Haryana

Yamunanagar

CC/663/2013

Naveen Gupta S/o Kanahiya Lal Gupta - Complainant(s)

Versus

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

Subhash Sharma

16 Aug 2017

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, YAMUNA   NAGAR.

 

                                                            

                                                                   Complaint No. 663 of 2013.

                                                                   Date of institution: 13.09.2013

                                                                   Date of decision: 16.08.2017.

 

 

Naveen Gupta, aged about 40 years, son of Shri Kanahiya Lal Gupta, resident of House No.100-B/R, Model Town, Yamuna Nagar.

                                     

                                                                                                                               …Complainant.

                                        Versus

1. The Life Insurance Corporation of India, Northern Zonal Office, Jeewan Bharti Cannaught Circus New Delhi through its zonal Manager.
2. The Life Insurance Corporation of India, Divisional Office Jeevan Parkash 489, Model Town, PB No.106, Karnal -132001 through its Divisional Manager.
3. Life Insurance Corporation of India Court Road, Sector 17, HUDA Jagadhri, District Yamuna Nagar.

 

 

                              ….Respondents.

 

BEFORE    SH. DHARAMPAL, PRESIDENT

                   SH. S.C.SHARMA, MEMBER.

                   SMT. VEENA RANI SHEOKAND, MEMBER.          

 

 

Present:       Sh. Subhash Chand, Advocate, for complainant.   

                    Shri Sushil Garg, Advocate for OPs

 

 

ORDER (DHARAM PAL, PRESIDENT)

 

 

1.                The complainant Naveen Gupta has filed this complaint under Section 12 of the Consumer Protection Act 1986 as amended up to date (hereinafter respondents will be referred as OPs). 

2.                Brief facts of the complaint, as alleged by the complainant, are that the mother of the complainant namely late Smt. Santosh Gupta has got herself insured with the Ops vide insurance policy No.171478452, date of commencement 08.04.1997, date of maturity 08.04.2017 for a sum assured of Rs.1,50,000/- and the mode of the premium was yearly and the premium was Rs.18,125/- yearly. The mother of the complainant was paying the installments of premium regularly and deposited the installments upto 08.04.2010 and the complainant is the nominee of Late Smt. Santosh Gupta. Suddenly on 19.12.2012, the mother of the complainant has died and the mother of the complainant could not deposit her last installment of Rs.18125/- with the OPs. Being nominee of his mother, the complainant applied for the benefits of the above policy, after fulfilling all the formalities and submitted the death certificate. The original policy and other documents as demanded from the complainant were submitted with the OPs but the Ops have intentionally and with malafide intention have not made the whole payment of claim of the complainant as per terms and conditions of the policy and has wrongly and illegally with-held the major portion of the claims of the complainant, as total claim of the complainant comes to more than 5 lac but the Ops have intentionally and deliberately released the meager amount of claim amounting to Rs.1,44,750/- to the complainant. The complainant being nominee of deceased Santosh Gupta, several times requested the OP No.3 to release the full payment of claim of above said policy of deceased mother of complainant but the Ops refused to entertain the claim of the complainant. Hence, this complaint wherein it has been prayed that the Ops may be directed to make payment of full claim amount under the said policy along with upto date interest and further to pay compensation as well as cost of litigations. 

3.                Upon notice, OP appeared and filed its written statement taking some preliminary objections such as there is no deficiency in service on the part of the OP and hence the present complaint is not maintainable; complainant has arisen no cause of action to file the present complaint; complainant has no locus standi to file the present complaint; complainant has concealed the true and material facts; the present complaint is false, frivolous and baseless and on merit it is stated that that as per record the premium paid upto 08.04.2010 under the policy and first unpaid premium (FUP) under the policy is 08.04.2011 and Shri Naveen and Shri Parveen both sons of smt. Santosh Gupta (DLA) are nominee under the above policy. It is submitted that being nominee, the complainant and his brother, after the death of the life assured, completed the documentary formalities as required inclusive LETTER OF DISCLAIMMER (Annexure R4) and because the policy in question was in lapse condition on the date of death of DLA and as such the paid up value was payable, which comes to Rs.1,44,750/- and the said amount transferred in account No.08721000022884 of HDFC Bank as given by the complainant on 13.02.2013 through NEFT as full and final payment, duly received by the complainant. It is also submitted that as per record the premium stands paid upto 08.04.2010 under the above policy and on the date of death of the DLA, the policy was in lapsed condition with FUP on 08.04.2011 complainant and Parveen Gupta are nominee. Rest contents of the complaint were denied being wrong and incorrect and lastly prayed for dismissal of the complaint.

4.                In support of his case, learned counsel for the complainant tendered into evidence affidavit of Shri Naveen Gupta as Annexure CW/A and documents such as photocopy of  LIC receipt as Annexure C1, photocopy of LIC detail as Annexure C2 and closed the evidence on behalf of complainant.

5.                On the other hand, learned counsel for the OPs tendered into evidence affidavit of Shri Balihar Singh Manager as Annexure RA and documents such as status report of LIC as annexure R1, letter to Shri Naveen Gupta as Annexure R2, photocopy of receipt details as Annexure R3, photocopy of letter of disclaimer as Annexure R-4, photocopy of LIC Policy and its terms and conditions as Annexure R5 and closed the evidence on behalf of OPs.

6.                We have heard learned counsel for the parties and have also perused the record. available on the file.

7.                The counsel for the complainant argued that the OP Company had made the payment of claim amount partially and the complainant is entitled for full claim amount under the policy along with interest.

                   On the other the counsel for the OPs argued that as per terms of the policy in question, the OPs had made a payment to the tune of Rs.1,44,750/- to the complainant and nothing is due against the OPs under this policy. The counsel for the Ops further argued that if a person already received full and final payment then he is not entitled to get any payment. Learned counsel for the OPs also referred the case law titled as “Ankur Surana Vs. United India  Insurance Co. Ltd. (Feb.) I 2013 440 CPJ (NC) which is reproduced here as under:

Consumer Protection Act, 1986- Section 21(b) insurance – Full and final settlment – discharge voucher signed- Coercion or misrepresentation not pleaded – Payment of balance amount denied- District Forum allowed complaint-State Commission allowed appeal- Hence, revision – Discharge voucher signed by petitioner indicates that he has received amount by way of full and final settlement- petitioner cannot approach consumer Fora for balance amount treating the payment as only part payment against claim unless he established that he accepted amount under undue influence, mis-representation or fraud played by insurance company – No such plea put-forth by petitioner- Insurance claim stood settled.   

8.                The foremost question arises before us whether the complainant is entitled to get the full amount of the policy in question or not? The terms and conditions of the policy of Sr. No.4 which is reproduced as under:

4. Non Forfeiture Regulations: if, after at least three full year premiums have been paid in respect of this policy any subsequent premium be not duly paid, this policy shall not be wholly void, but shall subsist as a paid up policy for a reduced so payable on the Date of maturity or at the Life assured prior death provided the paid up sum assured is not less than Rs.250/-. The amount of paid up assurance per integral number of years premiums paid will be calculated as per Table given below. The policy so reduced shall thereafter be free from the liability for payment of within mentioned premium but shall not be entitled to participate in future profits. The existing vested bonus additions if any, will remain attached to the reduced paid up policy. 

Notwithstanding what is above stated, if after at least three full years premiums have been paid in respect of this policy, any subsequent premium be not duly paid, in the event of the death of the Life assured with in six months from the due date of the first unpaid premium, the policy money will be paid as if the policy had remained in full force after deduction of (a) the premium or premiums unpaid with interest thereon to the date of death on the same terms as for revival of the policy during such period and (b) the unpaid premiums falling due before the next anniversary of the policy. Notwithstanding what is above stated, if after at least five years premiums have been paid in respect of the policy and subsequent premium be not duly paid, in the event of the death of the Life assured within 12 months from the due date of the first unpaid premium, the policy money will be paid as if the policy had remained in full force after deduction of (a) the premium or premiums unpaid with interest thereof to date of death, on the same terms as for revival of the policy during the period and (b) the unpaid premiums falling due before the next anniversary of the policy.

                   In view of the condition No.4 the complainant is only entitled for the paid up value as the policy in question was lapsed after April, 2011 and the OPs has already made the payment of paid up value of the policy in question.     

9.                Beside this the OP company had informed the complainant vide their letter dated 13.02.2013 (Annexure R2) that the paid up value of the policy in question was to the tune of Rs.1,44,750/- as full and final settlement but the complainant never protested the aforesaid letter and received the payment in question and as per law referred (supra) if the complainant received the payment as full and final settlement then the complainant is not entitled for the balance amount.

10.              In view of the law discussed above as well as terms and condition No.4, this Forum is of considered view that there is no violation of terms and conditions of policy and opposite parties have rightly made the payment to the complainant.  As such, there is no deficiency in service or unfair trade practice on the part of opposite parties. Hence, the present complaint is hereby dismissed with no order as to costs. Copies of this order be sent to the parties concerned free of costs as per rules. File be consigned to the record room after due compliance.

 

Announced in open court.                

Dated: 16.08.2017        

 

                                                          (DHARAMPAL)

                                                          PRESIDENT

                                                     D.C.D.R.F.YAMUNA NAGAR

                                                     AT JAGADHRI

 

 

(VEENA RANI SHEOKAND)          (S.C.SHARMA)

MEMBER                                            MEMBER

 

 

Note:           Each and every page of this order has been duly signed by me.

 

                                                     (DHARAMPAL)

                                                     PRESIDENT

                                                     D.C.D.R.F.YAMUNA NAGAR

                                                     AT JAGADHRI