BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, BHIWANI.

                                                          Complaint No.: 211 of 2016.

                                                         Date of Institution: 29.9.2016.

                                                          Date of Order: 26.02.2019.

Mukesh Kumar Yadav son of Shri Kamal Singh, resident of village & Post Office Bhageswari, Tehsil and District Charkhi Dadri.

                                                                   …..Complainant.

                    Versus

1.       LIC of India through its Chairman, Central Office, Jeevan Bima Marg, Mumbai.

2.       Branch Manager, LIC of India, Branch Office, Bhiwani.

3.       Senior Division Manager, LIC of India, Jaipur Division, Jaipur.

4.       Branch Manager, LIC of India, Branch Office 19C, Opposite Bus Stand, Kothputli (Rajasthan).

…...Opposite Parties.

                   COMPLAINT UNDER SECTIONS 12 AND 13 OF

                   THE CONSUMER PROTECTION ACT, 1986.

Before: -      Hon’ble Mr. Manjit Singh Naryal, President.

                   Hon’ble Mr. Parmod Kumar, Member.

                   Hon’ble Mrs. Saroj Bala, Member.

Present:       Shri Anand Singh Dabas, Advocate for the complainant.

                   Shri Sanesh Chaudhar, Advocate for the OPs.

ORDER:-

PER MANJIT SINGH NARYAL, PRESIDENT

                   The case of the complainant in brief, is that he purchased an insurance policy No.191805601 from OP No. 4 under table term 75-20, sum assured 50000/- with date of commencement 28.7.1999.  It is alleged that under terms & conditions of the insurance policy, it was agreed by the OPs that disability benefits to the life assured equal to sum assured would be payable during currency of the policy.  It is further alleged that such disability benefits will be paid in equal monthly installments during the currency of the policy and if any installments not fallen due will be paid along with maturity claim and future premium from the date of disability will be waived provided insurance policy is in force.  It is further alleged that the complainant paid the entire due premiums to take various benefits available under the insurance policy.  It is further alleged that complainant on 14.10.2008 while going to Mahandipur (Rajasthan) for Balaji Darshan met with a road accident and got multiple injuries, necessary FIR was lodged with PS Manpur, District Daussa (Rajasthan).  It is further alleged that after taking preliminary treatment, complainant was referred to PGIMS Rohtak and during the treatment, complainant slowly developed eye problems and with the result of this accident and internal injuries, complainant developed 100% disability of blindness.  It is further alleged that necessary 100% disability certificate has been issued by the office of Civil Surgeon, Bhiwani vide certificate No.37 dated 01 May, 2013.  It is further alleged that the complainant after receiving 100% disability certificate, completed the entire requirement for payment of disability benefits and to waive future premium under the insurance policy in the 1^st week of May 2013.  It is further alleged that the OPS No. 4 raised few observation vide letter No.PDB/19C dated 13.5.2015, which were also completed, but OPS No. 3 has repudiated the benefits claim vide letter dated 12.7.2016 without any jurisdiction and valid reasons.  It is further alleged that non-payment of genuine disability benefits claim is unjust, unwarranted & deficiency in service and the complainant is entitled to receive disability benefits claim amounting to Rs.50,000/- in equal monthly installments from May, 2013 till 28.7.2019 i.e. insurance policy maturity date.  It is further alleged that OPs are corporate body having their offices all over India including at Bhiwani and working for gain at Bhiwani, hence, this Hon’ble Forum has the jurisdiction to adjudicate and decide the present complaint.  Hence, it amounts to deficiency in service on the part of OPs.  Hence, this complaint.

2.                On notice, OPs appeared and filed the contested written statement and contested the claim of the complainant on the ground that the present complaint is not maintainable because no cause of action has accrued to the complainant within the territorial jurisdiction of this Forum, as the accident took place within the jurisdiction of police station Manpur (Rajasthan) and the insurance policy was issued at Kothputli (Rajasthan).  It is further alleged that the complainant is holder of money back insurance policy with profits and accident issued by the branch office Kothputli (Rajasthan).  It is further alleged that the complainant has lodged a disability benefit claim amounting to Rs. 50,000/- on the basis that he met with an accident took place on 14.10.2008 when he was going to a Temple from Balaji turning point Rajasthan via kacha path and sustained multiple injuries and has developed 100% disability of blindness.  It is further alleged that the complainant has filed a MACT petition No.111-RBT of 2010 in the court of Shri Naresh Kumar, the then Motor Accident Claims Tribunal, Bhiwani and he furnished a disability certificate showing that he has suffered 30% permanent disability on account of foot drop left side, restriction of ankle, movement, movement left and sensory deficit left foot and he has been awarded compensation in respect of the said permanent disability amounting to Rs.80,000/- vide award dated 14.2.2011.  It is further alleged that handicapped certificate issued by the office of Civil Surgeon, Bhiwani clearly show blindness is due to Glaucomatous, not by accident and as such the complainant does not come within the definition of disability qua alleged blindness under clause 10 (4) of the said insurance policy and is not entitled to the accidental benefit nor entitled for the waiver off the premium due.  It is further alleged that the competent authority after applying its judicial mind has repudiated the claim as per terms & conditions of the insurance policy, which was duly intimated to the complainant vide repudiation letter No.Claims/Rep/191805601 dated 12.7.2016 and was advised to continue payment of his due premium.  It is further alleged that the complainant is to lodge the claim in respect of accident benefit within 180 days from the date of occurrence, but the he has lodged the claim after the expiry of about 4 years 4 months i.e. after the expiry of 180 days.  Therefore, there is no deficiency in service on the part of the OPs and prayed for dismissal of complaint with costs.

3.                Ld. counsel for the complainant to prove his case placed on record affidavit and the documents Annexure C1 to C16 and closed the evidence and he further placed on record copy of receipt dt. 8.2.2019. 

4.                 Ld. Counsel for the OPs has placed on record documents Annexure R1 to R13 and closed the evidence.

5.                We have heard ld. counsel for both the parties at length and gone through the case file very carefully.

6.                Ld. Counsel for the complainant has contended as per Section-11 (2) (a) of the C.P. Act, a complaint shall be instituted where opposite party resides or carry on business or has a branch office at the time of institution of the complaint.  He further argued that the L.I.C. has its braches all over India including Bhiwani.  He further argued that thus the Forum at Bhiwani has territorial jurisdiction, as the OPs are corporate body having their offices all over India including their office at Bhiwani and working for gain at Bhiwani, so he is entitled to get his claim and compensation.  He further contended that the OPs wrongly and illegally repudiated his claim, so it amounts to deficiency in service on the part of OPs.  On the other hand, ld. counsel for the OPs has contended that the District Forum at Bhiwani has not jurisdiction to try and entertain the present complaint, because no cause of action has accrued to the complainant within the territorial jurisdiction of this Forum, as the accident took place within the jurisdiction of police station Manpur (Rajasthan) and the insurance policy was issued at Kothputli (Rajasthan). 

7.                In our view the arguments of ld. counsel for the OPs has no substance at all, because under Section-11 (2) (a) of the C.P. Act, a complaint shall be instituted where opposite party resides or carry on business or has a branch office at the time of institution of complaint and the L.I.C. has its braches at Bhiwani.  Moreover, the arguments advanced by ld. Counsel for complainant has substance, because as per the Section-11 (2) (a) of the C.P. Act, a complaint shall be instituted where opposite party resides or carry on business or has a branch office at the time of institution of complaint.  It is the admitted fact by both the parties that the L.I.C. has its braches all over India including Bhiwani.  It is also not disputed by OPs that the payment of premium or installments of insurance policies are being accepted by the L.I.C. in any branch office all over India.  In the present case also complainant has deposited an installment vide receipt dated 8.2.2019 with the OPs at their branch office at Dadri (Haryana).  So, we are of the view that when the OPs can receive the amount all over India then they should have no objection in making the payment to the insured in anywhere in the whole Country.  Thus, in our view the District Forum at Bhiwani has the jurisdiction to try, entertain and decide the present complaint.

8.                 It is pertinent to mention here that in the present case the complainant is a blind person and this Forum of the view that the OPs should have taken a sympathetic view in the case of the complainant instead of avoiding giving the benefit of an insurance policy on the basis of ifs and buts.  The plea taken by the OPs that as per handicapped certificate issued by the office of Civil Surgeon, Bhiwani the blindness is due to Glaucomatous and not by accident, is also not tenable, because this fact has been orally inquired from an Eye Surgeon, who told that the Glaucomatous can be caused as a result of an injury.  Moreover, the order of the Hon’ble MACT has been passed on 14.2.2011, whereas the 100% disability certificate has been issued by the Civil Surgeon, Bhiwani on 1.5.2013.  The plea taken by the OPs that there is delay of 4 years 4 months in lodging the claim by the complainant is also not tenable, because the 100% disability certificate has been issued by the Civil Surgeon, Bhiwani on 1.5.2013 and after that the complainant has immediately lodged his claim the OPs, thus, there is no delay in lodging the claim.  As we stated above, the case of the complainant may be treated as special case with sympathetic view, as this is an exceptional case, where a person has become blind for the whole life, who is unable in earning his livelihood.  Moreover, complainant is the bread earner of the family and he become permanent disabled due to accident during the subsistence of the insurance policy.  It is essential to mention here that the complainant appeared in person before this Forum and we found him in very pitiable condition as he become 100% blind. So, it is clear that he is living in this world with the mercy of others.  Therefore, survival to him is more than a death because he has lost his career in all respects.  The present case is a rarest of rare case and OPs needs to settle the claim of the complainant immediately.  Thus, there is gross negligence & deficiency in service on the part of the OPs and they cannot be allowed to run away from their responsibility.

8.                Therefore, in view of the above facts and circumstances, the complaint of complainant is partly allowed.  Thus, the OPs are directed to: -

i.        To release the disability benefits claim of Rs.50,000/-, in equal monthly installments till date of maturity of policy.

iii.      To pay Rs.5500/- as counsel fee as well as litigation charges. 

The salvage remained with the complainant.  The compliance of the order shall be made within 30 days from the date of the order.  In case of default, the OPs shall be liable to pay interest @ 18% p.a. on total amount as directed above vide clause No. ii & iii from the date of default i.e. after 30 days from the date of this order i.e. 26.2.2019.  Certified copies of the order be sent to parties free of costs.  File be consigned to the record room, after due compliance.

Announced in open Forum.

Dated: - 26.02.2019.     

(Saroj Bala)           (Parmod Kumar)        (Manjit Singh Naryal)

Member.               Member.                         President,

                                                                      District Consumer Disputes

                                                                   Redressal Forum, Bhiwani.