Orissa

StateCommission

CC/22/2018

Mrs. Jhumuri Das - Complainant(s)

Versus

Branch Manager, Bharati Axa Insurance Co. Ltd. - Opp.Party(s)

M/s. R.K. Pattnaik & Assoc.

20 Apr 2023

ORDER

IN THE STATE CONSUMER DISPUTES REDRESSAL COMMISSION
ODISHA, CUTTACK
 
Complaint Case No. CC/22/2018
( Date of Filing : 03 May 2018 )
 
1. Mrs. Jhumuri Das
W/o- Late Surendra Das, At- Gobindpur, Bendalia, Berhampur, Ganjam.
...........Complainant(s)
Versus
1. Branch Manager, Bharati Axa Insurance Co. Ltd.
1st Floor, Plot No.-10 & 12, City mart, Baramunda, Bhubaneswar-751003
2. Bharti Axa Life Insurance Co. Ltd.
represented through its Manager, Claims Unit No. 601,602, Raheza Titanium Off Western Express Hzizgzhwazy, ZGoregaon, Mumbai-400063.
............Opp.Party(s)
 
BEFORE: 
 HON'BLE MR. JUSTICE Dr. D.P. Choudhury PRESIDENT
 HON'BLE MS. Sudhiralaxmi Pattnaik MEMBER
 
PRESENT:M/s. R.K. Pattnaik & Assoc., Advocate for the Complainant 1
 
Dated : 20 Apr 2023
Final Order / Judgement

 Heard learned counsel for the complainant.

2.        This complaint case is filed under Section 17 of the Consumer Protection Act, 1986 read with Section 12 of the Act.

3.        The case of the complainant in nutshell is that complainant is the nominee of the original  policy holder who had purchased the policy of Bharti AXA Life Future Invest from the opposite party commencing  from 28.10.2015. It is alleged inter alia that the policy holder died on 20.3.2016. Thereafter, the complainant being the nominee of the original policy holder applied for settlement of the claim, but the same was repudiated on 16.5.2017 on the ground that the original policy holder expired before the policy is issued.

4.        Challenging the repudiation, the wife of the original policy holder filed the complaint case claiming the sum assured mentioned in the policy bond. In order to prove the case, the complainant has filed certain documents. The statement of the complainant is recorded is coupled with the affidavit treated as  the evidence of the complainant and the Annexure-1 go to show that the complainant’s husband has purchased the policy commencing from 28.10.2015 for a sum assured at Rs. 20 (Twenty) lakhs. The policy was issued for ten years. The complainant also produced Annexure-2, the death certificate of the original policy holder which goes to show that the policy holder died on 20.3.2016. He also proved the letter of the repudiation vide Annexure-3 and the complainant has also replied vide Annexure-4. All these  documents clearly go to show that the Policy Holder after purchasing the Policy Bond unfortunately expired on 20.3.2016 when the policy was in force. In such occasion, it is proved that the complainant is entitled to the death benefit accrued in the policy. The opposite party has been set ex parte and the repudiation letter has not been proved by them. The complainant has alleged in the complaint that due to the repudiation of claim, the complainant was mentally harassed  and the claim has not been settled on the vague ground that the policy holder has died before the policy commences.

5.        We have already discussed above that the policy holder died only after the policy commences and in such situation, mental agony is clearly proved. Therefore,  there is deficiency in service on the part of the opposite party  because the claim of the complainant has been repudiated on vague ground.

6         In view of the above, the complaint petition is allowed ex parte against the O.P. with cost.

7.        We hereby direct the opposite party to settle the claim of the complainant as per Part-C of the Policy Bond and make payment of the settled amount to the complainant with 9% interest per annum from the date of filing of case. The opposite party is also directed to pay compensation of Rs. 30,000/- (Thirty Thousand) and Rs. 20,000/- (Rupees Twenty Thousand) complainant as cost. All these orders should be complied with within 45 days from today.

Supply free copy of this order to the respective parties or the copy of this order be downloaded from Confonet or Website of this Commission to treat same as copy supplied from this Commission.

 
 
[HON'BLE MR. JUSTICE Dr. D.P. Choudhury]
PRESIDENT
 
 
[HON'BLE MS. Sudhiralaxmi Pattnaik]
MEMBER
 

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