Haryana

Karnal

CC/106/2021

Kavita - Complainant(s)

Versus

The Branch Manager, Life Insurance Corporation Of India - Opp.Party(s)

J.P. Duhan

28 Apr 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

 

                                                        Complaint No. 106 of 2021

                                                        Date of instt.19.02.2021

                                                        Date of Decision:28.04.2023

 

Kavita daughter of late Shri Suresh Kumar son of Shri Raghu Nath, resident of Ram Nagar, Karnal.

                                               …….Complainant.

                                              Versus

 

The Manager, Life Insurance Corporation of India, Jeevan Parkash Building, near Jewels Hotel, Karnal.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.       

      Sh. Vineet Kaushik…….Member

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri J.P. Duhan, counsel for the complainant.

                    Shri C.J. Wadhwa, counsel for the OP.

 

                    (Jaswant Singh President)

ORDER:   

                

                The complainant has filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that father of complainant namely Suresh Kumar son of Shri Raghu Nath during his life time had taken  life insurance policies from OP. The details of which are as under:-

 

Sr. no.         Policy no.              Plan policy term    premium amount   Sum assured

1.                144906698           843            15      3131-00               1,00,000/-

2.                144906699           827   15      15      3017-00               1,00,000/-

3.                144906700           843            15      3131-00               1,00,000/-

4.                14490701             843            15      3131-00               1,00,000/-

 

After taking the policy father of complainant was depositing the installments regularly without any default. The father of complainant  had appointed the complainant as his nominee in the said policies. The father of complainant had died on 27.06.2020. After the death of her father, complainant being nominee approached the OP and requested to pay the benefits of the deceased life assured but OP did not pay any heed to the request of complainant and lingered the matter on one pretext or the other. Then complainant sent a legal notice dated 16.12.2020 to the OP but it also did not yield any result. In this way there is deficiency in service and unfair trade practice on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability; locus standi; cause of action and concealment of true and material facts. On merits, it is pleaded that present complaint is premature. The complainant has not intimated the insurance company regarding the death of her father, nor submitted any claim form alongwith relevant documents required for consideration of the claim by the LIC or taking decision by the LIC, as such without submitting any claim from alongwith relevant documents for consideration of the claim by the LIC, the complaint is premature and the same is not maintainable at this stage. It is further pleaded that the installment of premium under the alleged policies were not deposited regularly by the life assured and the premium, due for the month of April, 2020 has not been paid and the same is first unpaid premium (FUP) under all the policies and only first premium was paid under all the four policies. Thereafter, no premium has been paid under all the four policies and the life assured died on 27.06.2020 as per the complainant and on the date of death all the policies were in a lapse condition without acquiring any paid up value and nothing is payable under the policies as per the terms and conditions of policy. The relevant policy clause under plan 843 and 827 reads as under:-

Plan 843 (LIC’s Aadhaar Stambh Plan)

Part D-CONDITIONS RELATED TO SERVICING ASPECTS

2.     Forfeiture and Non-Forfeiture Regulations:

Forfeiture Regulations

(i)     “If less than three years’ premiums have been paid in respect of this policy and any subsequent premium be not duly paid, all the benefits shall cease after the expiry of grace period from the date of first unpaid premium and nothing shall be payable and the premiums paid thereto are also not refundable”.

Plan 827 (Jeevan Rakshak Plan)

4.     Non-Forfeiture Regulations: If less than three years’ premium have been paid in respect of this policy and any subsequent premium be not duly paid, all the benefits under this policy shall ceases after the expiry of grace period from the date of first unpaid premium and nothing shall be payable.

The First unpaid premium under the policies is 04/2020. The grace period of one month expired on 25.05.2020 and the life assured expired on 27.06.2020 i.e. after expiry of grace period. Hence nothing is payable as per policy conditions. It is further pleaded that deceased life assured had obtained four policies from Branch Office Kaithal but the complainant intentionally did not mention the date of commencement of the policies in the complaint and date of proposal form, which is submitted by the complainant, on the basis of which, the policies in question were issued. There is no deficiency in service and unfair trade practice on the part of the OP. 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.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of death certificate Ex.C1/A, copies of insurance policies Ex.C1 to Ex.C5, premium receipts Ex.C6 to Ex.C8 and closed the evidence on 08.06.2022 by suffering separate statement.

5.             On the other hand, learned counsel for the OP has tendered into evidence affidavit of Puneet Kumar Manager Ex.OPW1/A, copies of insurance policies Ex.OP1 to Ex.OP4, copy of status report of the policies Ex.OP5 to Ex.OP8 and closed the evidence on 20.01.2023 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 for complainant, while reiterating the contents of the complaint, has vehemently argued that father of complainant (during his life time) had taken four life insurance policies from OP. Complainant is the nominee in the said polices. The father of complainant had died on 27.06.2020. After the death of her father, complainant being nominee approached the OP and lodged a death claim and also requested to pay the benefits of the deceased life assured but OP did not pay any heed to the request of complainant and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP, while reiterating the contents of written version has vehemently argued that the complainant has never intimated the insurance company regarding the death of her father, nor submitted any claim form alongwith relevant documents required for consideration of the claim, as such without submitting any claim from alongwith relevant documents for consideration of the claim by the LIC, the complaint is premature and the same is not maintainable at this stage. He further argued that the installment of premium under the policies were not deposited regularly by the life assured and the premium, due for the month of April, 2020 has not been paid and the same is first unpaid premium (FUP) under all the policies and only first premium was paid under all the four policies. The life assured died on 27.06.2020 and on the date of death all the policies were in a lapse condition and lastly prayed for dismissal of the complaint.  

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the father of complainant purchased the four insurance policies in the year 2019 and the dates of commencement of the said policies were 25.10.2019. It is also admitted that the complainant is the nominee in the said policies.  It is also admitted that the sum assured was Rs.1,00,000/-in each policy and mode of payment was half yearly. It is also admitted that the policies in question have been lapsed in month of April, 2020 for non-payment of premium amounts. It is also admitted that the life assured expired on 27.06.2020.

11.           The claim of the complainant has been denied by the OP, on the ground that life assured had expired on 27.06.2020 and policies had already been lapsed before the date of  death. Renewal premiums were due in April, 2020 and renewal premiums were not received and policies moved to lapse mode after completion of grace period on 25.05.2020. Thus, complainant is not entitled for any claim amount as alleged by her.

12.           Thus, in view of the above, the present complaint is devoid of any merits and deserves to be dismissed and same is hereby dismissed. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:28.04.2023                                                                     

                                                               President,

                                                   District Consumer Disputes

                                                   Redressal Commission, Karnal.

       

                (Vineet Kaushik)                (Dr. Rekha Chaudhary)

               Member                              Member