Complainant/s:                      Mudiyappa Halageri S/o Balappa, Age: 43 years, Occ: Business, R/o Shantageri, Taluk: Rona, Dist: Gadag.

                                                Mobile: 9980605772.

(By Sri.M.V. Mudagal, Advocate)

V/s

Respondent/s:                        1. The Managing Director,

ICICI Prudential Life Insurance Co. Ltd., Vinod Silk Mills Compound, Chakravarthy Ashok Nagar, Ashok Road, Kandivali (E), Mumbai-400 101.

(By Shri/Smt.G.M. Kanasogi, Advocate)

-::O R D E R::-

BY: SMT.C.H.SAMIUNNISA ABRAR, PRESIDENT.

1.       The complainant has filed this complaint claiming direction to the OP to Rs.22,25,000/- along with interest @ 12% to the complainant towards the policy amount, mental agony, physical and financial loss with cost and such other relief.

-::Brief facts of the case are as under::-

2.       The case of the complainant is that, his brother Yallappa S/o Balappa Halageri had taken insurance policy bearing No.17728044 for Rs.20,00,000/- on 02.05.2013 on yearly premium of Rs.5,259/-.  The complainant is the nominee to the said policy.  Such being the case, on 12.09.2013, his brother Yallappa died due to heart attack.  After his death, complainant knew about the policy taken by his deceased brother approached the OP.  wherein the OP had given a claim form, the same has been filled by the complainant and submitted the same to OP along with all the relevant documents.  After that, complainant got issued the legal notice through his Advocate on 20.05.2019, the same has been served but, OP has not replied to the said notice.  The complainant has submitted the claim form along with all the relevant documents but, the OP failed to pay the claim amount.  It is submitted that, at the time of taking the policy, the brother of the complainant was hale and healthy and he had no disease at all.  The OP has refused to pay the claim amount on evasive reasons, the same amounts to deficiency of service on the part of OP.  It is further submitted that, his brother had taken an another policy from the AVIVA company, the same has been settled before the Hon’ble State Consumer Commission in Complaint No.405/2017 on 10.07.2019, in which the insurance company has paid the full insured amount.  The cause of action for this complaint arose on 20.05.2019 when the legal notice was issued to the OP and when there was no reply from the OP which is within the jurisdiction of this Commission.  Hence, prayed to allow this complaint with a direction to the OP to pay Rs.22,25,000/- along with interest @ 12% p.a.

          3.   In pursuance of the notice issued by this Commission, the OP through counsel and filed written version. 

                                      Written Version of OP         

          4.       It is submitted that, the complaint filed by the complainant is not maintainable either on merits or on law and therefore, the same is liable to be dismissed.  It is submitted that, the OP received the filled proposal form bearing No.OL00606438 in the name of Yallappa Balappa Halageri for obtaining a life insurance of the OP namely ICICI Pru iCare Option.   On the basis of information provided in the proposal form and believing the same, OP issued a policy bearing No.17728044 on 02.05.2013 on annual premium of
Rs.5,259/-.  It is pertinent to mention that, in accordance with clause 6(2) of the insurance regulatory and development authority (Protection of Policyholder’s interest) regulations, 2002 and the OP sent the policy documents to the address mentioned in the proposal form via speed post AWB EK229070887IN on 25.05.2013, the same is not disputed.  Thereafter, the OP did not receive the renewal premiums towards the aforesaid policy and accordingly, the policy was foreclosed on 02.05.2016 in accordance with the terms of the policy contract.  It is further submitted that, the complainant has filed this complaint alleging that, the DLA expired on 12.09.2013 and the claim has not been settled by the OP.  It is submitted that, the OP for the first time by means of the present complaint came to know that, the DLA had expired on 12.09.2013 and as per the allegations of the complaint, the death of life assured had occurred on 12.09.2013 i.e., within four months from issuance of the policy at PMC, Shantagiri.  It is quiet suspicious as to why the complainant has waited for such a very long period of time and now directly approached this Commission without even registering the claim with company.  It is further submitted that, the death is having been taken place within four months of issuance of policy and the Death Certificate issued from PMC is on 06.07.2015, almost two years after the death and the Death Certificate is registered with the DC issuing authority only on 08.06.2015 raise the suspicion as to fraud and foul play in the subject matter.  The present complaint is filed with an ulterior motive and malafide intention to cause harassment and prejudice to the OP which is a company of high credibility and repute and to extract money from it without just cause or valid reason and the relief which the complainant is seeking from this Commission are in complete contravention to the terms and conditions of the contract of insurance between the parties and IRDA guidelines.  The complainant being fully aware about the said factual situation has prayed for reliefs which travels beyond express terms and insurance policy and thus this complaint is nothing but abuse of process of law and deserves to be dismissed as there is no deficiency of service on the part of OP.      

          5.  The complainant filed his Chief affidavit along with 06 documents.  The Senior Agency Manager of OP has filed his chief affidavit and no documents have been produced. 

    COMPLAINANT FILED DOCUMENTS AS follows

,        

          6.   On pursuance of the materials, placed by the complainant and OPs, the following points arises for our consideration:-

1. Whether the complaint filed by the complainant is barred by limitation?

2. What Order?

   7.        Our findings to the above points are:-

                   Point No. 1:  Affirmative.

                   Point No. 2:  As per the final Order

R E A S O N S

       8.  POINT NO.1:  The complainant has filed this Complaint against the OP claiming insurance amount of his deceased brother who had taken insurance policy from the OP.  On the other hand, OP filed objection stating that, complainant filed this case falsely, frivolously and the same is delayed one and hence, the complainant is not entitled for any compensation.  Further submits that, complainant is a habitual person to harass the OP to grab the money. 

          9.       On-going through the records on hand, the complainant submitted a policy bond along with some other documents i.e., the Death Certificate of Deceased Life Assured.  He has produced the photocopy of the Death Certificate.  Complainant issued the notice dated 20.05.2019 to the OP, therefore the complaint filed by the complainant itself reveals that, it is barred by limitation.  Since, it is clear that, the brother of Complainant died on 12.09.2013, complainant approached the insurance company in the year 2019.  Even the complainant has not filed any IA to condone the delay u/Sec.69 of the C.P Act.  Such being the fact, it is barred by limitation since issuance of notice cannot  continue the limitation period to file the complaint.  The citation reported in January 2016, Part-I, Vol-I, I(2016) CPJ 190 (NC) in the case of Jansatta Sahakari Awas Samiti Vs. Kone Elevators India Pvt. Ltd., has been held that:

                   Accrual of Cause of Action: Merely sending a notice does                  not constitute a cause of action nor does it extend period of                    limitation – complaint time barred.

Consumer Protection Act, 1986 – Section: 24A, 21(a)(i) – Limitation – Agreement executed to install lifts.  Non – installation – Accrual of cause of action – cause of action arose when two letter sent by opposite party insisting.  On-complainant to place purchase order for supply missing part from site – complainant’s plea that cause of action arose when legal notice sent to opposite party cannot be accepted – Merely sending a notice does not constitute a cause of action nor does it extend period of limitation – As no application for condonation of delay has been filed, there is no occasion to examine whether there was sufficient cause for delay or not – complaint is time barred.    

          On the observation of the citation, the Commission comes to the conclusion that, the complaint filed by the complainant is barred by limitation and accordingly we answer Point No.1 in Negative.

        10.  POINT NO. 2: In view of our findings on the above point, the complaint filed by the complainant is dismissed. In the result, we pass the following: 

//O R D E R//

1. The above Complaint is dismissed as time barred.  No order as to cost.

           2. Send the copies of this order to the parties free of cost.

           (Dictated to the Stenographer, transcribed by him, corrected and then pronounced by me in the Open Court on this 15^th day of December-2021)

,         (Shri B.S.Keri)                              (Smt.C.H.Samiunnisa Abrar)

               MEMBER                                               PRESIDENT