National Consumer Disputes Redressal
Birla Sunlife Insurance Company Ltd. vs Mahendra Todi on 26 October, 2017
NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION NEW DELHI REVISION PETITION NO. 546 OF 2017 (Against the Order dated 08/11/2016 in Appeal No. 1291/2016 of the State Commission Rajasthan) 1. BIRLA SUNLIFE INSURANCE COMPANY LTD. ONE INDIA BULLS CENTRE TOWER I, 15TH AND 16TH FLOOR, JUPITER MILL COMPIYBD 841, SENAOATU BAPAT MARG, ELEPHINSONE ROAD, MUMBAI-400013 MAHARASHTRA ...........Petitioner(s) Versus 1. MAHENDRA TODI S/O. LT. SH. SANWARMAL TODI, R/O. F-5, INDUSTRIAL AREA, JAIPUR ROAD, SIKAR RAJASTHAN ...........Respondent(s)
BEFORE: HON'BLE MR. JUSTICE V.K. JAIN,PRESIDING MEMBER
For the Petitioner : Ms. Meenakshi Midha, Advocate
Mr. Kapil Midha, Advocate
Mr. Akhil Roy, Advocate For the Respondent : NEMO
Dated : 26 Oct 2017 ORDER
JUSTICE V.K. JAIN (ORAL)
Late Shri Sanwarmal Todi, father of the complainant, submitted a proposal dated 29.3.2012 to the petitioner for obtaining an insurance policy. In the aforesaid proposal, he interalia declared that he was not suffering from Diabetes. However, in the Questionnaire dated 31.3.212, he interalia admitted that he was suffering from Diabetes for last more than 5 years and he had been on medication. The name of the medicine being taken by him was also disclosed in the answer to the Questionnaire. The cheque whereby premium of Rs.45,000/- was paid by the deceased was encashed by the petitioner. The case of the petitioner is that since the deceased was suffering from Diabetes, the proposal was never accepted by it and the amount received from him was sent back vide cheque No.482353 sent by Regd. Post on 25.4.2012. The aforesaid cheque, however, could not be served upon the deceased, he having expired in the on 25.4.2012. After the death of the deceased, the complainant submitted a claim for payment in terms of the policy for which the proposal had been submitted by the deceased. The claim was rejected vide letter dated 23.5.2013 which to the extent it is relevant, reads as under:-
"This is with reference to your concern registered with us for the Birla Sun Life Insurance Plan Policy No. 005515236.
We wish to inform you that we had received the Application No.A46115297 for Policy Number 005515236, however the same rejected by the underwriting in the initial stage due to medical reasons and the initial premium of Rs.45,000/- was processed through cheque number 482353 and the same was dispatched to your registered address on April 25, 2012; but the same was received undelivered to Head Office.
In order to issue the refund cheque in your name, kindly submit the below mentioned requirements at the nearest Birla Sun Life Insurance Branch:
Deed of relinquishment DOR - notarized on a Rs.200 stamp paper Death Certificate Photograph of the proposed policy owner Proof of identity of the proposed policy owner Proof of residence of the proposed policy owner On receipt of the same needful shall be done."
Being aggrieved from the rejection of the claim, the complainant approached the concerned District Forum by way of a consumer complaint alleging therein that the policy No.005515236 had been issued to him by the petitioner company.
2. The complaint was resisted by the petitioner interalia on the ground that since the proposal was never accepted by them, no concluded contract of insurance came into existence and no policy or document was actually issued to the deceased.
3. The District Forum having ruled in favour of the complainant, the petitioner approached the concerned State Commission by way of an appeal. The said appeal also having been dismissed, the petitioner is before this Commission by way of this revision petition. The learned counsel for the petitioner company has drawn my attention to clause 5 of the receipt which was issued to the deceased at the time cheque of Rs.45,000/- was received from him. The aforesaid condition reads as under:-
"For application under consideration, the insurance cover shall commence after the said application form for insurance has been examined and accepted by BSLI this shall be communicated separately to you. The prevailing NAV as on date of acceptance /commencement of risk will be applicable."
It would thus be seen that the insurance cover could not have commenced without the application form having been accepted by the petitioner company and the said acceptance having been communicated to him. There is absolutely no evidence of the proposal submitted by the deceased having been accepted at any point of time. Therefore, the insurance cover never commenced in this case. That precisely seems to be the reason why no policy document was ever issued by the petitioner to the complainant. Since the life of the deceased was never covered by the petitioner company, there could be no question of the petitioner paying the amount of Rs.10 lakh which would have been payable in the event of the proposal being accepted. The impugned orders, therefore, cannot be sustained and are hereby set aside. The complaint is consequently dismissed. The petitioner, however, is directed to refund the premium amount of Rs.45,000/- received from the deceased along with interest on that amount @ 9% p.a. from the date on which the cheque was enchased till the date on which the aforesaid amount along with interest is paid. The revision petition stands disposed of accordingly.
......................J V.K. JAIN PRESIDING MEMBER