This complaint petition has been filed by complainant
Ashok Jha Alias Ashok Kumar Jha against Branch Manager, LIC,
Jhanjharpur Branch Office, District- Madhubani and one another
(o.ps) for Rs. 5,75,000/- as sum assured with 18 % annual
interest since, the date of death of life assured namely Nilam
Devi (Complainant’s wife) till the date of payment. He further
prays for any relief or reliefs for which this forum deems and fit
proper.
The case of the complainant as envisaged in complaint
petition is that the complainant Ashok Jha has filed this

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complaint petition against o.ps in the capacity of nominee and
husband of life assured person namely Nilam Devi. Further case
is that the aforesaid company gave a proposal form to the wife
of complainant for insurance. The wife of complainant paid Rs.
11,764/- as premium amount to the company and purchased a
policy No.- 527944906 for sum assured amount Rs. 5 lakh along
with assured monitory benefits. The further case is that the
entire proposal form was filled up by company’s agent in
presence of company’s official and the complainant’s wife only
put her signature wherever the agent and company’s officials
told her to do so. The further case is that the company issued
premium receipt and bond in the name of life assured person
namely Nilam Devi and hence the said company started risk
coverage of life of Nilam Devi from 15-10-2015. The further case
of the complainant is that on 27-11-2015 the life assured person
namely Nilam Devi died with cold exposure and heart attac
leaving no time to consult with a doctor. Her death stunned
each & every member of family and pushed in great sorrow. The
further case is that after emerging from such an painful and
unfortunate incident the complainant filed death claim the
against policy No.527944906 to the aforesaid insurance
company with all the relevant documents but in spite of several
demand and persistent request, the company has not
responded positively. O.ps has neither settled the claim nor
repudiated the same, so after passing 2 years of the request, the
complainant filed this complaint petition.
O.ps appeared on 10-04-2018 and filed their w.s stating
therein that o.ps are ready to settle and pay the claim of the
complainant on the basis of compromise.

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In pursuance of settlement the o.ps have presented
cheque bearing No. 901896 for Rs. 4,83,387/- on 18-05-2018
and cheque No. 024544 of Rs. 28,849/- on 04-10-2018 which has
been received by the complainant.
The learned lawyer for the complainant has submitted that
the company has paid the sum assured amount with interest but
he has not paid the compensation and litigation cost.
The learned lawyer for the o.ps has submitted that the
o.ps company has paid the amount of sum assured with interest
and the complainant is not entitled for any other compensation
or monetory benefits. The insurance Regularity Development
Authority Notification dated 16-10-2002 and Insurance
Regulatory and Development Authority (Protection of Policy
holder’s interests) Regulations 2002 section -8 says as follows.
(1) A life insurance policy shall state the primary
documents which are normally required to be
submitted by a claimant in support of a claim
(2) A life insurance company, upon receiving a claim, shall
process the claim without delay. Any queries or
requirement of additional documents, to the extent
possible, shall be raised all at once and not in piece-
meal manner, within a period of 15 days of the receipt
of the claim.
(3) A claim under a life policy shall be paid or be disputed
giving all the relevant reasons, within 30days from the
date of receipt of all relevant papers and clarifications
required. However, where the circumstances of a claim
warrant an investigation in the opinion of the insurance
company, it shall imitate and complete such

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investigation at the earliest. Where in the opinion of
the insurance company the circumstances of a claim
warrant an investigation it shall initiate and complete
such investigation at the earliest, in any case not later
than 6 months from the time of lodging the claim.
(4) Subject to the provisions of section 47 of the Act.
Where a claim is ready for payment but the payment
cannot be made due to any reasons of a proper
identification of the payee, the life insurer shall hold
the amount for the benefit of the payee and such an
amount shall earn interest at the rate applicable to a
saving bank account with a scheduled bank (effective
from 30 days following the submission of all papers and
information.
(5) Where there is a delay on the part of the insurer in
processing a claim for a reason other than the one
covered by sub-regulation (4), the life insurance
company shall pay interest on the claim amount at a
rate which is 2 % above the bank rate prevalent at the
beginning of the financial year in which the claim is
reviewed by it.
As per above Regulations the Insurance company upon
receiving the claim shall process and claim without delay within
a period of 15 days of the receipt of the claim and if
investigation required, this same shall be completed not letter
than 6 months from the time of lodging the claim.
On perusal of annexure-6 it transpires that the complainant
made claim on 24-02-2016 and the agent made his confidential
report on the same date. In spite of the same the o.ps didn’t
settle the claim amount. On perusal of the record it also

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transpires that o.ps appeared before the forum on 10-04-2018
and he filed the w.s. on the same date with assertion that he is
ready to compound the case and settle the amount of the life
assured but he filed the first cheque on 18-05-2018. So, it
transpires that there is deficiency in service of the o.ps. Since the
o.ps have paid the sum assured with interest to the o.ps so, the
complainant is only entitled for compensation and litigation
cost.
Accordingly the complaint petition is allowed with
direction to the o.ps to pay the complainant a sum assured Rs.
Rs. 5000/-as compensation and litigation cost within Two
months from the date of order., On failure to pay the
compensation amount the o.ps shall pay the compensation
amount with 8 % interest from the date of order till date of
realisation.