State Consumer Disputes Redressal Commission
Krishna Devi vs Bajaj Allianz Life Insurance Company ... on 25 February, 2014
FIRST ADDITIONAL BENCH
STATE CONSUMER DISPUTES REDRESSAL COMMISSION,
PUNJAB
SECTOR 37-A, DAKSHIN MARG, CHANDIGARH.
First Appeal No.842 of 2011.
Date of Institution: 27.05.2011.
Date of Decision: 25.02.2014.
Krishna Devi wife of Sh. Amar Nath, R/o Village Bahadurpur Fakiran,
PO Devigarh, Tehsil and District Patiala.
.....Appellant.
Versus
1. Bajaj Allianz Life Insurance Company Limited, 2nd Floor, Victoria
Road, near Hyderabad Biriyani Hotel Road, Victoria Road,
Bangalore, Karnataka, through its M.D.
2. Branch Manager, Bajaj Allianz Life Insurance Company limited,
Leela Bhawan, opposite Income Tax office, Patiala.
...Respondents.
First Appeal against the order dated
13.04.2011 passed by the District
Consumer Disputes Redressal Forum,
Patiala.
Before:-
Shri Inderjit Kaushik, Presiding Judicial Member.
Shri Jasbir Singh Gill, Member.
...................................
Present:- Sh. Hardeep Singh, Advocate, counsel for the appellant.
Sh. Varun Chawla, Advocate, counsel for the respondents.
---------------------------------------- INDERJIT KAUSHIK, PRESIDING JUDICIAL MEMBER:-
Smt. Krishna Devi, appellant/complainant (In short "the appellant") has filed this appeal against the order dated 13.04.2011 passed by the learned District Consumer Disputes Redressal Forum, Patiala (in short "the District Forum").First Appeal No.842 of 2011 2
2. Facts in brief are that the appellant filed a complaint under section 12 of the Consumer Protection Act, 1986 (in short, "the Act") against the respondents/opposite parties (hereinafter called as "the respondents"), making the assertions that Sh. Amar Nath was her husband, who got himself insured on 24.08.2007 for a sum of Rs.3.00 lacs and premium of Rs.12,000/- was paid and the receipt dated 09.09.2007 was issued by the appellants and a policy bearing No.0066249011 was issued. The appellant was nominee, being the wife of Sh. Amar Nath, who died on 13.09.2007 and left the appellant as the only legal heir being widow and nominee.
3. The appellant lodged the claim, but nothing was done. The appellant got legal notice issued for making the payment of the claim, but no heed was paid. The appellant suffered mental tension and harassment and is entitled to compensation.
4. It was prayed that the respondents may be directed to pay a sum of Rs.3.00 lacs alongwith interest @ 12% p.a. from the date of death of policy holder Sh. Amar Nath and to pay Rs.50,000/- as compensation.
5. In the written version filed on behalf of the respondents, preliminary objections were taken that the appellant has not approached the District Forum with clean hands and concealed true facts. The complaint is false and frivolous and is not within litigation.
6. On merits, it was admitted that Sh. Amar Nath got himself insured for Rs.3.00 lacs and paid premium of Rs.12,000/- and receipt dated 09.09.2007 was issued. The life assured died on13.09.2007. The appellant never approached the appellants or lodged any claim. No legal notice was issued. The appellant is not entitled to any compensation, interest or any claim amount. All other allegations were First Appeal No.842 of 2011 3 denied and it was prayed that the complaint may be dismissed with costs.
7. Parties led evidence in support of their respective contentions by way of affidavits and documents.
8. After going through the documents and material placed on file and after hearing the learned counsel for the parties, the learned District Forum observed that if the date of issue of the policy has been recorded as 14.09.2007 in Ex.C-6, having noted the valuation date as 14.09.2007, it would mean that the decision to accept the proposal was taken two or three days earlier. As per section 126 of the Insurance Regulatory & Development Authority Act, 1999 and Regulations, 2002, the proposal has to be processed by the insurer with speed and efficiency and all the decisions have to be communicated within reasonable period, not exceeding 15 days from the receipt of proposal by the insurer. If the proposal was not processed by the insurer with speed and efficiency within a period of 15 days from the receipt of proposal, then the appellant cannot be blamed. It is the case of the appellant that her husband got himself insured on 24.08.2007, having made the payment of Rs.12,000/- vide cheque dated 24.08.2007 and that shows that the proposal form was filled on 24.08.2007 and the same should have been processed within 15 days i.e. upto 08.09.2007, but the respondents issued the policy on 14.09.2007. The life assured died on 13.09.2007, but the complaint was filed on 23.04.2010 after a period of two years and is time barred. The complaint was dismissed.
9. Aggrieved by the impugned order dated 13.04.2011, the appellant has come up in appeal.
First Appeal No.842 of 2011 4
10. We have gone through the pleadings of the parties, perused the record of the learned District Forum and have heard the arguments advanced by the learned counsel for the parties.
11. The appeal was filed on the grounds that the order passed by the District Forum is based on conjectures and surmises. The appellant filed the application on 14.07.2008, but the respondents did not pay the claim. The appellant again gave the application Ex.C-2 dated 08.04.2009 to pay the claim, but the respondents did not pay the same. Thereafter, legal notice was issued, but the claim of the appellant was neither rejected nor accepted and it cannot be said to be time barred. The District Forum has rightly held that the payment of policy amount for Rs.12,000/- was received vide cheque dated 24.08.2007 which was duly encashed and the receipt dated 09.09.2007 was issued. The appellant is an illiterate lady and the District Forum has not considered all these facts and the order passed by the District Forum is liable to be set aside.
12. It was contended on behalf of the appellant that in this case, the claim of the appellant has not been repudiated and the limitation was to start from the date of repudiation. The cause of action is continuous. The appellant has filed the claims vide applications Ex.C1 and Ex.C-2 and also served legal notice Ex.C-3, but the respondents have not replied the same and the impugned order is not sustainable and the same may be set aside, by allowing the appeal.
13. On the other hand, it was contended on behalf of the respondents that the order passed by the District Forum is detailed and speaking. The policy commenced from 14.09.2007, whereas the deceased life assured (In short, "DLA") died on 13.09.2007 before First Appeal No.842 of 2011 5 commencement of the policy and the order under appeal is legal and valid and the appeal may be dismissed.
14. We have considered the respective submissions advanced on behalf of the parties and have minutely scrutinized the entire record.
15. The husband of the appellant was insured with the respondents for a sum of Rs.3.00 lacs and the premium was deposited on 24.08.2007 vide cheque No.421385 dated 24.08.2007 which was encashed and the receipt dated 09.09.2007 was issued by the appellants. The husband of the appellant died on 13.09.2007 as per the death certificate Ex.C-5. The appellant lodged the claim with respondent no.2 vide application Ex.C-1 dated 14.07.2008 and another application Ex.C-2 was again filed for paying the claim amount on 08.04.2009. Ultimately, the legal notice Ex.C-3 dated 27.03.2010 was issued and sent through registered post to the respondents and the postal receipts are Ex.C-4. Ex.C-10 is the letter issued by respondent no.2 to deceased Amar Nath dated 19.09.2007 and the policy was sent. The receipt Ex.C-11 issued by respondent no.1 shows that the amount of Rs.12,000/- was received as proposal deposit from deceased Amar Nath on 09.09.2007 and the name of the policy holder was mentioned as Amar Nath.
16. Hon'ble National Commission in a very recent judgment in case "ICICI Prudential Life Insurance Company Limited Vs Bimal Kanta Kharab" I (2013) CPJ-155 (NC) held that the life cover commences from the date of deposit and observed in Para-16 as follows:-
"As per record, the cheque for the insurance premium was issued by the deceased on 13.12.2006, while he died on 30.01.2007. Thus, the death has occurred only after 47 days from the date of First Appeal No.842 of 2011 6 deposit of the amount of premium with the petitioner. Under these circumstances, the life cover had already commenced from 13.12.2006 and not from 02.01.2007 when the policy was issued."
17. Applying the above proposition of law to the present case, the deposit of premium of Rs.12,000/- was received on 09.09.2007 and, as such, the insurance cover started w.e.f. 09.09.2007 and the respondent insurance company is liable to pay the sum insured.
18. The argument that the complaint is time barred, is not tenable because a number of requests, including legal notice was issued on behalf of the appellant, but the claim was not decided and the cause of action remained continuous and it arises from the date of repudiation of the claim. Hon'ble National Commission in case "United India Insurance Company Ltd. & Anr. Vs. R. Piyarelall Import & Export Ltd.", I (2010) CPJ-22 (NC), held so.
19. In view of above discussion as well as the law, the order passed by the District Forum is not sustainable in the eyes of law and is liable to be set aside.
20. Accordingly, the appeal filed by the appellant is accepted and the impugned order under appeal dated 13.04.2011 passed by the District Forum is set aside. Consequently, the complaint filed by the appellant/complainant is allowed and the respondents are directed to pay the sum assured vide policy Ex.C-8 i.e. Rs.3.00 lacs alongwith interest @ 7.5% per annum from after three months of the death of life assured Sh. Amar Nath, till realization. The respondents are further directed to pay Rs.11,000/- as litigation expenses.
21. The respondents shall comply the order within 45 days of the receipt of copy of the order.
First Appeal No.842 of 2011 7
22. The arguments in this appeal were heard on 19.02.2014 and the order was reserved. Now the order be communicated to the parties.
23. The appeal could not be decided within the stipulated timeframe due to heavy pendency of court cases.
(Inderjit Kaushik) Presiding Judicial Member (Jasbir Singh Gill) Member February 25, 2014.
(Gurmeet S)