DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION-II

Udyog Sadan, C-22 & 23, Qutub Institutional Area

(Behind Qutub Hotel), New Delhi- 110016

Case No.199/2024

Jalaluddin

S/o Late Anil Kumar @ Abdul Zabbar R/ A-149 Sanjay Colony Bhatti Mines

New Delhi-110074

….Complainant Versus

TATA AIA Life Insurance Co. Ltd.

Through its CEO/Manager

14th Floor, Tower A, Peninsula Business Park,

Sanapati Bapat Marg, Lower Parel,

Mumbai-400013 ….Opposite Party

Date of Institution : 23.07.2024 Date of Order : 08.04.2026

Coram:

Ms. Monika A Srivastava, President

Ms. Kiran Kaushal, Member

Present: Adv. Nizamuddin for complainant.

Adv. Garud M.V for OP.

ORDER

Member: Ms. Kiran Kaushal

1. Briefly put, father of the complainant Late Sh. Anil Kumar@ Abdul Jabar during his life timetook life insurance policies from Tata AIA Life Insurance, hereinafter referred to as OP.

2. Currency period of the Life Insurance policies C-267673005 and C-248654344is stated to be from 26.10.2021 to 08.11.2021 and the mode of payment of premium was monthly through ECS mode. The assured sum of policies is Rs.5,77,575/- and Rs.3,46,545/- respectively. It is stated that complainant’s father expired due to Corona Pandemic on 14.12.2021 at his native place. Complainant and his family were in deep shock due to untimely death of their beloved one.

3. It is stated that complainant’s father had instructed the payment of monthly premium therefore, even after his death two premiums were deducted/debited through ECS from the account of the complainant. After the death of his father, complainant filed for the claim for both the policies along with all relevant documents but complainant was shocked and surprised as the claim was repudiated by OP on the ground that there is, ‘mis-match of the photo’.

4. It is further stated that complainant got an email on 30.10.2023 along with an attachment of letter dated 15.12.2022.The said letter was addressed to the late father of the complainant informing that there was disparity in the photographs hence OP was unable to process the application for insurance. It is stated that complainant received the email after the death of his father and states that OP repudiated the claim of the complainant in arbitrary manner with malafide intention.

5. It is further stated that complainant filed a complaint in the office of insurance ombudsman on 04.03.2024 which was rejected stating that complaint is time barred as the complainant had not approached ‘the IO within one year of repudiation of the death claim’.

6. Alleging deficiency of service and unfair trade practice, complainant approached this Commission for directions to OP to pay the sum assured of the insurance cover taken by the deceased father of the complainant with interest @24% p.a from the date of repudiation till payment; to pay sum of Rs.2,50,000/- for mental harassment, torture, agony, pain and suffering and to pay sum of Rs.20,000/- towards litigation expenses.

7. OP resisted the complaint stating inter alia that Mr. Anil Kumar hereinafter referred to as insured had taken Tata AIA Life Insurance Fortune Guarantee Plus policy valid from 26.10.2021 to 26.10.2034.

8. It is stated that complainant’s father took the said policy online from Policy Bazar. Thereafter, OP appointed an independent investigator to investigate the details of insured. The investigator visited at the given address of insured but could not meet and click the photograph of the insured. After receiving the report from investigator OP tried reaching the insured and gave enough time to the insured to reach back but there was no update from the insured. As the said information is of material importance and has direct impact on the underwriting decision and the basis of offering terms of this policy, OP vide letter dated 15.12.2022 cancelled the insurance policy of complainant’s father on the ground ‘disparity in contact details’ and refunded the premium amount to the insured.

9. It is next