DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, KANDHAMAL, PHULBANI
C.C.NO.07 OF 2017
Present: Sri Rabindranath Mishra - President.
Miss Sudhiralaxmi Pattanaik - Member .
Sri Purna Chandra Tripathy - Member .
Smt. Kabita Manjari Bhoi, aged- 47 years
W/O: Late Dillip Kumar Bhoi C/O Prahallad Sahoo
At/Po/PS: Daspalla. Dist: Nayagarh. ……………………….. Complainant.
Versus.
1. Branch Manager, L.I.C of India Phulbani Branch.
AT/Po/PS: Phulbani Dist: kandhamal.
2. Divisional Manager, L.I.C of India Berhampur Division
AT/Po/Ps: Berhampur Dist: Ganjam.
3. Block Education Officer, Harabhanga
At/Po: Charichhak,Dist : Boudh.
4. District Education Officer, Boudh.
At/Po/PS: Boudh. Dist: Boudh. …………………………….. OPP. Parties.
For the Complainant: Sri P.Sahoo, Advocate and his associates.
For the OPP. Parties: Sri B.K Mohanty, Advocate and his associates.
Date of Order: 28-07-2017
O R D E R
The case of the Complainant in brief is that her husband had a life Insurance policy bearing No. 570143038 under the O.P No.1 which was Salary Saving Scheme with accidental benefit. The husband of the Complainant died on 07-04-2007 on road accident. Then being nominee of her husband, the Complainant approached the O.P No.1 & 2 for settlement of the claim. As no action was taken by them on 02-06-2015 she reported the matter to O.P No.1 & 2 by registered post. After getting the notice the O.P No.1 send claim form by registered post. But the O.P No.1 returned the claim form along with documents to the Complainant. So, she communicated the matter to O.P No.2 who advised to submit all the policy numbers of the deceased in one letter. Then the Complainant reported this matter before the Insurance Ombudsman, Bhubaneswar. As per order of the Insurance
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Ombudsman, the Complainant submitted all documents before the O.P No.2 by registered post for settlement of the claim. But the O.P No.1 again sent a letter to her for submission of premium deduction certificate from O.P No.3 & 4. Accordingly she communicated the matter to O.P No.3 & 4 but they refused. This matter was reported to the O.P No.1 on 10-08-2016 through post but the O.P No. 1 & 2 remained silent without taking any steps for settlement of her claim. So, this complaint was filed by her against the O.Ps for award of the Insured amount to the tune of Rs. 50,000/- and the accidental benefit of Rs. 50,000/- along with Rs.15,000/- as bonus and compensation of Rs. 30,000 towards her mental harassment with litigation cost of Rs. 20,000/-.
The case of O.P No.1 & 2 as per their joint version is that the deceased policy holder had 3 numbers of policies in his name. The O.P No.1 & 2 had received the application of the Complainant against the policy No.5706136036 on 02-06-2015 and the policy No, 570143043 on 24-08-2015. So, the claim made by the Complainant was not relating to policy No. 570143038 for which the claim papers along with documents were returned to the Complainant on 20-08-2015. As per direction of the Insurance Ombudsman, the Complainant submitted her claim form along with documents and the same was received by the O.P on 04-07-2016. It was found that the said policy was Salary Saving Scheme. It was also found that the death claim discharge voucher has not been witnessed and left blank and signature of the claimant also differs from Claim form -A and Death Claim Discharge Voucher. Further the premiums for 15 months were not deposited with the O.Ps. So, the O.P issued notice to the Complainant on 05-07-2016 for submission of premium certificates from the paying authorities. The Complainant has not complied the requirements for which the claim of the policy can not be processed.
We have heard the learned counsel appearing for both the parties. We have carefully gone through the complaint petition, the joint version filed by the O.P No.1 & 2 and the documents filed by the Complainant in support of her case. The O.P No.3 & 4 are set exparte as they failed to appear. It is admitted that the policy of the deceased is coming under Salary Saving Scheme. As per settled principle of law, the premiums are to be remitted by the employer to the Insurer after deducting the same from the concerned employee’s salary and the employer acts as the agent of the L.I.C .So, the deduction of the premiums from the salary of the employee is a matter between the employer and the L.I.C . It is not the duty of the employee to intimate the L.I.C about non remittance. It is also not the duty of the nominee to submit the premium certificates of the deceased. The husband of the nominee died on 07-04-2007. In the mean time more than 10 years has already been passed but the Complainant who is an illiterate lady is suffering since long to get the death claim of her deceased husband, though she had produced all the necessary documents before the O.Ps after impugned order of the learned Insurance Ombudsman. So, the plea taken by the O.P No.1 & 2 that non submission of the premium certificates by the Complainant is the reason for non settlement of the claim has no merit. The complaint can not be rejected on this ground only. Hence, the complaint filed by the Complainant is allowed on contest against the O.P No.1 & 2 and exparte against O.P No.3 & 4.
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In the above facts and circumstances, the O.P No.1 & 2 are directed jointly and severally to settle up the death claim in connection with the Insurance policy bearing No. 570143038 of the deceased in favor of the Complainant including the accidental benefit within 30 days from the date of receipt of this order .They are also directed to pay Rs. 5,000/- as compensation and cost of litigation to the Complainant within the said period . In case of failure the Complainant shall be entitled to get 10 % interest per annum on the entire awarded amount from the date of this order till the date of realization.
The C.C is disposed of. Supply free copies of this order to both the parties at an early date.
MEMBER MEMBER PRESIDENT
