President.
(Suman Rana), (Rajbir Singh)
Member Member.
