<br /> COMPLAINT FILED: 26.06.2008<br /> <br /> <br /> <br /> 01st SEPTEMBER 2008<br /> <br /> <br /> PRESENT :- SRI. A.M. BENNUR PRESIDENT<br /> SRI. SYED USMAN RAZVI MEMBER <br /> SMT. M. YASHODHAMMA MEMBER <br /> <br /> COMPLAINT NO.1425/2008<br /> <br /> <br /> COMPLAINANT Smt.Mallika Jairaj,W/o Late A.Jairaj,No.15, Clarkes Road,Davis Road Cross,Richards Town,Bangalore – 560 005.Advocate – M/s. LexplexusV/s.<br /> OPPOSITE PARTY Life Insurance Corporation of India,Peenya Branch Office,No.14/43, 1st Floor,Tumkur Road,Yeshwanthpur,Bangalore – 560 022.Represented by itsBranch Manager.Advocate – Smt.N.Geetha<br /> <br /> <br /> O R D E R<br /> <br /> <br /> <br /> This is a complaint filed U/s. 12 of the Consumer Protection Act of 1986 by the complainant seeking direction to the Opposite Party (herein after called as O.P) to settle the insurance claim and pay the same with interest and for such other relief’s on an allegations of deficiency in service. <br /> <br /> The brief averments, as could be seen from the contents of the complaint, are as under:<br /> <br /> The husband of the complainant Sri.A.Jairaj has obtained two insurance polices noted below from OP,<br /> <br /> a) Policy No.611524965 dated 21.08.1997 for Rs.1,00,000/-.<br /> b) Policy No.612628534 dated 28.03.1999 for Rs.2,00,000/-.<br /> <br /> In the said policies he nominated his mother as a nominee. Unfortunately mother of A.Jairaj pre-deceased her son and the husband of the complainant passed away on 19.09.2007. Complainant being the wife and legal heir of the deceased life assured has made claim to OP on 28.04.2008. As per the demand made by the OP, she has produced all the necessary documents including that of Indemnity Bond with surety. But still OP didn’t settle the claim on one or the other reason, OP insisted for the production of the original death certificate of the nominee. Complainant is unable to get the same but she produced other relevant documents with regard to the death of her mother in law Smt.Saraswathi. With all that OP failed to honor the said claim and started insisting for getting the succession certificate. The hostile attitude of the OP has caused both mental agony and financial loss to the complainant that too for no fault of her. OP has unnecessarily retained the said claim petition and made the complainant to move from pillar to post. Thus she felt deficiency in service on the part of the OP. Under the circumstances she is advised to file this complaint and sought for the reliefs accordingly.<br /> <br /> 2. On appearance, OP filed the version denying all the allegations made by the complainant in toto. According to them they are entitled to get legal and valid documents to settle the said claim. Because of non-production of the said required documents by the complainant the claim is not settled, that will not amount to deficiency in service. In view of the existing facts and circumstances complainant is directed to obtain the succession certificate from the competent court of law because life assured her husband died intestate and the nominee pre-deceased him. In addition to that complainant failed to produce the death certificate of the nominee. So in absence of such relevant documents OP is unable to process the said claim. The other allegations of the complainant are baseless. Complaint is devoid of merits. Among these grounds, OP prayed for the dismissal of the complaint.<br /> <br /> 3. In order to substantiate the complaint averments, the complainant filed the affidavit evidence and produced some documents. OP has also filed the affidavit evidence. Then the arguments were heard.<br /> <br /> 4. In view of the above said facts, the points now that arise for our consideration in this complaint are as under:<br /> <br /> Point No. 1 :- Whether the complainant has Proved <br /> the deficiency in service on the part of <br /> the OP?<br /> <br /> Point No. 2 :- If so, whether the complainant is <br /> entitled for the relief’s now claimed?<br /> <br /> Point No. 3 :- To what Order?<br /> <br /> <br /> 5. We have gone through the pleadings of the parties, both oral and documentary evidence and the arguments advanced. In view of the reasons given by us in the following paragraphs our findings on:<br /> <br /> Point No.1:- In Affirmative<br /> Point No.2:- Affirmative<br /> Point No.3:- As per final Order.<br /> <br /> <br /> R E A S O N S<br /> <br /> 6. At the outset it is not at dispute that the husband of the complainant Sri.A.Jairaj, has obtained two insurance policies from the OP. Under the said policy he made his mother Smt.Saraswathi as the nominee. Unfortunately the mother of the life assured pre-deceased her son and later on the husband of the complainant that is life assured also expired on 19.09.2007. According to the complainant after the death of her husband she being the legal heir made claim to OP on 28.04.2008 that is nearly after seven months till then nobody has made the claim. It appears OP has not considered her claim for all these days. Thus she felt deficiency in service.<br /> <br /> 7. It is further contended by the complainant as per the demand made by the OP for the settlement of the claim she has produced all the relevant documents including that of the Indemnity Bond with surety to the satisfaction of the OP. She has also produced the documents with regard to the death of her mother in law Smt.Saraswathi including that of obituary public notice published in the daily newspaper. The certificate issued by the doctor including form No.4A and the certificate issued by the Bangalore Mahanagara Palike with regard to the performance of funeral rites. It appears OP didn’t trust those documents but it insisted for the production of the original death certificate. Complainant expressed her inability to produce the original death certificate. If OP doubts about the death of Smt.Sarawathi it would have got investigated the same, but no such steps are taken by the OP. What made the OP to disbelieve the contents of the above said documents with regard to the death of Smt.Saraswathi is not known.<br /> <br /> 8. It is further contended by the complainant that though she produced all the necessary documents with regard to her marriage with her husband and the death certificate of her husband and she being the legal heir of the deceased again OP didn’t trust the same, they wanted complainant to produce the succession certificate. As already observed by us there is a proof that complainant is the legally wedded wife of life assured. There is a proof that nominee under the said policy pre-deceased her son and so for so good no other heirs of the life assured has come forward to make a counter claim for all these days. <br /> <br /> 9. The complainant is the legal heir of her deceased husband and there is a proof that the nominee is dead. Complainant has rightly executed the indemnity bond with surety as contemplated but still why OP is not considering the said claim is not known. Complainant being widow of the life assured is legally entitled to receive amount covered under the policy. Under such circumstances we find OP is not justified in asking the complainant to produce the succession certificate for the payment of the assured sum. OP has not lead any other rebuttal evidence so as to discard the evidence and the documents produced by the complainant in support of her claim. <br /> <br /> 10. Wherein there is no dispute with regard to the legal representatives of the policyholder the non-consideration of the said claim for all these days by the OP, in our view amounts to deficiency in service. Under such circumstances complainant is entitled for the relief claimed. Accordingly we answer point Nos.1 & 2 and proceed to pass the following: <br /> <br /> O R D E R<br /> <br /> The complaint is allowed. OP is directed to settle the claim with respect to the insurance policy held by A.Jairaj in favour of his legal heir the complainant and pay the sum assured Rs.1,00,000/- with respect to policy No.611524965 and Rs.2,00,000/- with respect to policy No.612628534 within four weeks from the date of its communication. In view of the nature of dispute no order as to costs.<br /> <br /> (Dictated to the Stenographer and typed in the computer and transcribed by him, verified and corrected, and then pronounced in the Open Court by us on this the 01st day of September 2008.) <br /> <br /> <br /> <br /> <br /> MEMBER MEMBER PRESIDENT<br /> <br /> <br /> <br /> <br /> <br /> <br />