Before the District Consumer Disputes Redressal Forum, Rohtak.
Complaint No. : 534.
Instituted on : 12.09.2017.
Decided on : 29.07.2019
Tajender s/o Sh. Laxmi Narayan R/o H.No.734-D/29, Tilak Nagar, Rohtak.
………..Complainant.
Vs.
Kotak Mahindra Life Insurance Co. Ltd., 2nd Floor, Subhash Road, Opp. All India Radio, Rohtak.
……….Opposite party.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT,1986.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
SH. VED PAL, MEMBER.
DR. RENU CHAUDHARY, MEMBER.
Present: Sh.Sanjit Kadian, Advocate for complainant.
Sh. Gulshan Chawla, Advocate for opposite party.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case are that complainant got insured his son from the opposite party vide policy no.02819846 on dated 14.10.2013. That unfortunately, the son of the complainant had expired in an accident on 01.01.2014 and a case FIR No.1 dated 01.01.2014 was got lodged in P.S. Urban Estate Rohtak. After the death of his son, complainant intimated the officials of the opposite party and lodged his claim. That complainant submitted all the required documents with the opposite party and requested for disbursement of claim. But the opposite party has illegally repudiated of the claim of the complainant without any sufficient cause and reason. Later on, the respondent has refunded the premium amount of Rs.16696/- by sending a cheque to the complainant, whereas the complainant is entitled for the total sum assured. Complainant requested the opposite party to pay the remaining claim but despite his repeated requests, opposite parties have not disbursed the genuine claim of the complainant. Hence this complaint and the complainant has prayed for directing the opposite parties to pay the claim amount of Rs.680000/- alongwith interest, compensation and litigation expenses to the complainant, as explained in relief clause.
2. After registration of complaint, notice was issued to the opposite party. Opposite party in its reply has submitted that the answering opposite party has issued policy no.02819846 to the DLA. That on receiving the death claim intimation on 21.02.2014 from the complainant, the answering OP rightly paid an amount of Rs.15017/- as per terms and conditions of the policy. That the complainant has paid only one premium under the subject policy and hence no surrender value has accrued. That complainant is not entitled for the sum assured under the policy. The claim amount has already been paid by the respondent, so there is no deficiency in service on the part of opposite party and dismissal of complaint has been sought.
3. Ld. counsel for the complainant in his evidence has tendered affidavit Ex.CW1/A, documents Ex.C1 to Ex.C7 and closed his evidence on dated 20.12.2018. On the other hand ld. counsel for the OP tendered affidavit Ex.RW1/A, documents Ex.R1 to Ex.R5 and closed his evidence on 01.03.2019.
4. We have heard learned counsel for the parties and have gone through material of the case very carefully.
5. After going through the file and hearing the parties, it is observed that the complainant had taken the policy in the name of his son under “Kotak Child Advantage Plan”. The date of proposal is 14.10.2013 and the policy was issued on 21.10.2013, sum assured Rs.245000/- and the premium amount was paid Rs.16696/-. It is also observed that complainant has only paid one premium and after that his son had died. Complainant applied for insurance claim and on receiving the death claim intimation on 21.02.2014 from the complainant, the answering OP paid an amount of Rs.15017/- as per terms and conditions of the policy. Opposite party has placed on record copy of terms and conditions alongwith Ex.R2, and as per Schedule, under the head i)A(a) of Benefits payable, it is submitted that: “If death occur before 14.10.2018 and the life insured has not attained the age of 18, the benefit payable will be equal to: - The sum of premium paid (excluding all rider premiums) upto the date of death, or The surrender value as on the date of death, whichever is higher. But at the time of proposal for the policy and at the time of his death dated 01.01.2014, the age of Sahil was 13 years and he has not attained the age of 18 years. The complainant has paid only one premium. Hence no surrender value has accrued. As such, the claim has been paid by the opposite party as per terms and conditions of the policy and there is no merit in the case. Hence the complainant/nominee is not entitled for any further claim and accordingly, the present complaint is hereby dismissed with no order as to costs.
6. Copy of this order be supplied to both the parties free of costs. File be consigned to the record room after due compliance.
Announced in open court:
29.07.2019.
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Nagender Singh Kadian, President
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Ved Pal Hooda, Member.
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Renu Chaudhary, Member.
