Date of filing :14.6.2017
Judgment : Dt.16.4.2018
Mrs. Balaka Chatterjee, Member
This petition of complaint is filed under section 12 of C.P.Act, 1986 by Smt. Malati Chowdhury alleging deficiency in service on the part of the opposite parties (referred as OP hereinafter) namely (1) The Manager (Claims) LICI, Taratala and (2) The Branch Manager, LICI, KMDO-II, Sarsuna Branch.
Case of the Complainant in brief is that the Complainant is the mother of de ceased Srijan Chowdhury who was the policy holder in respect of Life Insurance Policy being No.458474312 commenced in 2014 with assured sum of Rs.7,00,000/- but after demise of the said policy holder the OP insurer repudiated her claim on baseless ground.
The Complainant has further stated that the said policy holder agreed to obtain an Insurance Policy and as such made payment of first premium of Rs.32,180/- as yearly premium by a cheque dt.20.8.2014, thereafter, the second premium fell due on 20.8.2015 and the same was paid within the grace period of one month i.e. within 20.9.2015 and the date of payment was on 24.8.2015. Similarly, third annual premium fell due on 24.8.2016 and grace period of one month was extended to 20.9.2016 but the Policy holder expired on4.9.2016. The Complainant, being nominee of the said policy applied for settlement of dues of her deceased son with the concerned branch but received no reply hence sent a demand notice dt.5.5.2017 through her Advocate but, after scrutiny of the documents the OP Insurer vide letter dt.13.5.2017 intimated her that her claim was not admissible on the ground stated therein. Accordingly, the Complainant has prayed for direction upon OPs to make immediate payment of the claim, to pay compensation to the tune of Rs.50,000/- and Rs.25,000/- towards litigation cost.
The Complainant has annexed Advocate’s letter dt.5.5.2017, reply dt.13.5.2017 from the end of LICI.
The OPs contested the case by filing written version denying and disputing all material allegation stating inter alia that one Srinjan Chowdhury obtained an Insurance Policy being No. 458474312 which became in force on and from 28.7.2014 with maturity date on 28.7.2035 for assured sum of Rs.7,00,000/- and yearly payable premium of Rs.31,480/-. The insured paid first and second premium within stipulated time including extended period of 30 days.
It is also mentioned by the OPs that unless and until third yearly premium is paid the insured cannot get the ‘paid up’ facility in respect of the policy as per terms of the Policy. The OP further stated that the third premium fell due on 28.7.2016 and the grace period of one month expired on 28.8.2016 but no premium was paid within the aforesaid period and therefore the said policy was treated as lapsed. It is also stated by the OPs that it would be evident from the document that the insured had died on 4.9.2016 which implies that at the pertinent time of Death of insured the policy was not in force and hence the claim filed by the nominee i.e. the Complainant was repudiated and accordingly the same was communicated to the Complainant vide letter dt.13.5.2017.
The Complainant adduced evidence. The OPs prayed for treating the written version as affidavit-in-chief which was allowed. Thereafter both the parties filed questionnaire and reply thereto.
Points for determination:
- Whether the OPs are deficient in providing service by repudiating the claim without basis?
- Whether the Complainant is entitled to get relief as claimed?
Decision with reasons
The Complainant stated that the OPs issued a policy insuring her son Srijan Chowdhury vide policy No. 458474312 with sum assured of Rs.7,00,000/- with yearly payable premium. The Complainant has claimed that his son paid first premium within stipulated time and second premium which fell due on 20.8.2015 and his son paid 2nd premium within the grace period and 3rd premium was fell due on 24.8.2016 and grace period of one month was till 24.9.2016 but his son died on 4.9.2016 and therefore as per terms of the said policy she is entitled to get death benefit of the insured being nominee of the said policy.
It is, however, observed that the Complainant has filed no document including copy of the policy wherefrom it would have been evident that her claim regarding validity of the policy as well as unjustified repudiation of her claim as alleged.
Burden of proof lies upon the claimant. In the instant case the Complainant has challenged the ground of repudiation of her claim which was intimated vide letter dt.13.5.2017.
The Complainant, however, failed to discharge the burden of proof by adducing cogent evidence as well as furnishing relevant documents including policy document.
In such view of the matter, we find no reason to allow the prayer of the Complainant.
Point Nos.1 & 3 decided accordingly.
In the result, the Consumer Complaint does not succeed.
Hence,
ordered
that CC/313/2017 is dismissed on contest but without any order as to cost.
