Andhra Pradesh

Visakhapatnam-II

CC/38/2014

Adari Lakshmi - Complainant(s)

Versus

Aegon Religare Life Insurance Company - Opp.Party(s)

Akkireddy Satya Rao

20 Feb 2015

ORDER

 Reg. of the Complaint:03-02-2014

                                                                                                                                 Date of Order:20-02-2015

FORE THE DISTRICT CONSUMERS FORUM-II

AT VISAKHAPATNAM

                   Present:

1.Sri H.ANANDHA RAO, M.A., L.L.B.,

       President

2.Sri C.V.RAO, M.A., B.L.,

                                             Male Member

3.Smt.K.SAROJA, M.A., B.L.,

       Lady Member

                                            

 

FRIDAY, THE 20^TH DAY OF FEBRUARY, 2015

CONSUMER CASE NO.38/2014

 

BETWEEN:

SMT.ADARI LAKSHMI D/O LATE GOVIND, HINDU,

AGED 30 YEARS, R/AT D.NO.18-5-15/2, VILLURI AKKAYYA STREET,

GAVARAPALEM, ANAKAPALLI, VISAKHAPATNAM-531 002.

 

…COMPLAINANT

AND:

1.AEGON  RELIGARE LIFE INSURANCE COMPANY,

REP. BY ITS MANAGING DIRECTOR,

2^ND FLOOR, PARANJPE “B” SCHEME,

SUBASH ROAD, NEAR GARWARE HOUSE,

VILE PARLE (EAST), MUMBAI-400 057.

 

2.AEGON RELIGARE LIFE INSURANCE COMPANY,

REP. BY ITS BRANCH MANAGER, OPP:SAMPATH

VINAYAKA TEMPLE, ASILMETTA, VISAKHAPATNAM.

…OPPOSITE PARTIES

This case coming on 19-02-2015 for final hearing before us in the presence of SRI AKKIREDDY SATYA RAO, Advocate for the Complainant, and of SRI P.KUMAR, Advocate for the 1^st Opposite Party, and of 2^nd Opposite Party, being set exparte, and having stood over till this date for consideration, this Forum made the following.

 

ORDER

 (As per SMT.K.SAROJA, Honourable Lady Member on behalf of the Bench)

1. The case of the complainant in brief is that Complainant’s father obtained an Insurance Policy from the OPs. The OPs issued policy bearing No.1105 13106289 dated 12-05-2011 and the date of maturity is 11-05-2026, wherein the complainant shown as nominee and the insured paid 1^st premium .  The complainant’s father died on 19-11-2011 due to vomitings and motions. After the death of her father, the complainant approached the 2^nd OP and by the advice of the 2^nd OP, the complainant submitted all necessary documents to the OPs for settlement of claim. The OP issued a letter dated 23-03-2012 and sent a cheque for Rs.13,435.29ps towards the fund value and also agreed that they will process the claim of the complainant at an early date,  but  till now the OPs did not settle the claim. Hence, this complaint.

1. To direct the Opposite Parties to refund an amount of Rs.4,00,000/- (Rupees Four Lakhs only) together with accrued interest at 24% p.a., from the date of payment of respective insurance policy after deducing Rs.13,435.29ps,
2. For damages, mental agony of Rs.50,000/-

c)  For costs of the complaint; and

d)  For such other relief or reliefs as the Honourable Forum deems fit and proper in the circumstances of the case.

2.       The 2^nd Opposite Party did not appear before this Forum, hence, it was set exparte and remained exparte. Though the 1^st OP appeared before this Forum and filed Vakalat, but they did not file any counter and other documents to support their contention.

4.       At the time of enquiry, the complainant filed Evidence Affidavit as well as written arguments to support her contention. Exhibits A1 to A8 are marked for the complainant, Exhibit A9 is suomoto marked. No documents are marked for the OP.  Heard the complainant.

          Exhibit A1 is the Insurance Policy, Exhibit A2 is the Proposal Form dated 09-05-2011, Exhibit A3 is the Claimant’s Statement dated 19-03-2012, Exhibit A4 is the Death Claim Intimation, dated 19-03-2012, Exhibit A5 is the Acknoweldgement No.ARL678166-P9QYD3 dated 19-03-2012, Exhibit A6 is the representation letter sent by the complainant to the OPs, dated 31-07-2012, Exhibit A7 is the acknowledgement, dated 08-08-2012, Exhibit A8 is the letter of complainant of death claim dated 23-03-2012, Exhibit A9 is the Death Certificate of the father of the complainant dated 29-12-2014.

5.       The fact shown from Exhibits A1 and A2 reveal that the OPs issued policy in favour of complainant’s father and also received an amount of Rs.20,000/- towards first premium of the Policy, Exhibits A3 and A4 reveal that the complainant sent the claim form along with necessary documents to the OPs for settlement of her claim. Exhibit A9 reveals that the complainant’s father i.e., Beda Appa Rao died on 19-11-2011 and so that a certificate was issued by Registrar of Births and Deaths, Anakapalle Municipality.

6.       The point that would arise for determination is:

Whether there is any deficiency of service on the part of the OPs? If so, Whether the Complainant is entitled to the   reliefs asked for?

7.       After careful perusal of the case record, this forum finds that there is no dispute regarding the issuance of the Insurance Policy in favour of the complainant’s father/deceased. The OP sent a cheque dated 23-03-2012 towards the payment of the fund value of the policy of Rs.13,435.29ps vide LR.No.036706 dated 21-03-2012 drawn on HDFC Bank to the complainant. After receiving the cheque, the complainant wrote a letter to the OP and requested them to settle her claim. After receiving the letter, they kept silent, it amounts to deficiency of service on the part of the OPs. The OPs failed to file counter and any other documents to show that the complainant’s claim is not maintainable, they kept silent after filing Vakalat. Hence, the complainant is entitled to Rs.3,86,564.71ps. as the complainant received an amount of Rs.13,435.29ps. So, it is to be deducted in the insurance amount of Rs.4,00,000/-  (i.e., Rs.4,00,000/- minus Rs.13,435.29ps = Rs.3,86,564.71ps). Hence, the complainant is entitled to insurance amount with interest, some compensation and costs too.

8.       In the result, this complainant is allowed directing the Opposite Parties to pay an amount of Rs.3,86,564.71ps. (Rupees Three lakhs, eighty six thousand, five hundred and sixty four and seventy one paise only) with 9% p.a., from 23-03-2012 till the date of actual realization, to pay a compensation of Rs.40,000/- (Rupees Forty Thousand only) and costs of Rs.5,000/-(Rupees Five Thousand only) to the complainant.   Time for compliance one month from the date of this order.

Dictated to the Stenographer, transcribed by him, corrected and pronounced by us in the open Forum, on this the 20^th day of February, 2015.

 

   Sd/-                                                    Sd/-                                           Sd/-M.MEMBER                                                    PRESIDENT                                                L.MEMBER  

 

APPENDIX OF EVIDENCE

Exhibits Marked for the Complainant:

Exhibits	Date	Description	Remarks
A-1		Insurance Policy Schedule	Photostat copy
A-2	09-05-2011	Proposal Form	Photostat Copy
A-3	19-03-2012	Complainant’s Statement	Photostat copy
A-4	19-03-2012	Death Claim Intimation	Photostat copy
A-5	19-03-2012	Acknowledgement No.ARL678166-P9QYD3	Photostat copy
A-6	31-07-2012	Representation letter sent by the complainant to the OPs	Photostat copy
A-7	08-08-2012	Acknowledgement	Original
A-8	23-03-2012	Letter of complainant of death claim along with postal receipt	Original
A-9	29-12-2014	Death Certificate	Original

 

EXHIBITS MARKED ON BEHALF OF THE OPS:   -NIL-

   Sd/-                                                    Sd/-                                                           Sd/-

M.MEMBER                                                     PRESIDENT                                                L.MEMBER