Haryana

Karnal

CC/439/2020

Ms. Ramandeep Kaur - Complainant(s)

Versus

PNB Metlife India Insurance Company Limited - Opp.Party(s)

S.S. Moonak

12 Jul 2023

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, KARNAL.

                                                        Complaint No. 439 of 202

                                                        Date of instt.19.10.2020

                                                        Date of Decision:12.07.2023

 

1. Ms. Ramandeep Kaur, aged 37 years wife of late Shri Pargat Singh son of late Shri sukhdev Singh. Aadhar card no.2049 5174 2446.

 

2. Smt. Swarn Kaur, aged 55 years, wife of late Shri Sukhdev Singh. Aadhar card no.8580 6353 9742.

 

3. Master Avarjot Singh, aged 10 years (minor) son of late Shri Pargat Singh, minor through his mother Smt. Ramandeep Kaur, being natural guardian and next friend, all residents of house no.690, New Prem Nagar, Karnal.

                                               …….Complainants.

                                              Versus

 

PNB Metlife India Insurance Company Limited through its Branch Manager, opposite mini secretariat, sector 12, Karnal.

 

                                                                      …..Opposite Party.

 

Complaint Under Section 35 of Consumer Protection Act, 2019.

 

Before   Sh. Jaswant Singh……President.

              Sh. Vineet Kaushik……Member 

      Dr. Rekha Chaudhary……Member

          

 Argued by: Shri S.S.Moonak, counsel for the complainants.

                    Shri Naveen Sharma, counsel for the OP.

 

                    (Jaswant Singh President)

ORDER:   

    

                 The complainants have filed the present complaint Under Section 35 of Consumer Protection Act, 2019 against the opposite party (hereinafter referred to as ‘OP’) on the averments that complainant no.1 is the widow of deceased Pargat Singh son of late Shri Sukhdev Singh, complainant no.2 is the mother of deceased, complainant no.3 is the minor son of deceased Pargat Singh respectively. Complainants being legal heirs of the deceased are the consumer of the OP. Pargat Singh (since deceased) had taken a life insurance policy form the OP namely PNB Metlife Endowment Saving Plan Plus bearing no.22750595 dated 18.12.2018. The premium of the policy was to be paid in 5 annual installments, the sum assured was of Rs.2,52,628/-. The installment of said policy was paid prior to his death by insured Pargat Singh by way of cheque no.000001, amounting to Rs.51125/- dated 12.02.2020. Pargat Singh died on 23.04.2020 and after his death the mother of deceased Pargat Singh i.e. complainant no.2 being nominee had applied for the payment of the policy including the bonus and other benefits, she submitted all the relevant documents as demanded by the OP. Thereafter, the brother of deceased namely Gurbaj Singh alongwith his mother visited the office of OP so many times and requested to settle the death claim of insured Pargat Singh but OP did not pay any heed to the request of complainants and lingered the matter on one pretext or the other and lastly told by the official of the OP that the claim is not payable but no written communication as given to the complainants. In this way there is deficiency in service on the part of the OP. Hence this complaint.

2.             On notice, OP appeared and filed its written version raising preliminary objections with regard to maintainability and concealment of true and material facts. On merits, it is pleaded that Shri Pragat Singh life assured (hereinafter called as ‘policyholder’) and Smt. Ramandeep Kaur, Swarn Kaur and master Avarjot Singh (hereinafter called as ‘complainants’) has submitted a proposal form with the OP for purchase of PNB Metlife Endowment Saving Plan Plus, the said proposal was accepted on the information provided by the life assured and consequently a policy was issued bearing policy no.22750595 dated 18.12.2018, where the sum assured was Rs.2,52,628/-, policy term was 10 years, premium paying term was of 5 years, policy premium was Rs.52,250/- mode of payment of premium was annual. The policy in question was issued in the year 2018 to the policyholder on the basis of proposal form which was submitted by him on his own life and till date the complainant has not filed any death claim before the OP. It is further pleaded that cheque of Rs.51,125/- was issued by the policyholder for paying the premium amount was bounced due to the reason “kindly contact Drawer/Drawee bank and present again” and the same was communicated to the policy holder. It is further pleaded that complainants never submitted any death claim with the OP and without intimation of the said claim, the company cannot process the claim. There is no deficiency in service and unfair trade practice on the part of the OP. The other allegations made in the complaint have been denied and prayed for dismissal of the complaint.

3.             Parties then led their respective evidence.

4.             Learned counsel for the complainant has tendered into evidence affidavit of complainant Ex.CW1/A, copy of insurance policy Ex.C1, copy of death certificate Ex.C2, copy of premium receipt Ex.C3, copy of application dated 27.07.2020 by complainant no.2 to Bank regarding cheque bounce detail Ex.C4, copy of application by complainant no.2 to Bank regarding submitting the documents Ex.C5, copy of statement of account of policy holder regarding debit of premium amount Ex.C6 and closed the evidence on 30.11.2021 by suffering separate statement.

5.             On the other hand, learned counsel for the OPs has tendered into evidence affidavit of Arijit Basu, Senior Manager, Ex.RW1/A, authority letter Ex.R1, copy of application form Ex.R2, copy of welcome letter Ex.R3 and closed the evidence on 16.01.2023 by suffering separate statement.

6.             We have heard the learned counsel of the parties and perused the case file carefully and have also gone through the evidence led by the parties.

7.             Learned counsel for complainants, while reiterating the contents of the complaint, has vehemently argued that Pargat Singh (since deceased) had taken a life insurance policy from the OP. The premium of the policy was to be paid in 5 annual installments, the sum assured was of Rs.2,52,628/-. The installment of said policy was paid by insured Pargat Singh prior to his death. The mother of insured Pargat Singh i.e. complainant no.2 being nominee submitted the claim form and other relevant documents with the OP and also requested the OP to settle the claim, but  OP neither settled nor repudiated the claim of complainants till today and lastly prayed for allowing the complaint.

8.             Per contra, learned counsel for the OP while reiterating the contents of written version, has vehemently argued that OP has never repudiated any claim of complainants because OP has not received any claim intimation form as prescribed by the company alongwith relevant documents till date and prayed for dismissal of the complaint.

9.             We have duly considered the rival contentions of the parties.

10.           Admittedly, the insured had purchased a PNB Metlife Endowment Saving Plan Plus from the OP. It is also admitted that sum insured was Rs.2,52,628/- under the said policy. It is also admitted that complainant no.2 is the nominee in the said policy. It is also admitted that insured had expired during the subsistence of the insurance policy.

11.           Before going to the merits of the case, firstly we decide, whether the present complaint is pre-mature or not?

12.           As per version of the OP, complainants have never intimated the OP regarding the death of insured and has also not submitted the claim with the OP till date and without submission of the claim, it cannot be decided whether same is payable or not. As per the version of the complainants, they have submitted the claim alongwith required documents with the OP. The onus to prove their version was relied upon the complainants but complainants have miserably failed to prove the same by leading any cogent and convincing evidence. If the complainants had submitted the claim with the OPs and supplied the required documents, they would have placed on file the copies of the said documents. Complainants have also failed to disclose date and month for submission of the claim form with the OP. Thus, we are of the considered view that complainants have not submitted the claim with the OP.  Hence, in view of the above, the present complaint is premature and not maintainable.

13.           In view of the above observation, the present complaint is disposed off with the liberty to the complainants to submit the claim form alongwith documents as required by the OP and on receipt of the same, OP is hereby directed to settle the claim of the complainants within 30 days. No order as to costs. This order shall be complied with accordingly. The parties concerned be communicated of the order accordingly and the file be consigned to the record room after due compliance.

Announced

Dated:12.07.2023                                                                    

                                                                President,

                                                    District Consumer Disputes

                                                    Redressal Commission, Karnal.

 

 (Vineet Kaushik)       (Dr. Rekha Chaudhary)

  Member                   Member