Before the District Consumer Disputes Redressal Commission, Rohtak.
Complaint No. : 14
Instituted on : 09.01.2018
Decided on : 03.01.2024
Savitri wife of Late Subhash son of Nathu Ram resident of ward no.12, Dher Panna, MehamDisttRohtak.
……….………….Complainant.
Vs.
- Life Insurance Corporation India, through its Divisional Manager, Opposite All India Radio, Subhash Road, Rohtak.
- Life Insurance Corporation India, through its Divisional Manager, 3,4,5, SCO, Sector-1, Rohtak.
...........……Respondents/OPs.
COMPLAINT U/S 12 OF CONSUMER PROTECTION ACT.
BEFORE: SH.NAGENDER SINGH KADIAN, PRESIDENT.
DR. TRIPTI PANNU, MEMBER.
DR. VIJENDER SINGH, MEMBER
Present: Sh. AshwaniPhougat, Advocate for the complainant.
Sh. PuneetChahal, Advocate for the opposite parties.
ORDER
NAGENDER SINGH KADIAN, PRESIDENT:
1. Brief facts of the case as per the complainant are that her husband namelySubhash had availed one LIC policy bearing no. 179201298 from the opposite party and sum assured under this policy was Rs.1,00,000/-. As per terms of the said LIC policy, if the policy holder Subhash is died in road side accident, in that event the respondent will be liable to pay double amount of assured amount. The husband of the complainant named Subhash has died in motor vehicle accident/road side accident which had taken place on 27.03.2017 and FIR no. 156/2017 under section 279/337/304A IPC PS Mehan was got registered in this regard. After the death of husband of complainant, complainant being widow and LR of her deceased husband intimated to the respondent about the death of her husband and lodged her claim to get the amount acquired under said policy i.e. double of the sum assured i.e. total Rs. 2,00,000/- and deposited all the documents required by respondents. Complainant visited to the respondents repeatedlyto get the claim amount but the respondents in an arbitrary and illegal manner only disbursed the sum assured Rs.1,00,000/- to the complainant on account of death of her husband in lieu of said LIC policy and as withheld the accident benefits. Complainant received the same under protest.That the act and conduct of the respondent of not disbursing the amount of accident benefit is illegal and there is deficiency in service on the part of the respondent. Hence this complaint and it is prayed that respondents/opposite partiesmay kindly be directed to pay Rs.1,00,000/- as accident benefit claim amount under the policy along with interest @ 18%р.а. from the date of realization to till its accrual and also to pay Rs.25000/- as compensation on account of deficiency in service and harassment suffered by complainant and Rs.11,000/- as litigation expenses to complainant.
2. After registration of complaint, notices were issued to the opposite parties. Opposite parties in their reply has submitted that he opposite parties have issued a policy no. 179201298 on the life of Subhash S/o Nathu Ram with date of commencement 28.5.2012 and first unpaid premium 11/2016, plan and term 165-20-20, mode Half Yearly, sum assured 1,00,000/-, premium-2426/. In the policy nominee is Savitri (wife). That the complainant's husband policy was in AUTO COVER period at the time of death of the life assured. As per terms and condition of this policy if premiums for three years received and further premiums not paid, policy will be treated in force for ONE YEAR and this ONE YEAR is termed as AUTO COVER.If death occurs in AUTO COVER period, only Basic Death Claim is payable and Accident Benefit is not payable as per terms and condition of the policy.The policy was in AUTO COVER period at the time of death of Life assured due to nonpayment of further premiums. Death claim amount Rs.116632/-has been paid on 22.5.2017 to the nominee by the opposite party as per terms and condition of this policy and accident benefits is not payable. Hence the respondent is not liable to pay any amount.
3. Ld. counsel for complainant in his evidence has tendered affidavit Ex. C1/A, documents Ex.C-1 to Ex.C-3 and closed his evidence on dated 18.04.2019. Ld. Counsel for opposite parties has tendered affidavit Ex.RW1/A, document Ex.R1 to Ex. R3 and closed his evidence on dated 11.09.2019.
4. We have heard learned counsel for the parties and have gone through material aspects of the case very carefully.
5. In the present case, insurance and death of husband of the complainant is not disputed. After the death of life assured, the death benefit under the policy has been paid to the complainant but the accident benefit is not paid to the complainant. The contention of ld. Counsel for the opposite parties is that the policy of complainant's husband was in AUTO COVER period at the time of death of the life assured. As per terms and condition of this policy if premiums for three years received and further premiums not paid, policy will be treated in force for one year and this one year is termed as AUTO COVER .If death occurs in AUTO COVER period, only Basic Death Claim is payable and Accident Benefit is not payable as per terms and condition of the policy. The policy was in AUTO COVER period at the time of death of Life assured due to non payment of further premiums. Hence the death claim amount Rs.116632/-has been paid on 22.5.2017 to the nominee by the opposite party as per terms and condition of this policy and accident benefits is not payable. We have perused the documents placed on record by both the parties. The last premium was paid on November 2016 and the date of death of life assured is 27.03.2017. Hence on the date of death of life assured, the policy was in lapsed condition. As per terms and conditions of the policy, death claim amount Rs.116632/-has already been paid by the opposite parties on 22.5.2017 to the legal heir of deceased and accident benefits is not payable. Hence there is no deficiency in service on the part of opposite parties and the present complaint stands dismissed with no order as to costs.
7. 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:
03.01.2024
........................................................
Nagender Singh Kadian, President
..........................................
TriptiPannu, Member.
……………………………….
Vijender Singh, Member
