CONSUMER DISPUTES REDRESSAL FORUM – X
GOVERNMENT OF N.C.T. OF DELHI
Udyog Sadan, C – 22 & 23, Institutional Area
(Behind Qutub Hotel)
New Delhi – 110 016
Case No.969/2008
MRS. VIMLESH DEVI
R/O A-111, MAIN SHARMA MARKET
CORNER PUL PEHLADPUR,
C/O BAL VIDYA PUBLIC SCHOOL,
NEW DELHI-110044
…………. COMPLAINANT
Vs.
- THE MANAGER,
TATA AIG LIFE INSURANCE CO. LTD.
PENINSULA TOWERS, 6TH FLOOR,
PENINSULA CORPORATE PARK,
GANPAT RAO KADAM MARG,
LOWER PAREL (W), MUMBAI-400013
- THE MANAGER
TATA AIG LIFE INSURANCE CO. LTD.
7TH AND 8TH FLOORS, LOTUS TOWER,
COMMUNITY CENTRE, NEW FRIENDS COLONY,
NEW DELHI-110065
…………..RESPONDENTS
Date of Order:13.08.2018
O R D E R
A.S. Yadav - President
The complainant is nominee of late Mr. Kapil Dev Garg who has taken insurance policy from OP on 21.03.2006 whereby he was required to pay quarterly premium of Rs.3000/- for 20 years.
The case of the complainant is that due to some financial constraint, deceased insured was not able to pay premium of one due installment, however, later on deceased insured deposited Rs.6,000/- on 06.11.2007 on account of renewal of premium and interest which was duly accepted by OP on 06.11.2007.
It is further stated that only after the death of deceased insured and after 4 months of having received the amount of premium, OP issued one letter dated 26.03.2008 in the name of deceased insured refunding an amount of Rs.6000/- by virtue of cheque dated 25.03.2008. It is stated that the brother of the deceased insured vide eltter dated 31.03.2008 duly informed OP about the demise of the policy holder on 14.03.2008 and requested them to register the claim. However, OP vide letter dated 24.04.2008 repudiated the claim on the ground that quarterly premium due on 21.06.2007 was not received by them. Terming the illegal action of OP as deficiency in service, the present complaint has been filed whereby the complainant has prayed for payment of the amount of policy alongwith interest and also sought compensation and litigation expenses
OP in its reply has not disputed about the insurance policy. It is stated that on 18.04.2008 the complainant applied to OP for death claim for the unfortunate and untimely suicidal death of her son on 14.03.2008. The same was declined by the company vide its letter dated 24.04.2008 inter alia stating as under:-
“According to our records, the quarterly premium due on 21.06.2007 was not received by us, therefore the said policy lapsed. As the policy remained lapsed on the date of death, we regret to advise that the company has no liability under the said policy.”
It is further submitted that as per the terms and conditions mentioned under the heading “Grace Period” the policy lapsed after expiry of 31 days from the date when the premium became due. Thereafter, it was only the prerogative of the OP to reinstate the policy that too, subject to the fulfillment of all the 5 conditions as mentioned in the terms and conditions under the heading “reinstatement” wherein depositing of the premium amount is merely one of the conditions. The policy holder in the present case was further required to fulfill the other conditions, however, inspite of receipt of letter dated 13.11.2007, he failed to comply with the requirements mentioned therein within the prescribed period and thus the policy could never be reinstated.
It is further submitted that the allegations that OP received the said amount without any objection is thus totally wrong and false. The complainant, in fact is guilty of concealing the letter dated 13.11.2007 which was written only because the deceased policy holder has not provided the details/documents as mentioned therein which were necessary and were a pre-condition for reinstatement of the policy. It is pertinent to mention that only after the receipt of the said cheque and the letter, the complainant came into action and registered a claim for the death of insured on 18.04.2008. OP was not aware of the death of the insured till 31.03.2008 when a letter from the brother of the deceased, intimating, for the first time, the death of the deceased insured was received by it on 31.03.2008. It is prayed that the complaint be dismissed.
We have gone through the case file carefully.
It is significant to note that the premium, which was due on 21.06.2007, was not paid. Next premium was due on 21.09.2007. On 06.11.07 a sum of Rs.6000/- was paid. OP has placed on record a letter dated 13.11.2007 whereby the insured was required to comply with certain formalities. That letter was not complied with and ultimately vide letter dated 24.04.2008, the claim was repudiated.
In fact the sum of Rs.6000/- which was deposited by the complainant on 06.11.2007, was refunded vide letter dated 26.03.2008 and that letter was sent to the complainant prior to the receipt of intimation of death of the policy holder. It is proved on record that the intimation regarding the death of the policy holder was given on 31.03.2008. The cheque for a sum of Rs.6000/- was already refunded before the receipt of intimation of death. The policy was not in existence at the time of repudiation of the claim when the insured died.
There was no deficiency in service on the part of OP. OP was justified in repudiating the claim. Hence the complaint is dismissed.
Copy of order be sent to the parties, free of cost, and thereafter file be consigned to record room.
(RITU GARODIA) (H.C. SURI) (A.S. YADAV)
MEMBER MEMBER PRESIDENT
