IN THE DISTRICT CONSUMER DISPUTES REDRESSAL COMMISSION, MURSHIDABAD AT BERHAMPORE.
CASE No. CC/227/2017
Date of Filing: Date of Admission: Date of Disposal:
29.12.2017 05.01.2018 14.09.2023
Complainant: Rehana Sultana
D/o-Hasneara Begum,
Vill &P.O.- Amtala
P.S.- Nowday,
Dist- Murshidabad,
Pin-742101.
-Vs-
Opposite Party 1. Branch Manager, Berhampore,
Life Insurance Corporation of India,
Berhampore Branch,
K.N. Road,
P.O. & P.S- Berhampore,
Dist- Murshidabad
Pin-742101.
2. Sr. Divisional Manager,
Life Insurance Corporation of India,
Kolkata Suburban Divisional Office,
Jeevan Prabha D.D. 5, Sector-1.
Salt Lake City, Kolkata-64.
Agent/Advocate for the Complainants : None
Agent/Advocate for the Opposite Parties : Subhash Saha
Present: Sri Ajay Kumar Das…………………………..........President.
Sri. Nityananda Roy…………………………………….Member.
FINAL ORDER
Sri. ajay kumar das, presiding member.
This is a complaint under section 12 of the CP Act, 1986.
One Rehana Sultana (here in after referred to as the Complainant) filed the case against Branch Manager, Life Insurance Corporation of India, Berhampore Branch and Anr. (here in after referred to as the O.P.s) praying for compensation alleging deficiency in service.
The sum and substance of the complaint case is as follows:-
The Complainant’s father died on 14.06.2011 leaving behind two L.I.C. Polices being Nos. 426872450 and 427977283 and the value of these policies are Rs. 200000/- and Rs. 250000/- respectively. The nominated beneficiary for both policies is the complainant's mother, Hasnara Begum, who is presently grappling with serious age-related health issues.
In spite of the Complainant’s mother ailment the Complainant had made numerous attempts to facilitate the claim process for these L.I.C. policies. They had visited the L.I.C. offices located in Berhampore and Kolkata on multiple occasions and she also submitted all documents and requested them by letters for the maturity of the abovementioned LIC polices but all efforts are in vain.
Finding no other alternative the complainant filed the instant case before the District Commission with the prayer as mentioned in the complaint.
Defence Case
After due service of the notice O.P.s appeared by filing W/V stating inter alia that the case is not maintainable. The specific defense case of O.P.s is that the two policies were purchased by Rejaul Karim bearing no. 426872450 and 427977283 with date of commencement 30.06.2008 and 30.09.2009 respectively for SA 2.5 lakhs, plan and term 14/15 and 165/14. First unpaid premium for both the policies were 06/2011 and 08/2011 respectively. Life assured died on 14.06.2011, Hasnara Begum, wife was the nominee under both the policies. Rehana Sultana, daughter of the nominee is the complainant.
The first intimation of death was submitted on 26.09.2011 but no requirements were submitted till 24.04.2014. Both the claims were very early i.e, death within 3 years from the date of commencement of policies. Further requirements were called for from the claimants and investigation was done to assess the genuineness of the claim.
From the claim Form B and B1 duly filled in by medical officer of SSKM Hospital, Kolkata reveals that deceased life assured was a known patient of diabetes for last 10 years on insulin, known case of Hodgkin’s Lymphoma for last 3 years, known case of CKD (Chorionic kidney Disease). All the history recorded as per BHT of hospital. Dural of policies was 2 years 11 months and 1 year and 8 months respectively.
Hence, it was clear that DLA (deceased life assured) was not in good health prior to taking both the policies.
Based on the claim papers (B and B1) the claim is repudiated due to non disclosure of the health condition of the deceased life assured in the proposal form in question no 9(i), 9(ii), 9(iv) which was vital for acceptance of both the policies.
Considering the merit of the case if Ld. forum so direct this OP can refund all premium paid through proper accepted mode of payment of LICI.
Points for decision
1. Is the Complainant consumer under the provision of the CP Act, 1986?
2. Have the OPs any deficiency in service, as alleged?
3. Is the Complainant entitled to get any relief, as prayed for?
Decision with Reasons:
Point no.1
We peruse the complaint. The averments made in the complaint indicate that the Complainant is a consumer under the Consumer Protection Act, 1986 as well as Consumer Protection Act, 2019, particularly when we find that the Complainant Rehara Sultana and her mother Hasnara Begum are the legal heirs of the deceased Rezaul Karim.
Point Nos. 2 & 3
Both these points are taken up together for the sake of convenience and brevity of discussion.
The point to be noted is that the Complainant has not been taken steps since 04.08.2020. The Complainant is also absent today i.e., on 14.09.2023. The record further shows that the O.P.s are also not interested in this case. Such being the position the instant case is required to be disposed of on merit on the basis of the materials available on record.
It is coming out from the W/V filed by the O.P.s that the first intimation of death was submitted on 26.09.2011 but no requirements were submitted till 24.04.2014. Both the claims were very early i.e, death within 3 years from the date of commencement of policies. Further requirements were called for from the claimants and investigation was done to assess the genuineness of the claim.
From the claim Form B and B1 duly filled in by medical officer of SSKM Hospital, Kolkata reveals that deceased life assured was a known patient of diabetes for last 10 years on insulin, known case of Hodgkin’s Lymphoma for last 3 years, known case of CKD (Chorionic kidney Disease). All the history recorded as per BHT of hospital. Dural of policies was 2 years 11 months and 1 year and 8 months respectively.
Hence, it was clear that DLA (deceased life assured) was not in good health prior to taking both the policies.
Based on the claim papers (B and B1) the claim is repudiated due to non disclosure of the health condition of the deceased life assured in the proposal form in question no 9(i), 9(ii), 9(iv) which was vital for acceptance of both the policies.
The O.P.s have further stated in the W/V, “Considering the merit of the case if Ld. forum so direct this OP can refund all premium paid through proper accepted mode of payment of LICI.”
The O.P.s have filed brief note of arguments wherein they have stated the same thing.
From the materials on record it is clear that the O.P.s are ready to refund the premium amount of the deceased.
Considering the facts and circumstances of the case and considering the submissions of the Ld. Advocate for the O.P.s we are of the view that the premium amount of the deceased Rezaul Karim in connection with the policies no. 427977283 dated 12.09.2012 and policy no. 426872450 dated 12.09.2012 is required to be refunded to the Complainant’s mother Hasnara Begum by the O.P.s.
Reasons for delay
The Case was filed on 29.12.2017 and admitted on 05.01.2018. This Commission tried its level best to dispose of the case as expeditiously as possible in terms of the provision under section 13(3A) of the CP Act, 1986. Delay in disposal of the case has also been explained in the day to day orders.
In the result, the Consumer case is allowed.
Fees paid are correct. Hence, it is
Ordered
that the complaint Case No. CC/227/2017 be and the same is allowed on contest against the O.P.s but under the circumstances without any order as to costs.
The premium amount of the deceased Rezaul Karim in connection with the policies no. 427977283 dated 12.09.2012 and policy no. 426872450 dated 12.09.2012 is required to be refunded to the Complainant’s mother Hasnara Begum by the O.P.s.
O.P.s are directed to refund the premium amount of the deceased as mentioned above to the Complaint’s mother Hasnara Begum within 60 days from the date of this order in default the aforesaid premium amount will carry interest @ 10 per cent per annum.
Let plain copy of this order be supplied free of cost, to each of the parties / Ld. Advocate/Agent on record, by hand /by post under proper acknowledgment as per rules, for information and necessary action.
The Final Order will also be available in the following Website:
confonet.nic.in
Dictated & corrected by me.
President
Member President.
