Haryana

Kurukshetra

CC/331/2019

Mahavir - Complainant(s)

Versus

Shree ram Life Ins - Opp.Party(s)

Rajesh Kaushik

01 Mar 2021

ORDER

BEFORE THE DISTRICT CONSUMER DISPTUES REDRESSAL COMMISSION, KURUKSHETRA.

 

Complaint Case No.331 of 2019.

Date of instt: 16.08.2019. 

                                                                        Date of Decision:01.03.2021.

 

Mahavir son of Ram Kishan, aged 43 years, resident of Sahuwala, District Hanumangarh, Rajasthan.

                                                ……..Complainant.

                        Vs.

 

1.Shri Ram Life Insurance Company Limited, 5^th Floor, Plot No.31-32, Ramky Selenium Financial District Gachibowli, Hyderabad 5000032.

2.Shri Ram Life Insurance Company Limited, 1^st floor, SCO – 43. Sector 17,  Kurukshetra.

 

..………Opposite parties.

 

                Complaint under section 12 of Consumer Protection Act.   

 

Before:      Smt. Neelam Kashyap, President.

                Ms. Neelam, Member.

                Sh.Issam Singh Sagwal, Member.

 

Present:     Sh. Rajesh Kumar Advocate for the complainant.

                Sh. Gaurav Gupta Advocate for the OPs.

ORDER     

 

                   This is a complaint under Section 12 of the Consumer Protection Act, 1986 moved by complainant Mahavir against Shri Ram Life Insurance Co. etc, the opposite parties.

2.            Brief facts of the present complaint are that Smt. Kalawati w/o  complainant during her life time obtained life insurance policy No.NP0118101128872 dated 28.10.2018 from the OP No.1 at Kurukshetra. Name of the policy is Shri Ram New Shri Life Plan and in case of death of the policy holder his nominee will receive sum of Rs.5,00,000/-. The complainant being his wife was nominee/legal heir of deceased Kalavati deceased during his life time. She has paid the premium of Rs.39,626/- at the time of getting the insurance policy.  Before issuance of the said policy, panel of the doctor’s of OPs  checked the health condition of  life assured Kalavati and after satisfying from the same, OPs issued the said policy.   The OPs suo moto filled up the proposal form after getting some information from the policy holder and has not taken any signatures on it.  It is further averred that life assured unfortunately died on 3.12.2018 at village Sahuwala as  she was sleeping at her home and did not woke up. She was taken to nearby hospital for checkup but the doctors did not attend him as she was expired.  However, before her death she was fit and she was not suffering from any ailment. It is further averred that after the death of life assured complainant informed the OPs regarding her death for grant of death claim but the OPs demanded certain documents to  issue the claim. The complainant supplied all the required documents  relating to her death  within the stipulated period  but the  OPs prolonged the matter on one pretext or the other and finally  declined the claim of the complainant on 9.05.2019 which amounts to deficiency in services on the part of the OPs. Thus, the complainant alleging deficiency in services on the part of the  OPs has filed the present complaint and prayed for grant of claim amount alongwith compensation for the mental harassment caused to him and the litigation expenses.

2.             Upon notice, OPs appeared and filed written statement  disputing the claim of the complainant. Obtaining of the insurance policy by the deceased life assured has been admitted by the OPs but with the exception that the said policy has been obtained by suppressing the material facts regarding obtaining of some other insurance policies by the DLA from various insurance companies. It is submitted that  OPs received intimation of death of life assured from Mahaveer  that she  died on 3.12.2018.  This being an early claim which arose within 36 days from the date of issuance of the policy, the company duly scrutinized all the available documents and investigated into the claim to ascertain the genuineness of the said claim.  During investigation, it was revealed that late deceased life assured Mrs. Kalavati was suffering from Cancer and did not have substantial income and she belonged to Below Poverty Line (BPL) category.  During the industry check conducted, it was found that the DLA had taken policies from other insurance company parallel to taking with OPs insurance company. The policy was issued in good faith by OPs believing the financial and health declaration given in the proposal form by the deceased.  She had  taken other four life insurance policies from Exide Life Insurance, Met  Life Insurance company, Max Life Insurance company and Birla Life Insurance companies for the sum assured Rs.23,57,130/- and has not disclosed this fact while obtaining the present policy and she is not entitled to any relief.  While denying other allegations made in the complaint specifically, preliminary objections regarding maintainability, cause of action, suppression of true and material facts etc. and prayed for dismissal of the present complaint.

4.             The complainant in support of his case has filed his affidavit Ex.CW1/A and tendered documents Ex.C-1 to Ex.C-8 and closed his evidence.

5.             On the other hand, OPs in support of their case have filed affidavit Ex.RW1/A and tendered documents Ex.R-1 to Ex.R-12 and closed their evidence.

6.             We have heard the learned counsel for the parties and gone through the case file very carefully.

7.             The learned counsel for the complainant has argued that Smt. Kalawati w/o  complainant  during her life time obtained life insurance policy No.NP0118101128872 dated 28.10.2018 from the OP No.1 at Kurukshetra. Name of the policy is Shri Ram New Shri Life Plan and in case of death of the policy holder his nominee will receive sum of Rs.5,00,000/-. The complainant being his wife was nominee/legal heir of deceased Kalavati deceased during his life time. She has paid the premium of Rs.39,626/- at the time of getting the insurance policy.  Before issuance of the said policy, panel of the doctor’s of OPs  checked the health condition of  life assured Kalavati and after satisfying from the same, OPs issued the said policy.   The OPs suo moto filled up the proposal form after getting some information from the policy holder and has not taken any signatures on it.  It is further argued that life assured unfortunately died on 3.12.2018 at village Sahuwala as  she was sleeping at her home and did not woke up. She was taken to nearby hospital for checkup but the doctors did not attend him as she was expired.  However, before her death she was fit and she was not suffering from any ailment. It is further  argued that after the death of life assured complainant informed the OPs regarding her death for grant of death claim but the OPs demanded certain documents to  issue the claim. The complainant supplied all the required documents  relating to her death  within the stipulated period  but the  OPs prolonged the matter on one pretext or the other and finally  declined the claim of the complainant on 9.05.2019 which amounts to deficiency in services on the part of the OPs. Learned counsel for the complainant has placed reliance on the law laid down  by the Hon’ble Punjab and Haryana High Court Chandigarh in case  Bajaj Allianz Life Insurance Co.Limited Vs. Santosh and another, CWP No.24862 of 2017 decided on 2.11.2017.

8.             On the other had learned counsel for the OPs has argued that the OPs received intimation of death of life assured from Mahaveer  that she  died on 3.12.2018.  This being an early claim which arose within 36 days from the date of issuance of the policy, the company duly scrutinized all the available documents and investigated into the claim to ascertain the genuineness of the said claim.  During investigation, it was revealed that late deceased life assured Mrs. Kalavati was suffering from Cancer and did not have substantial income and she belonged to Below Poverty Line (BPL) category.  During the industry check conducted, it was found that the DLA had taken policies from other insurance company parallel to taking with OPs insurance company. The policy was issued in good faith by OPs believing the financial and health declaration given in the proposal form by the deceased.  She had  taken other four life insurance policies from Exide Life Insurance, Met  Life Insurance company, Max Life Insurance company and Birla Life Insurance companies for the sum assured Rs.23,57,130/- and has not disclosed this fact while obtaining the present policy. It is argued that this Commission has got no jurisdiction to decide the present complaint because deceased was residing at Rajasthan and she died  in Rajasthan as mentioned in Ex.R-8 (death certificate) as also mentioned in Ex.R-2 Aadhar Card .It is further argued that the insurance policy (Ex.R-4) was obtained by the life assured  from Hyderabad and she  was residing at Sahuwala at Rajasthan as is clear from copy of ration card Ex.R-8.  Life assured also died at Sahuwala at Rajasthan as is clear from Ex.R-2(death certificate) and death certificate Ex.R-7. therefore, this Hon’ble Commission has no territorial jurisdiction to decide the present complaint.

9.             After hearing the learned counsel for the parties, we are of the view that the complainant is not entitled to any relief.  Perusal of the policy schedule Ex.R-4 shows that the policy in question was issued Hyderabad. Further perusal of death certificate Ex.C-4 shows that life assured died at Sahuwala, Hanumangarh at Rajasthan.  From the perusal of copy of Ration Card Ex.R-8 it is clear that life assured as well as complainant were residing at Sahuwala, Hanumangarh at Rajasthan. Proposal form Ex.R-2 seems to have been obtained by manipulation by writing with hand word “Kurukshetra” because it does not bear the stamp of OPs-company. The Hon’ble Supreme Court in case Sonic Surgical Vs. National Insurance Company has held that “ In our opinion, no part of cause of action arose at Chandigarh. It is well settled that expression “cause of action” means that bundle of facts  which gives rise to a right or liability. In the present case admittedly the fire broke out in the godown of the appellant at Ambala. The insurance policy was also taken at Ambala and the claim for compensation was also made at Ambala. Thus no part of cause of action arose in Chandigarh.

             In this case, no cause of action wholly or partly took place within the territorial jurisdiction of this Commission and as such this Commission has no territorial jurisdiction to decide the present the present complaint and the present complaint merits dismissal on this ground alone. The authority given by the learned counsel for the complainant is not applicable to the facts and circumstances of the present case.

 

11.            In view of our above discussion, we do not find any merit in the present complaint and the same is hereby dismissed. Copy of this order be communicated to the parties free of cost. File be consigned to the record room after due compliance.

 

Announced in open Commission:

Dt.:01.03.2021.                   

         (Neelam Kashyap)

                                                                                             President.

                      

 

(Issam Singh Sagwal),         (Neelam)       

                           Member                    Member