Haryana

Jind

CC/275/2011

Dhoop Singh - Complainant(s)

Versus

LIC Of India - Opp.Party(s)

Sh. Bal Raj Sharma

23 Dec 2016

ORDER

BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL
FORUM, JIND. 
                                                Complaint Case No : 275of 2011
                                                Date of Institution   : 22.06.2011
                                                Date of Decision      : 23.12.2016
⦁    Dhoop Singh son of Fateh Singh 2. Kamla wife of Dhoop singh s/o Fateh Singh both residents of village Alipura Tehsil Uchana District Jind. 

                                                                              ….Complainants.
                                       Versus
⦁    LIC of India Jind Distt. Jind through its Branch Manager, Jind.
⦁    LIC of India Division Office, 489, Jeewan Parkash Model Town Karnal through its Divisional Manager.
                                                                 …..Opposite parties.

⦁     Sudesh 4. Rakesh ds/o and 5 Vijender son of Dhoop Singh s/o
  Fateh Singh rs/o village Alipura Tehsil and Distt. Jind. 

                                  …Performa Respondents.
 
                          Complaint under section 12 of the
                          Consumer Protection Act, 1986.

CORAM: SH.A.K. SARDANA PRESIDENT.
                SMT. BIMLA SHEOKAND, MEMBER.
                SH. M.K. KHURANA, MEMBER.    

Present:  Sh. Balraj Sharma Adv. counsel for complainant.
              Sh. P.K. Gupta Adv. counsel for OPs No.1&2.
              Sh. Pawan Yadav Adv. consel for OPs No.3 to 5.
          
ORDER:

             Brief facts of the present complaint are that Vijay Singh son of complainants No.1&2 and brother of respondents No.3 to 5 purchased 3 insurance policies bearing No.175898048, 175898051 & 175898052 for a sum of Rs.1,00,000/- each from OP No.1 and aforesaid policies were never lapsed and all premium etc. were paid in time. Complainant Dhoop Singh was nominee of the above said policies.  Vijay Singh life assured has died on 17.11.2009 at village Alipura Tehsil Uchana District Jind. After the death of Vijay Singh, complainant  No.1 applied for claim under said policies of their son and submitted original policy, death certificate and affidavit etc. and fulfilled all the formalities as required by the OPs but they demanded treatment record of the life assured which was allegedly provided to him at PGIMS Chandigarh and in reply of their demand, the complainant informed OPs repeatedly by moving representations that life assured was never provided any treatment at  PGIMS Chandigarh as alleged but OPs avoided the payment of the claim under these policies on this vexatious reason. As such, the complainants have submitted that the OPs are  deficient in  not  releasing the sum assured under the policies alongwith benefits and  prayed that the complaint be accepted and OPs be directed to  pay the assured amount of Rs.1,00,000/-per policy  totalling Rs.3,00,000/- under all three policies alongwith other benefits  payable as per terms of policies alongwith interest @ 18% p.a. and to pay a sum of Rs.50,000/- as compensation on account of mental pain & physical harassment to the complainants.  
2.    Upon notice,   OPs No.1&2 appeared through counsel and tendered their joint reply whereas proforma  respondents  No.3 to 5  also appeared through counsel and submitted their  separate reply. OPs No.1 and 2  raised preliminary objections that this Forum has got no jurisdiction to entertain the present complaint and  said complaint is not maintainable in the present form whereas on merits, it has been urged that the deceased life assured was a patient of TB in June 2009 and was having previous details of X-ray/EP tests from PGI Chandigarh but no record could be available with the corporation so the LIC has admitted liability under all the three policies. Though the life assured was not in good health yet the claim has been decided taking a lenient view in the absence of treatment record and the amount payable under the policies was offered to Dhoop Singh but he did not receive the payment. Dhoop Singh was appointed as nominee under these policies who is entitled u/s 39 of Insurance Act 1938 to give valid discharge and receive the policy money. The LIC has no knowledge and evidence of legal heirs of Vijay Singh.  In the end,  answering OPs have   prayed for dismissal of complaint with costs. On the other hand OPs No.3 to 5 have urged that deceased life assured never taken any treatment from PGIMS Chandigarh. After the death of Vijay Singh, complainant  No.1 applied for claim under said policies of their son and submitted original policy, death certificate and affidavit etc. and fulfilled all the formalities as required by the OPs and requested to give the insured claim amount alongwith other benefits but OPs No.1 &2 did not pay any heed on the request of the complainant and prayed for acceptance of the complaint.  
3.    To prove his contention, counsel for  complainant tendered  affidavit of Dhoop Singh complainant as Annexure C-1, affidavit of   Kamla complainant as Annexure C-2 alongwith  documents as  Annexures C-3 to C-23  and closed the  evidence whereas on the other hand, counsel for OPs No.1&2  tendered affidavit of Sh.  P.K. Saxena, Manager Legal as Annexure OP-1 and closed their evidence but OPs NO.3 to 5 failed to tender evidence despite last opportunity and thus their evidence was closed by court order passed by the Forum on 28.10.2016. 
4.    Arguments heard and  record perused. Counsel for complainant argued that the OPs No.1 &2 have neither denied their liability to release the claim under these policies nor released the same despite completing all the formalities as required by the OPs and thus having no alternative, complainants have to file the present complaint whereas the counsel for OPs argued that the complainant Dhoop Singh was offered the amount payable under these policies but he did not receive the amount rather filed the present complaint which is not maintainable as the claim has not been repudiated.
5.    At the very outset, it is  admitted fact  on record that there is no any denial on the part of OPs No.1 &2 to release the insurance claim under the policies in question to complainant No.1 Dhoop Singh being nominee in these policies but their contention is that they offered the amount payable under these policies to complainant Dhoop Singh but he did not receive whereas complainant’s contention is that OPs failed to release the claim amount despite submission of all documents and completion of all formalities rather they avoided the payment under the garb of vexatious demand of alleged treatment record of DLA ( Deceased Life Assured) taken at PGI Chandigarh though no such treatment was ever taken at PGI Chandigarh. Surprisingly, OPs have failed to place on record any document/letter whereby they offered to complainant Dhoop Singh to receive the sum assured alongwith other benefits payable under these policies as alleged in the reply tendered in this case whereas on the other hand, complainant No.1 has tendered copy of applications dated 4.2.2011 & 24.3.2011 (Annexure C-22 & C-23) sent to OP LIC through registered post requesting for releasing of death claims payable under the policies in question. So, the version putforth by the OPs No.1 &2 is not tenable. 
    In view of the facts discussed above, we are of the considered view that the OPs  No.1 &2 are deficient in providing proper services to the complainant and thus we have no option except to allow the present complaint. Accordingly the present complaint is allowed and OPs No.1 &2 are directed to comply with the following directions within 30 days  from the communication of this order:-
(i )    To  pay the amount of Rs. 3,00,000/- i.e. Rs.1,00,000/- as sum assured in each policy alongwith all benefits including bonus etc. payable under these policies to the complainant No.1 being nominee of the DLA (deceased life assured) alongwith simple interest @ 9% p.a. from the date of institution of complaint to till date.
(ii)  To pay a sum of Rs.10,000/- as compensation on account of   
         mental harassment & physical pain etc.
             Let the aforesaid order/directions issued above must be complied with by the OPs No.1 &2 within the stipulated period failing which all the awarded amounts shall further attract simple interest @12% per annum for the period of default. So, the complaint is 
decided in above terms. A copy of this order be sent to the parties concerned free of cost. File be consigned to the record room after due compliance. 
Announced:
                                                                                                                                                PRESIDENT                                                                                                                                                                                       District Consumer Disputes
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