Chandigarh

StateCommission

A/346/2023

DAMANPREET SINGH - Complainant(s)

Versus

PNB METLIFE INDIA INSURANCE CO. LIMIITED - Opp.Party(s)

KARAN S GILL AND SIMRANPRET KAUR

16 Dec 2024

ORDER

STATE CONSUMER DISPUTES REDRESSAL COMMISSION,

U.T., CHANDIGARH

 

Appeal No.	:	346 of 2023
Date of Institution	:	27.12.2023
Date of Decision	:	16.12.2024

 

 

 

 

 

 

1.      Damanpreet Singh son of late Mr. Harjinder Singh minor through his mother Mrs. Priyanka Saini as his natural guardiarı.

2.      Priyanka Saini wife of late Mr. Harjinder Singh both residents of Ward No.8, Bhabat, Near Sokhi Doctor, Zirakpur, District SAS Nagar (Punjab)

 ….Appellant/Complainant.

Versus

1.      PNB Metlife India Insurance Co. Limited through its Branch Manager with its Branch office at SCO No. 64-65, Sector 17, Chandigarh (UT).

2.      PNB Metlife India Insurance Co. Limited through its Agent/Insurance Broker/Intermediary Amandeep Kaur daughter of Gurnam Singh, resident of Aliwal Road, Christrian Colony Batala, District Gurdaspur (Punjab).

3.      PNB Metlife India Insurance Co. Limited through its Managing Director/Chairman Unit No.101, First floor, Techniplex 1, Techniplex complex, Off Veer Savarkar Flyover, S. V. Road, Goregaon (West), Mumbai 400 062.

...Respondents/Opposite Parties.

 

BEFORE:    JUSTICE RAJ SHEKHAR ATTRI, PRESIDENT

                  MR. RAJESH K. ARYA, MEMBER

 

ARGUED BY :-    

Sh. Karan S. Gill, Advocate for the appellants.

Sh. Manpreet Singh Kanda, Advocate for the respondents – on VC.

 

PER  RAJESH  K. ARYA,  MEMBER

                   The instant appeal has been filed by the complainants (appellants herein) against order dated 01.11.2023 vide which their consumer complaint No.626 of 2021 has been dismissed by District Consumer Disputes Redressal Commission-I, U.T., Chandigarh (in short ‘District Commission).

2]             The facts as narrated in the impugned order passed by the District Commission, reads thus:-

“(a)    It transpires from the averments as projected in the consumer complaint that the deceased Harjinder Singh father of the complainant No.1 and husband of complainant No.2 (hereinafter to be referred as DLA) had purchased one policy namely "PNB METLIFE ENDOWMENT SAVING PLAN PLUS" (hereinafter to be referred as subject policy) Annexure C-1 from the OPs on 10.12.2017 commencing from 6.12.2017 for 15 years to be matured on 6.12.2032, on payment of annual premium of Rs.20,000.31 with basic sum assured to the tune of Rs.2,56,590/-. The first premium was paid by the DLA to the OPs which was duly acknowledged by them vide receipt Annexure C-2. Thereafter the installment of second premium was paid by the complainant to the OPs online on 6.12.2018 which has already been reflected in the statement of account of the DLA Annexure C-3. Thereafter the OP NO.2 through its agent approached the DLA for payment of next premium in the month of January 2019 and accordingly the same was paid by the DLA to the OP No.2, which was also acknowledged through receipt Annexure C-4. However, during the currency of the subject policy, the policy holder Harjinder Singh suddenly suffered massive heart attack and expired on 6.2.2020. Copy of death certificate is Annexure C-5. Thereafter the complainants informed the OPs about the death of insured and requested to pay the benefit of the policy vide Annexure C-6 but the claim of the complainants was repudiated by the OPs on the ground that the third year installment of premium has not been paid by the policy holder as a result whereof the policy has been lapsed. In this manner the OPs had ignored the receipt of third premium paid on 12.1.2019. The complainants filed complaint with Insurance OMBUDSMAN Chandigarh for the redressal of their grievances but the same was dismissed vide order Annexure C-7 dated 28.6.2021. As the OPs have wrongly repudiated the genuine claim of the complainants, the aforesaid act of the OPs amounts to deficiency in service and indulgence in unfair trade practice. OPs were requested several times to admit the claim, but, with no result. Hence, the present consumer complaint.

(b)     OPs No. 1 and 3 resisted the consumer complaint and filed their written version, inter alia, taking preliminary objections of maintainability, concealment of facts. However, it is admitted that Harjinder Singh DLA purchased the subject policy from the OPs by paying installments of premium for two years i.e. for the year 2017 and 2018 but alleged that as the installment of third premium has not been paid by the DLA and also that Annexure C-4 is a forged receipt which was never issued by the OPs, the claim of the complainants was rightly repudiated as at the time of death of the DLA Harjinder Singh, the policy was already lapsed for want of payment of third installment of premium by the DLA. It is further alleged that the complainants had approached the Insurance OMBUDSMAN by filing complaint which was dismissed. On merits, the facts as stated in the preliminary objections have been re-iterated. The cause of action set up by the complainant is denied. The consumer complaint is sought to be contested.

(c)      OP No.2 was properly served and when OP No.2 did not turn up before this Commission, despite proper service, it was proceeded against ex-parte on 15.3.2022.”

3]                The order of the District Commission has been assailed by the complainants on the ground that the District Commission has erred in not taking into account and completely ignored the version of the appellants that the third premium cash receipt, Annexure C-4, was handed over to the DLA by respondent No.2 in a similar way in which respondent No.2 had handed over the first premium cash receipt, Annexure C-2 to the DLA. It has further been stated that it was not the case of the appellants that the first premium cash receipt or third premium cash receipt was signed by respondent No.2 nor such an averment was ever made by the appellants anywhere in the complaint or in their evidence. It has further been stated that perusal of both the cash receipts would reveal that none of them was ever signed by respondent No.2 and that the handwriting on both the said cash receipts are identical. It has further been stated that the District Commission fell in error while holding that the third premium cash receipt, Annexure C-4, was not signed by respondent No.2 but was signed by agent Bikram Singh. It has further been stated that when there is no pleading to this effect on file, then, how the District Commission reached the conclusion that the alleged signatory of the third cash premium receipt was Bikram Singh or that he was the agent of the respondents is not understood. It has further been stated that the District Commission has also failed to observe that the third cash premium receipt, Annexure C-4, bears the bar code, which points towards the factum of its being genuine and being issued by the authorized person(s) of the respondents. It has further been stated that the DLA was not responsible for the acts of omission and commission perpetrated by respondent No.2 and there arose no occasion to suspect that the official cash premium receipt, Annexure C-4, was not signed by the authorized person as in the past also, the said respondent No.2 had handed over a similar receipt bearing signatures of some authorized person. It has further been stated that the DLA was only expected to pay the due premium against receipt, which he has done during his lifetime, so the DLA or the appellants cannot be penalized for the fraud committed by respondent No.2. Lastly, prayer for setting aside the impugned order and allowing the consumer complaint has been made by the appellant – complainant.

4]                On the other hand, Counsel for the respondents – opposite parties has submitted that the District Commission has rightly dismissed the consumer complaint of the appellants – complainants by passing well reasoned order after appreciating the material available on record. The respondents prayed for dismissal of the appeal.

5]                After hearing the rival contentions of the parties and going through the material available on record, the impugned order, the written arguments filed by the appellants and the affidavit of Sh. Sanchit Gupta, Manager (Legal) of the respondents, we are of the considered view that the appeal deserves acceptance and the impugned order is liable to be set aside for the reasons to be recorded hereinafter. It is an admitted case of the parties that the installment of annual premium was payable by the insured on 6^th  December annually and the DLA had paid first premium on 2.10.2017 vide Annexure C-2, which was duly acknowledged by OP No.2 through its agent Amandeep Kaur. Copy of statement of account, Annexure C-3 further indicates that the second installment was paid by the DLA on 6.12.2018 online, which was reflected in the statement of account, making it clear that the third installment was payable by the DLA on 6.12.2019. The appellants – complainants contend that the DLA - Harjinder Singh made the third premium payment for the year 2019 on 12.01.2019, as is evident from the receipt (Annexure C-4). They assert that the policy was valid at the time of death and that the respondents – opposite parties wrongfully repudiated the claim despite the policyholder meeting the premium obligations, whereas, the respondents – opposite parties admit the payment of premiums for the years 2017 and 2018 but denied receipt of the third premium for 2019. They argued that the receipt (Annexure C-4) presented by the appellants - complainants is forged and not issued by them.

6]                We have gone through the receipt in question, Annexure C-4. To avoid an unfair outcome to the appellants-complainants, this Commission is inclined to infer in favor of the appellants-complainants that the receipt (Annexure C-4) is valid. Given that the receipt was presented at the time of the claim and the respondents-opposite parties have failed to substantiate their claim that it was forged, this Commission finds it reasonable to hold that the third premium was paid and the policy remained valid at the time of the insured’s death. Here, it is not to be seen, who has signed the receipt but the fact is that there is a document on record in terms of receipt, Annexure C-4 issued by “pnb MetLife” against the cash payment of ₹20,000/-, which the DLA paid towards the third premium. The premium can be paid even before the due date, therefore, the observation of the District Commission that it raised doubt in so far as the receipt, Annexure C-4 is concerned, is not valid. The appellants-complainants have made a prima facie case that the third premium was paid for the year 2019, as evidenced by the receipt (Annexure C-4). The respondents - opposite parties have not provided sufficient evidence to conclusively prove that the receipt was forged. While there were inconsistencies in the mind of the District Commission regarding the signature on the receipt, this does not automatically render the receipt invalid, especially when weighed against the fact that the respondents – opposite parties did not provide alternative evidence to show non-payment of the third premium. Furthermore, the District Commission failed to consider that the receipt, Annexure C-4 contains a barcode indicating its authenticity and issuance by the respondents’ authorized personnel. Thus, in our view, the deceased policyholder (DLA) was not responsible for the actions of Respondent No.2, especially when similar receipts were provided by the agent(s) of the respondents in past also. Thus, in our considered view, the repudiation of the claim by the respondents – opposite parties on the ground of non-payment of premium is found to be unjustified and they are very much liable to pay the claim alongwith interest w.e.f. 10.11.2020 as prayed for. By repudiating the genuine claim of the appellants – complainants, the respondents – opposite parties are deficient in rendering service and also indulged into unfair trade practices, for which they are also liable to compensate the appellants – complainants for suffering mental agony and harassment.  

7]                For the reasons recorded above, the appeal is accepted. The impugned order dated 01.11.2023 passed by District Commission-I, U.T., Chandigarh in Consumer Complaint No.626 of 2021 is set aside. The respondents – opposite parties, jointly and severally, are held liable and directed as under:-

1. to pay the claim amount of ₹2,56,590/- to the complainants, being the legal heirs of Late Sh. Harjinder Singh (DLA) alongwith interest @9% p.a. w.e.f. 10.11.2020, within a period 30 days from the date of receipt of certified copy of this order, failing which, the said amount shall carry penal interest @12% p.a. from the date of default i.e. after expiry of stipulated period of 30 days till actual realization.
2. to pay to the complainants lump-sum compensation to the tune of ₹75,000/- for mental agony and harassment and unfair trade practice and cost of litigation to the tune of ₹20,000/- to the complainants, within a period of 30 days from the date of receipt of a certified copy of this order, failing which, the said amounts shall carry interest @9% p.a. from the date of default i.e. after expiry of stipulated period of 30 days till realization.

8]                Pending application(s), if any, in this case stands disposed of accordingly.

9]                Certified copies of this order be sent to the parties free of charge forthwith.

10]              File be consigned to Record Room after completion.

Pronounced

 16.12.2024.

[JUSTICE RAJ SHEKHAR ATTRI]

PRESIDENT

 

 

 

(RAJESH  K.  ARYA)

MEMBER

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