Haryana

Ambala

CC/10/2022

Pushpa Devi - Complainant(s)

Versus

PNB Metlife India Insurance Co. Ltd - Opp.Party(s)

Neetu Singh

11 Jan 2024

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, AMBALA.

Complaint case no.	:	10 of 2022
Date of Institution	:	06.01.2022
Date of decision	:	11.01.2024

 

Pushpa Devi age about 50 years wife of late Sh. Amar Dutt, R/o H.No. 16-A, New Luxmi Nagar, Ambala City.

          ……. Complainant

                                                Versus

PNB Metlife India Insurance Company Ltd. (formerly known as Metlife India Insurance Company Ltd.) First Floor, Techniplex I, Techniplex Complex, Off. Veersavarkar Flyover Goregaon (West), Mumbai-4000062 through its Managing Director/Authorized Signatory.

                                                                                               ….…. Opposite Party.

Before:        Smt. Neena Sandhu, President.

                      Smt. Ruby Sharma, Member,

          Shri Vinod Kumar Sharma, Member.           

 

Present:       Ms. Neetu Singh, Advocate, counsel for the complainant.

                     Shri Dev Batra, Advocate, counsel for the OP.

Order:        Smt. Neena Sandhu, President.

                   Complainant has filed this complaint under Section 35 of the Consumer Protection Act, 2019 (hereinafter referred to as ‘the Act’) against the Opposite Party (hereinafter referred to as ‘OP’) praying for issuance of following directions to it:-

1. To settle the claim of the complainant to the tune of Rs. 1,53,846/-
2. To pay Rs.50,000/- as compensation, on account of harassment, and mental tension, financial loss etc.
3. To pay Rs.22,000/- as litigation expenses

Or

Grant any other relief or order which this Hon’ble Commission may deems fit.

2.            Brief facts of the case are that  the husband of the complainant namely Amar Dutt purchased a Insurance policy named PNB Metlife Guranteed Income Plan vide Policy No.22920850 in the month of May, 2019 for sum insured of Rs.1,53,846/-  on making payment of installment of Rs.19,094/- for one year. As per policy, the premium payment term was 10 years and the policy was effective from 24.05.2019. Next premium was due to be paid on or before 17.05.2020, but due to the spreading pandemic Corona Virus {Covid-19} and due to lockdown in the country, the husband of the complainant could not pay the next premium till 25.10.2020. As per the Govt. instructions all the financial institutes i.e. Bank and Insurance Companies etc. waived off some period to deposit some installments due to Covid-19 as well as lock down in the country. Unfortunately the husband of the complainant died on 25.10.2020 in roadside accident and a DDR bearing No.012 dated 26.10.2020 was also registered in Police Station Parao Ambala Cantt. Postmortem of the deceased husband of the complainant was also conducted by the Civil Hospital Ambala City on 26.10.2020. The complainant gave application to the OP to settle the claim and also attached all the relevant documents alongwith that application i.e. Copy of DDR as well as Postmortem report of the deceased husband of the complainant, but the claim was not paid.  Thereafter finding no other alternative, the complainant got issued a legal Notice on 22.01.2021 through her counsel which was not replied. Thereafter, legal notice was again issued on 02.8.2021 but the OP gave false and baseless reply dated 22.09.2021 and failed to settle the claim.   Hence, the present complaint.

3.           Upon notice, the OP appeared and filed written version raising preliminary objections to the effect that the present complaint is an afterthought and has only been filed with an ulterior motive to harass and humiliate the OP;  the present complaint is presented with distorted and twisted facts; the complainant has failed to setup the nexus between the damages claimed in the present complaint and the damages suffered by her;  the present complaint is frivolous and vexatious;   the present complaint is not maintainable etc.  On merits, while admitting the fact that the policy in question had been purchased by the deceased husband of the complainant, it has been stated in the declaration for submission of E-application he had submitted that he had duly provided the true and correct information in the proposal form after reading all the questions provided in the application form carefully. Further, before acceptance of the proposal by the OP, adequate information with regard to the contents of the proposal form, illustrations addendum forms, product, nature and its significance were carefully understood by the deceased life assured in the language best known to him. Accordingly, after understanding all the terms and conditions of the policy, the declaration for online proposal form was duly signed by the policy holder/life assured to that effect. On the basis of the information furnished in the proposal form, the proposal was processed by the OP and thereafter the said policy was issued to the insured, as per the details mentioned below:-

product/plan	PNB Metlife Guaranteed Income Plan
Policy Number
Date of Issue	23.05.2019
Date of Commencement of Risk	17.5.2019
Policy Holder/Life Assured	Mr.Amar Dutt
Sum Assured	1,53,846
Policy Term	20 Years
Premium Payment Term	10 Years
Annualized Premium Amount	19094.55
Premium Frequency	annual
Name of Nominee	Mrs. Pushpa Devi (Spouse)

 

The OP had sent/dispatched the policy document dated 24.05.2019 to the communication address mentioned in the proposal form, stating the policy term and conditions and a forwarding letter stating the Free Look provision along with a copy of proposal form which were duly delivered at the address provided in the proposal form. After the issuance of subject policy and delivery of policy documents, free look period for subject policy was provided which reproduced as under:- Free look Provision: Please go through the terms and conditions of your Policy very carefully. If you have any objections to the terms and conditions of your Policy, you may cancel the Policy by giving a signed written notice to Us within 15 days (30 days in case the Policy is sold to You through Our Website or Distance Marketing mode (as defined by IRDAI)) from the date of receiving your Policy, stating the reasons for your objection and you will be entitled to a refund of the premium paid, subject to a deduction of proportionate risk premium for the period of cover, stamp duty and/or the expenses incurred on medical examination (if any)."

4.           After the issuance of the subject policy as per the premium paying schedule, DLA was supposed to pay the renewal premium before 17.05.2020 which he failed to do so, resultantly the subject policy got lapsed due to non-receipt of the renewal premium and as such policy lapse notice was sent. The complainant has informed through the legal notice through her counsel that the DLA had died in a road accident on 25.10.2020 but the complainant has never lodged any death claim with the OP and the OP has accordingly replied the legal notice dated 22.01.2021 and informed the complainant that the subject policy has lapsed due to the non-payment of the renewal premium. The complainant has alleged that as per the provided instruction during Corona all the insurance companies has provided the more grace period which is false and baseless. It is submitted that as per the Circular issued by the IRDAI bearing reference no. IRDAI/Life/CIR/Misc/114/05/2020 dated 09.05.2020 which is reproduced as under:

"Sub: Grace Period up to 31st May 2020

This is further to the Authority's Circulars Ref:IRDA/Life/Cir/MISC/072/03/2020 dated 23rd March 2020 and Ref: IRDAI/Life/Cir/MISC/078/04/2020 dated 4th April 2020.

On a review of the recent situation of lockdown resulting from Global Pandemic of Covid 19 across the country and representations received, it has been decided that, for all life insurance policies where the premium falls due in the month of March 2020, the Grace period shall be allowed till 31st May 2020."

Therefore, it is submitted that the DLA died on 25.10.2020 and he has ample opportunity to pay the premium till 31 May, 2020 but he had not paid the same and accordingly the policy got lapsed due to nonpayment of premium. Therefore, the complainant cannot take the undue advantage of any fact. The contract of insurance is an agreement between the proposer and the insurance company wherein both the parties to the contract accepts to abide by the express terms and conditions of the contract. Thus, the company is bound by the terms and conditions of the contract of insurance under the policy. Rest of the averments of the complainant were denied by the OP and prayed for dismissal of the present complaint with heavy costs.

5.           Learned counsel for the complainant tendered affidavit of complainant as Annexure C-A alongwith documents as Annexure C-1 to C-6 and closed the evidence on behalf of complainant. On the other hand, learned counsel for the OP tendered affidavit of Mr. Devendra Verma, Manager (Legal) of the OPs Company-PNB Met Life India Insurance Corporation limited, having corporate Office At Unit No.302, 3^rd Floor, Worldmark-3, Sector-65, Gurgaon, Haryana-122018 as Annexure OP-1/A alongwith documents as Annexure OP-1/1 to OP-1/7 and  closed evidence on behalf of the OP.
6.           We have heard the learned counsel for complainant and learned counsel for the OP and have carefully gone through the case file and also gone through the written arguments filed by the learned counsel for the OP.
7.           Learned counsel for the complainant submitted that by not making payment of the sum assured under the policy in question, after death of the husband of the complainant, the OPs are deficient in providing service and adopted unfair trade practice.  He further submitted that pending premium could not be paid because of restrictions imposed by the Govt. due to COVID-19 in the country.
8.           On the other hand, learned counsel for the OP while reiterating the averments contained in its submitted that the policy stood lapsed because of non-payment of the premium. He further submitted that the liability of the OP under the policy in question arises only if the policy is in force on the date of death of life assured. He has also quoted the law cases referred in the written arguments, filed by him.   
9.           It is an admitted case of the complainant that her deceased husband could not pay the premium due in respect of the policy in question on 17.05.2020 to the OP.  To writhe out of the situation, the complainant had taken a plea that premium could not be paid due to nationwide lockdown due to COVID-19 as a result of which, her husband could not deposit the due amount. It may be stated here that we are not convinced with the plea taken by the complainant because lockdown was imposed in the country in March 2020 and lifted in April 2020 but the premium due was neither paid on the due date i.e. on 17.05.2020 or even by 24.10.2020 i.e. one day before the death of the insured, when there was no restriction or lockdown in the country. We have gone through the Circular dated 09.05.2020, Annexure OP1/7 reliance of which has been placed by the OP and find that the Govt. had given grace period for making payment of the due amount of premium under insurance policies by 31.05.2020 but the insured did not avail the said benefit also, as he did not make payment of due premium by 31.05.2020.  Under these circumstances, when the insured had failed to deposit the premium due by the committed date or within the grace period or even thereafter before his death till 24.10.2020, now no benefit can be availed by the complainant being his legal hier/nominee under the policy in question. In Life Insurance Corporation of India and Ors. Vs. Sunita, MANU/SC/1018/2021 and Life Insurance Corporation of India and Ors. Vs. Mani Ram, MANU/SC/0459/2005, it was held by the Hon’ble Supreme Court that no claim is payable to the insured or his nominee, in case, the policy stood lapsed because of nonpayment of premium. It is therefore held that in the present case, the OPs therefore were right in not making payment of the sum assured to the complainant, due to non-payment of premium by the insured, as referred to above, as a result of which the policy had lapsed.  
10.           In this view of the matter, this complaint stands dismissed with no order as to cost. Certified copy of the order be supplied to the parties concerned, forthwith, free of cost as permissible under Rules. File be indexed and consigned to the Record Room.

Announced on:- 11.01.2024

 

(Vinod Kumar Sharma)	(Ruby Sharma)	(Neena Sandhu)
Member	Member	President